Objective To explore the effect of nursing clinical pathway in percutaneous coronary intervention(PCI)for patients with acute myocardial infarction(AMI).Methods Sixty AMI patients were randomly divided into nursing clinical pathway(NCP) group and control group equally by their registration sequence.Patients in the control group received routine nursing care,while patients in NCP group received nursing according to the nursing clinical pathway.Results Compared with the conventional group, the time of preoperative preparation,bed rest and hospitalization was obviously shortened.The incidence of complications and hospital costs were both declined,and meanwhile the quality of care and patient satisfaction improved significantly(P<0.05). Conclusions The application of nursing clinical pathway in patients with AMI can be timely and effective in the treatment of PCI, lower the mortality and complications and moreover improve nurses' working enthusiasm.

Objective To evaluate the capability of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry ( MALDI-TOF MS) for rapid identification of methicillin-resistant Staphylo-coccus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) strains.Methods Twenty-five MRSA and thirty MSSA isolates were collected from the Second Affiliated Hospital of Zhejiang University School of Medicine as the experiment group .Twelve MRSA and twenty-two MSSA clinical strains were isola-ted as the control .All strains were identified by MALDI-TOF MS and the results were further analyzed by ClinProTools 3.0 software.Results Four algorithms including support vector machine (SVM), genetic al-gorithm ( GA) , supervised neural network ( SNN) and quick classifier ( QC) showed similar results in dis-tinguishing MRSA from MSSA isolates .The sensitivity of GA was 100 .0%and the sensitivities of other algo-rithms were all greater than 95.0%.The specificities of GA, SVM and QC were all greater than 90.0%. The areas under the receiver operating characteristic ( ROC) curves of four characteristic peaks at mass-to-charge ratios (m/z) of 3279, 6485, 6555 and 3299 m/z were all greater than 0.9.The virtual gel view showed that the bands generated by MSSA isolates at 3279 , 6485 and 6555 m/z were obviously deeper in color than those generated by MRSA isolates .However , the bands of MSSA isolates at 3299 m/z were appar-ently lighter in color than those of MRSA isolates .83.3%of MRSA and 90.0%of MSSA isolates from the control group were correctly identified by the GA model .Conclusion MALDI-TOF MS could rapidly and accurately identify MRSA from MSSA isolates under the strictly controlled experimental conditions with the advantages of less time-consuming, high sensitivity and high specificity .The accurate identification of MRSA from MSSA isolates could be applied for the prevention and treatment of MRSA infection .

Objective To estimate the application for the rapid identification of common clinical bacteria by MALDI-TOF MS. MethodsFour hundred and twenty-six bacteria, including Salmonella spp strains collected from Zhejiang center for disease control and prevention were collected from blood, sputum,secretion and urine in 2nd Affiliated Hospital of Zhejiang University during December 2008 to August 2009. The isolates included 76 gram positive coccus and 350 gram negative bacilli. Species identification was performed with the Vitek system, and serotypes of Salmonella and Shigella were determined by serum agglutination test. 16s rDNA gene of 91 bacteria were amplified by PCR. The RCP products were sequenced. Then the results were compared with the reported sequences from GenBank. All strains were identified by MALDI-TOF MS. Results of three identification methods were compared with each other. Results Among 426 tested isolates, identification results from Vitek system and MALDI-TOF MS for gram positive coccus and 323 out of 350 gram negative bacilli (exception for Salmonella and Shigella spp.),were identical. For 23 Salmonella and Shigella spp. , only 2 Salmonella enterica subsp, enterica serovar Typhimurium were identified the same results by the three methods. Besides, results from Vitek system and serum agglutination test for 1 Salmonella enterica subsp, enterica serovar Typhi, 3 Salmonella enterica subsp.enterica serovar Paratyphi A, 1 Salmonella enterica subsp, enterica serovar Paratyphi B, 1 Salmonella enterica subsp, enterica serovar Enteritidis, and 1 Salmonella enterica subsp, enterica serovar Bovis-morbificans were consistent with that from 16S rDNA gene sequence. Four isolates which were confirmed as S. flexneri by Vitek system and serum agglutination test were identified as Escherichia coli by both 16S rDNA gene sequence and MALDI-TOF MS. ConclusionMALDI-TOF MS could be used for rapid and accurate identification of common clinical bacteria with good repeatabihty, excepting for the Salmonella and Shigella spp.

Objective To explore the protective effects and the mechanisms of peritoneal dialysis (PD) on multiple organs induced by acute organophosphoms pesticide poisoning(AOPP)in order to get a scientific basis for the application of PD to treat AOPP patients. Method The model of AOPP rabbits was made by intragastric administration of 25 mg/kg(0.5LD50)40% omethoate, and the symptoms of poisoning such as myosis, salivating and muscular tremor were observed. Eighteen male Japanese rabbits were randomly divided into control group and peritoneal dialysis group (PD group). Pralidoxime chloride and atropine were given by intra-muscular injection to rabbits of control group (re = 9). Rabbits of PD group ( n = 9) had a tube inserted into peritoneal cavity and peritoneal dialysis was given for 10 times after administration of pralidoxim chloride and atropine. Serum TNF-α,CK-MB (M.B. isoerizyme of creatine kinase), ALT, creatinine, and amylase were observed dynamically. The dialysate of peritoneal dialysis was remained in the peritoneal cavity for testing the nature of intoxicant by using Varian 3900/ Saturn 2100T GC/MS device. All data were analyzed with SPSS version 12.0 software. Statistical comparison between two groups was carried out by using student t-test and analysis of variance(ANOVA) followed by Dunnett-ttests before and after intoxication. The pearson correlation analysis was used for determination of the relationship between TNF-α and other biomarkers. Results After intoxication, serum TNF-α, CK-MB, ALT and amylase increased except creatinine, but the serum levels of those biomarkers in PD group were significantly lower than those in control group.The level of TNF-a had positive correlations with CK-MB ( r = 0.470), ALT ( r = 0.649), and amylase ( r = 0.517). The omethoate was detected in the dialysate of peritoneal dialysis. Conclusions Organophosphorus pesticides can lead the cardiac muscle, liver, kidney and pancreas to the injury through several mechanisms,and the inflammatory mediators play important role in the development of MODS induced by AOPP. Peritoneal dialysis can clean up intoxicants slowly and continuously and in turn lower down the level of inflammatory mediators resulted in protecting multiple organs from AOPP.

Objective To evaluate the effectiveness of applying simulation based medical education (SBME) in critical care medicine PBL teaching. Methods Totally 46 undergraduates in medical college of Shanghai JiaoTong University , who participated in critical care medicine PBL teaching in our Hospital from 2012 to 2013 were chosen as research objects. These students were divided into two groups: PBL group (2009 grade, n=24) and SBME-PBL group (2010 grade, n=22). The teaching effectiveness was evaluated by questionnaire survey, theoretical exam, direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (Mini-CEX). Data were analyzed by SPSS 17.0 software. The data of questionnaire survey were expressed as percentage and the assessment results were expressed as x±s. Chi-square and t test were used to do statistical analysis. P<0.05 signi-fies for statistically significant differences . Results ①The results of questionnaire survey showed that:there was no significant difference between two groups in study interests(P=0.665, 0.937, 0.746) and study ability(P=0.937, 0.665). But regarding collaboration ability, SBME-PBL group performed better than PBL group (P=0.019, 0.038, 0.024). ②These was no significant difference in the theo-retical knowledge exam between PBL and SBME-PBL group(P=0.743). But the DOPS scores of car-diopulmonary resuscitation (P=0.000), endotracheal intubation (P=0.023), defibrillation (P=0.002) and central venous catheterization(P=0.047) were all significantly higher in SBME-PBL group than in PBL group. ③In Mini-CEX, there was no statistical difference in physical examination skills (P=0.790) and clinic judgment(P=0.426) between the two groups. However, SBME-PBL group performed better in medical interviewing capacity(P=0.002), humanistic care (P=0.001), counseling skills(P=0.017), organization efficiency(P=0.029) and overall clinical competence(P=0.024) than PBL group. Conclusions SBME can promote the students' team work spirit, basic clinical skills and comprehen-sive clinical capacity in critical care medicine PBL teaching and can improve the teaching quality of critical care medicine.

To develop a specific, rapid and convenient method based on molecular motor biosensor to detect food-borne rotavirus. A specific probe was encompassed the conservative region of rotavirus's VP7 segment, and a molecular motor detect device was constructed by connecting probes to F0F1-ATPase molecular motor through biotin-streptavidin system. This biosensor's sensitivity was 0.005 ng/mL for rotavirus RNA. Extracted virus RNA was conjugated with the biosensor separately, at the same time ATP was synthesized. By comparing fluorescence intensity, we can detect rotavirus RNA in samples. This method possessed specificity for rotavirus, without any cross-reaction with Hepatitis A virus and noroviris, and it could be accomplished within 1 h. We detected 15 samples using this method and the results were compared with RT-PCR results. This method is sensitive and specific for rotavirus, and it can be used to detect food-borne rotavirus.
Biosensing Techniques ; methods ; DNA, Viral ; analysis ; genetics ; Food Microbiology ; methods ; Rotavirus ; genetics ; isolation & purification ; Sensitivity and Specificity

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
.