Objective To understand the influencing factors of satisfaction degree with nursing in our hospital by investigation in satisfaction degree in central injection room.Methods 252 patients were selected in our hospital from January to December 2011 as the research object,questionnaires were used to investigate the patients,and the influencing factors of satisfaction degree of nursing work were analyzed.Results Among the patients who accepted the investigation,patients' satisfaction scores were correlated with the patients' age,education level,income level,inpatient department,hospital stay time and whether they accepted an operation.Conclusions Nursing staff should pay attention to and strengthen the nursing work quality and efficiency,improve the satisfaction degree with nursing of clinical patients.

PPARγ2 gene C1431T polymorphism was assayed by PCR-RFLP in 200 polycystic ovary syndrome( PCOS)patients and 150 normal subjects. Serum adiponectin and leptin levels were determined by ELISA method. Polymorphism of the site might be associated with serum leptin and adiponectin concentrations and thiazolidinedione treatment in women with PCOS ( P<0.05 or P<0.01).

Objective To investigate the protective effects of active components of notoginseng on immunological liver injury in mice. Methods Sixty Kunming mice were randomly divided into normal group (group A), model group (Group B), PNS group (Group C), total flavonoids group (Group D),and polysaccharide group (group E). C,D and E groups were given PNS, total flavonoids and polysaccharide orally, 1/day for 14 days. Then BCG was intravenous injected in B, C, D and E groups, and after 26 days lipopolysaccharide (LPS) was intravenous injected. Samples of eye venous plexus blood were collected, and serum levels of alanine aminotransferase (ALT), total superoxide dismutase (T-SOD) and Interleukin-4 (IL-4) were detected. Organs index was calculated by checking pathological results of liver, spleen and thymus. Results Com-pared with group B, the thymus index and serum ALT levels were significantly decreased in C, D and E groups (P<0.01), but the levels of IL-4 and T-SOD increased significantly (P<0.01). Pathological results showed that there were more serious inflammatory cell infiltration in liver, edema and necrosis of dot in C, D and E groups than those in group B. Conclusion The active components of notoginseng showed a significant protective effect on immunological liver injury.

Objective To investigate the relationship between phosphatidylinositol 3-kinase catalytic subunit α(PIK3CA) expression and the incidence and different pathological grade of gastric cancer, and the mechanism thereof. Meth-ods The expressions of PIK3CA, serine/threonine protein kinase (pAkt) and cell proliferation associated nuclear antigen (ki-67) in gastric carcinoma and adjacent tissues and normal gastric mucosa were detected by immunohistochemical method. The relationship between expressions of PIK3CA, pAkt and ki-67 and tumorigenesis was analyzed. The expressions of PIK3CA, pAkt and ki-67 in different pathological conditions of gastric tissues were analyzed. The relationship between tu-mor pathologic classification and differentiation were analyzed too. Results There were significantly higher expressions of PIK3CA, pAkt and ki-67 in gastric cancer (P＜0.05), which were the highest in the poorly differentiated gastric adenocarci-noma (P＜0.05). There were a positive correlation between expressions of PIK3CA, pAkt and ki-67 and different pathologi-cal levels of gastric carcinoma and adjacent tissues and normal gastric tissues (P＜0.05). Conclusion PIK3CA may be the initiating factor of PI3K/Akt signaling pathway, which induced phosphorylation of Akt and activation PI3K/Akt signaling pathway, promoting the proliferation, invasion and metastasis of gastric adenocarcinoma.

Objective To investigate the value of critical scoring system in the treatment of multiple organ dysfunction after exposure to poisoning by analyzing 3 cases of industrial organic fluorine gas poisoning.Methods Clinical data of symptoms,signs,treatments,outcome and the changes in the scores as APACHE Ⅱ,SOFA,MODS were collected,the differences among the patients were compared and the relevance was analyzed.Results The first APACHE Ⅱ was 19-26.Scores of case 1 in the three scoring systems constantly increased and different components were found,with the suggestion of sequential organ dysfunction.Other two patients' scores decreased and survived without complications.Conclusiorn Multiple critical scoring systems can be used to evaluate the outcome of multiple organ dysfunction due to organic fluorine gas poisoning.System evaluation and individualized treatment are both important.More studies can help to set up a special critical scoring system.

Objective To investigate the changes of serum N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration in patients with Graves' disease (GD) and its clinical significance. Methods Two hundred and sixty-nine patients with GD were enrolled in this study. Serum concentrations of thyroid hormones,TRAb, and NT-proBNP were measured. Results Serum NT-proBNP levels were positively associated with FT3(r=0.260, P<0.01), FT4(r=0.297,P<0.01) and heart rate (r=0.251, P<0.05) independent of age,sex and body mass index (BMI). The difference of serum NT-proBNP concentrations between newly-onset and treated patients existed (P<0.01) after the adjustment for thyroid hormone levels, age, sex and BMI. Serum FT4level exerted a significant impact on NT-proBNP level (P <0.01). Serum NT-proBNP increased even in patients with controlled thyroid function. Conclusion Serum NT-proBNP level in patients with GD increases with elevation of FT4 independent of sex, age and BMI. The measurement of serum NT-proBNP concentration appears to be helpful to monitor the alteration of vascular stiffness and fluid volume in GD patients, and may provide useful evidence for early intervention of cardiovascular disease induced by hyperthyroidism.

Objective To assess the value of transesophageal echocardiography (TEE) in left atrial appendage (LAA) closer with Amplatzer Cardiac Plug (ACP).Methods Consecutive 32 atrial fibrillation patients (CHADS2≥1) with high risk bleeding underwent LAA occlusion with ACP LAA occlusion device under the guidance of TEE.Measurements of LAA anchoring area diameter (AAD) and LAA anatomical orifice diameter (AOD) including maximum,minimum values,and LAA depth on 2 dimentional TEE (2D TEE) were conducted before closer device implantation.The outcomes of LAA occlusion were analyzed.Results Among 32 patients,27 cases achieved successful LAA occlusion,including 2 cases with peripheral leakage ≤5 mm,and 5 cases failed occlusion.Among 5 failed closed patients,3 cases with LAA AAD≥ 30 mm,1 case with LAA of short depth,and 1 case with anatomical variation of LAA of low position that access sheath could not be positioned in the LAA.LAA AAD maximum,minimum and LAA depth were (25.9±4.9)mm,(20.0±3.8)mm,(31.0±5.6)mm,respectively,and LAA AOD maximum,minimum diameters were (26.2±6.2)mm,(19.4±4.3)mm,respectively.Among 10 cases with LAA AAD≥30 mm,7 cases achieved successful LAA occlusion,but 3 cases failed.The implanted device diameter was (26.4±3.8)mm,and device compression rate was (7.6±5.5)%.The coefficient of correlation between device diameter and large LAA AAD and AOD is 0.770 and 0.717,respectively.There was no complication but 1 case with pericardial effusion.Conclusions Two dimentional TEE measurements of LAA have clinical guiding significance in the selection of proper size of ACP LAA occluder.The AAD of 2D TEE has the good correlation with ACP occluder′s size,the AADs are important factors which affect the success of LAA occlusion.

Objective:To investigate the effect of guided imagery relaxation therapy on pain self-efficacy and quality of life in patients with gynecological malignant tumor.Methods:A total of 94 gynecological malignant tumor patients were assigned to study group and control group by random digits table method with 47 cases each, the control group received routine nursing, while the study group carried out guided imagery relaxation therapy for 4 weeks. The pain degree, pain self-efficacy and quality of life was assessed by Chinese version of Brief Pain Inventory (BPI-C), Chronic Pain Self-efficacy Scale (CPSS) and Quality of Life Questionnaire-core 30 (QLQ-C30), before and 4-week after intervention.Results:Compared to the control group, the scores of pain right now, pain at worst in the 24 hours, pain on the average of BPI-C and symptom scales, single items of QLQ-C30 were (3.76±0.54), (4.37±1.39), (3.63±0.73), (32.40±8.69), (34.34±5.81) points in the study group, and (4.18±0.93), (5.18±1.75), (4.23±0.97), (37.72±6.37), (38.54±6.84) points in the control group, the differences were statistically significant( t values were 2.415-3.287, all P <0.05). The scores of self-efficacy for pain management, self-efficacy for physical function, self-efficacy for coping with symptoms, total CPSS total scale and function scales, global QOL scale were (17.43±5.50), (27.25±4.40), (29.76±6.46), (74.44±9.21), (72.73±17.74), (64.02±11.03) points in the study group, and (14.68±3.53), (22.60±4.01), (24.87±4.03), (62.14±7.10), (65.60±13.89), (57.23±15.60) points in the control group, the differences were statistically significant( t values were 2.105-7.036, P <0.05 or 0.01). Conclusions:Guided imagery relaxation therapy can alleviate cancerous pain and promote pain self-efficacy and quality of life of patients with gynecological malignant tumor.

Objective　To investigate the effect of U14 vaccine transfected with the B7 gene in inducing antitumor immune response to murine cervical carcinoma in Chinese 615-strain mice. Methods　A recombinant retroviral plasmid vector expressing mouse B7-1 gene (pLNSX-mB7) was transfected into 615-strain mouse cervical carcinoma cell line No. 14 (U14) by electroporation to set up a highly-expressed mB7-1 U14 cell clonal strain (B7+U14). In vivo experiments: (1) B7+U14 vaccine was primed to protect the 615-strain mice against U14 re-challenge. (2) B7+U14 vaccine was injected into tumor-bearing mice with different tumor sizes. Lifetimes and tumor sizes were recorded. In vitro cytotoxicity assay: Mice were immunized with B7+U14 or U14 vaccine and 2 weeks later, spleen cells of those mice were cultured for 2 days. The cytotoxicity of these cells against U14 was detected by 5-diphenyl tetrazolium bromide assay. Results　We obtained several B7-1 high expression clonal U14 lines. In vivo experiment, we did not find tumor growing in 3 of the 6 mice primed by B7+U14 vaccine during their entire life after re-challenge with U14. The other 3 mice developed tumors and their average survival time was longer than that of the control group (P<0.01). All 6 mice grew tumors in the control group. When the transplanted tumors became palpable, the mice were randomly divided into 3 groups to be injected with B7+U14 vaccine. It was effective for tumor-bearing mice only when the tumor diameters were <3?mm. When the diameters were ≥3?mm, it was not efficacious to inject B7+U14 vaccine (P<0.05). In vitro cytotoxicity assay, cytotoxic T lymphocytes induced by B7+U14 vaccine had a higher cytotoxicity against U14 than that induced by U14 vaccine (F=310.8, P<0.001). Conclusions　Vaccines of cervical cancer cells transfected with the costimulatory molecule B7 gene can induce antitumor immune protection in host mice against U14 re-challenge. This treatment may cure part of the tumor-bearing mice but be restricted by tumor size. The results suggest that transfecting the B7 gene into cervical cancer as a cell vaccine may be an efficient supplementary method to treat cervical cancer after operation.

Objective To compare the diagnostic accuracies of deep convolutional neural network (CNN) and dermatologists for pigmented nevus and seborrheic keratosis.Methods CNN network ResNet-50 was trained with 5 094 dermoscopic images of pigmented nevus and seborrheic keratosis using transfer learning,so as to establish a CNN two-classification model.Then,this model was applied to the automatic classification of 30 dermoscopic images of pigmented nevus and 30 dermoscopic images of seborrheic keratosis.Meanwhile,in combination with clinical photos of skin lesions,95 experienced dermatologists who had received dermoscopy training gave their diagnosis for the above 60 dermoscopic images.The diagnostic accuracies were compared between the two methods,and misclassified images were further analyzed.Results The CNN automatic classification model had the diagnostic accuracies of 100％ (30/30)and 76.67％ (23/30) for pigmented nevus and seborrheic keratosis respectively,and the total accuracy was 88.33％ (53/60).The average diagnostic accuracies of 95 dermatologists were 82.98％ (25.8/30) and 85.96％ (24.9/30) for pigmented nevus and seborrheic keratosis respectively,and the total accuracy was 84.47％ (50.7/60).There were no significant differences in the diagnostic accuracies for pigmented nevus or seborrheic keratosis between the CNN automatic classification model and 95 dermatologists (x2 =0.38,P ＞ 0.05).The dermoscopic images misclassified by CNN were divided into 3 categories:special-type lesions with high pigment content and marked keratosis,typical skin lesions with interference factors,and typical skin lesions without definite reasons for misclassification.Conclusions The performance of CNN automatic classification model is similar to that of experienced dermatologists in the two classification of pigmented nevus and seborrheic keratosis.The reasons for misclassification by CNN still need to be explored by dermatologists and professionals in artificial intelligence.