Objective:To explore the relations of psychological stress reactions to workplace violence and so-cial acknowledgement among emergency nurses.Methods:Totally 444 emergency nurses from 8 tertiary hospitals and 1 second A hospital in Beijing were selected.Psychological stressful reactions were measured with the Impact of Event Scale-Revised (IES-R).The social acknowledgment from general society and family to victims was assessed with the Social Acknowledgment Questionnaire (SAQ).Results:Among the 444 samples,96.8% sustained verbal assaults,43.2% underwent physical assaults,32.0% encountered threats,and 4.3% suffered sexual assaults.The results of ANOVA analysis indicated that nurses who suffered 3 types of violence had higher scores of IES-R than the ones who endured one type of violence and 2 types of violence[(22.0 ±16.1)vs.(15.4 ±15.6),(18.1 ± 16.1),Ps <0.01)].Similarly,those nurses who suffered 4 types of violence had higher scores of IES-R than the ones who enduredone type of violence and 2 types of violence [(33.4 ±17.1)vs.(15.4 ±15.6),(18.1 ±16.1), Ps <0.01].Regressive analysis showed that family disapproval,general disapproval,and violence types predicted psychological stress reactions,(β=0.13 -0.40,P <0.05,adjust R2 =0.27).Conclusion:It suggests that violence types,social disapproval and family disapproval may play vital roles in predicting the degree of posttraumatic dis-tress in emergency nurses after suffering from hospital violence.

BACKGROUND:Previous research has proved good therapeutic effect on the acute hepatic failure by the treatment of polylactic acid-O-carboxymethylated chitosan(PLA-O-CMC) nanoparticles-cultured porcine hepatocytes embedded in type I collagen.OBJECTIVE:To investigate the effect of PLA-O-CMC nanoparticles on immunological rejection in intraperitoneal porcine hepatocyte xenotransplantation for treatment of acute liver failure rats.DESIGN,TIME AND SETTING:Randomized control animal experiments were carried out at the Institute of Hepatobiliary Surgery and Laboratory of Nerve Regeneration in Nantong University from May 2005 to May 2006.MATERIALS:In situ recirculating collagenase perfusion method was used to isolate porcine hepatocytes.64 SD rats were intraperitoneally injected with D-galactosamine to induce acute hepatic failure models.METHODS:Totally 64 rats were divided into four groups:Model group received no intervention;Nano-collagen hepatocytes group was transplanted with PLA-O-CMC nanoparticles-cultured porcine hepatocytes embedded in collagen gel,which was then wrapped up using greater omentum;Porcine hepatocytes embedded in collagen gel(collagen hepatocytes group) and free porcine hepatocytes suspension(pure hepatocytes group) were transplanted into peritoneal cavity of SD rats,respectively.At 48 hours following the modeling,the porcine hepatocytes transplantations were performed and the number of transplanted cells was 5.0?107 hepatocytes in all groups.MAIN OUTCOME MEASURES:The serum interleukin-2,interferon-?,IgG and IgM levels of rats were determined at days 1,2,3,5 and 7.The pathological changes of transplants were observed under microscope at days 1,3 and 7.RESULTS:There were no significant differences in serum interleukin-2 and interferon-? levels of all groups during 7 days post-transplantation.Serum IgG levels increased with a peak at day 3 after hepatocytes transplantation,and then began to decline.Serum IgG levels in nano-collagen hepatocytes group were lower than those in collagen hepatocytes group and pure hepatocytes group at days 2 and 3(P

Objective To observe the hypoglycemic mechanism of total saponins of Momordica charantia (MC) in type 2 diabetes mellitus (DM) rats. Methods Among the selected 60 male Specific Pathogen Free (SPF)rats, 8 were random- ly chosen as control group, while others were fed with high fat and high glucose diet following streptozotocin injection from caudal vein 8 weeks after to construct type 2 DM models. After the DM models were successfully built, rats were then ran- domized into five groups: DM control group (n=8), the metformin group (n=8) and three groups of total saponins of MC with different dosage (n=8 in each group). The total saponins of MC groups include DM rats administrated with total saponins of MC 100, 200, 400 mg/(kg·d) for 8 weeks, the metformin group include DM rats administrated with metformin 50 mg/(kg·d) for 8 weeks. At the end of the experiment, the fasting blood glucose and insulin were examed. At the same time, a part of pan- creas islet, liver and skeletal muscle were preserved. The pancreas islet structure, the hepatic glycogen and Glucose trans- porter 4 (GLUT4) expression were observed by electron microscope, glycogen dyeing and immunoblot respectively. Results After 8 weeks treatment, compared to type 2 DM control group, fasting blood glucose and insulin values in MC groups were reduced more obviously. However, skeletal muscle GLUT4 expression level, insulin granules and hepatic glycogen increased obviously in MC groups. Conclusion Total saponins of MC has hypoglycemic effect. It’s mechanisms maybe include pro- moting the hepatic glycogen synthesis, inhibiting the hepatic glycogen decomposition and promoting insulin sensitivity by in- creasing peripheral tissue’s GLUT4 expression.

Objective To investigate the changes of expression of apoptosis-related proteins Bcl-2,Bax and Fas of the transplantated hepatocytes after intraperitoneal transplantation in rats using porcine hepatocytes cultured with polylactic acid-O-carboxymethylated chitosan nanoparticles.Methods Recirculating collagenase perfusion method was used to isolate porcine hepatocytes.At 48h after D-galactosamine intraperitoneal injection,5 mL polylactic acid-O-carboxymethylated chitosan nanoparticles-cultured porcine hepatocytes embedded in collagen gel(group A) and 5 mL porcine hepatocytes embedded in collagen gel(group B) were transplanted into peritoneal cavity of SD rats,respectively.The amount of transplanted porcine hepatocytes was 5.0?107 hepatocytes in two groups.The expression of Bcl-2,Bax and Fas in transplanted hepatocytes three days after transplantation was detected with immunohistochemistry.Results At 1,2 and 3d after transplantation,the rates of Bcl-2 positive cells in group A was significant higher than those in group B,whereas the rates of Bax and Fas positive cells in group A were significant lower than those in group B(P

Objective To study the protective effects of human umbilical cord-derived mesenchymal stem cells (ucMSCs)against severe acute pancreatitis (SAP) in rats.Methods A total of 135 Sprague-Dawley male rats were randomly divided into Sham group,SAP group and SAP+ucMSCs group (45 each).SAP+ucMSCs group:Severe acute pancreatitis was induced by injecting 5％ sodium taurocholate (0.1ml/100g) into the common bilio-pancreatic duct and then CM-DiI-labeled ucMSCs at 1 × 107cells/kg were injected via the tail vein.All the rats were sacrificed 12,24 and 72 hours after SAP.The 72h death rate was counted.Pathological changes in the pancrease were detected by HE staining and pathological score was graded,ucMSCs colonization was observed by fluorescence microscopy.The serum levels of amylase,lipase,TNF-α,IL-1β,IL-4 and IL-10 were determined by ELISA.Results ucMSCs colonize the injured area of pancreatic tissue,the 72h death rate was reduced,and the serum amylase and lipase were also reduced significantly.Moreover,ucMSCs significantly reduced the pathological score of the pancrea and the level of proinflammatory cytokines (TNF-α and IL-1β),but the levels of anti-inflammatory cytokines were increased (IL-4 and IL-10).Conclusion Transplantation of ucMSCs can reduce the severity of pancreatic injury and inflammation in SAP rats.

Objective To observe the effect of treating Diabetic Peripheral Neuropathy with Acupoint Injection. Methods 65 patient with DPN were randomly recruited into a control group and a treatment group after adjusting stage. The control group was treated with acupuncture, while the treatment group was treated with the Safflower inoculation fluid acupuncture point injects. Nerve function parameter (MDNS、 NCV) and clinical symptoms were observed after 3 therapeutic courses. Results Nerve function parameter (MDNS、 NCV) and clinical symptoms in the treatment group were apparently improved after treatment (P<0.05) . Conclusion Acupuncture point injected with Safflower inoculation fluid may improve clinical symptoms and nerve functions of DPN patients.

Objective To explore the reason of misdiagnosis and discuss the reoperation in thyroid carcinoma.Methods The data of 77 patients that had reoperation because of misdiagnosis were analyzed.Results The daignosis of all 77 cases were only based on pre-operative physical and uhrasound examination.The post-reoperative follow up (3～41 monthes):no case was found local recurrence.Conclusions The preoperative frozen section may avoid misdaignosis and the effect of reoperation for misdaignosed cases are satisfactory.

Objective:To explore the diagnostic values of Wells score and YEARS algorithm in the patients with pulmonary embolism and to compare the areas under receiver operating characteristic (ROC) curves (AUC) of Wells score and YEARS algorithm, and to find the more suitable score method for pulmonary embolism in clinic.Methods:A total of 139patients who were suspected with pulmonary embolism were collected, among them48patients were clinically as confirmed pulmonary embolism.The disease history, clinical manifestation and results of auxilliary examinations of the patients were collected.All the patients were assessed by Wells score and YEARS algorithm, respectively;the computed tomographic pulmonary angiography (CTPA) was considered as golden standard.The sensitivities, specificities, misdiagnosis rates and omission diagnostic rates, and the accuracies of Wells score and YEARS algorithm of the patients in two groups were analyzed with SPSS 22.0software;the conformities of results of Wells socre, YEARS algorithm, and CTPA were analyzed.Then ROC curves of Wells score and YEARS algorithm in diagnosis of pulmonary embolism were made, and the AUC was calculated and compared.Results:Compared with YEARS algorithm, the specificity and accuracy of Wells score in diagnosis of pulmonary embolism were markedly increased (P＜0.05) , the misdiagnosis rate was decreased (P=0.037) , however the sensitivity and the misdiagnosis rate had no significant differences (P＞0.05) .The Kappa value of Wells score and CTPA was 0.45, the conformity was moderate;the Kappa value of YEARS algorithm and CTPA was 0.22, the conformity was passable;the Kappa value of Wells score and YEARS algorithm was 0.11, the conformity was bad.The AUC of Wells score and YEARS algorithm were 0.753±0.044 (P＜0.01) and 0.585±0.049 (P=0.101) .Conclusion:The Wells score is superior to the YEARS algorithm in the diagnosis of pulmonary embolism.

The incidence of iatrogenic bile duct injuries has been increased along with the application of laparoscopic surgery, although surgical lesions have been reduced and postoperative recovery has been accelerated. Once bile duct injury occurs, the short-term and long-term adverse effects are very severe. Therefore, the prevention and timely diagnosis and treatment of bile duct injuries are critical. In order to better understanding iatrogenic bile duct injuries and guiding the clinical practices for young surgeons, this paper provides the updated information on common causes, mechanisms, diagnosis, and treatment of iatrogenic bile duct injuries through review of domestic and international literature.

Objective To compare the safety and efficacy of direct and remedial rotational atherectomy in the treatment of heavily calcified coronary artery lesions.Methods We retrospectively reviewed 58 patients admitted in the Shanghai Chest Hospital and Liaocheng People Hospital from May 2012 to July 2015 who had received stent implantation and rotational atherectomy.The 58 patients were divided into two groups which were the direct atherectomy group (n =27) and the remedial atherectomy group (n =31).General clinical date,lesion and procedural characteristics,intraoperative complications,in-hospital and follow-up MACCE were compared between the two groups.Results There were no differences between the two groups in general clinical date intraoperative complications,amount of contrast agent used,proceduraltime,rates of in-hospital and follow-up MACCE.Nevertheless,compared with the direct artherectomy group,the remedial group had more number of balloon dilations during procedure [3 (1,5) vs.2 (1,2),P ＜ 0.001] and higher peak cardiac troponin levels [1.1 (0.3,3.0) μg/L vs.0.5 (0.1,2.3) μg/L,P =0.032].Conclusions Remedial rotational atherectomy with drug-eluting stent had the same safety and efficacy as direct atheretomy with drug-eluting stent in treating patients with heavily calcified coronary lesions.It is reasonable and safe to transform routine PCI to remedial rotational atherectomy when the 2.0 mm semi compliant balloon or/and 2.5 mm non-compliant balloon cannot pass through or dilate the lesions.