ObjectiveTo assess the value of the area of ground glass opacities (GGOs) in lungs displayed by high-resolution computed tomography (HRCT) in paraquat (PQ) poisoned patients in evaluating prognosis. Methods Clinical and imaging data of 137 patients with acute PQ poisoning admitted to Affiliated Hospital of the Medical College of Chinese People's Armed Police Forces from January 2012 to August 2014 were analyzed retrospectively. The plasma concentration of PQ on admission and the area of GGOs were compared between two groups. The lung HRCT within 10 days of poisoning was performed every 3 days, and the areas of GGOs were evaluated on five levels, including aortic arch, aortic pulmonary window, left upper lobe bronchial, right inferior pulmonary vein, and left diaphragmatic dome. Receiver operating characteristic curve (ROC) was plotted to evaluate the value of all the parameters for prognosis.Results Among 137 patients, 45 died within 28 days after poisoning, with the mortality rate of 32.85%. The plasma PQ level in the non-survivors was significantly higher than that in the survivors (mg/L:7.06±0.67 vs. 3.51±0.34,t = 5.280,P = 0.000). The areas of GGOs at three time points in the non-survivors were significantly higher than those in the survivors [1-3 days: (32.0±5.0)% vs. (2.5±0.4)%,t = 7.860,P = 0.000;4-6 days: (45.5±5.7)% vs. (2.8±0.5)%,t = 12.420,P = 0.000; 7-10 days: (68.0±4.8)% vs. (3.0±0.6)%, t = 23.950,P = 0.000]. ROC analysis demonstrated that the area under the ROC curve (AUC) of GGOs in 7-10 days was 1.000, which could be used to determine the prognosis, but it was too late for the treatment. The AUC of GGOs in 4-6 days was 0.979, with the threshold of> 12.0%, the specificity of 96.15%, the sensitivity of 85.19%, the positive predictive value of 88.46%, and the negative predictive value of 94.94%, which presented good effect in predicting prognosis in the early stage of acute PQ intoxication. But plasma PQ concentration was relatively poor for determining prognosis, AUC was 0.821, with the threshold of> 1.95 mg/L, the specificity of 34.52%, the sensitivity of 88.64%, the positive predictive value of 41.49%, and the negative predictive value of 85.29%.Conclusions The area of GGOs displayed by HRCT can be used to evaluate the fully developed acute PQ lung injury, and it is superior to plasma PQ concentration. The area of GGOs displayed by HRCT 4-6 days after intoxication can be used for the evaluation of PQ induced pulmonary injury in the early stage and the evaluation of clinical prognosis.

Objective To analyse the clinical characteristics,treatments and prognosis of the chemotheray-induced lung injury in malignant hematological diseases patients.Methods 26 malignant hematological diseasespatients with chemotheray-induced lung injury were collected.The clinical characteristics,chemotherapy regimen,treatments and prognosis of the patiants were retrospectively analyzed.Results Among 26 patients,10 patients were male and 16 patients were famale.The dignosis were nonHodgkin's lymphoma (16 cases),leukemia (9 cases) and multiple myeloma (1 case).The chemotherapy regimens inducing lung injure probably were R-CHOP,R-BEACOP and BEACOP in lymphoma,while they were HA,AA,DA and IA in leukemia.The symptoms of lung injury in these patients were fever,cough,hemoptysis,dyspnea,fatigue,or asymptomatic radiological examination revealed.Pulmonary diffuse infiltration and shadows were showed in CT scan.21 cases were cured by hormone therapy,5 cases died of lung injury,2 cases died of tumor recurrence after lung injury cured.There was no effect on the quality of life in most cured patients.Conclusion The lung injury induced by chemotherapy has no specific clinical characteristics and diagnostic criteria,and it could progress rapidly to cause death.But early dignosis and early hormonal treatment can obtain good therapeutic effect.The occurrence regularity and clinical characteristics should be studied furtherly.

Objective To know the sources of the working stress of head nurses in primary hospitals.Methods A total of 100 head nurses from 14 hospitals were investigated through nurse stressor scale by random cluster sampling.Results The total score of working stress source of the head nurses was 2.60±0.52.The stress sources scores were ranked as job characteristics,organizational structure,family conflict,career,work roles,and interpersonal conflict.Conclusions The levels of stress of head nurses in primary hospitals were at the middle level.Skills and capability of head nurses are necessary to be improved to deal with stress.Meanwhile,administration department and leaders of hospitals need to reduce the stress of head nurses to improve their psychological conditions by improving the working environment,establishing the reasonable incentive measures,and so on.

Objective To assess the effect of three-grade nursing clinical-rounds implemented on new patients with mental disorders.Methods 360 new patients with mental disorders who were selected from ward one to six in our hospital were divided into the experimental group and control group,patients in experimental group who were selected from January to December in 2010 were given three-grade nursing clinical-rounds and patients in control group who were select from January to December in 2009 were given ordinary nursing clinicalrounds.Passing rate of health education,incidence of accident and satisfaction to nursing care in two groups were evaluated.Results Passing rate of health education in experimental group was 96.7％ and 89.4％ in control group,the difference was obvious( x2 =7.264,P ＜ 0.05 ).there was statistically significant difference in the incidence of accident,2.8 ％ in experimental group and 10.6％ in control group ( Z =- 2.726,P ＜ 0.05 ).the satisfaction of patients were 98.9％ and 93.3％ in experimental and control group respectively( x2 =6.020,P ＜0.05).Conclusions Three-grade nursing clinical-rounds have a significant effect on the overall quality of nursing care,and it is worthy of spreading in clinical work.

AIM: To investigate the effects of PAR-2 agonist peptide on the proliferation and cytosolic calcium concentration ([Ca~(2+)]_c) in human hepatoma cells HepG2. METHODS: Human hepatoma cell line HepG2 was cultured. The cells were treated with PAR-2 agonist peptide SLIGKV-NH_2 and the reverse PAR-2 agonist peptide VKGILS-NH_2, respectively. The [Ca~(2+)]_c of hepatoma cells were measured by microfluorimetric techniques based on calcium indicator fura-2/AM. The influences on proliferation of hepatoma cells were determined by MTT method. The changes of cell cycle were evaluated by flow cytometry, and the changes of cyclin D1 mRNA expression were detected by RT-PCR. RESULTS: After treated with 50 μmol/L SLIGKV-NH_2, a rapid rise of [Ca~(2+)]_c in HepG2 cells was induced (P<0.01), percent S phase, G_2/M phase and proliferation index (PI) of HepG2 cells were elevated (P<0.01), and cyclin D1 mRNA expression was significantly upregulated (P<0.01). The proliferation rates of HepG2 cells treated with 1-50 μmol/L SLIGKV-NH_2 were significantly increased, and the effect was in a dose-dependent manner (P<0.01 or P<0.05). No statistical significance of the difference between VKGILS-NH_2 and control group was observed (P>0.05). CONCLUSION: PAR-2 agonist peptide induces the rise of [Ca~(2+)]_c in HepG2 cells, upregulates the expression of cyclin D1 mRNA, accelerates the progress of cell cycle, promotes the synthesis of DNA and the proliferation of hepatoma cells via activating PAR-2 in vitro.

OBJECTIVETo evaluate the reliability, validity, and responsiveness of traditional Chinese medicine (TCM) clinical outcomes rating scale for heart failure (HF) based on patients' report.

METHODSTCM clinical outcomes rating scale for HF (TCM-HF-PRO) were evaluated based on 340 HF patients' report from multiple centers. The completion of the investigation was recorded. Cronbach's α coefficient and split-half reliability were used for reliability analysis, and factor analysis was used to assess the construct validity of the rating scale. Pearson correlation analysis was then used for criterion validity analysis. Discriminant analysis was used to assess the responsiveness of the scale. All 340 HF patients having complete TCM-HF-PRO data were assigned to the treatment group and the control group by central randomization. The total TCM-HF-PRO scores of the two groups were compared using paired t-test to reflect the longitude responsiveness of the scale before treatment and at week 2 after treatment.

RESULTS(1) The recycling rate of the scale was 100.0%. One of them was not filled completely, which was rejected thereby. So the completion rate was 99.7%. The completion time for TCM-HF-PRO scale ranged 15 to 25 min. (2) The Cronbach's α coefficient of rating scale was 0.903, split-half reliability was 0.844 and 0.849. (3) Confirmatory factor analysis showed that 7 factors and items formed according to maximum load factor basically coincided with the construct of the rating scale, 7 factors accumulated contribution rate was 43.8%. TCM clinical outcomes rating scale for HF based on patients' report was relatively better correlated with the Minnesota living with HF questionnaire (r = 0.726, P < 0.01). (4) Discriminant analysis showed that the rating scale correctly classified more than 78.8% of case studies having confirmed initial differential diagnosis by experts. The total scale of the rating scale decreased more in the two group after treatment, with significant difference as compared with before treatment (P < 0.01.

CONCLUSIONTCM clinical outcomes rating scale for HF based on patients' report had good reliability, validity and responsiveness, hence it could be used to assess clinical efficacy for HF patients.

Diagnosis, Differential ; Discriminant Analysis ; Factor Analysis, Statistical ; Heart Failure ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods ; standards ; Reproducibility of Results ; Surveys and Questionnaires

Objective To measure the current environmental radioactivity levels in some districts of Yunnan Province,and to estimate the external doses to local residents.Methods The surface soil,aerosol and water samples were collected and analyzed by HPGe gamma spectrometry.Based on the estimation model selected by Ministry of Health in the nationwide soil survey,the doses to local residents from 238U,226Ra,232Th,40K and 137Cs in environmental samples were estimated.CARI-6 software issued by FAA (Federal Aviation Administration ) was used to estimate cosmic radiation dose to the local population.Results The external annual dose rate to the local people was 1.13 mSv per year,of which 0.52 mSv per year was contributed by natural radionuclides in soil,0.6 μ Sv per year by 137 Cs in soil and 0.61 mSv per year by cosmic radiation.Conclusions The cosmic radiation and natural radionuclides in soil might contribute 99.95％ of external exposure dose,while artificial radionuclide 137Cs contribute 0.05％ of external exposure dose.

Objective To test a full range of processes of sample collection,preparation,measurement and analysis by conducting the intercomparison of gamma-ray spectrometry measurement and analysis of radionuclides among key laboratories,so as to facilitate the development of gamma-ray spectrometry measurement and analysis technology.Methods To complete the collection and preparation of soil samples by Chinese Center for Disease Control and Prevention (CDC) laboratory and to measure and analyze the content in two soil samples of 214Pb,214Bi,208TI,228Ac,40K and 137Cs by three laboratories using gamma-ray spectrometry.Results The value calculated by any two laboratories were less than 1 in terms of assessment standards agreed by these three laboratories and based on the activity concentrations and the total uncertainty reported from them.The measurement results from our lab were acceptable.Conclusions Measurement results from these three laboratories are in agreement to some extent.This intercomparison activity has tested the analytical ability of the three laboratories and raised the level of our laboratory in testing homogeneity of sample preparation.

Objective To study the diarrhea causes and nursing care after kidney transplantation from donation after cardiac death(DCD).Methods The clinical data of 91 patients undergoing kidney transplantations from DCD were retrospectively analyzed from November 2011 to May 2013 in our department,to investigate the incidence of diarrhea and the causes.Results Eighty three cases contracted diarrhea in 91 recipients,with the incidence of diarrhea 91.2%.The use of immunosuppressive agents,intestinal flora,infection and bowel movement dysfunction were all related to the diarrhea.Conclusions The incidence of diarrhea is high and the causes are complex after kidney transplantation from DCD.So nurses should take the appropriate care measures to improve the quality of nursing,avoiding complications and ensuring transplant results based on a different cause of diarrhea.

Objective To explore the relationship of methylenetetrahydrofolate reductase (MTHFR)gene C677T,factor V(FV)gene G1691A and prothrombin(PT)gene G20210A polymorphisms to unexplained recurrent early spontaneous abortion(URESA).Methods One hundred and twelve patients with URESA and 100 women with at least 1 normal pregnancy and without any miscarriage were analyzed for MTHFR,FV and PT gene polymorphisms by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Results MTHFR gene T/T genotype and T allele frequencies were increased in URESA patients[38.4%(43/112)and 59.8%(134/224)]versus controls[18.0%(18/100)and 43%(43/100),P