Objective To explore the application effect of the model of clinical nursing path management in clinical nursing. Methods A comparative study was conducted of the clinical nursing paths respectively with regard to patients who had received thyroid adenoma resection and with regard to patients who had received hysteromyomectomy. Results In the experimental group involving clinical nursing path management, the average length of stay was shortened, pre operation days were reduced, and the average hospitalization expenses were lowered while the satisfaction rate of patients with thyroid adenoma rose by 2.18%, reaching 98.96% and that of patients with hysteromyoma rose by 2.87%, reaching 99.55%. At the same time, clinical nursing path management also enhanced the job satisfaction of nurses. Conclusion It is viable to adopt the model of clinical nursing path management in clinical nursing in China.

Objective To evaluate the efficacy of laparuseopic and open D_2 radical gastrectomy for gastric cancer. Methods From January 2008 to February 2009, 64 gastric cancer patients received laparoscopic radical gastrectomy (LAP group) and 60 gastric cancer patients received open gastrectomy (open group) at Changzhou No. 2 People's Hospital. Clinical parameters including operation time, blood loss, resection margin of gastric cancer, number of lymph nodes dissected, time for passage of flatus, time for out-of-bed activity, hospital stay and postoperative complications in the 2 groups were analyzed via t test and chi-square test. Results Gastrectomy was successfully performed on all patients. Mean operation time in LAP group was significantly longer than open group (t=5.56, P<0.05). There was no significant difference in the length of resection margin and number of lymph nodes dissected between the 2 groups (t=0.67, 0.86, 1.09, P>0.05). The mean blood loss, time for passage of flatus, time for out-of-bed activity and hospital stay in LAP group were significantly lesser than in open group (t=4.59, 5.56, 16.39, 4.79, P<0.05). Six patients in LAP group and 5 patients in open group had compli-cations postoperatively. All patients were followed up for 1-13 months, and no recurrence or death occurred. Conclusion Laparoscopic D_2 radical gastrectomy is safe and effective for gastric cancer.

OBJECTIVE:To study the time-concentration curves of single dose of ambroxol hydrochloride orally integrating tablets in healthy volunteers and to evaluate its bioequivalence.METHODS:A single oral dose of 90mg ambroxol hydrochloride orally dissolving tablets and 90 mg ambroxol hydrochloride tablets were given to 18 healthy volunteers by a randomized crossover design.The concentrations of ambroxol hydrochloride in plasma were determined by HPLC.RESULTS:The main pharmacokinetic parameters of the test and references preparations of ambroxol hydrochloride were as follows:Cmax were(169.58?39.43)ng?mL-1 and(170.28?43.26)ng?mL-1;tmax were(1.6?0.5)h and(2.2?0.6)h;t1/2 were(6.77?2.04)h and(6.50?1.27)h;AUC0～24 were(1 131.26?289.36)ng?h?mL-1 and(1 191.54?270.17)ng?h?mL-1;AUC0～∞ were(1 215.27?306.56)ng?h?mL-1 and(1 281.44?291.51)ng?h?mL-1,respectively.The relative bioavailability of the test preparation was(95.5?15.6)%.CONCLUSION:The result demonstrated that the two preparatioins were bioequivalent in absorption degree,suggesting the rapid release characteristics of the preparation.

Objective To investigate the effect of deltaNp63(ΔNp63) silencing on the proliferation of pancreatic cancer PANC1 cells.Methods ΔNp63 mRNA level in 23 pairs of pancreatic cancer and adjacent tissue specimen was detected by real-time PCR, andΔNp63 protein in human normal pancreatic ductal cell line HPDE6-C7 and pancreatic cancer cell line PANC1, CFPAC1 and BXPC3 was detected by Western blot. PANC1 cells were transfectedΔNp63 specific siRNA (ΔNp63-siRNA ) and scramble siRNA ( Con-siRNA ) using liposome, and untransfected cells served as control.ΔNp63 mRNA and protein was detected by real-time PCR and Western blot to validate the silencing ofΔNp63 expression.MTT assay and BrdU method were used to detect the proliferation and DNA synthesis of transfected PANC1 cells.Results TheΔNp63 mRNA expression in pancreatic cancer tissues and matched adjacent normal tissues was 0.99 ± 0.07 and 0.70 ±0.07, respectively.ΔNp63 mRNA expression in pancreatic cancer tissue was significantly up-regulated compared with that in the normal tissue (P=0.0034).TheΔNp63 protein expression in HPDE6-C7, PANC1, CFPAC-1 and BxPC3 cells was 0.97 ±0.09,3.06 ±0.16,2.57 ±0.11 and 2.45 ±0.08, respectively.TheΔNp63 protein level in pancreatic cancer cells were higher than that in HPDE6-C7 cells (P<0.001).ΔNp63 mRNA level in control, Con-siRNA and ΔNp63-siRNA group was 0.97 ±0.07,0.97 ±0.07 and 0.28 ±0.03, respectively, andΔNp63 protein expression level was 0.97 ±0.06,1.00 ±0.10 and 0.26 ±0.03.The expression ofΔNp63 mRNA and protein inΔNp63-siRNA group were significantly down-regulated comparing with those in Con-siRNA group (P<0.01).Significant inhibition on cell proliferation was observed in ΔNp63-siRNA group, which was statistically different from that in control and Con-siRNA group.The A490 value (DNA synthesis) of control, Con-siRNA andΔNp63-siRNA group was 0.55 ±0.04, 0.56 ±0.01 and 0.55 ±0.00 at 24 h after transfection, and 0.84 ±0.05,0.87 ±0.07 and 0.71 ±0.05 at 48 h after transfection.The DNA synthesis inΔNp63-siRNA group was significantly down-regulated compared with that in control and Con-siRNA group (P<0.05).Conclusions Knockdown ofΔNp63 could greatly inhibit the proliferation and DNA synthesis of pancreatic cancer PANC1 cells.

Electroacupuncture (EA) at Zhongliao (BL33) can improve the symptoms of overactive bladder (OAB),such as urinary frequency,urgency,and incontinence.However,its performance compared with other acupoints remains unclear.This study investigated the effects of EA at BL33 with deep needling on rats with OAB by detecting urodynamics in eight groups:no intervention group,D-BL33 group (deep needling at BL33),S-BL33 group (shallow needling at BL33),non-acupoint group (needling at the non-acupoint next to BL33),Weizhong (BL40) group,Sanyinjiao (SP6) group,Tongtian (BL7) group,and Hegu (LI4) group.Results revealed that EA at BL33 with deep needling,BL40,and SP6 prolonged the intercontraction interval (ICI) of rats with OAB (P=0.001,P =0.005,P =0.046,respectively,post-treatment vs.post-modeling).Furthermore,the change in ICI from post-modeling in the D-BL33 group was significantly greater than those of the no intervention and other EA groups (all P ＜ 0.01).Significantly shortened vesical micturition time (VMT) and elevated maximum detrusor pressure (MDP) were also observed in the D-BL33 group (P =0.017 and P =0.024,respectively,post-treatment vs.post-modeling).However,no statistically significant differences in the changes of VMT and MDP from postmodeling were observed between D-BL33 and the other EA groups.In conclusion,EA at BL33 with deep needling may inhibit acetic-acid-induced OAB more effectively.

ObjectiveTo detect the serum level of follistatin-like protein 1 (FSTL1) in patients with systemic lupus erythematosus (SLE) and its expression in renal biopsy tissues in lupus nephritis (LN) patients as well as its clinical significance were analyzed.MethodsThe serum concentration of FSTL1 in 54 SLE patients and 27 healthy controls was measured with enzyme-linked immunosorbent assay (ELISA).The distribution of FSTL1 in renal biopsy tissues was stained by immune-histochemical method.Mann-Whitney U test,t test,X2test and Pearson test were selected to compare the changes and data analysis.ResultsThe serum FSTLI level was significantly higher in SLE patients(26±21) μg/L than those of healthy controls ( 12± 14) μg/L (P＜0.01).The level of serum FSTL1 was significantly higher in SLE patients with hypertension than in patients without hypertension.The serum FSTL1 level had statistically significant changes between SLE patients with disease duration ≥ 5 years and ＜5 years.The level of serum FSTL1 correlated positively with SLEDAI score (r=0.319,P=0.022),age (r=0.700,P＜0.01),disease duration (r=0.513,P＜0.01),complement C4 level (r=0.443,P=0.004),and total serum cholesterol level (r=0.460,P=0.001 ).FSTL1 correlated inversely with platelet count (r=-0.422,P =0.001 ),anti-dsDNA antibody levels (r=-0.276,P=0.046).FSTL1 expression was evident in the cytoplasm of epithelial cells of kidney tubules.ConclusionThe level of serum FSTL1 is significantly increased in SLE patients.FSTL1 concentration correlats positively with disease activity.These data indicate that FSTL1 may play a role in the pathogenesis of SLE.

Objective To estimate the effect of the enviromental pollutant 2,3,7,8-tetrachlorodibenzo-pdioxin (TCDD),a representative of the dioxin family,on the expression of cytochrome P4501A1 (CYP1A1) in cultured human immortalized SZ95 sebocytes in vitro,so as to improve understanding of the pathogenesis of chloracne.Methods SZ95 sebocytes were cultured with or without the presence of 10 nmol/L TCDD for two hours or three days.Real time fluorescence-based PCR was performed to quantify the mRNA expression of CYP1A1,immunohistochemistry and Western blot to determine the expression level of CYP1A1 protein,in the SZ95 cells.Chi-square test was done to compare the protein and mRNA expressions of CYP1A1 between untreated and treated SZ95 cells.Results Real time PCR showed that the mRNA expression of CYP1A1 was low in SZ95 sebocytes,and increased by 5.622 times after 2-hour treatment with TCDD(P ＜ 0.05).Immunohistochemistry revealed a weak expression of CYP1A1 protein in the cytoplasm and nuclei of untreated SZ95 sebocytes,which was also significantly enhanced by the TCDD treatment.Western blot results showed that the relative expression level of CYP1A1 protein was 4.233 ± 0.252 in SZ95 sebocytes treated by TCDD for three days,significantly higher than that in untreated sebocytes(0.123 ± 0.208,P ＜ 0.05).Conclusions There is a low expression of CYP1A1 mRNA and protein in SZ95 sebocytes,which can be upregulated by TCDD,suggesting that the CYP1A1 gene is a downstream target of the aryl hydrocarbon receptor responsible for the abnormal differentiation of human sebocytes.

Objective To investigate the combined biological effects of low dose radiation,carbon monoxide,benzene and noise on rats.Methods Sixteen male SD rats were randomly divided into experiment group and control group.The experiment group was exposed to carbon monoxide,benzene,low dose radiation and noise daily,the control group was in common environment.Peripheral blood,organ index,and marrow DNA content were detected.Two-dimensional electrophoresis (2-DE) was performed on serum protein analysis.Differential expressed proteins were identified by a matrix assisted laser desorption/ionization time of flight mass spectrometry (MAIDI-TOF-MS).Results Compared to control group,the liver index,spleen index,thymus index,leukocytes,platelets count,and marrow DNA content of the experiment group were decreased significantly (t =2.732,4.141,3.053,2.211,2.668,11.592,P ＜0.05).12 altered proteins were detected and through identification,3 proteins were definite in terms of serum amyloid A-4 protein (SAA4),trichoplein keratin filament-binding protein (TCHP) and tubulin alpha-4A chain (TUBA4A).Conclusions The hematopoietic system and immune system of rats are damaged significantly with the changes of several serum protein expressions by the combined exposure of low dose radiation,carbon monoxide,benzene and noise.This study may provide new information for the mechanism of the combination effects.

Objective To discuss the establishment,implementation and clinical effect of appraisal system of self-injection of insulin.Methods 100 type 2 diabetes patients were chosen as the objects.The appraisal system of self-injection of insulin for diabetes patients was established to quantify the level of related knowledge and self-injection level.Selective health education was given to patients and plan-imple-mentation-appraisal-processing(PDCA)method was adopted in the quality control management of health education.Results After the implementation of the appraisal system,the patients'grades of the related knowledge and skill on self-injection of insulin were enhanced.Fasting blood glucose and 2 h postprandial Mood glucose was stably controlled,which was statistically different from that before the implementation of the appraisal system.Conclusions The implementation of the appraisal system can sharpen the patients'self-control ability of disease and avoid the blindness,low efficiency and duplication of health education workers.

Objective To investigate the value of remnant stomach-jejunal dual pathways reconstruction after laparoscope-assisted radical proximal gastrectomy in the treatment of upper gastric cancer. Methods Twenty-five patients with upper gastric cancer underwent laparoscope-assisted radical proximal gastrectomy and the remnant distal stomach was preserved for side-to-side remnant stomach-jejunal anastomosis and end-to-side jejuno-jejunal anastomosis to reconstruct dual pathways. Results The mean operation time was (240±35) minutes, the mean number of lymph nodes dissected were 22±5, and all the incised margins were negative. No anastomotic leakage, obstruction or stenosis occurred. All patients received postoperative barium meal examination. A large amount of barium directly entered the jejunum, leaving a small amount of barium entered the jejunnum via the route of remnant stomach-duodenum, and was detained in the remnant stomach for 30-60 minutes. No esophageal reflux of barium was observed. All the patients were followed up for 4-18 months, no reflux esophagitis was detected and the short-term life quality was satisfactory. Conclusions Remnant stomach-jejunal dual pathways reconstruction prevents the reflux esophagitis and dumping syndrome, preserves the pathway of duodenum and promotes the life quality of patients.