Objective To discuss the nurses'satisfaction degree with work and its influencing factors and analyze the difference of nurses'satisfaction degree with work with different background.Methods 398 nurses in a certain comprehensive hospital were investigated with Mueller/McCloskey(MMSS)satisfactory inventory. Results The nurses'general satisfaction degree with work was less than middle level with a score of (3.12±0.46).The satisfaction degree was statistically different in different dimensionality and nurses with different background. Conclusion The management department of hospitals should adopt positive measures to improve the nurses'satisfaction degree with work and prompt them to supply more high-quality and effective nursing services.

Objective To observe the efficacy and safety of cetuximab chemotherapy combined with irinotecan in the treatment of advanced colorectal in the elderly.Methods 40 irinotecanresistant patients with K-Ras wild type were randomized to cetuximab weekly combined with irinotecan group (group A) and cetuximab biweekly combined with irinotecan group (group B).In group A,cetuximab was given at an initial dose of 400 mg/m2,followed by weekly 250 mg/m2.In group B,cetuximah and irinotecan were given at 500 mg/m2 and 180 mg/m2 respectively every two weeks.Time to progression (TTP),overall survival (OS) and toxicity were compared between the two groups.Results There were no significant differences in objective response rate (RR),disease control rate (DOC),TTP and OS between goup A and group B (30.0％ vs.25.0％,60.0％ vs.55.0％,5.8 months vs.5.6 months,9.8 months vs.9.5 months,respectively,all P＞0.05).Grade 3 or more toxicities including hematological toxicity,gastrointestinal reactions and skin toxicity were found in 2 cases,2 cases and 1 case respectively in group A and 3 cases,1 case and 2 cases respectively in group B.The two groups had no significant differences in toxicities (all P＞0.05).Conclusions Cetuximab combined with irinotecan therapy is effective in the treatment of advanced colorectal cancer in elderly irinotecan resistant patients.Cetuximab biweekly regimen is more convenient but has the same efficacy and toxicity as compared with cetuximab weekly regimen.

OBJECTIVE To explore the condition of the cellular immune function of children with obstructive sleep apnea hypopnea syndrome(OSAHS) and its change after operation METHODS Eighty children diagnosed as OSAHS were included in this study. T lymphocyte subsets and NK cells of the blood were measured before operation and one month after operation respectively. Children without the related disorders or systemic disease were recruited as control group.RESULTS Before operation, CD4+T cell percentage, CD4+/CD8+ ratio and NK cell percentage in OSAHS children were significantly lower than that in the control group[(26.19±3.38)%vs (5.10±4.09)%, (0.90±0.19)%vs (1.61±0.52)%, (11.45±4.35)%vs (13.73±3.78)%,P<0.05], CD8+T cell percentage was significantly higher than that in the control group[(30.02±5.50)%vs (22.31±3.42) %,P<0.05]. The difference, between the two groups, in CD3+T cells was not statistically significant. After operation, the CD4+T cells, CD8+T cells, CD4+/CD8+ ratio, the percentage of NK cells and CD3+T cells showed no significance difference compared with that before operation (P>0.05). CONCLUSION OSAHS may damage the cellular immune function. The operation does not reduce the cellular immune function in the short term.

All information processing and transmission in the brain involves synapses, the synaptic cell adhesion molecules play an important role in the formation, maturation and maintenance of synapses. Neuroligin1 ( NL1) is excitatory postsynaptic trans?membrane cell adhesion molecules. The interaction between NL1 and other molecules, such as Neurexin1 ( NRXN1) , involves in the formation, plasticity and function of synapses. NL1 knockout or overexpression displayed impairment in learning and memory, thus sug?gesting that NL1 participates in the pathophysiology of neuropsychiatric disease with cognitive dysfunction. Therefore, study of NL1 will open up new avenues to understand pathogenesis of cognitive dysfunction, and may provide a novel insight into prevention and treatment of cognitive dysfunction?associated diseases.

Objective Accumulating evidence has demonstrated that the sub-anesthetic dose of ketamine exerts rapid and ro-bust antidepressant-like effects though its action mechanisms are not yet fully understood .The aim of this study was to investigate the role of gamma-aminobutyric acid ( GABA) in the antidepressant effects of ketamine . Methods Thirty-two male Wistar rats were e-qually randomized into four groups: saline, ketamine, GABA, and GABA+ketamine.All the animals were implanted with a guide cannula into the lateral ventricle and on the eighth day after operation subjected to a 15 min forced swimming test (FST) for the estab-lishment of a depression model .At 24 h after modeling , the rats of the saline and ketamine groups were treated intracerebroventricularly with 2μL isotonic saline solution, and those of the GABA and GABA +ketamine groups with 50μg (2μL) GABA, followed by intrap-eritoneal administration of 1 mL saline in the former two groups and 10 mg/kg (1 mL) ketamine in the latter two groups 10 min later.At 30 min after treatment , the open field test ( OFT) was carried out for crossing and rearing scores and a 6-min FST was performed to re-cord the immobility time in the last 5 minutes.The content of GABA in the prefrontal cortex of the rats was measured following behav -ioral tests. Results The immobility time was significantly decreased in the ketamine group ([107.5 ±21.2]sec) as compared with the saline, GABA, and GABA+ketamine groups ([167.2 ±22.1], [159.8 ±17.5], and [143.8 ±22.1]sec) (P<0.05), with no significant difference between the GABA and GABA +ketamine groups (P>0.05).The level of GABA in the prefrontal cortex was remarkably lower in the ketamine group ([12.4 ±3.4]ng/mg prot) than in the saline, GABA, and GABA+ketamine groups ([23.3 ± 6.3], [27.3 ±5.7], and [18.0 ±5.4]ng/mg prot) (P<0.05), but markedly higher in the GABA than in the GABA +ketamine group (P<0.05).OFT scores exhibited no significant difference in the lo-comotor activity among the four groups of rats ( P >0.05 ). Conclusion The antidepressant effects of ketamine are related to the decreased GABA level in the prefrontal cortex in rats receiving FST .

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Objective To design a nursing checklist for continuous renal replacement therapy in ICU patients and to apply it to clinical settings. Methods A nursing checklist for continuous renal replacement therapy was de-signed through reviewing guidelines and literatures. The checklist was used in ICU patients treated with continu-ous renal replacement therapy,and nursing situation (including operation time,operation quality,etc.) was compared before and after application of the checklist. Results After applying the nursing checklist for continuous renal re-placement therapy,the nursing procedures were standardized,the operation time was reduced,and operation quality was improved. Conclusion The application of nursing checklist in nursing management of continuous renal replace-ment therapy helped to standardize continuous renal replacement therapy operating procedures,improve efficiency and quality at work,and ensure patient safety.

Objective To investigate the effect of penehychdine hydrochloride (PHCD)on acute lung injury induced by acute severe acute pancreatitis and the expression of hypoxia inducible factor-1α(HIF-1α)in rats.Methods Forty healthy adult male SD rats were used and randomly divided into 3 groups, group S of sham operation,group ALI of pancreatitis-associated acute lung injury (PALI)and group P of PALI with PHCD.Rats of group ALI and group P were the model established of acute lung injury associated with SAP by retrograde injection of 4% sodium taurocholate into biliopancreatic duct.Rats of group P of acute lung injury with SAP were immediately given PHCD after SAP.Rats of group S and group ALI were injected the same amount of 0.9% sodium chloride solution.After modeling,the rats were sacri-ficed at 12 h.The wet/dry weight ratio (W/D)of lung tissue was calculated.Pathological changes of pan-creatic and lung tissues were scored.HIF-1α,IL-1β,IL-6 of lung tissues and serum amylase were detected by ELISA.The expression of TLR4,NF-κB p65 in lung tissue was detected by Western blot.Results Ex-tensive infiltration of neutrophils,alveolar hemorrhage and necrosis and fat necrosis with pancreatic tissue were observed in group PALI and group P.Pancreatic tissue injury score was significantly higher than that of group S (P <0.01).However,there was no statistically significant difference between the level of serum amylase in group P and group ALI.The W/D ratio of lung tissue in rats of group ALI and group P was sig-nificantly higher than those in group S (P <0.05).Compared with those of group ALI,the lung tissue pathological changes of group P were significantly improved,and the lung W/D value was significantly lower than that of group ALI (P <0.05).Compared with group S,the expression of TLR4,NF-κB p65,HIF-1αin lung tissue of group ALI and group P was significantly higher (P <0.01),and the expression of TLR4, NF-κB p65,HIF-1α,IL-1βand IL-6 in group P was significantly lower than that in group ALI (P <0.05).Conclusion PHCD could not alleviate the damage of pancreatic tissue of SAP.It suppressed the expression of HIF-1α,IL-1βand IL-6 and reduced the acute lung injury induced by SAP in rats,which might be depen-ded on suppressing the expression of inflammatory factors,such as HIF-1α.

Objective To analyze the epidemiologic data of patients withClostridium botulinum food poisoning, and to improve the understanding, diagnosis and treatment of food borne botulism.Methods A retrospective study was conducted. Fifty-three patients withClostridium botulinum food poisoning admitted to Chinese PLA Center of Poisoning and Treatment from January 2009 to December 2016 were enrolled, and they were divided into mild, moderate, and severe groups according to the severity of disease. The clinical data including medical history, epidemiology data, routine blood test and blood biochemistry at hospital admission, the vital signs and arterial blood gas analysis before and after treatment, as well as the occurrence frequency of symptom and sign on set were collected.Results Fifty-three patients with food borne botulism were enrolled, with 33 patients in mild group, 13 in moderate group, and 7 in severe group. Most of the patients were female, the age distribution was in large span, the outbreak of disease was in groups mainly with the family, and patients were mainly located in Hebei Province, Beijing and Henan Province. The outbreaks were mainly happened in Spring and Summer, and homemade fermentation products were still the first cause of poisoning with the average latent period of (51.01±4.78) hours. The majority of patients with botulism were in mild resulted from the type A toxin. With the aggravation of disease, hospitalization time was gradually increased, white blood cell (WBC) and neutrophils (NEUT) at hospitalization admission, and respiratory rate (RR), heart rate (HR), fraction of inspired oxygen (FiO2) before the treatment were shown in obviously rising trend, albumin (ALB) at hospitalization admission and pH, arterial partial pressure of oxygen (PaO2), arterial oxygen saturation (SaO2) before treatment were in decline. The parameters in severe group were most severe, and had significant differences as compared with those of mild group [hospitalization time (days): 72.57±39.52 vs. 6.61±3.72, WBC (×109/L): 13.01±6.44 vs. 6.85±2.07, NEUT: 0.85±0.07 vs.0.63±0.14, RR (bpm): 32.14±4.33 vs. 15.18±1.70, HR (bpm): 132.29±5.19 vs. 75.54±8.24, FiO2: 0.32±0.05 vs. 0.21±0.00, ALB (g/L): 38.57±4.65 vs. 42.09±4.57, pH: 7.08±0.10 vs. 7.38±0.07, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 75.16±5.24 vs. 98.39±1.50, SaO2: 0.78±0.06 vs. 0.97±0.02, allP < 0.05]. The symptom and sign on set of 53 patients with food borne botulism was dizziness, followed by fatigue, blurred vision, nausea, and other symptoms and signs were lower than 50%, and the occurrence of dizziness with rank one happen rate was significantly higher than blurred vision and nausea (χ2 values were 7.209 and 10.502 respectively, andP values were 0.007 and 0.004 respectively). After the on time prescription of botulinum antitoxins treatment, the clinical symptoms of patients could be relived quickly. All the patients were discharged without deaths.Conclusion In order to improve the recovery of the food borne botulism poisoning patients, adequate antitoxin and the related organ supports should be prescribed on time.

Objective To study the clinical features of hand-foot-mouth disease(HFMD) in neonates.Method From April 2015 to May 2016,the clinical manifestations,laboratory examinations,treatments and prognosis of neonates with HFMD in our hospital were retrospectively analyzed.Result A total of 6 cases of neonatal HFMD were included,with 4 males and 2 females.The ages of 2 patients were ≤7 days and the other 4 patients 8 ～ 28 days.5 patients developed this disease during April to July,while the other one in January.2 cases had a definite contract history of HFMD.4 cases presented with fever and rashes in hand and foot,one case with fever,rash and oral ulcer,and one case with rash in hip and oral ulcer without fever.The nucleic acid test of enterovirus were positive in 4 cases.The symptoms of these neonatal HFMD were mild and recovered after symptom-relieving treatment.Conclusion HFMD in neonates with fever and/or rash should be considered during the HFMD epidemic period.