Objective To explore the methods of training emergency nurses under the Trinitarian Mode.Methods 77 emergency nurses were distributed to different groups and received different training contents and assessment criteria stratifiedly as well as in phases according to their working ages.The training content contained emergency capability,emergency specialist skills,evidence based nursing,nursing scientific research,and clinical practice,etc.Results Through the on-the-job training,their emergency caring ability were overall improved,the human resource was effectively utilized,and the overall ability for coping with public health emergencies had made great progress.Conclusions Under the Trinitarian emergency treatment mode,a diversified on-the-job training for the emergency nurses will promote the development of emergency care,as well as help keep pace with the rapid development of emergency medical sciences.

BACKGROUND:Modern imaging technology, computer-aided design and processing, rapid prototyping technology and other digital technology have enabled a new era of orthopedic field. Digitalization, individualization, minimal invasion, precision and intel igence are the potential topics in future orthopedics. ＜br> OBJECTIVE:To investigate clinical efficacy of computer-aided design of digital plate in the treatment of hip dislocations associated with posterior wal acetabular fracture. ＜br> METHODS:Sixteen patients of posterior wal acetabular fractures associated with hip dislocations were repaired with customized digital plate fixation. According to Thompson-Epstein fracture type:there were 7 cases with typeⅡ, 5 cases with type Ⅲ, 2 cases with type Ⅳ, and 2 cases with type Ⅴ. Radiographic examination showed the presence of 2-5 mm displacement on the acetabular articular surface, average 3 mm. The time from the injury to hospitalization was 6 hours to 2 weeks, average 1.5 days. After admission, patients underwent femoral condyle bone traction, 12 cases achieved a reduction and three cases of femoral head entrapment were reset during surgery. At 4-10 days after admission, al patients received computer-aided design of digital plate fixation for acetabular fractures. ＜br> RESULTS AND CONCLUSION:Postoperative fracture quality was assessed according to Matta standards, 15 cases had anatomical reduction (displacement＜1 mm) and 1 case had poor reduction (displacement 2-3 mm). The findings indicate that, computer-aided design of digital customized plate has achieved individualized and precise outcomes, as wel as firm fixation in the treatment of hip dislocations associated with posterior wal acetabular fracture. It avoids intraoperative repeated shaping, effectively restores the integrity of posterior wal , al ows early functional exercise, and provides alternative internal fixation for hip dislocations associated with posterior wal acetabular fracture.

Objective To explore the effects of community-based comprehensive intervention on social function and quality of life of patients with bipolar disorder. Methods 244 bipolar disorder patients were assigned into control group (n=119) and intervention group (n=125). The control group accepted antipsychotics only, and the intervention group accepted community-based comprehensive intervention in addition. They were assessed with Social Disability Screening Schedule (SDSS) and Generic Quality of Life Inventory-74 (GQOLI-74) before and 6, 12 months after treatment. Results The SDSS score was lower (P<0.05) and the GQOLI-74 score was higher (P<0.05) in the intervention group than in the control group. Conclusion Community-based comprehensive intervention can improve the social function and quality of life of patients with bipolar disorder.

Dendrimers are new macromolecules synthesized in recent years, which are of great interests in many fields where they have potential important applications because of their hyperbranched, well defined and monodisperse structures. In this paper, the unique structures, general synthesis routes and basic physical and chemical properties of dendrimers are introduced in brief, and the progress in the research of dendrimers in drug (gene) delivery, contrast agents, cancer therapy were reviewed, as well as the perspective in research and applications.
Contrast Media ; chemistry ; Dendrimers ; chemistry ; pharmacology ; Drug Carriers ; chemistry ; Drug Delivery Systems ; Gene Transfer Techniques ; Humans ; Polyamines

Objective To evaluate the value of high-frequency ultrasound in diagnosing the early reduced function of mice and to make sure the impact of aldosterone in cardiac remodeling after myocardial infarction.Methods Twenty aldosterone silence mice were selected as the experimental group and 20 healthy wild-type mice as the control.Animal models of acute myocardial infarction (AMI) were established by the method of the left anterior descending artery ligation.Cardiac function was measured by highfrequency echocardiography before and 2 weeks,4 weeks,6 weeks after AMI.Produce biopsy and Masson staining in both the experimental and the control groups were made post 6 weeks after AMI.Results ①Left ventricular long axis view and various short-axis views of mice could be clearly displayed by high-frequency echocardiography,and accurate measurements of the cardiac function could be obtained.② Compared with that in the control,left ventricular ejection fraction progressed more gradually in the experimental group than the control group (35.81 ± 2.88 vs 29.10 ± 4.50 at 6 weeks after AMI,P ＜0.05).Conclusions Blocked aldosterone may play a positive effect in reducing the myocardial injury.

Objective To investigate the feasibility of measuring femoral neck torsion angle and anteversion angle by laser projection method .Methods The femoral neck torsion angle and anteversion were observed and described .An angle measuring device was designed and produced .With the device , the femoral torsion angle and anteversion angle were measured by laser projection method two times .Statistical analysis was performed on the measured value , and sides difference .Results The differences between femoral neck torsion angle and anteversion angle were observed .There was no significant difference ( P >0.05, power =100%) between the two measurements by laser projection method . Measurements of the femoral anteversion were 13.58 °±6.55 °on the left side , and 12.15 °±5.83 °on the right side . Measurements of the femoral neck torsion angle were 18.50 °±7.38 °on the left and 19.08 °±8.59 °on the right .There was no significant difference between left and right side ( P >0.05 ) .Conclusion The laser projection method is the effective method in measuring femoral neck torsion angle and anteversion angle , and has excellent repeatability .

Objective To assess the potential clinical signiifcance of myocardial composite index (MCI) in the evaluation of left ventricular myocardial function in breast cancer patients with postoperative chemotherapy by speckle tracking echocardiography (STE). Methods A total of 33 consecutive breast cancer patients with postoperative chemotherapy were prospectively enrolled in Shanghai East Hospital, Tongji University, from February 2012 to February 2013. Thirty-six female healthy volunteers were enrolled as the controls. Routine echocardiographic parameters [left ventricular end diastolic volume (EDV), end systolic volume (ESV), interventricular septum thickness at diastole (IVSTd), left ventricular posterior wall thickness (PWTd) and left ventricular ejection fraction (LVEF)] were obtained. EDV and ESV were corrected for body surface area, and then end diastolic volume index (EDVI) and end-systolic volume index (ESVI) were calculated. STE-derived parameters [left ventricular global longitudinal strain (GLS), global radial strain (GRS), left ventricular twist (LVtw) and myocardial composite index (MCI)] were evaluated. All above data were obtained after 5 anthracycline-based chemotherapeutic cycles and compared with baseline measurements in controls respectively. Receiver operating characteristic (ROC) curves were constructed to determine optimal sensitivity and specificity of continuous variables for the prediction of future cardiotoxicity. Results (1)Changes in EDV, ESV, IVSTd, PWTd and LVEF showed no significant decreases compared with baseline and controls (F=1.35, 2.04, 1.28, 2.34, 2.16, P > 0.05 for all), while the changes in ESVI and EDVI showed statistically decreases (F=4.73, 6.86, P < 0.05 for all);(2)The changes in EDVI and ESVI showed signiifcant decreases compared with baseline (t=6.10, 5.13, P<0.05 for all) and controls (t=5.26, 4.24, P<0.05 respectively);(3)The change in GRS showed no statistical signiifcance compared with baseline and controls (F=1.23, P>0.05), while change in GLS, LVtw and MCI showed statistical significances compared with baseline and controls (F=4.29, 5.02, 12.35, P<0.05 for all);(4)The changes in GLS, LVtw and MCI showed signiifcant decreases compared with baseline (t=5.33, 13.94, P<0.05 respectively) and controls (t=4.97, 4.46, 7.18, P<0.05 all);(5)The area under receiver operating characteristics curve (AUC) of MCI was 0.894, and its optimal cut-off value was-265.7 (%×degree) with sensitivity of 82.6%and specificity of 78.7%. Conclusion MCI based on STE, combining myocardial strain and cardiac twist, may be an accurate predictor in identifying potential cardiotoxicity in postoperative chemotherapeutic survivors with breast cancer.

Objective To explore the curative effect of knee flexion deformity on spastic cerebral palsy treatment method.Methods All of 30 patients with spastic cerebral and knee flexion deformity were randomly divided into two groups:traditional operation group and modified operation group,using the commonly used operation (In 15 cases,with traditional hamstring post surgery) and) modified operation (In 15 cases,with modified hamstring post surgery),two groups of patients were treated with Ilizarov external fixation drafting device in the correction of knee flexion deformity after soft tissue release.Adjustment began 7 days after the soft tissue release operation of external fixation,and stretched approximately 0.2 degrees each time,3 times/d,until knee flexion deformity was corrected to hyperextension for 10 degree and maintained for 3 weeks,and the flexion contracture degree of knee joint was measured every 2 weeks;then the Ilizarov external fixation drafting device was removed.Then wear a walking straight leg brace for more than 3 months,until the knee walking function is good.Clinical evaluation included the joint pain index,walking function index,knee flexion deformity degree and range of joint motion score of Dimeglio standard.Results Flexion contracture deformity of knee joint in 30 cases (60 knees) was corrected when Ilizarov external fixator was removed,knee extension to 0 degrees-5 degrees.The two groups of patients had the knee flexion angle range of-1.2 degrees to 13.3 degrees,with an average of (7.32°±3.41°) after removed of the walking straight leg brace,in which 4 cases (8 joints) got recurrent deformity of 10°-15° at the time of removing of the walking straight leg brace.Knee activity significantly was improved at the end of treatment.60 cases of knee joint activity were close to normal,with flexion of 100 degrees to 135 degrees,extension of 0 degrees to 10 degrees.Two groups of patients were statistically significantly improved before and after surgery.Curative effect comparison:The walking function index of the modified operation group was obviously superior to that of the traditional operation group,there was significant statistical difference.There were no statistically significant differences in pain index,knee flexion,and range of joint motion.Conclusion For the treatment of flexion deformity of the knee joint in spastic cerebral palsy,traditional surgery using the semitendinosus and gracilis,post and semimembranosus lysis,combined with the Ilizarov draft external fixation could improve the walking function of the patients,simplify the surgical incision and reduce trauma.As a result,modified hamstring post surgery is an ideal,effective treatment method.

BACKGROUNDInflammatory myofibroblastic tumor (IMT) is an uncommon disease which usually occurs in the lung. Recently, several reports have suggested that IMT is a true neoplasm rather than a reactive lesion. In this retrospective study, we reviewed clinicopathological characteristics and prognoses of patients with surgically resected IMT of the lung at our department.

METHODSFrom January 1999 to December 2003, 14 patients had surgical intervention for IMT of the lung at Tongji Hospital. The resected lesions were studied histologically and immunohistochemically. One to 5 years' follow-up was completed in all patients.

RESULTSThese 14 patients included eight men and six women. They ranged in age from 11 to 46 years old. Nine patients were asymptomatic. The other five symptomatic patients had cough, hemoptysis, and dyspnea. For all these patients, the diagnostic procedure was surgical excision. The resected tumor size ranged from 1.0 to 8.0 cm in diameter. Histologically, a variety of inflammatory and spindle cells were observed. The spindle cells corresponded ultrastructurally to myofibroblasts or fibroblasts. There was no recurrence in these patients, and all of them were in good health during the follow-up.

CONCLUSIONSHistopathologically, IMT is characterized by myofibroblasts which are mixed with chronic inflammatory cells, including plasma cells, lymphocytes, and histiocytes. Surgical resection, when possible, should be chosen as the first choice and complete resection leads to excellent survival.

OBJECTIVE: To investigate the relationship between the expression of leptin, p-mTOR protein and the pathogenesis, development and clinicopathological features in colon carcinoma. METHODS: The expression of leptin and p-mTOR protein was evaluated by immunohistochemical methods in 40 normal colon mucosas, 40 colon adenomatous polyps and 108 cases of colon carcinomas. The relationship between the staining pattern and clinicopathogical features was examined. RESULTS: The positive rates of detection of leptin in normal colon mucosa, adenomatous polyps and colon carcinomas were 10% (4/40), 27.5% (11/40), and 71.3% (77/108), respectively; with significant differences among the three groups (P<0.05). The positive rates of p-mTOR protein in the normal colon mucosa, the adenomatous polyps, and the colon carcinomas were 2.5% (1/40), 20% (8/40), and 61.1% (66/108), respectively; with significant differences among the three groups (P<0.05). The expression of leptin and p-mTOR proteins were related to invasive depth, TNM stages, lymph node metastasis, distant metastasis and tumor differentiation (P<0.05), but not to age, sex, or site (P>0.05). In colon carcinoma tissues, leptin expression was positively correlated with p-mTOR expression (P<0.01). CONCLUSION Leptin and p-mTOR proteins may play important roles in the occurrence and development of colon carcinoma. The detection of leptin and p-mTOR may be helpful for evaluation of the prognosis of the patient with colon carcinoma.
Adenocarcinoma ; metabolism ; pathology ; Adenomatous Polyps ; metabolism ; pathology ; Aged ; Colon ; metabolism ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Humans ; Intestinal Mucosa ; metabolism ; Leptin ; metabolism ; Male ; Middle Aged ; Neoplasm Metastasis ; Phosphorylation ; Prognosis ; TOR Serine-Threonine Kinases ; metabolism