To investigate the immunophenotypings of malignant epithelial mesothelioma (MEM), and to seek the valuable markers in distinguishing peritoneal MEM from peritoneal metastatic ovarian adenocarcinoma (OA) and colorectal adenocarcinoma (CA), immunohistochemical SP method was used to detect expressions of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 in paraffin-embedded tissues of 18 cases of MEM, 20 OA and 20 CA. The results showed that there was a significant difference in the expressions of E-cadherin, CA19-9 and MOC-31 between MEM and OA group (P<0.05). Similarly, the difference in the expression of HBME-1, E-cadherin, CA19-9, MOC-31 and CK7 between MEM and CA groups is significant (P<0.05). These results indicate that HBME-1 could be used as a positive marker in distinguishing MEM from CA. E-cadherin, CA19-9 and MOC-31 are considered to be useful negative markers in diagnostic distinction between MEM and metastatic adenocarcinomas, including OA and CA. CK7 is the best positive marker in distinguishing MEM from CA, but this marker appears to be valueless in discriminating MEM from OA.

Objective To analyze the clinical features of pulmonary embolism(PE) after urologic surgery in order to provide the theory base for preventing pulmonary embolism Methods CNKI database was used to look for our subjects who were with PE after urologic surgery from January 2005 to December 2011.Ten cases were selected.Three related patients simultaneously in Xuancheng Central Hospital were also recruited as our subjects.The information of diagnosis and treatment information and clinical features were collected.Results Among the 13 patients,3 were women and 10 were men with confirmed PE.Their age ranged from 48 to 79 years old and the average was 61.Among the 13 patients,2 conducted routine surgery,and the other 11 conducted mini-invasion operation.The 13 patients underwent PE from 2 to 18 days after urologic surgery and 7 patients (53.85％) died of PE.Conclusion No specificity of clinical feature for PE was found to contribute to cure rate.Early diagnosis and prevention of PE are important,and anticoagulant treatment and immediate thrombolytic are critical.

Objective:To explore the effect of case teaching in clinical nursing teaching and medical ethics ed-ucation in the department of cardiology. Methods: A sample of 75 nurse interns came to practice in November 2014 to April 2015 were allocated to the control group, while 96 nurse interns came in July 2015 to December 2015 were allocated to the experimental group. The interns in control group were taught according to the traditional teach-ing method, and the case teaching method was used in the experimental group. The scores of critical thinking abili-ty and the times of praise were compared between the two groups. Results:Both critical thinking ability and praise of the interns in the experimental group were better than those in the control group ( P<0 . 01 ) . Conclusion:In-troducing the case teaching method to clinical nursing teaching and moral education can improve nurse interns′clin-ical critical thinking ability and stimulate the enthusiasm for learning. Meanwhile, it is beneficial to cultivate nurse interns′medical humanistic spirit and improve the medical humanistic quality.

Objective To investigate the posttraumatic stress disorder(PTSD) and ethical decision-making in nurses suffered workplace violence, and analyze the relmionship between them. Methods Totally 340 nurses suffered workplace violence were questionnaired by the PTSD Scale and the Ethical Decision- making Scale. Results The incidence rate of PTSD was 17.06%(58/340), the total score of PTSD was (38.77± 13.57).The scores of ideal ethical practice, actual ethical practice and ethical decision- making in the PTSD group were 121.36±8.33, 105.56±7.76, 226.92±15.52, and were significantly lower than that in the non-PTSD group (140.60±9.01, 117.65±8.41, 258.27±16.73) (t=-14.996, -10.015, -13.153, P < 0.01). The score of PTSD was negtively correlated with the scores of ideal ethical practice, actual ethical practice and ethical decision- making (r=-0.415, -0.431,-0.420, P < 0.05). Conclusions The PTSD probably occurred after workplace violence, nursing administrators should pay close attention to the PTSD and therefore improve nurses′ethical decision-making.

Aim To study the effects of ferulic acid (FA) on E-selectin expression in human umbilical vein endothelial cells (HUVECs) activated by lipopolysaccharide and leukocyte-endothelial cell adhesion. Methods The effects of FA on E-selectin and E-selectin mRNA expression were determined by flow cytometry and reverse transcription polymerase chain reaction. The effect of FA on HL60-HUVEC adhesion was evaluated with the method of staining the cells by Rose Bengal. Results The expression of tively). Conclusion FA can inhibit the expression of E-selectin and E-selectin mRNA and HL60-HUVEC adhesion. This may contribute to its protective effect against ischemia-reperfusion injury.

Objective To screen and identify the predominant T-and B-cell ( T-B) combined an-tigenic epitopes on the outer membrane protein Loa22 of pathogenic Leptospira interrogans ( L.interrogans) stains and to further analyze their immunogenicity.Methods PCR analysis was used to detect loa22 gene in L.interrogans strains belonging to eight different serogroups or serovars prevalent in China.The PCR prod-ucts were sequenced after T-A cloning.A prokaryotic expression system for loa22 gene of L.interrogans sero-group Icterohaemorrhagiae serovar Lai strain Lai was constructed.The expressed recombinant protein rLoa22 was extracted by Ni-NTA affinity chromatography.The rabbit anti-rLoa22 serum samples and IgG were pre-pared.The T-B combined antigenic epitopes on Loa22 protein were predicted by using professional bioinfor-matic softwares.Phage display in combination with Western blot assay and ELISA were performed to identify the immunogenicity of the recombinant phage PⅢ protein-displayed and artificially-synthesized T-B com-bined antigenic epitopes, respectively.MTS assay and ELISA were performed to detect the activation of T cells and the expression of IL-2, IL-4 and IFN-γinduced by T-B combined antigenic epitopes, respectively. Results All of the tested pathogenic Leptospira strains were positive for loa22 gene, sharing 85.5%-99.8%homologies in nucleotide sequences and 93.9%-99.5%homologies in amino acid sequences.The construc-ted prokaryotic expression system for loa22 gene efficiently expressed the rLoa22 protein.Among four T-B combined antigenic epitopes (Loa22-77, Loa22-90, Loa22-125 and Loa22-157), only Loa22-90 epitope presented a strong positive band in Western blot analysis.The proliferation of CD4+T cells and the expres-sion of IL-2 ( Th1 ) and IL-4 ( Th2 ) were significantly enhanced by the stimulation with Loa22-90 epitope peptide (P<0.05).Conclusion Loa22 protein is a sequence-conserved genus-specific outer membrane protein of L.interrogans.The Loa22-90 epitope is the predominant T-B combined antigenic epitope of Loa22 protein, which might be used as a candidate antigenic epitope in the development of multiple antigenic pep-tide ( MAP) vaccines against Leptospira infection.

Objective To explore the differences among CT angiography(CTA) at different doses in both lower extremity arteries,and the relationship among volume rendering(VR) image quality,CT number and standard deviation(SD) value.Method CTA in lower extremity artery was performed in 90 patients.The participants were randomly divided into three groups,including a routine group (120 kV,150 mAs),120 kV and 80 mAs group,and 100 kV and 130 mAs group with 30 cases in each group.The images were processed with VR and classified into three degrees,the first class,the second class and the third class,and VR image quality levels of three groups were compared.The receiver operating characteristic curve(ROC) was used to analyze the correlation among VR image quality level,CT number and SD value.Results The percentage of VR image level at the first class was 93.3％ in the routine group,86.6％ in the 120 kV and 80 mAs group and 96.6％ in the 100 kV and 130 mAs group.According to the correlation analysis between the SD value and VR image quality of CTA in lower extremity artery,the area under curve in ROC analysis was 0.9078.According to the correlation analysis between the CT number and VR image quality of CTA in lower extremity artery,the area under curve in ROC analysis was 0.9116.Conclusions The low-dose CAT in lower extremity artery is feasible.Application of 100 kV and 130 mAs could ensure better image quality.

Objective To study the perception of patients and nurses for the artificial airway suction,in order to provide theoretical reference for building the artificial airway suction clinical practice guidelines.Methods CNKI,Wanfang,VIP,Pubmed,Science direct databases were searched for papers of patients and/or nurses' perception over the limited period of 2005 to 2013.The retrieved papers were analyzed.Results Nineteen eligible papers were identified.Extract relevant contents found the majority of patients retained the memory of that airway suction,mainly for pain,choking,suffocation,and eager to get the relevant knowledge and information.There were few researches on nurses' subjective feeling about airway suction.Conclusion We should pay attention to the perception of patients,while strengthening the research on nurses' perception of artificial airway suction and improve communication with patients,in order to relieve their discomfort experience,and could be helpful for the building of airway suction clinical practice guidelines.

Objective To investigate the biological effects of low intensity of pulsed ultrasound (LIPUS) on human periosteal cells and marrow stromal cells in vitro. Methods LIPUS of 30 mW/cm2 was used to stimulate the cultured human periosteal cells and marrow stromal cells for 5 min, 10 and 20 min per day, respectively, followed by the examination of cell proliferation and differentiation potential. Results Thymidine incorporation and total protein assay indicated that LIPUS had no significant effect on DNA and protein synthesis of the periosteal and marrow stromal cells, suggesting that LIPUS did not promote proliferation of these cells. However, ALP activity and osteocalcin secretion of the human periosteal cells were dramatically increased. Conclusion The results suggested that low intensity pulsed ultrasound stimulated periosteal cell proliferation and differentiation toward osteogenic lineage, this might contribute to the curing effect of low intensity pulsed ultrasound for fracture.

Objective To investigate the application of leukoreduction filter in removal of leukocytes in platelet concentrate . Methods Platelet concentrate was prepared by using platelet‐rich plasma method .35 bags of the same type of prepared platelet concentrate were filtered by using leukoreduction filter .The changes of conventional indicators of platelet before and after filter were measured and recorded .The activating platelets indicators PAC‐1 and CD62p were detected by using flow cytometry .The platelet hypotonic shock was measured by biochemical analyzer .The platelet aggregation was measured by using platelet aggrega‐tion instrument .Results After platelet concentrate was filtered by using leukoreduction filter ,leukocyte removal rate was(98 .28 ± 0 .97)% ,platelet recovery rate was(86 .37 ± 2 .84)% .After filtration ,white blood cell count ,platelets ,red blood cells were reduced than before filtration(P<0 .05) .The differences of capacity of platelets ,mean platelet volume and pH before and after filtration were not statistically significant(P> 0 .05) .Before and after filtration ,the expression of platelet activation markers PAC‐1 and CD62p ,platelet aggregation and platelet hypotonic shock were not statistically different(P>0 .05) .Conclusion Platelet leukore‐duction filter could effectively filter leukocytes in platelet concentrate .It would not change the conventional indicators ,and not affect platelet activation ,aggregation and anti‐hypotonic shock capacity significantly .