Objectives To explore the effect of evidence-based nursing on the recovery of severe trauma patients complicated with stress ulcer in department of orthopedics.Method Seven severe trauma patients with stress ulcer hospitalized in the department of orthopedics were treated with evidence-based nursing intervention and the effects were observed.Results The effect of nursing intervention of stress ulcers in 7 patients were obvious and moderate in 5 and 2 cases,respectively.All of them were discharged after being cured.Conclusion The evidence-based nursing can effectively improve the quality of nursing staff,effectively improve the cure rate by way of early intervention and treatment.

According to the Rules for the Implementation of the Standards for Review of Level 3 General Hospital (2011) of Formor Ministry of Health,the paper analyzes the requirements of review of level 3 general hospital for decision support,and takes the Sixth Affiliated Hospital of Sun Yat-sen University as an example to introduce the decision support solution and the application of Decision Support System (DSS).

Objective To investigate the NAD+ - dependent protein deacetylase SIRT1 expression in the cochlea of C57BL/6 mice ,a mouse model of age - related hearing loss(AHL) .Methods A total of 46 C57BL/6 mice were used ,and were divided into 2 groups ;according the age ,there were young group (1 ~ 2 months old ,23 mice) and old group (12 ~ 16 months old ,23 mice) .ABR measurements were performed on young and old C57BL/6 mice . The expression of SIRT1 in the cochlea was detected by qRT - PCR and immunofluorescence .Results The ABR thresholds in the old mice(4 kHz :82 .7 ± 7 .32 dB SPL ,8 kHz :80 .9 ± 7 .8 dB SPL ,16 kHz :89 .3 ± 5 .5 dB SPL ,32 kHz :89 .9 ± 4 dB SPL) were significantly higher than those in the young C57BL/6 mice(4 kHz :52 .1 ± 8 .3 dB SPL ,8 kHz :40 .5 ± 6 .1 dB SPL ,16 kHz :50 .7 ± 9 .4 dB SPL ,32 kHz :57 .6 ± 11 .9 dB SPL)(P < 0 .001) .SIRT1 mRNA expression was significantly decreased in the cochlea of old C57BL/6 mice in comparison with young mice ( P <0 .01) .SIRT1 protein was abundantly expressed in the inner hair cells ,outer hair cells ,supporting cells ,strial marginal cells ,strial intermediated cells ,and spiral ganglion neurons .The positive area and the average flourescence intensity of SIRT1 protein were reduced in old C57BL/6 mice(P< 0 .001) .Conclusion The down - regulation of SIRT1 mRNA and protein expression in the older C57BL/6 mouse cochlea may be correlated with the pathogenesis of AHL .

Medical service system integration follows the logic of system innovation and development.Case studies of the UK,the USA and Australia found that medical delivery system integration is the product of a series of mixed factors.Health care financing and payment mechanism reform,physician team building,stair-cased movement to grassroots of healthcare service,shared clinical norms utilization as well as its gradual development constitute the general logic of such an integration.In the evolution process,the check and balance between the government and market,equity and efficiency have been affecting the integration process all the way.In light of these logics,China should speed up its transform of the integration concept,improve the integration elements,and strengthen the guidance of integration principles during its integration of the medical service integration.

Migraine is a kind of nerve vascular disease, characterized by hemialgia, moderate and severe, pulsating pain. Acupuncture as a safe and effective analgesic therapy, has been widely used in more than 160 countries and regions around the globe. Treating migraine with acupuncture has certain good features as effective, non-toxic side effects and untoward effect.But its mechanism is still not very clear.The cerebral blood flow study ( CBF study) is currently the most credibility of migraine pathogenesis theory.Now based on the theory of CBF study, this paper discusses the acupuncture treatment of migraine which can provide the basis for clinical treats.

AIM: To determine the low content of Ophiopogon japonicus saponin metabolite in vivo. METHODS: HPLC-MS method of determining rat's metabolite diosgenin in vivo was established after single-dose oral Ophiopogon japonicus saponin enteric microsphere. RESULTS: The detection limit was about 50 ng/mL,Linearity,precision of intra and inter-day and reproducibility of the method were good. CONCLUSION: This method accords with the analysis requirement.It can give an effective measure and foundation for studying TCM saponin bioavailability.

Objective:To investigate the expression and the significance of inflammatory cytokine IL-6 through regulating Gli1 in acute pancreatitis.Methods: In this study,C57 mice were randomly divided into three groups:control group,model group,inhibitor group.caerulein intraperitoneal injection induce acute pancreatitis model.Use HE staining and amylase to testify the model successfully.Use RT-qPCR,Western blot to detect the expression of Gli1 in the pancreas,liver,lung,kidney and intestine and ELISA method to detect inflammatory cytokines IL-6.Results: Compared with control group,the expression of Gli1 is higher in model group,then the expression of IL-6 increases in inhibitor group which uses Gant61 to suppress Gli1 compared with model group.Conclusion: Gli1 may involved in the process of the distant tissue injury and repair in acute pancreatitis and through regulate its downstream cytokines like IL-6 to play a protective role in acute pancreatitis.

Loss of E-cadherin, a 120 kDA transmembrane glycoprotein responsible for cell-cell adhesion, is one of the hallmarks of epithelial-mesenchymal-transition (EMT). E-cadherin expression was immunohistochemically studied in 94 histopathologically re-confirmed colorectal carcinomas (CRC) using a monoclonal antibody to E-cadherin (Dako: Clone NCH-38) on a Ventana Benchmark XT automated system. Each case was assessed for E-cadherin immunopositivity at two separate locations viz the tumour centre (TC) as well as the infiltrating front (IF). Expression was semiquantitated for proportion of immunopositive malignant cells as 0 (negative), 1 (1-25% staining), 2 (26-50% staining), 3 (51-75% staining) and 4 (>75% staining) and staining intensity: 0 (negative), 1 (weak), 2 (moderate) and 3 (strong). The final histoscore of E-cadherin immunopositivity was arbitrarily computed as proportion of immunopositivity multiplied by staining intensity of the malignant cells. E-cadherin histoscores were significantly lower at the IF (4.5 ± 2.5) compared with TC (10.7 ± 2.4). Furthermore, the histoscores were significantly reduced at the IF of 49 TNM III+IV tumours (3.6 ± 2.5) compared with 45 II+III CRC (5.4 ± 2.2). Reduction of E-cadherin expression was also noted in the 23 high grade (TC=8.6 ± 3.2; IF=2.6 ± 2.3) compared with 71 low grade tumours (TC = 11.4 ± 1.5; IF = 5.1 ± 2.3). E-cadherin is downregulated at the infiltrating front of CRC, possibly marking for EMT at this location. The downregulation is further enhanced amongst late stage and high grade tumours compared with earlier stage and low grade tumours; findings which are similar to that noted in CRC of other populations.

OBJECTIVE To explore an effective cleaning method to improve the quality of sterilization,in order to control infections in the hospitals. METHODS To adopt orthogonal experimental forms of L_9(3~4) and take water temperature,cleaning agent type and cleaning method as experimental factors,in this way to investigate decontamination method for surgical instruments,using TOSI indicator cards and Browne STF load device to test the effectiveness of cleaning results. RESULTS It showed that by KQ-4200SY medical digital full-automatic ultrasonic cleaner with washing water at 33-35℃ an optimal cleaning result would be obtained. CONCLUSIONS It is practical to clean surgical instruments by KQ-4200SY medical digital full-automatic ultrasonic cleaner,and by TOSI indicator cards and Browne STF used as test method.

Objective To analyze mRNA expressions of 7 cytoklnes which influence the immune response in lym- phocytes in pleural effusion of non-small cell lung cancer patients to evaluate the effect of local tumor microenviron- ment on anti-tumor immune response and to explore the mechanism of tumor escape. Methods Detecting the mRNA expression of IL-2,INF-γ,IL-12,IL-18,IL-10,IL-4 and TGF-β 1 in lymphocytes in pleural effusion of non-small cell lung cancer patients and tuberculotic pleurisy patients on the single cell level by using in situ hybridization. Results In the pleural effusion of non-small cell lung cancer, the mRNA expressions of IL-10,TGF-β1 and IL-4 were signifi- cantly higher than those of IL-2,IL-12,IL-18 and INF-γ,as well as these of control group. The cytokine expression levels of tuberculotic pleurisy patients were very Iow, and there were no significant differences between different cy- tokines. Conclusion Type 2 cytokines are expressed predominantly in the pleural effusion of non-small cell lung can- cer. The increased co-expression of IL-10 and TGF-β1 indicates that they might act Jointly and play a critical role in the immunosuppression of non-small cell lung cancer.