Objective To explore the effect of the situation-background-assessment-recommendation mode of SBAR communication on the clinic communication competence of nurses.Methods 20 obstetric nurses were selected for the study,the mode of SBAR communication was applied to the communication between doctors and nurses,nurses and nurses,nurses and patients.The clinic communication competence was investigated by the questionnaire of clinic communication competence before and after using the mode of SBAR communication.Results The scores of the clinic communication competence after using the mode of SBAR communication was (56.41±6.32),which was higher than that before the implementation,(48.15±5.26),there were statistically significant differences,P＜0.05.The scores of communication competence between doctors and nurses,between nurses and nurses,between nurses and patients were higher after implementation of SBAR compared with those before,(4.06±1.26)vs.(2.62±1.31),(4.05±1.41)vs.(3.59±1.46),(3.98±1.32) vs.(3.36±1.36),there were statistically significant differences in all of them,P＜ 0.05.Conclusions SBAR communication mode helps improve clinic communication competence of nurses,promote the establishment of harmonious team between doctors and nurses,ensure patients' safety and quality of care.

Objective To investigate the effects of pentoxifylline on the cell proliferation of, collagen synthesis and TGF-β1 expression by human fibroblasts derived from keloid. Methods Skin samples were obtained from the lesions of 3 patients with keloid and normal skin of 3 human controls followed by primary culture of fibroblasts. Fibroblasts of 5th to 8th generation were cultured with pentoxifylline of 0.1 to 3 g/L for various durations. Then, MTT assay was performed to detect the cell proliferation of fibroblasts, double antibody sandwich-enzyme linked immunosorbent assay (ELISA) to measure the expression of TGF-β1, and reversetranscription PCR to examine the mRNA expressions of procollagen Ⅰ and Ⅲ in these fibroblasts. Results The pentoxifylline of 0.1 to 2 g/L markedly inhibited the proliferation of fibroblasts derived from keloid lesions and normal skin, in a dose- and time-dependent manner, with the strongest effect observed in fibroblasts treated with pentoxifylline of 2 g/L. A significant reduction was induced in the TGF-β1 mRNA expression in keloidand normal skin-derived fibroblasts by pentoxifylline of 0.5 to 2 g/L (all P < 0.01), and in the mRNA expression of procollagen Ⅰ and Ⅲ by pentoxifylline of 1 and 2 g/L (P < 0.05 or 0.01). Concretely, the relative mRNA expression level of procollagen Ⅰ and Ⅲwas 0.873 ± 0.077, 0.571 ± 0.050 respectively in keloid fibroblasts respectively, and 0.473 ± 0.035, 0.370 ± 0.045 in the control fibroblasts, after treated with pentoxifylline of 1 g/L, 0.750 ± 0.036 and 0.433 ± 0.045 respectively in keloid-derived fibroblasts, 0.390 ± 0.030 and 0.250 ±0.123 respectively in the control fibroblasts, after treated with pentoxifylline of 2 g/L, significantly lower than that in the keloid-derived (1.216 ± 0.061 and 0.953 ± 0.060) and control (0.836 ± 0.080 and 0.776 ± 0.041) fibroblasts without treatment. Conclusion Pentoxifylline shows an evident suppressive effect on the cell proliferation of, as well as the expression of TGF-β1 and procollagen Ⅰ and Ⅲ in fibroblasts derived from keloid lesions and normal skin.

BACKGROUND:Total knee arthroplasty mainly used fixed platform, but more and more movable platform was selected year by year in the clinic. Rotary platform theoretical y can apparently improve the curative effects, but it has not been verified in the clinic.
OBJECTIVE:To summarize the design characteristics and clinical results of Gemini MKII (Link, Germany) rotary platform.
METHODS:From January 2004 to January 2009, 108 patients (119 knees) including 31 males and 77 females were treated with total knee arthroplasty by using Gemini MKII system. There were 97 unilateral cases and 11 bilateral cases at the first stage of replacement. Preoperative diagnosis:1 case of hemophilic arthritis, 1 case of venereal Charcot’s disease, 8 cases of post-traumatic arthritis, 11 cases of rheumatoid arthritis, and 87 cases of degenerative osteoarthritis. The prosthesis was fixed with bone cement. None received patel ar replacement. RESULTS AND CONCLUSION:None experienced infection, femoral condyle fracture or nerve and vascular damage. Except bilateral replacement, the average operation time of unilateral replacement was (56±13) minutes. Average postoperative hemoglobin decreased (25±5) g/L. After replacement, hemoglobin maintained over 100 g/L in 83 patients (86%), without blood transfusion. Knee joint score and function score recovered to (92.0±4.7) points and (90.3±6.8) points at half years after replacement, and became (94.4±3.2) points and (91.6±5.9) points during final fol ow-up, which was significantly improved as compared with that pre-replacement (P<0.01). No revision surgery should be done for lining prolapse or spin out, osteolysis and prosthesis loosening. These results indicated that the early and midterm results of Gemini MKII rotating-platform prosthesis were satisfactory, but the long-term results remain to be confirmed.

BACKGROUND:In recent years,pentoxifyIline has been found to have a wide range of anti-fibrosis capacity However,there are few studies explore the suppress effect of pentoxifyIline on fibroblasts in human keloid.and the maximum inhibitory concentration remains poorly understood.OBJECTIVE:To study the effect of pentoxifyIline on proliferation activity of human keloid fibroblasts and to select the maximum inhibitory concentrationMETHODS:Human keloid fibroblasts were used as original cells,passaged till the 5~(th) to the 8~(th) generations.and then divided into the experimental and control groups.PentoxifyIline with concentrations of 0.1,0.25,0.5,1.0,2.0 and 3.0 g/L were added to the experimental group.The effects of different concentrations of pentoxifylline on proliferation of keloid fibroblasts were detected by MTT chromometry.RESULT AND CONCLUSION:Compared with the control group,the inhibitory effect of pentoxifylline on the proliferation of keloid fibroblasts was more evident in the experimental group(P＜0.05)The inhibition rates of pentoxifylline on proliferation of keloid fibroblasts showed apparently time-and dose-effect relationships within the concentration of 0.1-2.0 g/L.which presented a greatest level at 96 hours after culture.The maximum inhibitory rate was 53 37%,and the concentration was 2.0 g/L in the experimental group.Consequently,pentoxifyIline plays a notable inhibitory role in the proliferation of human keloid fibroblasts with concentration of 2.0 g/L at 96 hours after culture.

BACKGROUND: The femoral intramedul ary guides in total knee arthroplasty require high precision, complex operation, it is very important for prosthesis and joint function to choose more precise positioning method and determine the correct needle point. OBJECTIVE: To study the effect of needle point position on prosthesis arrangement when applying different femoral intramedul ary guides methods in total knee arthroplasty. METHODS: Total y 80 patients who received the treatment of total knee arthroplasty in Changshu No.1 People’s Hospital from January 2012 to July 2015 were selected and divided into test and control groups according to random number table (n=40/group). The patients in the test group accepted CT scan for femoral intramedul ary guides. The theoretical position of femoral intramedul ary guides entry point was marked using radiographic parameters. In the control group, the traditional total knee arthroplasty technology was used to mark the entry point of femoral intramedul ary guides. The needle point position when applying different femoral intramedul ary guide methods was observed. The effect of femoral intramedul ary guides on prosthesis arrangement in total knee arthroplasty was discussed. RESULTS AND CONCLUSION: Compared with the control group, the distance from entry point to femoral anatomic line on positive and lateral X-ray film in the test group was shorter, femoral prosthesis lateral angle and physiological valgus angle were closer to the theoretical value, distance from intersection of femur axis and femoral condyle to block center was shorter; the differences were statistical y significant (P < 0.05). These results demonstrate that compared with the traditional two-dimensional intramedul ary positioning, the needle point position of three-dimensional CT scan stimulative positioning is more accurate. The location more concentrates on within intercondylar fossa 2-5 mm, more front of intercondylar fossa 3-10 mm, three-dimensional CT scan stimulative positioning is a reliable choice for femoral intramedul ary guides.

BACKGROUND:Currently, human umbilical cord derived-mesenchymal stem cel s are mainly for local transplantation, which has some shortcomings, such as large trauma, bleeding, complications, that limit its widespread application in clinical practice. OBJECTIVE:To investigate the feasibility of intravenous transplantation of human umbilical cord derived-mesenchymal stem cel s for repair of spinal cord injury. METHODS:Eighty Wistar rats with spinal cord hitting were divided into five groups:blank control group with no transplantation (n=10), DMEM local transplantation group (n=15), DMEM intravenous transplantation group (n=15), cel local transplantation group (n=20), cel intravenous transplantation group (n=20). The functional recovery of spinal cord injury was observed with Basso, Beattie and Bresnahan scores at regular time as wel as hematoxylin-eosin staining and immunohistochemistry staining. RESULTS AND CONCLUSION:During 1 day to 2 weeks after transplantation, there was no significant difference in the Basso, Beattie and Bresnahan scores between the five groups;within 4-12 weeks after transplantation, the Basso, Beattie and Bresnahan scores were significantly higher in the two cel transplantation groups than the other three groups, but there was no difference between these two cel transplantation groups (P>0.05). Histological observation showed that the number of voids and glial scars was less in the cel local transplantation group and cel intravenous transplantation group compared with the other three groups, and there was also no difference between the two cel transplantation groups. These results indicate that the intravenous transplantation of human umbilical cord derived-mesenchymal stem cel s is similar to the local transplantation in the repair of acute spinal cord injury, which is simple and avoids secondary injuries and various complications. It is recommended that this method provide a new approach for cel transplantation.

Objective To find an efficient plan for the arrangement of the beds in hospital so that the beds-operating efficiency can be raised and the requirement of patients can be perfectly met. Methods According to the data analyzed via the method of mathematical statistics, optimizing model was built and automatic stimulation program was generated as well as conducted by matlab software. Results The characteristics of bed-occupation condition was acquired by data analysis, the result of optimizing model was stimulated by program and the most efficient plan emerges which was obviously better than the original FCFS (First Come First Serve) Plan. Conclusion The mathematical model built up is of great maneuverability in the practical situation to ameliorate the management efficiency of hospital beds considerably.

AIM: To investigate the preventive effect of tetrahydroxystilbene-glucoside (TSG) on experimental atherosclerosis rats. METHODS: Sixty one male rats were randomly divided into six groups. normal control; model control; TSG low dose(30 mg?kg-1?d-1);TSG middle dose(60 mg?kg-1?d-1);TSG high dose(120 mg?kg-1?d-1); simvastatin(2 mg?kg-1?d-1). The AS model of rats was made by feeding high grease food and injecting VitD3 .All the rats were fed for 12 weeks, blood samples were drawn from carotid artery of rats, the levels of TC, TG, HDL-C, LDL-C ,CRP,IL-6 and TNF-? in serum were measured with biochemical method. After blood samples were collected , the aorta samples were separated from the bodies, then they were placed 4% paraformaldehydea and were through Sudan Ⅳ and HE staining. STATA7.0 software was used to evaluate the differences between groups. RESULTS: Data of the study demonstrated that the levels of TC、TG、LDL-C、TNF-?、IL-6 and CRP were decreased remarkably, the level of HDL-C was increased by TSG 60, 120 mg?kg-1?d-1 group in the high cholesterol-fed rats, which showed a dose-dependent effect. The result of Sudan Ⅳ and HE staining suggested that the lipid deposits in aortic endothelium in TSG group were less than those in model group. CONCLUSION: TSG has preventive effect on the experimental atherosclerosis among the high cholesterol-fed rats. The anti-atherogenic effect of TSG seems to be closely related to regulating plasma lipid profile, and inhibiting inflammation.

Aim To investigate the effects of TSG on the content of nitric oxide and the expression of endo-thelium nitric oxide synthase in artery vessels of experimental atherosclerotic rats.Methods Sixty male rats were randomly divided into six groups.GroupⅠ,Normal control;GroupⅡ,Model control;Group Ⅲ,TSG low dose;Group Ⅳ,TSG middle dose;GroupⅤ,TSG high dose;group Ⅵ,Simvastatin.After 12 weeks,blood samples were collected from carotid arteries of rats,and the levels of NO in serum were measured.After that,the aortas were separated from the bodies and placed in-70℃,then the content of nitric oxide synthase was detected,and gene expression of eNOS and iNOSmRNA in artery vessels were respectively measured with RT-PCR method.STATA 8.0 software was adopted in date analysis..Results compared with those of the model group,the level of NO,the activity of NOS and the gene expression of eNOS were increased,and the gene expression of iNOS was reduced by simvastatin and TSG 30,60,120 mg?kg-1?d-1 in the high cholesterol-fed rats,which showed a dose-dependent effect.Conclusion TSG can enhance the expression of eNOS gene and reduce the expression of iNOS gene in aorta vessels of experimental atherosclerotic rats,which may be one of the anti-atherosclerosis mechanisms of TSG.

Aim To observe the effects of 2,3,4',5-tetrahydroxystilbene-2-O-?-D glucoside on expression of ICAM-1、VCAM-1 and VEGF in atherosclerotic rats,and approach the influence of TSG in atherogenesis.Methods Sixty SD rats were randomly divided into six groups(Control,Model,TSG 30、60、120 mg?kg-1?d-1 and Simvastatin 2 mg?kg-1?d-1 groups),given high-fat-diet for 12 weeks,the level of SOD and MDA then were determined.ICAM-1、VCAM-1 and VEGF protein were determined with Western blot assay,ICAM-1 mRNA and VCAM-1 mRNA were measured with RT-PCR,and VEGF expression was assessed by immunohisto-chemistry.Results In comparison with the model,the level of SOD increased markedly and the level of MDA decreased markedly after administering TSG;TSG could inhibit the expression of ICAM-1、VCAM-1 and VEGF in atherosclerotic arteries.Conclusions TSG could show its antiatherosclerotic effect by anti-oxydation and inhibiting the excretion of adhesion molecules.