Objective To understand the nurses' evaluation of current grading nursing system.Methods Self-questionnaire was designed and used to investigate 141 clinical nurses coming from three general hospitals sampled conveniently.Results (1)Clinical nurses lacked in-depth study of grading nursing instruction principle;(2)Doctors and nurses lacked the cooperation during the process of identifying the level of care;(3)Level of care was not consistent with the patients' condition and self-care ability;(4)Disease inspection and primary care were not consistent with patients' level of care;(5)Health guidance and mental nursing couldn't meet the actual needs of patients;(6)Senior nurses' evaluation of the implementation of grading nursing was lower than Junior nurses; (7)Clinical nurses held positive attitudes to nurses and patients participating in grading nursing.Conclusions Nurses thought poorly of grading nursing system in operation,it was necessary to improve the content of principles about grading nursing manner,health instruction and psychological nursing,and implement grading nursing system correctly.It was also important to take patients' willingness of participating in care into account.

OBJECTIVE:To provide reference for rational use of narcotics drugs in the clinic. METHODS:A total of 5 841 prescriptions of narcotic drugs in our hospital from Jan. 2012 to Dec. 2013 were selected as subjects. The utilization of drugs was an-alyzed statistically using DDDs,DDC and DUI as index. The situation of pharmacists prescriptions dispensing was analyzed with missing rate of unqualified prescriptions as an indicator. RESULTS:7 narcotics drugs DUI≤1.00 in 2012. 9 narcotics drugs DUIs≤1.00 in 2013. The highest missing rate of unqualified prescriptions was 9.33% in the inpatient pharmacy in 2013. The amount and DDDs of Morphine hydrochloride injection,Morphine sulfate sustained-release tablet and Oxycodone sustained-release tablet all in-creased in 2013,compared to in 2012;DUI of all morphine preparation were >1.00. DUI of Codeine phosphate tablet and Bucin-nazine tablet were decreased from 1.64 and 1.11 in 2012 to 1.02 and 0.74 in 2013,tending to be reasonable. The amount and DDDs of Sulfentanyl injection,Remifentanil injection and Fentanyl patch all in 2013,compared to in 2012. CONCLUSIONS:The utilization of narcotics drugs in our hospital basically tend to be rational,but still many deficiencies exist. We should strengthen in-tervention and management on the the utilization of narcotic drugs further.

Objective To validate the clinical applicability of the published standard reference interval of routine clinical chemistry(WS/T 404.1-2012,WS/T 404.1-2012) based on the results of health examination.Methods This was a retrospective study.The results of serum TP(Biuret),ALB (BCG),ALT(Rate without 5'-pyridoxal phosphate),AST (Rate without 5'-pyridoxal phosphate),ALP (Rate,AMP),GGT(Rate) from healthy examinatiou individuals (from January to July,2013) were collected to calculate the 2.5％ and 97.5％ pereentiles,excluding the significant abnormal results according to the Medical Deciding Level 2 recommended by Staland.The number of the cases after excluding were 19 708(M 12 044,F 7 664) 、19 728(M 12 069,F 7 659) 、45 569(M 26 299,F 19 270) 、45 877(M 26 739,F 19 138)、5 965(M 4 208,F 1 757)、4 726(M 3 164,F 1 562),respectively.The proportions of all the examined results (with and without the excluded results) that fell in the published standard reference interval were also calculated.Results The test of normality revealed that the frequency distributions of all verified items were skewed distributions after excluded the abnormal results.The 2.5％-97.5％ percentiles of TP,ALB,ALT(M),ALT(F),AST (M),AST (F),ALP (F20-49),ALP (F50-79),GGT (M) and GGT (F) were 64-79 g/L,40-59 g/L,9-52 U/L,7-39 U/L,13-41 U/L,12-33 U/L,42-116 U/L,36-98 U/L,44-130 U/L,11-72 U/L and 7-50 U/L respectively.More than 90％ results of TP,ALB,ALT(M),ALT(F),AST (M),AST(F),ALP(F20-49),ALP(F50-79),GGT(M) and GGT(F) (with and without the excluded results) fell in the reference intervals of national standards,GGT(M) was 80％ and 91％.Conclusions The published standard reference interval of routine clinical chemistry (WS/T 404.1-2012,WS/T 404.1-2012) are applicable to our laboratory.

Objective To investigate the cellular viability and mitochondrial reactive oxygen species (ROS) production of the Müller cells under high glucose condition,and explore the protection role of the 5,6-dihydrocyclopenta-1,2-dithiole-3-thione (CPDT) on Müller cells.Methods Müller cells from Sprague Dawley rats were divided into 5 groups randomly,including 25 mmol/L normal glucose group (group A) and 65 mmol/L high glucose group (group B).High glucose group with 45,60,70 μmol/L CPDT and cultured them 72 hour was set as group C,D and E.Water soluble tetrazolium salt (WST)-8 was used to measure the cellular viability.Flow cytometry was used to measure the active oxygen and apoptosis index.The expression of nuclear factor erythroid 2-related factor 2 (Nrf2),hemeoxygenase-1 (HO-1),Bcl-2 and Bax protein were measured by Western blot.Results Compared with group A,the WST-8 showed that the viability of Müller cells apparently decreased in group B (t=39.59,P＜0.05).Compared with the group B,the viability of Müller cells had changes in group C (t=0.97,P＞0.05),but recovered in group D and E (t=-4.17,-7.52;P＜0.05).Compared with group A,the FCM showed that the mitochondrial ROS levels was higher in group B (t=-30.99,P＜0.05).Compared with group B,the mitochondrial ROS levels were decreased in group D (t=27.68,P＜0.05).Compared with group A,Bax,Nrf2 and HO-1 increased (t=-11.03,-63.17,-11.44;P＜0.05),while the bcl-2 decreased in group B (t=7.861,P＜0.05).Compared with the group B,Nrf2,HO-1 and Bax decreased (t=15.11,26.59,6.27;P＜0.05),while the bcl-2 increased in group D (t=-6.53,P＜0.05).Conclusions Under the high glucose,CPDT may reduce the mitochondrial ROS levels and the expression of Nrf2,HO-1 and Bax protein of Müller cells.It may inhibit apoptosis through activating the Nrf2/HO-1 pathway and balancing of level of Bcl-2 protein and mitochondrial ROS.

Objective We observed influence of different handgrip exercise on the changes of blood flow velocity and blood vessel diameter of basilic vein before and after the PICC placement and discuss the best model for handgrip exercise.Methods 60 patients with PICC were chosen and divided into group A,B and C with 20 patients in each groups.Group A received routine guidance on unarmed handgrip exercise,group B used electronic handgrip,the frequency was 25 times/min,the time period was 2 min with 4 times a day,once every 4 hours,group C adopted the same model as that of group B and 6 times a day,once every 3 hours.The venous blood flow velocity and blood vessel diameter was measured by pulsed Doppler ultrasound one hour before the PICC placement and one hour,1 day,3 days,7 days,10 days,14 days,21 days after placement.Results The venous blood flow velocity before and after PICC placement had statistically significant differences at different time points (F=2.934,P ＜ 0.05).The effect of group B and C was better than that of the group A and group C showed the best effect.The blood vessel diameter before and after PICC placement had significant differences at different time points(F=3.940,P ＜ 0.05).There was significant differences in the blood vessel diameter 1h before and 1h after PICC placement.Conclusions Handgrip exercise can effectively promote the upper limb venous blood flow velocity in patients with PICC,but shows little effect on the blood vessel diameter.Using the electronic hand grip in weak tap position,25 times/min,2 min every time,and 6 times a day (once every 3 hours),can obviously promote the upper limb venous blood flow velocity.

Animals ; Dentate Gyrus ; Hippocampus ; Rats ; Receptors, Adrenergic, beta ; Sleep ; Spatial Learning

No abstract available.
Abortion, Habitual* ; Cytogenetics* ; Family Characteristics* ; Female ; Pregnancy

Objective To assess the correlation and agreement of the mitral valve geometry parameters obtained by real-time three-dimensional transthoracic echocardiography ( RT-3D-TTE) and real-time three-dimensional transesophageal echocardiography ( RT-3D-TEE) . Methods RT-3D-TTE and RT-3D-TEE were performed on 29 healthy volunteers under conscious state and general anesthesia respectively . The mid-systole mitral valve parameters were analyzed by TomTec Imaging Systems . The repeatability test of the mitral valve parameters obtained by RT-3D-TTE was performed . The correlation and agreement of the mitral valve parameters obtained by RT-3D-TTE and RT-3D-TEE were assessed , and then the differences of mitral valve parameters between the two methods were compared . The study was approved by the Shanxi Dayi Hospital Ethics Committee ( Approval no .YXLL-2015-040) . Results ① The mitral valve parameters obtained by RT-3D-TTE showed excellent intra- and interobserver reproducibility ,in intra-observer and inter-observer with ICC > 0 .8 for all the parameters ,and the Bland-Altman plots displayed the average differences of anterior-posterior ( AP) ,anterolateral-posteromedial ( ALPM ) ,annular circumference ( AC) ,three-dimensional annular area ( AA3D ) for intra- and interobserver were 0 .009 ± 0 .11 , - 0 .008 ± 0 .10 , - 0 .036 ± 0 .32 ,0 .030 ± 0 .36 in intra-observer and - 0 .018 ± 0 .09 ,0 .087 ± 0 .20 , - 0 .037 ± 0 .44 ,- 0 .016 ± 0 .62 in inter-observers ,respectively . ② There were close correlations ( r = 0 .566 - 0 .870 , P <0 .01) and good agreement ( ICC = 0 .719 - 0 .931 , P < 0 .01) between the mitral valve parameters obtained by RT-3D-TTE and RT-3D-TEE . ③ The mitral valve parameters obtained by RT-3D-TTE were similar to those obtained by RT-3D-TEE .Among the parameters ,AP ,two-dimensional annular area ( AA 2D ) ,annular height ( AH) ,tenting volume ( TV) ,anterior leaflet length ( ALL) and posterior leaflet length ( PLL) had no statistically significant differences between the two methods ( P > 0 .05) . The rest of parameters including ALPM ,sphericity ( SPI) ,commissural diameter (CD) ,AC ,AA 3D ,nonplanarity angle ( NPA) ,tenting height ( T H) ,maximum annular displacement ( ADmax) and maximum annular displacement velocity ( ADVmax) had significant differences ( P < 0 .05) . Conclusions The mitral valve parameters obtained by RT-3D-TTE are highly reproducible and similar to those obtained by RT-3D-TEE ,and the two methods have close correlations and good agreement . Therefore ,RT-3D-TTE has higher potential clinical application value in the evaluation of mitral valve geometry .

The accepted and supported items of National Natural Science Foundation related to biomarker research in laboratory medicine during 2010 to 2014 were summarized. The grants were categorized according to the biochemistry property of biomarkers and disease type .The features in the past 5 years were analyzed and the issues worth noticing for further research were also pointed out .

Objective To investigate the association between CHI3L1 polymorphism and asthma in the Han population of Guangdong,and to explore the clinical values of chitinase-like protein YKL-40 in evaluating disease severity and monitoring the progression of the disease.Methods Total 251 objects were divided into asthma group (n=150)and control group(n=101).The single nucleotide polymorphism (SNP)at CHI3L1 gene was detected with Massarray method. The serum YKL-40 levels, total IgE levels, peripheral blood eosinophil percentage (Eos%)of the obj ects in asthma and control groups were detected. The asthma patients were divied into asthma exacergation group and stable group,and the serum YKL-40 levels were compared.Results The distribution of A/G at rs3806448 of CHI3L1 had significant difference between asthma and control groups (P<0.01 ), and the frequency of A allele at rs3806448 of the patients in asthma group was significantly higher than that in control group (OR= 1.93,95% CI=1.30-2.62,χ2=11.6,P<0.01).The serum YKL-40 levels,total IgE and Eos% of the patients with AA at rs3806448 were higher than those of the patients with GG or AG at rs3806448 (P<0.05);the FEV1% of the patients with AA was lower than those of the patients with GG or AG at rs3806448(P<0.01). The serum YKL-40 level of the patients in asthma group was significantly higher than that in normal control group (P<0.01),and the serum YKL-40 level of the patients in asthma exacergation group was higher than those in asthma stable group and normal control group(P<0.01).The serum YKL-40 level of the patients in asthma group was positively correlated with the peripheral blood Eos% and total IgE level(rEos=0.348,rIgE=0.437,P<0.01), and was negatively correlated with the lung function(r=-0.745,P<0.01). Conclusion The polymorphism of CHI3L1-rs3806448 may correlate with asthma of Han population in Guangdong area.The serum YKL-40 may be a new biomarker to evaluate asthma disease severity and helpful for monitoring illness stage.