This paper has reported the data of health volunteer's liver sections, which are measured with B-Model ultrasonic scan, so as to provide the data to be for clinical reference.15 data for each volunteer were measured and treated them with statistics, the conclusions represent as follows:1. The thick diameter (i.e. anterior-posterior diameter of liver)of liver mear-suing at right midclavicular and preaxillar line are compared with body surface area and thoraxic width(transverse diameter)and thickness, the thick diameter has relevance to them closely (r= 0.3159-0.4409, P

Objective To understand the status and features of nursing care adverse events and to offer scientific basis for improving patient safety management of nursing at high altitude area. Methods Data such as categories, causes, time distribution and other factors of nursing care adverse events were collected from January 2013 to August 2014 in the People′s Hospital of Tibet Autonomous Region were analyzed. Results Over the study period, 50 adverse events were recorded and the most common types were tube emersion(26%,13/50), pressure sores(14%,7/50) and scald(12%,6/50) respectively. The proportions of different severity of adverse events were hidden events (48%,24/50), events without bad consequence(36%,18/50), adverse events(14%,7/50) and warning events(2%,1/50) respectively. The ineffective communication, inadequate assessment, and not abiding by the rules accounted for 70%(35/50) of the causes of adverse events. 7:00-10:59 and 19:00-22:59 period was the high incidence of adverse events, respectively accounted for 32%(16/50) and 26%(13/50). Conclusions The management of nursing adverse events at high altitude area need to consider the geographical characteristics,besides, to guarantee the implementation of the system,reduce the bed / nurse ratio, improve the comprehensive quality of nurses and other measures can be taken to reduce the occurrence of adverse events.

Objecflve To study the heredity and variance of E1 gene of rubella villls Matsuba vac-cine strain.and to evaluate the protective efficacy of the vaccine prepared by Matsuba vaccine strain on genelevel.Methods The Matsuba strain was passaged on primary rabbit kidnev cells from 14 to 23 generations.and the E1 genes of 14,16,17,18,23 passages amplified by RT-PCR were cloned into the T-A cloning vector pGEM-T and sequenced,respectively.The sequences of E1 gene of the passaged viruses were tom-pared with rubella virus Matsuba reference strain E1 gene(Accession No.D50673)and other rubella strains in GenBank.respectively.Results The Matanba passaged shared higher homology of nucleotide and amino acid with Matsuba reference strain(D50673).,The sequences of nucleotide and amino acid of RV14,RV16.RV18 were identical to D50673.The homology of nucleotide sequences of RV17,RV23 and D50673 was 99.9%and 99.7%,respectively,andthe homology of amino acidwgg 99.8% and 99.2%,respective-ly.The amino acid related to glycosylation and epitopes of the passage viruses were highly conservative.The phylogenetic tree showed Matsuba strain belonged to la genotype.The rubella virus genotypes circulated in China recent years were 1E,lF,2A and 2B,and 1E genotype was the predominant genotype.The homology of nucleotide and amino acid of Matsuba strain and the other genotype reference strains was 92.1%-99.6% and 98.1%-99.8%.respectively.Condusion The Matsuba vaccine strain possesses highly genetic stabil-ity.which indicates that the Matsuba strain and its vaccine are stable on molecular level.And the vaccine prepared by Matsuba vaccine strain can prevent the infection of various genotype rubella viruses.

Objective To study the levels of Matrix Metalloproteinase-3 (MMP-3) and interleukin (IL-1) in the synovial fluid and plasma of C57 black mice with osteoarthritis (OA) and their relationships with the severity of pathological changes so as to investigate their effects and correlation with OA. Methods The C57 black mice with OA were enrolled for this study. Different levels of exercise were appicated based on their age. Knee joint pathological changes were examined for pathological severity of OA. ELISA sandwich method was used to measure the levels of MMP-3 and IL-1 in serum and synovial fluid. Correlation analysis was performed to demonstrate the relationship between the levels of MMP-3 and IL-1 in the serum and synovial fluid, and the pathological severity of OA. Results ①Morphological observations: C57 black mice were characterized by spontaneously developing OA and the incidence and the severity of osteoarthritis gradually increased with age and exercising burdens. ② The level of MMP-3 and IL-1 in the synovial fluid of exercising mice MMP-3 (84±6) ng/ml, IL-1 (48±3) ng/ml was higher than that in the aged ones [MMP-3 (84±6) ng/ml, IL-1 (71±5) ng/ml J, the difference was significant (P<0.01). The level of MMP-3 and IL-1 level in the serum had a linear correlation with that of the synovial fluid. At the same time, they also had linear correlation with the pathological severity of OA (All r>0.67, and all P<0.01). Conclusion The levels of MMP-3 and IL-1 in serum and synovial fluid can help to make early diagnosis of OA, especially elevated MMP-3 level.

Objective To investigate the expression of c-Jun-N-terminal kinase(JNK) in rat brains with chronic fluorosis and try to reveal the molecular mechanism for the neural impairment induced by the disease.Methods The rats were randomly divided into 3 groups, normal control group(drinking water containing less than 0.5 mg/L of sodium fluoride, NaF), lower fluoride exposed group(drinking water containing 5 mg/L NaF) and higher fluoride exposed group(drinking water containing 50 mg/L NaF), 24 in every group. The rats were examined at the sixth month after feeding. The concentration of fluorine in urine and blood was detected by F-ion selective electrode. The expression of JNK in brains was investigated by using Western blotting and immunohitochemistry staining, and analyze the correlation between activating of JNK and the concentration of fluorine in blood. Results The increased concentration of fluorine in urine(control: 0.92 ± 0.30, lower fluoride exposed group: 2.56 ± 0.91,higher fluoride exposed group: 5.73 ± 3.14, P ＜ 0.05) were observed when 6 months after the beginning of the experiment, and the amount of fluorine in blood was also higher in rats with fluorosis(control: 0.12 ± 0.07, lower fluoride exposed group: 0.36 ± 0.14, higher fluoride exposed group: 0.50 ± 0.18, P ＜ 0.05). The expression of phospho-JNK at protein levels were higher in the brains of rats with fluorosis than that of controls (control: 1.00 ± 0.37, lower fluoride exposed group: 1.20 ± 0.28, higher fluoride exposed group: 1.74 ± 0.69, P ＜ 0.05), whereas no change of total-JNK was found(F = 0.046, P ＞ 0.05). Furthermore, the expression of phospho-JNK in the parietal cortex(119.3 ± 14.1), occipital cortex(112.7 ± 5.4), hippocampus CA3(100.6 ± 8.9), dorsal thalamus (117.8 ± 10.4) and olivary nucleus( 112.6 ± 5.9) of rats in higher fluoride exposed group were higher than that in control( 104.1 ± 8.9,106.6 ± 9.6,106.6 ± 9.7,108.9 ± 6.4,100.3 ± 8.4, all P ＜ 0.05) and lower fluoride exposed group(96.7 ± 17.1,102.5 ± 8.3,106.4 ± 6.5,110.2 ± 9.3,102.4 ± 4.7,102.5 ± 9.8, all P＜ 0.05). The positive stained neurons of total-JNK also distributed in the same brain regions of rats, but no difference was detected between the rats with fluorosis and controls(all P ＞ 0.05). The increased level of phospho-JNK was positively correlated with the fluoride contents in blood of the rats with fluorosis (r = 0.677). Conclusions The expression of phospho-JNK in brains of rats with fluorosis was significantly increased with a correlation to fluoride content in blood, which might be connected to the mechanism of neural impairment induced by chronic fluorosis.

Objectives: To find out the demands and status in quo of the development of specialty nursing and to provide positive suggestions for the further development of specialty nursing in Tibet. Methods: Self-designed questionnaire was adopted to investigate 16 different level hospitals across Tibet. Results: Among the 16 hospitals in which there were altogether 1677 nursing staff and only 11 hospitals had cultivated specialty nurses with a number of 123 in total. The rate of specialty nurses allocated was 7.2%. 9 hospitals expressed the need to develop specialty nurses in nearly future and the number of specialty nurses needed was 577. Conclusion Tibet should step up the development of specialty nursing, establish and perfect the training method and management system about specialty nurses as soon as possible.

Click chemistry has been proven to be very useful in drug delivery. Due to the availability of a large number of click reactions with a various characteristics, selection of appropriate chemistry for a given application is often not a trivial task. This review is written for pharmaceutical researchers who are interested in click chemistry applications and yet may not be click chemistry experts. For this, the review gives an overview of available click reactions organized by application types. Further, the general understanding of click reactions being fast and high yielding sometimes overshadows the need to analyze reaction kinetics in assessing suitability of a given reaction for certain applications. For this, we highlight the need to analyze the relationship among reaction kinetics, concentration effects, and reaction time scales, knowing that lack of such analysis could easily lead to failures. Further, possible issues such as chemical stability with various click reagents are also discussed to aid experimental designs. Recent examples and extensive references are also provided to aid in-depth understanding of technical details. We hope this review will help those interested in using click chemistry in drug delivery to select the appropriate reactions/reagents and minimize the number of pitfalls.

Objective:To compare the safety apnea time during endotracheal intubation in the patients from different altitudes using oxygen reserve index (ORI).Methods:Sixty American Society of Anesthesiologists physical status Ⅰor Ⅱ patients, aged 18-70 yr, undergoing elective surgery requiring tracheal intubation under general anesthesia and requiring catheterization via arterial puncture, were included.Among the patients, 30 cases who had long lived at an altitude of 1 500-3 000 m in Qinghai Province People′s Hospital (Xining, 2 200 m above sea level) served as middle-altitude group, and 30 Tibetan patients who had long lived at an altitude >3 000-meter area in Yushu People′s Hospital (Yushu, 3 600 m above sea level) served as high-altitude group.The patients were preoxygenated for 5 min before induction of anesthesia, and then endotracheal intubation was performed with a video laryngoscope.Before induction (T 0), at 3 min of pre-oxygenation (T 1), and at 5 min of pre-oxygenation (T 2), arterial blood was collected for blood gas analysis, and PaO 2 was recorded, ORI and SpO 2 were simultaneously recorded.The time from the beginning of intubation to the time when ORI was decreased to 0 and the time from the beginning of intubation to the time when SpO 2 was decreased to 98% were recorded. Results:Compared with middle-altitude group, the time from the beginning of intubation to the time when ORI was decreased to 0 and the time from the beginning of intubation to the time when SpO 2 was decreased to 98% were significantly prolonged ( P<0.05), and no significant change was found in SpO 2, ORI and PaO 2 at each time point in high-altitude group ( P>0.05). Conclusions:The safety apnea time during endotracheal intubation is longer in the patients at high altitudes (altitude > 3000 m) than those at the moderate altitudes (altitude 1500-3000 m).

Objective To investigate the stroke classification of different age groups in Ganzi Tibetan Autonomous Prefecture,Sichuan Province in order to provide a basis for targeted prevention and treatment of stroke in the area. Methods From October 2011 to June 2014,a cross-sectional survey was used for cluster sampling and stratified sampling in 10000 residents,farmers,and herdsmen in Dege,Ganzi,Litang, Batang,and Kangding counties,Ganzi Tibetan Autonomous Prefecture,Sichuan Province. The questionnaires were used to collect demographic characteristics,stroke,hypertension,and other information. A total of 9186 effective questionnaire responders were enrolled. According to their ages,they were divided into five groups (18-29,-39,-49,-59,and ≥60 years). The included respondents in each group were 2492,2356, 2161,943,and 1234,respectively. Strokes were classified as transient ischemic attack,cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage groups. The differences in the prevalence among the groups used chi-square test. Results In 9186 subjects, 4584 ( 49. 9%) were females and 4602(50. 1％) were males. There were 174 patients with stroke,the prevalence was 1. 89％. The incidences of stroke in 5 age groups from small to large were 0. 08％％ (2/2492),0. 68％ (16/2356),1. 39％ (30/2161),2. 65％ (25/943),and 8. 18％ (101/1234),respectively. There were significant differences in the incidence of cerebrovascular diseases in different age groups (χ2 =693. 72,P<0. 01). The proportions of cerebral infarction,intracerebral hemorrhage,transient ischemic attack,and subarachnoid hemorrhage in the classification of stroke were 44.2％ (n=77),43.7％ (n=76),7.5％ (n=13),and 4.6％ (n=8),respectively. The prevalence of hypertension in the above stroke types were 77. 9％ (60/77),94. 7％(72/76),7/13 and 5/8,respectively. Conclusions The prevalence of cerebrovascular diseases is high in Ganzi Tibetan Autonomous Prefecture,Sichuan Province,and hemorrhagic stroke is significantly higher, the incidence of hypertension is the highest,which suggests that hypertension is an important risk factor for high incidence of hemorrhagic stroke in the local area. It is necessary to do a good job of health education on stroke according to the characteristics of local stroke

Objective To observe the influencing factors of early hypocalcemia after microwave ablation(MWA)for treating secondary hyperparathyroidism(SHPT).Methods Data of 82 SHPT patients who underwent MWA were retrospectively analyzed.The patients were divided into hypocalcemia group(n=36)and non-hypocalcemia group(n=46)based on presence of early hypocalcemia after MWA or not.Patients'age,gender,body mass index(BMI),dialysis method,dialysis time and number of lesions were compared between groups,so were baseline blood calcium,blood phosphorus,intact parathyroid hormone(iPTH),alkaline phosphatase(ALP),hemoglobin,albumin,creatinine,uric acid and 2 5-hydroxy vitamin D3.Logistic analysis was performed to screen the influencing factors of early hypocalcemia after MWA.Results Significant differences of dialysis methods,number of lesions,blood calcium,iPTH and ALP were found between groups(all P＜0.05).Univariate and multivariate logistic regression analysis showed that the number of lesions,iPTH and ALP were all independent influencing factors of early hypocalcemia after MWA for treating SHPT(all P＜0.05).Conclusion The number of lesions,iPTH and ALP were influencing factors of early hypocalcemia after MWA for treating SHPT.