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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 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.

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

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 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.

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.

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

OBJECTIVESince glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common hereditary hemolytic erythrocyte enzyme deficiency, most cases have single nucleotide mutations in the coding region, and current test methods for gene mutation have some missed detections, this study aimed to investigate the feasibility of RT-PCR sequencing in the detection of gene mutation in G6PD deficiency.

METHODSAccording to the G6PD/6GPD ratio, 195 children with anemia of unknown cause or who underwent physical examination between August 2013 and July 2014 were classified into G6PD-deficiency group with 130 children (G6PD/6GPD ratio <1.00) and control group with 65 children (G6PD/6GPD ratio≥1.00). The primer design and PCR amplification conditions were optimized, and RT-PCR sequencing was used to analyze the complete coding sequence and verify the genomic DNA sequence in the two groups.

RESULTSIn the G6PD-deficiency group, the detection rate of gene mutation was 100% and 13 missense mutations were detected, including one new mutation. In the control group, no missense mutation was detected in 28 boys; 13 heterozygous missense mutations, 1 homozygous same-sense mutation (C1191T) which had not been reported in China and abroad, and 14 single nucleotide polymorphisms of C1311T were detected in 37 girls. The control group showed a high rate of missed detection of G6PD deficiency (carriers) in the specimens from girls (35%, 13/37).

CONCLUSIONSRT-PCR sequencing has a high detection rate of G6PD gene mutation and a certain value in clinical diagnosis of G6PD deficiency.

Adolescent ; Child ; Child, Preschool ; Female ; Glucosephosphate Dehydrogenase ; genetics ; Glucosephosphate Dehydrogenase Deficiency ; diagnosis ; genetics ; Humans ; Infant ; Male ; Mutation ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA

Objective To explore the diagnostic value of endoscopic ultrasonography(EUS)for the minimal submucosal invasion of early gastrointestinal tumor. Methods A total of 242 patients with early gastrointestinal tumor,who underwent endoscopic submucosal dissection,were retrospectively analyzed. The accuracy of EUS diagnosis was calculated based on postoperative histopathological findings as the golden standard,and influencing factors were also analyzed. Results Overall diagnostic accuracy of EUS for sub-mucosal invasion of early gastrointestinal tumors was 72. 3%(175/ 242),with an overstaging rate of 21. 5%(52/ 242)and an understaging rate of 6. 2%(15/ 242).Tumor size(P = 0. 018)and location(P = 0. 005) had significant effects on the diagnostic accuracy of the minimal submucosal invasion of early gastrointestinal tumor by EUS. The overstaging rate in the lesion length of diameter>3 cm was higher than those of 3 cm or less[27. 0%(33/ 122)VS 15. 8%(19/ 120),P = 0. 807],the overstaging rates of early colonrectal and gastric cancer were also significantly higher than the understaging rate[ Colonrectum:12. 2%(9/ 74)VS 2. 7%(2/ 74),P= 0. 028;Stomach:26. 9%(28/ 104)VS 2. 9%(3/ 104),P = 0. 000]. Conclusion Endoscopic ultrasonography is of diagnostic value for the invasion depth of early cancer in gastrointestinal tract. However,precaution should be taken in large lesions and the tendency of overstaging in gastrointestinal tract.