Objective To understand the nurses' evaluation of current grading nursing system.Methods Self-questionnaire was designed and used to investigate 141 clinical nurses coming from three general hospitals sampled conveniently.Results (1)Clinical nurses lacked in-depth study of grading nursing instruction principle;(2)Doctors and nurses lacked the cooperation during the process of identifying the level of care;(3)Level of care was not consistent with the patients' condition and self-care ability;(4)Disease inspection and primary care were not consistent with patients' level of care;(5)Health guidance and mental nursing couldn't meet the actual needs of patients;(6)Senior nurses' evaluation of the implementation of grading nursing was lower than Junior nurses; (7)Clinical nurses held positive attitudes to nurses and patients participating in grading nursing.Conclusions Nurses thought poorly of grading nursing system in operation,it was necessary to improve the content of principles about grading nursing manner,health instruction and psychological nursing,and implement grading nursing system correctly.It was also important to take patients' willingness of participating in care into account.

Volume holographic imaging system (VHIS) incorporates a volume hologram grating (VHG) as the critical optical field processing component in a new imaging system.High spectral resolution and high sensitivity in obtaining 3D information at multi-depths are achieved without time consuming scanning mechanism and complex reconstruction algorithms by utilizing the Bragg diffraction selectivity and degeneracy properties.We briefly introduced the system structures and principles,then we presented intensively on how these VHGs were devised and VHIS were configured into the qualified spectral VHIS (S-VHIS) and multiplexed VHG imaging systems.The superiorities over conventional imaging systems and the features to be improved of VHIS were summarized and discussed.

Head ; pathology ; Head and Neck Neoplasms ; diagnosis ; Humans ; Neck ; pathology ; Sarcoma, Alveolar Soft Part ; diagnosis

Objective To explore the job tasks and qualifications of midwives in China for the next five years.Methods Anonymous surveys were sent by email to 80 professionals to learn the job tasks and qualifications of midwives in China using the Delphi method.The recipients include senior midwives, nursing administrators and nursing educators,senior obstetricians and gynecology department chiefs,as well as health administrators.Results Learnt in the survey were the qualifications and job tasks of professional midwives in China for the next five years.The system concludes 77 job tasks of midwives, among which 31 items are supposed to be completed independently.Conclusion China should develop the midwife system as soon as possible,strengthen the midwife training and education,develop the midwife access system and the corresponding laws and regulations for midwives,standardize midwife management,clear the midwife qualifications and job tasks,formulate normative midwife promotion system,and realize the midwifery scientific management.

Objective To develop a new type of lumbar puncture needle to facilitate to measure intracranial pressure,decrease the risks for intracranial infection and brain hernia.Methods The needle was composed of a body,no.1 and no.2 sleeves,a stylet,a needle base,a catheter,joints and etc.The needle had body and stylet made of stainless steel,the catheter manufactured with medical silicone tube,the joints produced by medical rubber and the remained components by medical plastics.Results The developed needle executed pressure measuring,cerebrospinal fluid collection and medication injection with no extracting the stylet.The outflow velocity of cerebrospinal fluid was limited,and the incidences of the complications were decreased including infection,brain hernia and etc.Conclusion The lumbar puncture needle has simple structure,easy operation and high safety,and thus is worthy promoting practically.

Objective To investigate the evaluation of plasma osteoprotegerin (OPG) measurement for assessing the prognosis of intermediate coronary lesions in elderly patients.Methods We retrospectively analyzed patients met the inclusion criteria of suspicious chest pain or confirmed coronary artery disease (CHD),and intermediate stenosis lesions (20 ％ ～ 70 ％) in 3 main coronary arteries served as target vessels for qualitative comparative analysis (QCA).Plasma OPG level was detected by protein array method,and the concentration of hypersensitive C-reactive protein (hs-CRP)was determined by enzyme-linked immunosorbent assay(ELISA).Clinical endpoints were followed up.Results A total of 890 patients with intermediate coronary stenosis were enrolled in this study,and were divided into＜60 years of age group(n＝370)and ≥ 60 years of age group(n＝520).There were statistical differences in age,smoking history,hypertension history,triglycerides (TG),high-density lipoprotein cholesterol(HDL-C),white blood cell count,OPG,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI)between the two groups.The morphological indices in coronary lesions assessed by QCA had no differences between the two groups.During a median of 24 months of follow-up,58 patients(l1.2％)had clinical endpoints events.Age,smoking history,hypertension history,TC,TG,HDL-C,white blood cell count,levels of OPG above-median,hs-CRP,SBP,DBP,and BMI were used as the independent variables,and the clinical end events as the dependent variable.Forward stepwise logistic regression analysis showed that HDL-C,levels of OPG above-median,hs-CRP were the independent risk factors in elderly patients.The risk of cardiovascular events in patients with levels of OPG above-median was 2.510 fold higher than those with levels of OPG below-median.Conclusions The high levels of OPG and hs-CRP are the independent risk factors for the occurrence of coronary heart disease in the elderly with intermediate coronary lesions.

Objective:To systematically evaluate the effectiveness and safety of intra-articular in-jection of mesenchymal stem cells (MSCs) and hyaluronic acid (HA) in the treatment of knee osteoarthritis.Methods:The relevant literatures published in both English and Chinese were systematically searched in PubMed, Embase, Wanfang database, China Knowledge Network (CNKI), SinoMed database and other data-bases from inception to May 2020. Two researchers independently extracted data and evaluated the included literature. Risk assessment of literature bias was carried out. RevMan 5.3 software was used for Meta analysis, and the combined sensitivity were calculated.Results:Finally, 13 references were included, including a total of 726 patients with knee osteoarthritis. Meta-analysis results showed that compared with the HA group, the Western Ontario and McMaster University Osteopathic Index Total Score (WOMAC) [ MD=-10.92, 95% CI (-16.87, -4.96), P<0.01], the visual analogue scale (VAS) score [ MD=-1.70, 95% CI(-2.44, -0.95), P<0.01], and the knee joint Lequesne index score of MSCs group all decreased significantly [ MD=-13.78, 95% CI (-15.03,-12.52), P<0.01]. Furthermore, there was no significant difference in the incidence of adverse events (AEs) between the two groups [ RR=1.11, 95% CI(0.90, 1.37), P=0.33]. However, American Knee Association Score (AKS score) [ MD=-10.15, 95% CI(-22.33, 2.03), P=0.10] and whole-organ magnetic resonance imaging score (WORMS) [ MD=-3.93, 95% CI(-11.60, 3.75), P=0.32] were not statistically significant ( P>0.05). Conclusion:Compared with intra-articular injection of HA, intra-articular injection of MSCs can significantly improve the symptoms and dysfunction, and has favorable clinical tolerability and safety, suggesting that MSCs is expected to bea new treatment for knee osteoarthritis.

OBJECTIVESince glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common hereditary hemolytic erythrocyte enzyme deficiency, most cases have single nucleotide mutations in the coding region, and current test methods for gene mutation have some missed detections, this study aimed to investigate the feasibility of RT-PCR sequencing in the detection of gene mutation in G6PD deficiency.

METHODSAccording to the G6PD/6GPD ratio, 195 children with anemia of unknown cause or who underwent physical examination between August 2013 and July 2014 were classified into G6PD-deficiency group with 130 children (G6PD/6GPD ratio <1.00) and control group with 65 children (G6PD/6GPD ratio≥1.00). The primer design and PCR amplification conditions were optimized, and RT-PCR sequencing was used to analyze the complete coding sequence and verify the genomic DNA sequence in the two groups.

RESULTSIn the G6PD-deficiency group, the detection rate of gene mutation was 100% and 13 missense mutations were detected, including one new mutation. In the control group, no missense mutation was detected in 28 boys; 13 heterozygous missense mutations, 1 homozygous same-sense mutation (C1191T) which had not been reported in China and abroad, and 14 single nucleotide polymorphisms of C1311T were detected in 37 girls. The control group showed a high rate of missed detection of G6PD deficiency (carriers) in the specimens from girls (35%, 13/37).

CONCLUSIONSRT-PCR sequencing has a high detection rate of G6PD gene mutation and a certain value in clinical diagnosis of G6PD deficiency.

Adolescent ; Child ; Child, Preschool ; Female ; Glucosephosphate Dehydrogenase ; genetics ; Glucosephosphate Dehydrogenase Deficiency ; diagnosis ; genetics ; Humans ; Infant ; Male ; Mutation ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA

Objective To explore the effects of aminolevulinic acid-based photodynamic therapy (ALA-PDT) on the proliferation and apoptosis of HaCaT cells stably expressing human papillomavirus type 16 E7 protein (HaCaT/HPVl6 E7 cells).Methods Cultured HaCaT/HPV16 E7 cells were divided into several groups: blank control group receiving no treatment, ALA group treated with ALA alone, irradiation group irradiated with 630-nm red laser (30 mW/cm2,12 J/cm2), ALA-PDT groups pretreated with ALA for 5 hours followed by 630-nm red laser radiation at 4, 8, 12 J/cm2 respectively.CCK8 assay was performed to determine the survival rate of cells at 24 hours after PDT, and flow cytometetry and confocal microscopy were conducted to detect cell apoptosis and observe cell morphology respectively at 3 hours.Results At 24 hours, the survival rate of cells was 68.98％ ± 1.03％, 46.03％ ± 2.96％ and 23.57％ ± 3.83％ in the 4-,8-and 12-J/cm2 ALA-PDT groups respectively, significantly lower than that in the blank control group, ALA group and irradiation group (99.15％ ± 0.64％, 98.13％ ± 0.83％ and 96.85％ ± 1.37％ respectively, all P ＜ 0.05).With the increase in radiation dose, cell apoptosis was accelerated with obvious morphological changes and shrinkage of cells in the ALA-PDT groups.Conclusion ALA-PDT can inhibit the proliferation, and promote the apoptosis of HPV-infected HaCaT cells in a dose-dependent manner within a certain range of radiation dose.

Aim To investigate the effect of ketamine plus fluoxetine on depressed behavior and the expres-sion of neuronal nitric oxide synthase (nNOS)and CA-PON in prefrontal lobe of mentally depressed rats at different time points,so as to study the possible mecha-nism of ketamine plus fluoxetine inducing antidepres-sant behavior.Methods Healthy adult male Sprague-Dawley rats,aged 2.5 ~3 months,weighing 220 ~270 g,were induced as the rodent model of depression by chronic unpredictable mild stress (CUMS).After the models of depression were established,96 of CUMS modeling successfully depressed rats were selected. Then they were randomly divided into four groups (n =24 each):the depressed group (group D,untreated group),ketamine group (group K,treated with intrap-eritoneal injection of ketamine 1 0 mg·kg -1 once a day for 3 days or 7 days),fluoxetine group (group F,trea-ted with gavage of fluoxetine 1 .8 mg·kg -1 once a day for 3 days or 7 days),or ketamine plus fluoxetine group (group KF,treated with intraperitoneal injection of ketamine 1 0 mg·kg -1 plus gavage of fluoxetine 1 .8 mg·kg -1 once a day for 3 days or 7 days).Open field test and sucrose preference test were performed 1 day before depression model was established,and 1 day before and after treatment.The rats were sacrificed 1 day after the last test for determination of the expres-sion of nNOS and CAPON protein (using immuno-his-tochemisity)and mRNA (by RT-PCR)in the prefron-tal lobe.Results After the models of depression were established,the total distance,rearing number and the sucrose preference percentage (SPP)were decreased significantly compared with those before (P <0.05). There was no significant difference among all groups in the total distance,rearing number and the SPP before treatment (P >0.05 ).Compared with groups D and F,the total distance was prolonged,the number of rea-ring and SPP were significantly increased,the expres-sion of nNOS protein and mRNA was down-regulated and the expression of CAPON protein and mRNA was up-regulated in groups K and KF,with 3 days’treat-ment (P <0.05).Compared with group D,the total distance was prolonged,the number of rearing and SPP were significantly increased,the expression of nNOS protein and mRNA was down-regulated and the expres-sion of CAPON protein and mRNA was up-regulated in groups K,F and KF with 7 days’treatment (P <0.05).Compared with group F,the total distance was prolonged,the number of rearing and SPP were signifi-cantly increased,the expression of nNOS protein and mRNA was down-regulated and the expression of CA-PON protein and mRNA was up-regulated in group KF with 7 days’treatment (P <0.05).Conclusion Co-administration of antidepressant fluoxetine with ket-amine may induce a more pronounced antidepressant activity than treatment with each antidepressant alone and it can shorten the time to improve the depressive state through promoting the expression of CAPON and inhibiting nNOS activity in the prefrontal lobe of men-tally depressed rats.