Objective To describe the real experience of nurses from different grade hospitals during further study in the three-level hospital.And to provide the basis to make plans,improve the effect of fustther study and ensure the realization of further study aim.Methods In-depth interviews were canied out with 28 nurses by using Hidegerian phenomenological method.The acquired data were reorganized,analyzed and extracted themes.Results Different grade hospital nurses had different psychological experience such as aims,willingness,effects,obtainment and stress.Condusions Further study should be based on subjective willingness and definite goals.Hospitals should strictly select nursing teachers,give differential treatment in education,fully understand the pressure source and provide corresponding measures to reduce stress of nurses.

The optimum condition of shaking-flask p roducing enzyme were the tempe rature 26℃,initial pH 6 4,fermentation period 19 hours,medium volume 15mL m e dium/300mL Flask.soymilk-clotting enzyme was obtained from ammonium sulfate p r ecipitation.The optimum temperature and pH for the soymilk-clotting activity wa s 70℃and 5 8.The enzyme was easy to lose activity in acid or alkaline circumst a nce.About 60% of the original activity remained after 1 hour at 60℃.Ca 2+ ,Fe 2+ , Mg 2+ ,Na +increased the clotting activity,whereas Zn 2+ ,Al 3+ ca use inhibition.

Objective To investigate quantitatively the thermal sensation characteristics of the patients with facial palsy and the value of quantitative thermal test (QTT) in prognostication.Methods The QTT threshold of the fore ear and cheek of 30 patients with peripheral facial palsy was tested,their facial nerve conduction velocity was measured,and House-Brackmann facial nerve grading system was used to estimate facial nerve function at 2～3 weeks,a month,two months and half a year post onset.Results It was found that 12 out of 30 patients had abnor- mal QTT threshold value;the majority of them suffered from herpes virus and diabetes.In those with abnormal QTT, 8 were with diabetes mellitus (account for 66.7%),3 with partial shingles (account for 25%),and 1 with positive serum virus infection (account for 8.3%).Those with normal QTT were significantly different from those with abnor- mal QTT,with regard to the House-Brackmann rating scores after 2 and 6 months post onset (P

OBJECTIVETo evaluate the therapeutic effect on pain in the dressing change after perianal abscess surgery treated with warm suspending moxibustion at Changqiang (GV 1).

METHODSOne hundred and sixty patients were randomized into a moxibustion group and a far-infrared therapy group, 80 cases in each one. In the moxibustion group, the warm suspending moxibustion at Changqiang (GV 1) was applied. In the far-infrared therapy group, the infrared ray was radiated at Changqiang (GV 1). The treatment started in 10 min after dressing change in the two groups. Totally, 8 treatments were required. The time requirement being equal to or less than 2 score in the assessment face scale (AFS), the case number of pain relief in 10 min after treatment and the intention of the two therapies after everyday dressing change were observed in the patients of the two groups.

RESULTSIn the moxibustion group, the time of pain relief was shorter than that of the far-infrared therapy group [(11.5 +/- 3.9) min vs (17.8 +/- 3.8) min on the 1st day; (9.4 +/- 3.6) min vs (15.2 +/- 4.3) min on the 2nd day; (7.8 +/- 2.7) min vs (14.3 +/- 3.2) min on the 3rd day; (6.4 +/- 3.3) min vs (10.5 +/- 2.9) min on the 4th day; (5.9 +/- 2.9) min vs (11.2 +/- 1.9) min on the 5th day; (5.3 +/- 2.2) min vs (8.8 +/- 2.3) min on the 6th day; (5.4 +/- 1.8) min vs (9.2 +/- 2.1) min on the 7th day; (5.1 +/- 1.4) min vs (9.5 +/- 2.6) min on the 8th day, all P < 0.05]. The case numbers of pain relief in 10 min after treatment were 74 cases, 75 cases, 77 cases and 78 cases from the 1st to the 4th day separately in the moxibustion group, which were much more than 63 cases, 65 cases, 68 cases and 69 cases in the far-infrared therapy group (all P < 0.05). The treatment intention scores in the moxibustion group were better than those in the far-infrared therapy group (all P < 0.05).

CONCLUSIONThe warm suspending moxibustion at Changqiang (GV 1) relieves pain rapidly in the dressing change of much more patients after perianal abscess surgery in much shorter time as compared with the far-infrared therapy. Moreover, the patients have more expectation to be treated with moxibustion therapy.

Abscess ; surgery ; Adolescent ; Adult ; Aged ; Anus Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Pain, Postoperative ; therapy ; Young Adult

Objective To investigate the association of PGC-1 α gene single nucleotide polymorphisms (SNPs) with type 2 diabetes mellitus in Southern China Han population. Methods 350 patients with type 2 diabetes mellitus and their parents and 366 normal Han volunteers were recruited in the study. Their blood specimens were collected to extract the genornic DNA. Thr394Thr(G/A), Gly482Ser(G/A), Thr528Thr(A/G) and Thr612Met (C/T) genotypes were identified by PCR-RFLP and DNA direct sequencing. The possible association was analyzed between diabetic patients with the specific cSNPs and their haplotypes by case-control and haplotype relative risk (HRR) and transmission disequilibrium test (TDT) methods. Results (1) The case- control study indicated that G and A allele frequencies of PGC-1 α gene Gly482Ser variant were 0.589, 0.411 in type 2 diabetic group and 0.687, 0.313 in normal group respectively (X<'2> = 15.076, P < 0.01). The allele frequencies of Thr394Thr, Thr528Thr, Thr612Met polymorphisms did not show significant difference between twogroups respectively (all P > 0.05). The distributions of Thr394Thr-Gly482Ser-Thr528Thr haplotypes in the diabetic group were significanly different from the controls (X<'2> = 40.2, P < 0.05) and had a linkage disequilibrium with type 2 diabetes mellitus (t = 2.503, P < 0.05). (2) The family-basod studies showed that 482A allele was transmitted more significantly both via TDT and extended TDT from heterozygous parents to patients than expected respectively (all P < 0.05). HRR also supported that the 482A allele was more often transmitted to patients than predicted by chance (X<'2> = 7.217, P = 0.007, HRR = 1. 450). TDT analyses of haplotypes suggested that the frequencies of 394A-482A-528A-612C,394A-482A-528A-612T, 394A-482A-528G-612C and 394A-482A-528G- 612T haplotypes significantly deviated from 0.5 (P < 0.05 or P < 0.01). Conclusion In Southern China Hanpopulation, type 2 diabetes mellitus is associated with the Gly482Ser variant of PGC-1α gene, and Thr394Thr (G/ A) variant of PGC-1α gene appears to play an auxiliary role in this association.

Background Central corneal thickness (CCT)is an important parameter to evaluate corneal healthy status and is crucial for surgical planning.However,clinical study found that the center of cornea does not correspond to the thinnest point of cornea.Thus,it is essential to characterize the minimum corneal thickness(MCT) and its location.Objective Present study was to determine the thickness and location of MCT and its relationship to the fellow eye using Pentacam High Resolution technique.Methods The 564 eyes from 282 Chinese myopic patients were reviewed in this study.The CCT,MCT,pupillary central corneal thickness(PCT) and x-y coordinate of thinnest point were bilaterally measured.Written informed consent was obtained prior to the ocular biomedical measurement.Results CCT was (540.07±31.78) μm in the right eyes and (539.24±31.06) μm in the lefi eyes; PCT was (540.25±30.75)μm in the right eyes and (539.48±31.00)μm in the left eyes.MCT was (537.87± 31.91)μm in the right eyes and (536.35±31.24)μm in the left eyes,showing significant differences in all the parameters between the right eyes and left eyes expect for PCT(CCT:P=0.046;PCT:P=0.065 ;MCT:P=0.000).The C CT,PCT and M CT were significantly correlated between the right eyes and left eyes (r =0.97,0.97,0.98,P＜ 0.01).Bland-Altman plot showed a good consistence between the both eyes.The mean distance from the center was (0.50±0.21) mm in the right eyes and (0.56±0.22)mm in the left eyes,showing a significant difference (P =0.000).The difference between CCT and MCT was approximately (2.20±1.74)μm in the right eyes and (2.88±1.75) μm in the left eyes.The location of MCT in both the right eyes and left eyes tended to symmetry along the vertical midline.The distance between the R (x,y) to transformed L (x,y) was (0.29 ± 0.17)mm and the angular distance was (28.28±28.21)degree.Conclusions This study offers a range of MCT and its location in Chinese myopic patients.The difference exists between the CCT and MCT in bilateral eyes.The location of the thinnest point tends to be symmetrical along the vertical midline between the both eyes.The changes of these parameters may be helpful for the diagnosis of some corneal diseases.

Background and objective With the most recent introduction of microarray technology to biology, it becomes possible to perform comprehensive analysis of gene expression in cancer cell. In this study the laser microdissection technique and cDNA microarray analysis were combined to obtain accurate molecular profiles of lymphatic metastasis in patients with lung squamous cell carcinoma.Methods Primary lung squamous cancer tissues and regional lymph nodes were obtained from 10 patients who underwent complete resection of lung cancer. According to the source of lung cancer cells, the samples were classified into three groups: the primary tumor with lymphatic metastasis (TxN+, n=5), the primary tumor without lymphatic metastasis (TxN-, n=5) and matched tumor cells from metastatic lymph nodes (N+, n=5). Total RNA was extracted from laser microdissected tumor samples. Adequate RNA starting material of mRNA from primary tumor or metastatic nodes were labeled and then hybridized into the same microarray containing 6 000 known, named human genes/ESTs. After scanning, data analysis was performed using GeneSpringTM6.2. Results A total of 37 genes were found to be able to separate TxN+ from TxN-. TxN+ have higher levels of genes concerned with structural protein, signal transducer, chaperone and enzyme. TxN- have higher levels of genes coding for cell cycle regulator, transporter, signal transducer and apoptosis regulator. Interestingly, there were no differentially expressed genes between N+ and TxN+.Conclusion The acquisition of the metastatic phenotype might occur early in the development of lung squamons cancer. We raise the hypothesis that the gene-expression signature described herein is valuable to elucidate the molecular mechanisms regarding lymphatic metastasis and to look for novel therapeutic targets.

Objective To investigate the prevention of glucocorticoid-induced osteoporosis or bone loss in systemic lupus erythematosus (SLE) patients by Bugu capsules.Methods Sixty-six patients with SLE were randomly divided into A and B groups:34 patients in Group A were treated by glucocorticoid and Bugu capsules,and 32 patients in Group B by glucocorticoid alone.All patients were measured for bone mineral density (BMD) in Wards triangle,and for related biochemical parameters such as serum calcium, phosphonium,alkaline phosphatase,parathyroid hormone (PTH) and interleukin-6 (IL-6) before and after the treatment.As the control group,thirty healthy subjects were measured for the above parameters.Results There was significant difference in the serum level of IL-6,calcium and PTH between the Group B and con- trol group (P＜0.01).The occurrence rate of osteoporosis or bone loss in group A was significant lower than that in group B [2/34 (5.88%) vs 9/32 (28.13%),P=0.0364].Conclusion Bugu capsules can prevent glucocorticoid-induced osteoporosis or bone loss in SLE patients,possibly by restoring the balance among serum IL-6,calcium and PTH.

Objective To observe expression of the keratin 10 (K10), c-myc and cox2 in buccal mucous membrane exfoliated cells, and changes of liver function of coal-burning arsenism patients, in order to explorate coal-burning arsenic poison circumference biology symbol. Methods The buccal mucous membrane exfoliated cells were collected from both arsenism patients and normal controls. Real-time PCR was employed to detect the changes of K10, c-myc, cox2 genes expression in these cells. Simultaneously, circumference venous blood was extracted and examinated liver function. Results K10 was found obviously overexpressed in arsenism patients(3.60±0.94) compared to control(1.82±0.68), the difference had statistics significance(t=2.15, P<0.05), c-mye and cox2 did not found obviously changed(c-myc: 3.50±2.77,3.39±2.07; cox2:5.90±1.40,4.73±1.91; t=1.26,1.65, P> 0.05). The serum ALT of patients(25.83±2A5) obviously increased than control(36.86±1735, t=2.55, P<0.05). Conclusions Expression of K10 gene in buccal mucous membrane cells may be regarded as sensitive molecular markers for skin pathologic changes in arsenic patients. The liver is a sensitive target organ of inorganic arsenic.

Objective To investigate the operative indication,timing,method,selective standards of fetieided fetus and the number of reduced fetuses of selective multifetal pregnancy reduction in second trimester,and the pregnancy outcome of multifetal pregnancy by this operation.Methods Trans-abdominal selective multifetal pregnancy reductions in 37 cases of multiple pregnancy (twins 6 cases,triplets 21cases, quadruplets 8 cases,and quintuplets 2 cases) during 12~(+1) -25 weeks were performed under ultrasound guidance.The fetus to be reduced was injected potassium chloride (KC1) intraeardiacally until the fetal heartbeat stopped gradually.Totally 46 fetuses were reduced.Periodic prenatal examination and monitoring of coagulation function were carried out after the procedure.The pregnancy complications and pregnancy outcome of all cases were recorded.Results (1) The successful ratio of reduction was 100% (46/46 fetuses) and the successful pregnancy ratio was 88.9% (24/27).(2) Among all the 37 cases,fifteen deliveried after 36 weeks,seven deliveried in 32-36 weeks,three deliveried in 28-32 weeks,two aborted after feticide,and ten cases were in pregnancy at the time of this study.The mean gestational age of all was (34.9?4.1) weeks,and the delivery ratio after 28 weeks was 92.6% (25/27).(3) The mean birth weight of singletons was (3014?640) g,and of twins was (2557?573) g.The neonates of three triplets all died except for in one case two fetuses were alive.(4) Except in two cases after reducing one fetus of monoamniotie twins,another one died within 24 hours,the remaining fetuses were all alive.(5) Pre- eclampsia occurred in three cases.None of the cases had blood coagulation disturbances.Conclusion (1) Selective muhifetal pregnancy reduction in second trimester can feticide the abnormal fetus objectively or reduce the fetal number effectively.It is a safe procedure to decrease the complications of multifetal pregnancy and increase the birth weight.(2) ff the intention is reducing the fetal number,we choose the fetus who lies in the fundus uteri and reduce the muhifetal pregnancy to twins.(3) It is advised to aviod performing the procedure during vaginal bleeding.We reduce fetus after vaginal bleeding stops for one or more weeks.(4) Selective second-trimester multifetal pregnancy reduction will not result in the disturbance of blood coagulation and the death of remaining fetus.The incidence of pre-eclampsia is decreased after muhifetal pregnancy reduction.