Objective:To describe the status and influencing factors of emergency nurses′ high-alert drugs knowledge level in maternal and child hospital.Methods:Totally 171 nurses working in emergency department from 6 hospitals in Chengdu including West China Second University Hospital, Sichuan University, Sichuan Maternal and Child Health Hospital, Chengdu Women and Children Central Hospital, Chengdu Longquanyi Maternal and Child Health Hospital, Chengdu Chenghua Maternal and Child Health Hospital, Chengdu Pengzhou Maternal and Child Health Hospital were selected through convenient sampling to fill out the scale.Results:Nurses′ average score of high-alert drugs knowledge was 29.52±2.74. The accuracy of each item ranged from 22.2% to 100.0%. Multivariate linear regression analysis showed that major influencing factors for their knowledge level included monthly income, length of service in the emergency department, professional title, the model explained 12.7% amount of variance ( R2 value was 0.127, P<0.01). Conclusions:Emergency department nurses in maternal and child hospitals have insufficient awareness of intravenous infusion of high-alert drugs, and they have a high demand for knowledge. In order to ensure the safety of clinical drug use, it is urgent to formulate targeted training programs to improve nurses' knowledge level of high-alert drugs.

OBJECTIVE: To discuss the influences of the concentrations of sodium cholate, cholesterol and drug, preparation temperature, ultrasonic time and power on the particle size and encapsulation efficiency of Flos Magnoliae volatile oil nano-liposome through film-ultrasonic wave technique together with membrane filter method. METHODS: The nano-liposomes were prepared by film-ultrasonic wave technique together with membrane filter method. The drug content in liposomes was determined by gas chromatography and the particle size was determined by laser light scattering granularity equipment. RESULTS: By film-ultrasonic wave technique together with membrane filter method, the liposomes in the range of 30-40 nm were prepared. The prepared nano-liposomes demonstrated good decentralization and homogeneity, and the encapsulation efficiency was (91.7+/-3)%. CONCLUSION: Film-ultrasonic wave together with membrane filter method is a simple method to fabricate nano-magnoliae liposome.

Objective:To establish a method for isolating adipose derived stem cells(ADSCs)from resected human subcutaneous adipose tissues.Methods:ADSCs were isolated,cultured,and expanded from human subcutaneous adipose tissues.Immuno-fluorescent staining of specific molecules.FACS and multi-lineage differentiation induction were used to characterize the obtained ADSCs.Results:ADSCs obtained in this study had the characteristics of stem cells and expressed specific molecules;they also possessed a multi-lineage differentiation potential,which was genetically stable.Conclusion:ADSCs can be isolated from human subcutaneous adipose tissues,which provides a novel and abundant seeding cells for tissue engineering.

Objective To assess the relationship between maternal plasma tumor necrosis factor-related apoptosis-inducing ligand ( TRAIL ) before 20 weeks′gestation and hypertensive disorder complicating pregnancy (HDCP);and to evaluate the predictive value of plasma TRAIL for HDCP.Methods A 2-phase screening/validation study was designed.In the screening phase , a nested, case-controlled study was performed , the plasma samples collected before 20 weeks′gestation from 20 women who later developed HDCP and 20 age-and gestation week-matched controls were tested in prospective screening test for protein expression profiling during pregnancy and HDCP.Plasma samples were analyzed by a human protein microarray technology designed to detect 507 proteins simultaneously.Differently expressed proteins′functional annotation and clustering were performed by using of Database for Annotation , Visualization and Integrated Discovery ( DAVID) and Gene Ontology ( GO) database.The TRAIL level of plasma samples obtained before 20 weeks′gestation from 53 women who later developed HDCP and 106 similarly matched controls were further validated by ELISA and 62 clinical risk factors were investigated.Logistic regression and ROC analysis were used to evaluate the relationship between TRAIL and HDCP and its predictive value for HDCP.Results In protein microarray analysis , 23 proteins expressed differently before 20 weeks′gestation between the two groups.Further validation results showed that TRAIL levels in HDCP patients were lower significantly (45.7 ±13.1) pg/ml than those in healthy pregnant controls (51.2 ±14.7)pg/ml, P=0.021.Multiple factor logistic regression analysis of 159 pregnancies showed that three features were finally entering the logistic model, they were:anemia (OR=4.87, 95% CI 1.05-24.26), pre-pregnancy BMI (OR=1.72, 95% CI 1.35 -2.19) and TRAIL (OR=0.96, 95% CI 0.92 -0.99).The predictive accuracy of logistic model was 81.8%.The model significantly increases the predictive value (AUC=0.81, 95%CI 0.73-0.87) compared to TRAIL as independent predictor (AUC=0.59, 95%CI 0.51-0.67).Conclusions Totally 23 proteins were expressed differentially before 20 weeks′gestation in plasma of women who later developed HDCP , confirming that HDCP is a heterogeneous disease with different biological changes.The data suggests that plasma TRAIL levels relate with the development of HDCP and its combination with pre-pregnancy BMI and anemia have a high predictive value for HDCP before 20 weeks′gestation.

Objective To evaluate the value of 2D ultrasound and elastic strain ratio (SR) in diagnosis of thyroid nodule by fine needle aspiration (FNA).Methods 196 thyroid nodules were analyzed retrospectively with 2D ultrasound,elastography and FNA results,pathology results as the golden standard.A receiver operating characteristic (ROC) curve was used to identify the best cut-off point of SR.The Logistic regression analysis was used to evaluate the variables effectiveness on age,nodule echo,calcification and SR.Tried to discuss how to use SR before or after US-FNA in diagnosis of thyroid nodule.Results The SR of the malignant nodules group was significantly different from the benign nodules group,and the best cut-off point was 0.5 with sensitivity 91.7％,specificity 90.2 ％ and accuracy 90.8 ％.The Logistic analysis results were SR,age,echo,calcification according to the odds ratio.SR can screened nodules without puncture necessary before FNA,and increase the FNA sensitivity,specificity and accuracy after FNA.Conclusions SR has good application value in diagnosis thyroid malignant tumor.SR can reduce unnecessary FNA and make a supplementary diagnosis of FNA.

Tanshinones are the bioactive components of the Chinese medicinal herb Salvia miltiorrhiza, while its biosynthetic pathway remains to be characterized. Rapid identification and characterization of the genes correlated to tanshinones biosynthesis is very important. As one of the intermediates of tanshinones biosynthesis, the ferruginol content is relative low in both root and engineered bacteria. It is urgent to construct an efficient system for conversion of miltiradiene to ferruginol to obtain large amount of ferruginol as the substrates for further identifying other downstream genes involved in tanshinones biosynthesis. In this study, we constructed the whole-cell yeast biocatalysts co-expressing miltiradiene oxidase CYP76AH1 and cytochrome P450 reductases (SmCPR1) from Salvia miltiorrhiza, and then characterized it with RT-PCR. After permeabilization, the yeast whole-cell could catalyze turnover of miltiradiene to ferruginol efficiently through single-step biotransformation with a conversion efficiency up to 69.9%. The yeast whole-cell biocatalyst described here not only provide an efficient platform for producing ferruginol in recombinant yeast but also an alternative strategy for identifying other CYP genes involved in tanshinones biosynthesis.

Objective To evaluate the value of elastic strain ratio (SR) in ultrasound guided fine needle aspiration (US-FNA) of thyroid nodule.Methods A total of 222 thyroid nodules from 216 patients were reviewed and analyzed by Logistic regression of clinical data,2D ultrasound,and SR.The odds ratios of variables in the equation were compared to assess various variables,especially of SR in the diagnosis.The sensitivity,specificity,and accuracy of the SR method,US-FNA method,and combined method were calculated.Results Three statistically significant features finally entered the Logistic regression model,followed by SR,echo,and age according to the odds ratio.The sensitivity,specificity,and accuracy of the SR method,US-FNA method and combined method were 85.4％,82.1％,83.3％ ; 91.5％,82.1％,85.6％ ; 97.6％,94.3％,95.5％ respectively.Conclusions SR＜0.5 is the most important risk factor in differential diagnosis of thyroid malignant nodules from benign nodules.SR raises the sensitivity,specificity,and accuracy of US-FNA method and plays an important role in diagnosing thyroid nodules via US-FNA.

Objective To investigate the clinical characteristics and the optimal time of delivery in pregnant women with severe preeclampsia complicated with ascites. Methods A retrospective study was conducted on 179 severe preeclampsia mothers and their 195 neonates,presented in the First Affiliated Hospital of Wenzhou Medical College from Jan.2003 to Dec.2005,who were divided into two groups:32 complicated with ascites(ascites group)and 147 without(non-ascites group). The general conditions,mode of delivery and complications including eclampsia,hemolysis,elevated serum level of 1iver enzymes,and low platelets(HELLP syndrome),liver failure,renal failure,heart failure,hypoproteinemia,placental abruption,postpartum hemorrhage and puerperal infection,were also analyzed.Clinical data of all infants(38 from ascites group and 157 from non-ascites group)were analyzed.The incidence and mortality rate of small for gestational age(SGA)in both group within the same gestational age group and those between different gestational age groups in the ascites group were compared. Results (1)The average gestations at admission and delivery in the ascites group were earlier than the other[admission:(32.5±2.1)weeks vs(36.1±3.5)weeks;delivery:(34.1±2.3)weeks vs(37.2±1.5)weeks,P＜0.053.The rate of systemic antenatal care in the ascites group waslowcr than that of the non-ascites group(25.0%vs 53.7%,P＜0.05).More complications werefound in the ascites group than in the non-ascites group(hypoproteinemia:100.0%vs 47.0%;liver and renal failure:31.2%vs 8.2%;HELLP syndrome:9.4%vs 2.0%;postpartum hemorrhage:18.8%vs 2.0%;all P＜0.05).(2)The incidence of SGA in the ascites group was all higher than that in the non-ascites group,however,significant differences was only found between the tWO groups at＞36 weeks(7/9 vs 30.2%,P＜20.05).The perinatal mortalily rates of SGA in the ascites group at＜32 weeks and 32～34 weeks were significantly higher than that in the non-aseites group respectively(＜32 weeks:69.2%vs 19.2%,P＜0.05;32～34 weeks:2/7 vs 0,P＜0.05).(3)The highest perinatal mortality rate and the highest incidence of SGA in the ascites group were found in the groups of＜232 weeks and＞36 weeks,respectively. Conclusions The early onset of ascites and higher rate of complications in severe preeelamptie women implies the adverse maternaI and fetal outcomes.Ascites in severe preeclampsia cases should alert the clinicians.The optimal time for delivery might be at 32～36 weeks of gestations.

Objective To investigate the changes and clinical significance of plasma N‐terminal pro‐brain natriuretic peptide (Nt‐proBNP) in patients with asphyxia of newborns combined with myocardial injury .Methods Fifty‐eight term neonates with neonatal asphyxia born within 24 h were included in our study ,18 of the 25 severe asphyxia cases were combined with myocardial injury ,15 of 33 mild asphyxia cases were with myocardial injury ,there were 25 subjects were not cardiac injured after asphyxia to‐tally .Patients of the same age without asphyxia or any cardiovascular disease were recruited into the control group .Levels of plasma Nt‐proBNP and creatine kinase isoenzyme (CK‐MB) were detected on the first ,third and the fifth days after birth for statistical a‐nalysis .Results On the first and third days after birth ,levels of plasma Nt‐proBNP in severe and mild asphyxia combined with my‐ocardial injury group were significantly higher than the groups without myocardial injury and the control (P<0 .05) .Levels of plas‐ma Nt‐proBNP in severe asphyxia myocardial injured group were significantly higher than those of the mild asphyxia myocardial in‐jured ones (P<0 .05) .On the fifth day ,the levels of plasma Nt‐proBNP in severe asphyxia myocardial injured group were signifi‐cantly higher than others (P<0 .05) .There was no difference in Nt‐proBNP levels between mild asphyxia myocardial injured group and the ones without myocardial injury (P>0 .05) .On the first day after birth ,levels of Nt‐proBNP ,CK‐MB were positively corre‐lated in the mild asphyxia group (r=0 .58 ,P<0 .05) and severe asphyxia group (r=0 .47 ,P<0 .05) .On the first day after birth , the cutoff value for myocardial injury was 695 .87 fmol/mL ,the area under the ROC curve was 0 .763 ,with the sensitivity of 71 .9%and specificity of 65 .4% ,the positive predictive value was 73 .3% and negative predictive value was 63 .8% .Conclusion The Nt‐proBNP level has important clinical value for early evaluation of the severity of myocardial injury after asphyxia .

OBJECTIVETo observe the effect of detoxifying and blood circulation activating Chinese herb extraction of polygonum cuspidatum and hawthorn on carotid intima-media thickness (IMT), plaque integral and plaque stability related serum indexes of patients with carotid atherosclerosis.

METHODSixty and four cases of carotid artery atherosclerosis patients were assigned randomly to 2 groups: detoxifying and blood circulation activating treatment group (treatment group, 32 cases) and control group (32 cases). Patients in treatment group were treated with capsules of extraction of polygonum cuspidatum and hawthorn, 1 pill po, bid (dosage of administration: polygonum cuspidatum extraction 5.33 mg x kg(-1) x d(-1), hawthorn extraction 5.0 mg x kg(-1) x d(-1)); patients in control group were treated with lovastatin 20 mg po, qd (dosage of administration: 0.33 mg x kg(-1) x d(-1)). The course of treatment was six months. To observe changes of IMT, plaque integral, and detect the level of plaque stability related serum indexes such as Hs-CRP, MMP-1 and TIMP-1.

RESULTAfter 6 months of treatment, in control group one patient quit the clinical trial because of liver dysfunction and one patient was rejected because of having not followed the therapeutic regimen. 32 cases in treatment group and 30 cases in control group were analyzed. The results showed that IMT and plaque integral of treatment group decreased significantly after the treatment (P < 0.05, P < 0.01), and there was no significant difference compared with control grope. Serum Hs-CRP, MMP-1 and MMP-1/TIMP-1 decreased after the treatment (P < 0.05, P < 0.01), and the treatment group was superior to control group in decreasing serum Hs-CRP (P < 0.05).

CONCLUSIONDetoxifying and blood circulation activating Chinese herb extraction of polygonum cuspidatum and hawthorn has good effect of anti-atherosclerosis and promoting plaque stability. Its mechanism might be related with anti-inflammation and inhibiting degradation of extracellular matrix, and deserves further studies.

C-Reactive Protein ; metabolism ; Carotid Artery Diseases ; blood ; drug therapy ; Crataegus ; chemistry ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Fallopia japonica ; chemistry ; Female ; Humans ; Male ; Matrix Metalloproteinase 1 ; blood ; Middle Aged ; Safety ; Tissue Inhibitor of Metalloproteinase-1 ; blood