Objective To study the effect of pre-hospital and in-hospital integrated rescuing pathway on group injury treatment in high-altitude areas.Methods According to pre-hospital and in-hospital integrated rescuing pathway,24 cases of group wounded were treated with field evaluation,triage category,emergency care measures,specialist nursing,monitoring during transfer,in-hospital first aid,processing during and after operation,and effect of clinical treatment.Results There were 7 cases of combined injury,12 cases of debridement surgery and 5 cases of damage control surgery in this group,with the successful rate of 100％.Conclusions rofessional pre-hospital and in-hospital integrated rescuing pathway in high-altitude areas can provide ordered rescuing for group wounded and shorten the time without treatment,which is an important measure to ensure fast and efficient treatment and to improve the quality of nursing.

Objective To isolate Japanese Encephalitis virus (JEV) from mosquitoes collected in Liaoning province and analysis the genotype of new isolated JEV strains and the characters of nucleotide and amino acid in the E gene. Methods Collected mosquitoes in Dandong Liaoning province in August, 2006. Virus isolation was using issue culture cells. Isolated viruses were identified by using serological and molecular methods. Results Two new JEV strains, LNDG07-02, LNDG07-16, were isolated from 1500 mosquitoes were belonging to genotype 1. The identity of nucleotide and amino acid of E gene between new JEV strains and live attenuated vaccine strain SA14-14-2 were 87.8%-88.0% and 97.2% , respectively. Total 11 amino acid sites were differences in E gene between new isolates and SA14-14-2. However, there were no differentiation between the new JEV strains and the isolates in Donggang 2002. Conclusion Genotype 1 JEV was isolated again from Donggang, since the first isolation of this genotype in 2002. Genotype 1 JEV continues in existence in Donggang Liaoning province.

Objective To construct a scientific,reasonable,effective index system for performance appraisal in the whole army urology care demonstration base.Methods The weight,reliability,construct validity and discriminant validity of each index were quantitatively analyzed and tested by literature data,theoretical analysis,a qualitative research method and Delphi (Delphi) expert consultation method,and the index system for performance appraisal was established in the whole army urology care demonstration base.Results The index system for performance appraisal was identified including level Ⅰ indicators 4 and level Ⅱ indicators 20 item pool in the whole army urology care demonstration base,Lanzhou General Hospital of Lanzhou Military Region.The quality of care,the operational capacity of nurses,nurses job satisfaction and patient satisfaction after the implementation of the performance appraisal were significantly higher than those before the implementation (P ＜ 0.05).Conclusions The index system for performance appraisal has good construct validity,internal continuity measurement reliability and discriminant validity.The research results is high reliability,and provides a basis for carrying out the effective performance management and controlling quality of care in the whole army urology care demonstration base.

AIM To identify the in vivo metabolites of Cynanchum auriculatum Royle ex Wight extract in functional dyspepsia rats by UHPLC Q-Exactive Plus Orbitrap HRMS.METHODS The rat models for functional dyspepsia were established.The analysis was performed on a 40℃ thermostatic Hypersil GOLD C18 column(2.1 mm×100 mm,1.9 μm),with the mobile phase comprising of water(containing 0.1％formic acid)-acetonitrile(containing 0.1％formic acid)flowing at 0.3 mL/min in a gradient elution manner,and electrospray ionization source was adopted in positive and negative ion scanning.RESULTS Total 4 prototypes(baishouwubenzophenone,deacylmetaplexigenin,qingyangshengenin,syringic)and 110 metabolites were identified,12 of which were common metabolites in feces and urine,56 of which were unique metabolites in urine,42 of which were unique metabolites in feces.The metabolic pathway of prototypes contained phase Ⅰ metabolism(reduction,oxidization,etc.),phase Ⅱ metabolism(sulfonation,glucuronidation,etc.)and phase Ⅰ,Ⅱ composite reactions.CONCLUSION This effective and comprehensive method can lay the theoretical foundation for further discovery of potential active metabolites in C.auriculatum.

OBJECTIVETo evaluate the middle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty(PKP) for vertebral fragility fracture in the elderly.

METHODSThe clinical data in elderly patients with vertebral fragility fracture treated by unilateral and bilateral PKP between January 2008 and January 2010 was retrospective analyzed. According to a unified criteria to divided into two groups for 104 patients(44 males and 60 females), of them, 50 cases were divided in unilateral group using unilateral pedicle surgical approach for PKP and 54 cases were in bilateral group using bilateral pedicle approach. VAS score, Cobb angle, and the height of anterior and posterior vertebral body were respectively analyzed peroperatively and at 3 d, 3 months, 1 year, 3 years postoperatively and final follow-up. Clinical effects and safety were assessed in two groups.

RESULTSAll the operations were successful. Operative time and bone cement injection volume in unilateral group were less than those of bilateral group(<0.05). Postoperative VAS scores, Cobb angle, and the height of anterior and posterior vertebral body were obviously improved in two groups(<0.05), and there was no significant difference between two groups(>0.05). Bone cement leakage occurred in 12 cases(11.5%), recurrent fracture of vertebral body occurred in 5 cases(4.8%), cerebrospinal leak occurred in 2 cases(1.9%), and nerve root irritation occurred in 3 cases(2.9%). The above complications were transient and released after symptomatic treament.

CONCLUSIONSMiddle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty for vertebral fragility fracture are safe and satisfactory, and may be extended as a minimally invasive method. Unilateral approach for PKP has advantages of short operation time, relative less trauma, thus is a more ideal method.

The present study cloned wpGuamerin gene from a non-bloodsucking leech (Whitmania pigra), and the bioinformatics analysis of the sequence was performed. Additionally, the effects of feeding duration on the expression profile of the wp Guamerin gene were explored. The results showed that its sequence consisted of 295 nucleotides encoding a peptide of 83 amino acids(Genbank: KX768545), and its relative molecular weight is 9 145.95 Da. wp Guamerin does not encode proteins with a signal peptide, belonging to the hydrophilic protein. Its secondary structure is mainly composed of α-helix, extending chain, folding and random curl. Its similarity with other blood-sucking leeches ranges from 29% to 65%. The results revealed that wpGuamerin mRNA was detected higher expression in muscle than in salivary glands of Wh. pigra, and did not expressed in ingluvies and intestine. Its expression in muscle and salivary glands showed a single peak curve after feeding and the peak was observed in the 1st and 3rd after feeding, respectively. In summary, wp Guamerin in Wh. pigra is a small molecule polypeptide protein and is different from the Guamerin in blood-sucking leeches. wpGuamerin does not express in the digestive tract of Wh. pigra, and mainly express in muscle. Feeding behavior would stimulate the expression of wpGuamerin gene in muscle and salivary glands, but not in digestive tract.