Objective:To explore the application effect of seamless nursing in aged patients with coronary heart dis‐ease (CHD) .Methods :A total of 60 aged CHD patients ,who were hospitalized from Aug 2013 to Feb 2014 in our hospital ,were enrolled .The 60 patients were divided into seamless nursing group (n=30) and routine nursing group (n=30) .Seattle angina questionnaire (SAQ) was used to score all patients ;angina pectoris control condition and prognosis were compared between two groups .Results:Compared with routine nursing group ,there were significant rise in anginal stability [ (78.25 ± 9.42) scores vs .(89.14 ± 10.38) scores] ,anginal frequency [ (85.13 ± 11.57) scores vs .(93.24 ± 12.58) scores] and disease perception [ (58.52 ± 12.36) scores vs .(72.16 ± 14.57) scores] of SAQ scores in seamless nursing group , P<0.05 all;and significant reductions in incidence rates of adverse cardio‐vascular events ,including angina pectoris (20.0% vs .10.0% ) ,recurrent myocardial infarction (6.7% vs .0) and heart failure (10.0% vs .0) after discharge in seamless nursing group , P<0.05 all .Conclusion:Seamless nursing can provide continuous and scientific nursing service for patients with coronary heart disease ,which contributes to angina pectoris control and improving prognosis .

Problem-based learning (PBL)was used in resident standardized training in depart-ment of pediatrics of Changhai Hospital. Attending doctors with authority were taken as leaders teach-ing group and 3-5 resident doctors as team members. Cases were set up according to the targets of resident standardization training and common clinical diseases in each system. According to the results of the questionnaire after the teaching , both teachers and students were satisfied with the teaching effect and expected targets were reached. Residents made great progress in handling clinical problems.

Objective To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Myco-plasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and in-creased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI:2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI:2.42-56.08) and CRP (OR=14.87, 95%CI:2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.

Objective To observe the ability of cultured dermal papilla cells(DPCs) to induce hair follicle regeneration and to sustain hair growth in vivo and in vitro. Methods The expression of basic fibroblast growth factor (bFGF), endothelin-1 (ET-1) and stem cell factor (SCF) in different passages of DPCs, and their possible effects on biologic behaviour of DPCs were measured by in situ hybridization and immunohistochemistry. Hair follicle regeneration induced by DPCs in hair follicle organotypic culture model and the model implantated into nude mice were studied. Results The expression of ET-1 and SCF in the early passages of cultured DPCs was strong, but became weak and even negative after 6 passages. Hair follicle-like structures were formed in the hair follicle organotypic cultures, composed of DPCs and hair follicle epithelium cells. When the hair follicle organotypic cultures were implanted into the subcutis of nude mice, relatively intact hair follicles were formed. Injection of the early passage DPCs mixed with hair follicle epithelial cells into the subcutis of nude mice resulted in the formation of hair follicle-like structures, while the structures were not formed after the injection of the mixture of hair follicle epithelial cells with dermal sheath fibroblasts or with scalp fibroblasts. There was a positive correlation between the expression levels of ET-1 and SCF in DPCs and the ability of DPCs to induce hair follicle regeneration . Conclusions Cultured DPCs can induce hair follicle regeneration and sustain hair growth in vivo and in vitro. Moreover, the expression levels of ET-1 and SCF are positively correlated with the ability of DPCs to induce hair follicle regeneration.

Objective To analyze the etiology and treatment of autoimmune hemolytic anemia. Methods The clinical data of 29 children with autoimmune hemolytic anemia during January 2013 to December 2015 were retrospectively analyzed. Results In 29 children, 10 cases were idiopathic 19 cases were secondary and 11 cases occurred after infections. The main clinical manifestations were pallor, jaundice, dark urine, and hepatosplenomegaly. 21 cases were Coombs test positive. In 29 children, 22 cases had a good response to adrenocortical hormone therapy while in 7 cases which had not response to adrenocortical hormone, good efficacy was achived after combined with the gamma globulin treatment. Conclusions The first line drug for autoimmune hemolytic anemia treatment is adrenocortical hormone. The gamma globulin can improve the efficacy.

Objective:To explore the molecular mechanism of paraquat (PQ)-induced lung injuries.Methods:Male C57BL/6 mice aged 6 to 8 weeks were randomly divided into four groups. Mice in the experimental groups (three groups, nine rats in each group) were intraperitoneally injected with 40 mg/kg PQ to establish an infection model, and mice in the control group ( n=9) were intraperitoneally injected with the same dose of saline. Mice were sacrificed at day 2, 7 and 14 after PQ administration. Pathological changes of lung tissues from mice model were observed by Hematoxylin-eosin staining. The expression of different proteins in the lung tissues at different time points were detected and identified by tandem mass spectrometry tag technology (TMT), and the functional analysis was performed. Results:Compared with the control group, there were 91 (69 up and 22 down), 160 (103 up and 57 down) and 78 (45 up and 33 down) proteins in the PQ-2 d, 7 d, and 14 d groups, respectively, and there was significant difference of protein expression . The subcellular localization analysis showed that compared with the control group, the differentially-expressed proteins in the PQ-2 d and -7 d groups were mainly distributed in the extracellular space, while in the PQ-14 d group were mainly distributed in the nuclear. GO analysis showed that compared with the control group, the differentially-expressed proteins in the PQ-2 d and PQ-7 d groups were mainly involved in humoral immunity and coagulation-related reactions, while in the PQ-14 d group were mainly involved in chemotactic and regulatory responses such as neutrophil aggregation. The KEGG signaling pathway analysis showed that the complement and coagulation cascades was the most important pathway in the PQ-2d and PQ-7 d groups, while metabolism of xenobiotics by cytochrome P450 was the most important pathway in the PQ-14 d group.Conclusions:It is the first time that TMT was used to analyze PQ-induced lung injuries in mice model at different time points. This study demonstrates the molecular mechanism of PQ-induced lung injuries at protein levels, and elucidates that humoral immunity and complement-coagulation pathways charge the main role of PQ-induced lung injuries. This study may provide an important theoretical basis for further research and clinical treatment.

Objective To explore the clinical characteristics and gene analysis of hexokinase deficiency (HKD). Methods Clinical symptoms, hemolysis, laboratory findings and gene analysis of a boy with HKD in our department were retrospectively analyzed, and the literatures of HKD were reviewed. Results The patient was a six months old boy presented with neonatal hyperbilirubinemia, nonspherocytic hemolyticanemia, and increased proportion of reticulocytes. Genetic testing found two compound heterozygous mutations in HK1: c.995+5G > A (intron 12) inherited from father and c.2216G C (exon 20) inherited from the mother. In the literature, clinical features of the HKD patients were mainly anemic, neonatal jaundice and hepatosplenomegaly, and the gene detection mainly includes point mutation in HK1 gene exon and intron nucleotide. Conclusions In the case with neonatal anemia, jaundice, increased indirect bilirubin, HKD should be considered. Gene analysis can be used for early diagnosis.

Background/Aims: Metabolic risk factors could accelerate hepatitis B virus (HBV)-related mortality; however, their impacts on disease severity in HBV-related acute on chronic liver failure (HBV-ACLF) patients remain unexplored. In this study, we assessed the effects of metabolic risk factors on the outcome of HBV-ACLF patients. Methods: This study retrospectively enrolled antiviral therapy naïve HBV-ACLF patients from a single center in China. Patients were evaluated according to Child-Turcotte-Pugh score, Model for End-Stage Liver Disease (MELD) score, 30-day, 90-day mortality and survival rate to estimate the prognosis of HBV-ACLF. The impacts of different metabolic risk factors were further analyzed. Results: A total of 233 patients, including 158 (67.8%) with metabolic risk factors and 75 (32.2%) without metabolic risk factors, were finally analyzed. Patients with metabolic risk factors had significantly higher MELD score (22.6±6.1 vs 19.8±3.8, p<0.001), 90-day mortality rate (56.3% vs 38.7%, p=0.017), and shorter median survival time (58 days vs 75 days: hazard ratio, 1.553; 95% confidence interval, 1.061 to 2.274; p=0.036) than patients without them. Moreover, metabolic risk factors were independently associated with patients’ 90-day mortality (hazard ratio, 1.621; 95% confidence interval, 1.016 to 2.585; p=0.043). Prediabetes/diabetes and hypertension were related to higher rates of infection and worse renal function in HBV-ACLF patients. Conclusions HBV-ACLF patients with metabolic risk factors, especially prediabetes/diabetes or hypertension, could have more severe disease and lower survival rates. In addition, the existence of metabolic disorder is an independent risk factor for HBV-ACLF patients’ 90-day mortality.

Objective To investigate the current status of nursing work environment and nurses′perceived stress, and to explore the influences of work environment on perceived stress in nursing staff. Methods The study used questionnaire survey to investigate 302 nurses of a second-class hospital in Shanghai from February to April in 2014. The scores of nursing work environment and perceived stress would be collected and the results would be evaluated and correlation analyzed. Results The average score of nursing work environment was (218. 92 ± 33. 54). The scores of workload and acceptance were lowest, and the scores of system maintain and transform were highest. The average score of the perceived stress scale was ( 26. 58 ± 6. 10);however, 103 (34. 1%) nurses were still in unhealthy status. Furthermore, the work environment had negative correlation to the perceived stress (r= -0. 422). Multivariate analysis demonstrated that workload and system maintain and transform were impact factors of perceived stress. Conclusions Nursing work environment is closely related to nurses′ perceived stress. Thus, the perceived stress can be relieved by reducing nurses′workload and improving system maintain and transform in order to develop their health and the quality of nursing.

Objective To explore and get insight into the demands and perplex of development in nurses, and provide evidence of nurse′s training and occupational planning for hospital administrators. Methods This study utilized live recording and noting to deeply interview 17 clinical nurses in a hospital of Shanghai, and analyzed the sound recordings by Colaizzi way. Results Clinical nurses had different orientation on their future career, and the inside and outside influencing factors included external recognition degree and opinion of family;they were eager to getting supports and opportunities, and looking forward to effective training mode and rich information resources. Conclusions Hospital administrators should pay more attention to the thoughts and needs of nurses about the career development, help them build occupational confidence, create more study opportunities, offer high-quality training courses, so as to improve the career development of clinical nurses.