Objective To discuss application of evidence-based nursing in nasopharyngeal carcinoma patients undergoing radiotherapy. Methods Evidence-based nursing was used in 33 nasopharyngeal carcinoma patients undergoing radiotherapy. Results After evidence-based nursing, all the patients actively cooperated with the doctors and nurses, lived through the treatment process smoothly, and radiotherapy complications were reduced or avoided. Conclusions Evidence-based nursing is an idealized nursing method which could reduce or avoid the complications and alleviate the pain of patients and improve the quality of nursing.

Hemifacial Spasm ; etiology ; surgery ; Humans ; Trigeminal Neuralgia ; etiology ; surgery

Objective To investigate the association between polymorphism of cytochrome P450 subfamily Ⅺ A polypeptide 1 (CYP11A1) gene and polycystic ovarian syndrome (PCOS) in Chinese population. Methods From May 2005 to Dec.2008,290 PCOS cases treated in the First affiliated hospital of Anhui Medical University matched with 344 reproductive women as controls were enrolled in this study. Genotypes of 7 tagging single nucleotide polymorphisms(tSNP,rs12438594,rs4077582,rs9806234,rsl6968477,rs4887139,rs1843090,rsl 1632698)covering CYP11A1 gene (r~2≥0.8) and 3 microsatellite markers (D15S1547,D16S520,D15S1546) were chosed from the phase II database of Han population in HapMap data.Genotype and frequency of allele were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and haplotype of gene polymorphism were analyzed in 290 PCOS cases and 344 controls.Results Among 7 tSNPs and 3 microsatellite markers,the frequency of rs4077582,D15S1547,D15S1546 and rsl 1632698 between two groups reached statistical difference (P =0.010,0.044,0.018 and 0.026).The allele frequency of rs4O77582,rs4887139,rsl843090,D15S1547 and Dl 6S520 showed significant difference between two groups(P=0.002,0.048,0.030,0.001 and 0.024).Among 5 haplotype of CYP11A1(ACGCA13/6/9AG,ACGTA16/6/11AA,GCACG12/8/8AA,GTACA14/4/7GG,GTGCA13/6/7AG),the frequency of GTACA14/4/7GG and ACGCA13/6/9AG were 7.8% (45/580) and 25.3% (147/580) in PCOS group and 11.9% and 19.6% in control group,which showed statistical difference (P< 0.05 ).There was no significant difference in the level of serum androgen at difference genotype from rs4077582 between two groups (P>0.05).Conclusion The polymorphism of CYP11A1 gene was associated with PCOS,however,the relationship between gene sequence covered by tSNP/microsatellite markers and hyperandrogenism of PCOS should be further investigated.

Objective To investigate the effects of Xanthoceraside on the learning and memory impairment induced in mire by innacere-broventricular injection of aggregated amyloid β peptide _(1-42)(Aβ_(1-42)). Methods Learning and memory functions in mice were examined us-ing step-through test and water maze test. Biochemical determination of acetylcholinesterase (AchE) and choline acetyl transferase (ChAT) were measured with spectrophotometric melhod. Results Administration of Xanthoceraside reduced number of error and prolonged the laten-cy in step-through test in mice impaired by Aβ_(1-42) (P < 0.05,P< 0.01,respectively). In water maze test,the swimming time decreased in mice treated with Xanthoceraside compared with the model mice impaired by Aβ_(1-42) (P< 0.05,P< 0.01,respectively). The results of bio-chemical determination showed that decrease level of AchE and ChAT in mice impaired by Aβ_(1-42) were significantly ameliorated by Xantho-ceraside administration (P < 0.05 and P < 0.01). Conclusion Xanthoceraside has the effect of improving learning and memory impairment in mice inducel by intracerebroventricular injection of Aβ_(1-42) via enhancing the cholinergic system functions.

Objective To investigate the molecular types of carbapenem-non-susceptible Esche-richia coli ( E.coli) isolates and their mechanism of carbapenem resistance .Methods Twenty-two carbap-enem-non-susceptible E.coli strains were isolated from 3 hospitals in Hangzhou from 2007 to 2011.The mini-mum inhibitory concentrations ( MICs) of antimicrobials to those isolates were determined by agar dilution method and E-test.The molecular mechanisms of carbapenem resistance of E.coli isolates were analyzed by conjugation experiment,PCR and DNA sequencing.Pulsed-field gel electrophoresis (PFGE),multilocus se-quence typing ( MLST ) , and phylogenetic typing were performed to analyze the molecular epidemiology of those isolates.Results The MICs of imipenem and meropenem to 22 E.coli isolates were ranged from 1 μg/ml to 16 μg/ml,and the MICs of ertapenem were 2 μg/ml to 64 μg/ml.All E.coli isolates produced the KPC-2 carbapenemase and various β-lactamases , and some of them also produced plasmid-mediated AmpC enzymes.Carbapenem resistance was transferred by conjugation and transformation from 22 E.coli iso-lates to E.coli EC600 strains.The E.coli transconjugants or transformants acquired the blaKPC-2 gene and showed similar antibiotic susceptibility patterns in comparison with donor strains .Only a few isolates were in-distinguishable or closely related as indicated by PFGE .Four sequence types including ST131 (9 isolates), ST648 (5 isolates),ST38 (2 isolates) and ST405 (2 isolates) were identified by MLST.Phylogenetic analy-sis indicated that 9 ST131 isolates belonged to phylogenetic group B 2 and the other isolates belonged to group D (11 isolates),group B1 (1 isolate) and group A (1 isolate),respectively.Conclusion The sequence type of prevalent E.coli isolates producing KPC-2 from Hangzhou was ST131,which is an international epi-demic,multidrug-resistant clone,followed by ST648.

The paper reviewed the history of drug price addition system and its impact on hospital management. Based on such facts,authors stated that the significance of abolishing drug price addition helped hospital management not to run their hospitals as a business, helped medical practitioners to make their clinical decisions based on medical needs, and to make the health care service deserve the professionals′value and contributions. Following the abolishment, the hospitals need to reform their internal operating mechanisms before they can achieve better performance.

Objective To investigate the expression of c-FLIPL in leukemia and explore its clinical significance. Methods The expression level of c-FLIPL mRNA in bone marrow mononuclear cells was determined by real-time polymerase chain reaction(PCR)in 103 leukemia patients with different types of leukemia,including 54 cases of acute lymphocytic leukemia(ALL)with 37 newly diagnosed,5 relapsed,and 12 complete remis-sion,38 cases of acute myeloid leukemia(AML)with 24 newly diagnosed,6 relapsed,and 8 complete remission,newly diagnosed 2 cases of acute undifferentiated leukemia(AUL),6 cases of chronic myelocytic leukemia(CML),and 3 cases of chronic myelomonocytic leukemia(CM-ML). The immunophenotype of patients were detected by flow cytometry. Results Expression level of c-FLIPL mRNA was higher in newly diag-nosed and relapsed leukemia patients. There was no significant difference between newly diagnosed and relapsed leukemia patients(P>0.05). Ex-pression level of c-FLIPL mRNA of AUL and CML was higher than that in other patients ,but there was no significant difference(P>0.05). Ex-pression level of c-FLIPL mRNA of all newly diagnosed and relapsed leukemia patients was significantly higher than that in control group and com-plete remission group(P<0.05). The expression level of c-FLIPL mRNA was correlated with risk stratification ,white blood cell(WBC),lactate dehydrogenase(LDH),hydroxybutyrate dehydrogenase(HBDH),CD45 and TEL-AML1,but was not associated with age,sex,fibrinogen and chromosome abnormality. Conclusion c-FLIPL mRNA is highly expressed in leukemia patients ,and is closely related with risk stratification , WBC,LDH,HBDH and prognosis.

Objective To explore the in vitro cytotoxicity of sunitinib in highly metastatic hepatocellular carcinoma cell line MHCC97-H, and the effect of it on the expression level of focal adhesion kinase (FAK). Methods MHCC97-H hepatoma cells were cultured and divided into control group and experimental (sunitinib) group. Experimental groups were added 2.5, 5,10 and 20μmol/L of sunitinib for 24, 48 and 72 hours respectively. The morphological changes were observed before and after sunitinib treatment in MHCC97-H with Giemsa stain. The inhibitory rate of proliferation in MHCC97-H was detected by MTT assay. The expressions of FAK protein before and after sunitinib treatment were detected by Western blot assay. Results Sunitinib showed the inhibitory effect on hepatoma cell line MHCC97-H. Giemsa staining showed that chromatin condensation, nuclear fragmentation, apoptotic bodies and other typical morphological features. The inhibitory rate was the most obvious in 48-h treatment group. The inhibitory rates were (0.433 ± 0.115)%, (32.863 ± 1.471)%, (49.240 ± 2.256)%, (63.797±2.707)%and (58.887±3.409)%for 2.5, 5, 10 and 20μmol/L concentration groups, and there were signifi-cant differences between groups (P<0.05). Results of Western blot assay showed that the expression levels of FAK protein were significantly reduced after different concentrations of sunitinib treatment for 48 h (P<0.05). Conclusion Sunitinib has inhibitory effect on hepatoma cell line MHCC97-H, enhances the apoptosis and decreases the the expression of FAK pro-tein.

Background The data on the prognostic values of high sensitivity C-reactive protein (hsCRP) levels in patients with advanced symp-tomatic heart failure (HF) receiving cardiac resynchronization therapy (CRT) are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome. Methods A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF. Results During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP (>3 mg/L) prior to CRT was associated with a significant 2.39-fold increase (P=0.006) in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels (–0.5 ± 4.1 mg/L reduction) compared with non-responders (1.7 ± 6.1 mg/L increase, P=0.018). Com-pared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations (Log-rank P<0.001). The echocardio-graphic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high. Conclusions Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.

Objective:To study the chronic disease management’s key factors in community health service insti-tution based on the Innovative Care for Chronic Conditions Framework ( ICCC ) . Methods: The purposive sampling method was adopted. Twelve community health service centers were selected as the field survey sites in Beijing, Shanghai, Zhengzhou and Chengdu. During the key factors description at macro-, meso-and micro-level in the IC-CC framework, thematic framework analysis was used to describe the key factors at maro-, meso-and micro level in the ICCC framework. Results:From the community health institutions’ perspective, the key factors at meso level in the ICCC framework played a better role in the management of chronic conditions while the key factors in both macro and micro level still lacked. Conclusion:Based on the ICCC framework, the management of chronic diseases needs to emphasize the cooperation with relevant departments outside the health area and legislative strategies at macro level, the ability of community supporters to mobilize and coordinate resources at meso level and the improvement of self-management skills for the patients with chronic diseases.