In the implementation of community health service,the working efficiency of the community nurses becomes increasingly important to the overall service standards of the service centers as the local residents have begun to take it into consideration when evaluating the service quality.By illustrating the roles of nurses in all the six major functions played by the community health service,this paper intends to arouse the attention from the concerning authorities to the training of the nurses so that the nurses can be developed in an all-round way and provide better services for the community.

Objective To determine the effect of resurfacing completely degloved thumbs by free perforator flaps in a spiral fashion.Methods A retrospective case series study was made on 22 patients with completely degloving injury of the thumb treated by different free perforator flaps in a spiral fashion from June 2009 to December 2014,including 19 male and 3 female patients at the age of 18-46 years (mean,27.8 years).A total of 13 patients were reconstructed using the medial arm perforator flaps ranging in size from 8.0 cm × 3.0 cm-14.5 cm × 3.5 cm,and 9 patients were reconstructed using the peroneal artery perforator flaps ranging in size from 6.0 cm × 3.5 cm-21.0 cm × 10.0 cm.Follow-up was made to evaluate the sensation,appearance and function of the thumbs and the recovery of flap donor sites.Results All flaps survived completely,with no occurrence of postoperative vascular crisis and infection.Only one medial arm flap and one soleus perforator flap distal flap showed blood flow disorder in the distal sections and were healed uneventfully after conservative therapy.Function and cosmetic recovery of the reconstructed thumbs were good.Follow-up ranged from 9 to 22 months (mean,14.5 months).Twopoint discrimination test of the flaps was recovered to 6-13 mm.No linear scar contracture was left.Flap donor site wound healed primarily.All patients were satisfied with the overall results.Conclusion The free perforator flap in a spiral fashion can avoid linear scar contracture,maximally decrease donor site morbidity and achieve satisfactory functional recovery and good aesthetic restoration,indicating a good candidate for reconstruction of thumb degloving injury.

Objective To explore the pathogenesis of invasive pituitary adenomas,and to improve the effect of clinical treatment.Methods 15 pairs of invasive pituitary adenoma tissues and noninvasive pituitary adenoma tissues were selected from 114 specimens collected and the Id1 gene expression and Id1 protein expression in invasive pituitary adenoma tissues and noninvasive pituitary adenoma tissues were tested by quantitative RT-PCR,Western blot and immunohistochemical methods;Then small interfering RNA (siRNA) was used to interfer Id1 gene expression in NQ-04 cells.Results The Id1 gene expression in invasive pituitary adenoma tissues was significantly higher than that in noninvasive pituitary adenoma tissues(n =15,t =2.725,P =0.013) ;The migration of pituitary adenoma cells interfered was significantly reduced.Conclusion The invasive pituitary adenoma tissues has high level of Id1 gene expression,which may be correlated with its invasion.And Id1 is expected to become a biological marker of diagnosis and determination in the prognosis of pituitary adenoma.

OBJECTIVE:To establish a RP-HPLC method for simultaneous determination of caffine,acetaminophen and isopropylphenazone in human plasma after oral dose of saridon.METHODS:Hypersil Hypurity TM Advance was used as chromatographic column and the mobile phase was a mixture of0.01mol/L phosphoric acid-methanol-tetrahydrofuran(86∶12∶2).The detection wavelength was273nm.RESULTS:The calibration curves were linear in the ranges of0.39～100.0?g/ml for caffine,1.96～500.0?g/ml for acetaminophen,and1.17～300.0?g/ml for isopropylphenazone,respectively.The accuracy of all was higher than95.0%.The inter-day and intra-day RSD was less than10.0%.CONCLUSION:The present method is sensitive,accurate,convenient,and highly specific,which can meet the requirement in plasma determination of three components in Saridon tablet.

Objective Medication for pituitary adenomas is mainly targeted on the prolactin-secreting and growth-hormone types and shows poor therapeutic effects on other adenomas .Therefore, new drugs urgently need to be developed for this purpose .This study was to investigate the effects of glivec and everolimus on mouse pituitary AtT-20 cells and their molecular mechanisms in vitro. Methods Mouse pituitary AtT-20 cells were incubated with glivec or everolimus or combination of both and their inhibitory effect on the proliferation of the cells was measured by CCK-8 assay.The mRNA levels of AKT and ERK were determined by q-PCR and the ex-pressions of the phosphorylated AKT (p-AKT) and ERK (p-ERK) were detected by Western blot. Results Used alone, both glivec and everolimus inhibited the proliferation of the AtT-20 cells in a time-and dose-dependent manner , but their combination produced a mutually antagonistic effect, with combination index values of 1.13 ±0.06, 1.12 ±0.03, and 1.07 ±0.03 respectively.The two a-gents , either used alone or in combination , induced no significantly inhibitory effects on the mRNA and protein expressions of AKT and ERK ( P >0.05 ).Both glivec and everolimus up-regulated the expressions of p-AKT and p-ERK, and their combination manifested an even stronger effect (P>0.05). Conclusion Both glivec and everolimus inhibit the proliferation of AtT-20 cells when administered alone, but their combination produces an antagonistic effect .Their action mechanism might be that when targeting some signaling path-ways to inhibit cell proliferation , glivec, as well as everolimus , in-duces a feedback activation of AKT and ERK .

Objective To provide evidence for clinical practice by analyzing the factors associated with bloodstream infection in ICU patients through retrospective case-control study. Methods Using self-made data collection form, 133 cases of blood sample record from HIS system during May 2013 to December 2015 at Peking Union Medical College Hospital ICU ward were collected. In this study, 54 patients with positive blood culture results were allocated to the case group while 79 patients with negative results were in the control group. Baseline characteristics, which included sex, age and chronic diseases, were almost the same between both groups. Binary Logistic regression analysis was used to identify factors related to blood infection. Results During May 2013 to December 2015, there were 54 blood infectious cases, among which 19 cases with positive gram bacteria accounted for 35.2%(19/54), 57.4%(31/54) of gram-negative bacilli and 7.4%(4/54) of fungal infection. Logistic regression analysis revealed that blood filtration treatment (OR=7.691), pulmonary infection (OR=7.682), ICU (OR=1.115), Acute Physiology and Chronic Health Evaluation (APACHEⅡ) scores(OR=1.096), procalcitonin (OR=1.065) were risk factors of bloodstream infection for ICU patients, while albumin (OR=0.763) was a protective factor. Conclusions Blood filtration treatment, pulmonary infection, hospital length of stay, APACHEⅡand procalcitonin are factors associated with bloodstream infection in ICU patients. Clinical procedures in ICU should mainly focus on improvement of prevention awareness, strict aseptic technology, professional quality of nursing staff. Besides, guarantee of patients′nutrition, effective treatment of primary diseases, and shortened hospital length of stay are also important to reduce the infection and improve quality of life of these patients.

OBJECTIVE:To establish the HPLC fingerprint chromatogram of Danzhen headache capsules. METHODS:HPLC method was adopted. The column was Dikma Diamonsil C18 with the mobile phase of methanol-acetonitrile-water(gradient elution) at the flow rate of 1.0 ml/min;the temperature was 40 ℃,the detection wavelength was 340 nm,the sample size was 20 μl and the detection time was 65 min. RESULTS:RSDs of precision,stability and reproducibility tests were no more than 0.23%;13 com-mon peaks were identified in 10 batches of Danzhen headache capsules and the similarity of all samples were higher than 0.90. CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for the process stability evaluation and quali-ty control of Danzhen headache capsules.

Objective To study the effects of complex polysaccharides immune milk (CPIM) on cellular and humoral immune functions in mice. Method Sixty ICR mice were divided into five experimental groups and a control group. The mice in experimental groups were given i.p. Ganoderma lucidum polysaccharide (GLP) immune milk,Lycium barbarum polysaccharides (LBP) immune milk and different doses (low,medium and high) CPIM,and the control group was given equivalently skimmed and sterilized goat's milk respectively for 15 d. The cellular and humoral immune functions and the feces were examined. Results Transformation ability of spleen lymphocytes:There were highly marked differences between all experimental groups and control group,between medium dose group of CPIM and GLB group,LBP group (P

BACKGROUND:Matrix attachment region(MAR)are DNA elements that bound to the nuclear matrices after chromatin digested with restriction endonuclease.Plenty of studies have shown that MAR considered as initiaI point of DNA replication or transcription of regulatory gene.Thereby,construction of MAR expression vector can elevate the overall level of transgene expression,enhance stability of exogenous gene.as welI as increase frequency of stable transfectant cells.OBJECTIVE:To construction pLXSN-CAT recombinant retrovirus vector that containing chloramphenicol acetyltransferase(CAT)via cloning MAR sequence of human.and to explore the influence of MAR on the gene expression.METHODS:An open experiment was performed at the Department of Biochemistry and Molecular Biology.Xinxiang Medical College from September 2007 to December 2007 The PLXSN-CAT vector of CAT was constructed by the laboratory.TaqDNA polymerase,T_4 DNA ligase,DNA Marker,restriction enzyme BamH I,agarose gel DNA purification kit,as well as plasmid purification kit were purchased fromTakara Biotechn0Iogy(Dalian)Co.,Ltd.The sequence of csp-B MAR was amplified by polymerase chain reaction(PCR)method applied to human DNA.The fragment was inserted into retrovirus vector PLXSN-CAT plasmid.The recombinant plasmid was verified by double digestion and DNA sequencing.RESULTS AND CONCLUSION:The length of specific fragment applied by PCR was 931 bp,and the recombinant plasmid PLXSN-CAT-MAR presented two bands:5.9 kb and 931 bp using respective restriction enzymes BamH I The sequence of MAR was confirmed by blasting to Genbank(serial numobr:M6271 6).It suggested that MAR had been cloned into PLXSN-CATR vector correctly.The recombinant retrovirus vector PLXSN-MAR was successfully constructed.

BACKGROUND: Scoparone,which is a major principle separated from traditional Chinese herbs artemisia scoparia, which possesses actions of immunosuppression, anti-inflammation and relaxing bronchial smooth muscle. It' s not known whether scoparone possesses the regulation of the imbalance of interferon-gamma(IFN-γ) and interleukin-4(IL-4) in asthmatic guinea pig.OBJECTIVE: To investigate the inhibition and immunoregulation of scoparone on asthmatic guinea pig.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Department of ethnopharmaeology in a university.MATERIALS: The experiment was completed in the Department of Ethnopharmacology,China Medical University between July 2000 and March 2002. Totally 84 male guinea pigs were selected at sanitation grade,weighting about(200 ± 50) g.INTERVENTIONS: The ameliorative effects of scoparone on the imbalance of IFN-γ and IL-4 in asthmatic guinea pigs were investigated by using the acute and delayed asthmatic guinea pigs which were respectively challenged by the aerosol mixture of 10 g/L histamine and 1 g/L acetylcholine,and 10 mL/L ovalbumin.MAIN OUTCOME MEASURES: The asthmatic latent periods in acute and delayed asthma, and the levels of IgE, IL-4 and IFN-γ in serum and pulmonary tissue homogenate in the asthmatic animals.RESULTS: Scoparone significantly prolonged the asthmatic latent periods in acute and delayed asthma,observably reduced the levels of IgE and IL-4 and raised the content of IFN-γin serum and pulmonary tissue homogenate in the asthmatic animals (P<0. 05).CONCLUTION: The anti-asthmatic effects of scoparone result from the ameliorative effects on the imbalance of IFN-γ/IL-4 ratio thereby to inhibit the abnormal synthesis of IgE.