Objective To discuss the correlation between the leading style of lead nurses and nurses satisfaction degree with work of by applying managerial grid theory.Methods 300 nurses from 40 nursing units of 5 hospitals above class-two level were investigated with 3 kinds questionnaires.Results The number of head nurses who were considered to conduct with bureaucratic style reached 39.7%.Thosewith democratic style,parent style,autocratical style and indulgent style ranked the 2nd,3th,4th and 5th position respectively.In addition the leading styles were correlated with nurses'satisfaction degree with work,among which the democratic style gained the highest satisfaction degree of nurses.Conclusion The democratic leading style Was the most satisfying and it put forward new thinking and reference for futurenursing management.

One-hundred and eighty-eight cases of metabolic syndrome conforming to the criteria of International Diabetes Federation(IDF) were enrolled,and 166 healthy subjects served as control.Phalangeal bone mineral densities in both groups were measured.Osteocacin,bone alkaline phosphatase,and parathyroid hormone were determined with Enzyme-linked immunosorbent assay.Results:Body mass index,waist circumference,waist-tohip ratio,fasting blood glucose,blood pressure,triglycerides,total cholesterol,and low-density lipoproteincholesterol in the group with metabolic syndrome were higher than those in normal control group(all P＜0.01),while high-dcnsity lipoprotein-cholesterol was lower (P ＜ 0.01).T values,Z values,and osteocacin in the metabolic syndrome group were lower than those in control group (all P＜0.05),while parathyroid hormone was higher (P＜0.05).There was no significant difference in levels of bone alkaline phosphatase between the two groups.Metabolic syndrome as an aggregate of multiple metabolic disorders was prone to be accompanied with osteoporosis.Body mass index was an important protective factor of osteoporosis,triglycerides and waist-hip ratio were independent risk factors.

OBJECTIVE: To evaluate the preoperative utilization of antibacterial in orthopaedic patients in our hospital. METHODS: The preoperative use of antibacterial in 300 orthopaedic patients in our hospital in 2008 was reviewed. RESULTS: Of the 300 patients in our study, 100% of them were recieved preoperative antibacterial. Two of the most widely used antibacterials were clindamycin and cefuroxime sodium. The use of antibacterial in 228 patients were overtime after operation (76.00%), of which the use of antibacterial in 161 patients in type Ⅰ incision exceed 24 hour(70.61%), 56 patients in type Ⅱ incision exceed 2 days(24.56%) and 11 patients in type Ⅲ incision exceed 7 days (4.82%). CONCLUSION: The usage of preoperative antibacterial was inappropriate and the duration of administration is too long, which should be standardized.

Objective To study the synergism effect of 131 I-Herceptin and high-energy X-ray on HER2 overexpressed breast cancer SK-BR-3 cells.Methods The protein expression and gene amplification of human epidermal growth factor receptor-2 ( HER2 ) in SK-BR-3 cells were identified by immunohistochemistry and fluorescence in situ hybridization ( FISH ) method, 131 I-Herceptin was prepared by iodogen method, and the IC15 concentration of 131 I-Herceptin on SK-BR-3 cell were selected by MTT method.The cells were divided into control group and drug group according to 131 I-Herceptin used or not, and were delivered five different doses of external irradiation (0,2,4 and 6Gy), and the synergism effect was detected by colonogenic assay.The cells were divided into blank group, drug group(131I-Herceptin), X-ray group(2 Gy external irradiation) and combination group (131I-Herceptin+2 Gy external irradiation), the apoptosis rate and death rate were detected by AO/EB method and cell cycle were detected by flow cytometry.Results The labling rate, radiochemical purity and specific radioactivity of 131 I-Herceptin were 86.8%, 93.9% and 868.3 μci/mg, respectively.The IC15 of 131 I-Herceptin was 15.625μci/mL.131 I-Herceptin and high-energy X-ray significantly reduced surviving fraction ( SF) ( F=628.888,F=964.97,P<0.05) and there were interactions between them (F=113.046,P<0.05).There were significant differences in apoptosis rate and death rate among blank group, drug group, X-ray group and combination group(F=103.324,F=13.33,all P<0.05),and there were significant differences of pairwise comparison (P<0.05).After irradiation and 131I-Herceptin administration, the cell cycle changed obviously from G1-phase to G2-and S-phase.Conclusion 131 I-Herceptin combined with high-energy X-ray has the synergism effect on HER2 overexpressed breast cancer SK-BR-3 cells.

Aim To study the effect of activating Sonic hedgehog( Shh) pathway on the function of endothelial progenitor cells ( EPCs ) in type 1 diabetic mice. Methods EPCs were isolated and cultured by density gradient method from diabetic mice. The effects of Shh N-terminal peptide and agonist SAG on EPCs prolifera-tion were evaluated by using the MTT colorimetric as-say. EPCs migration was measured by Transwell meth-od. EPCs tube formation ability was estimated by Matrigel . EPCs senescence activity was determined by β-galactosidase staining. Results Compared with control mice, the function of EPCs in type 1 diabetic mice was impaired. The proliferation, migration and tube formation of diabetic EPCs could be promoted by Shh peptide and agonist SAG. The senescence of dia-betic EPCs could be decreased by Shh peptide and ag-onist SAG. Conclusion Activating Shh signaling pathway can improve the impared function of diabetic EPCs in type 1 diabetic mice.

Objective To clone CYP3A4 gene and to construct CYP3A4 recombinant mammalian expression vectors which are transferred into K562 cells for expression,and detect the anti-tumor effect of CYP3A4 combined with Cyclophosphamide (CPA) in vitro.Methods Mammalian expression vector containing CYP3A4 gene cloned from human hepatocytes by RT-PCR were constructed and transferred into K562 cells via liposome. The expression of CYP3A4 was detected by RT-PCR and Western blot respectively. MTT detected the anti-tumor effect of CYP3A4 recombinant mammalian expression vectors combined with CPA.Results We cloned CYP3A4 gene and constructed the recombinant mammalian expression vectors pcDNA3, 1/myc-His A (+)-CYP3A4 successfully. Both RT-PCR and Western blot showed significantly higher mRNA and protein expression of CYP3A4 in gene-transfected group than in empty vector-transfected controls and in empty cells controls. The IC_(50) values were 1. 090 16 mmol/L in gene-transfected group, which were significantly lower than in other two groups and could be reduced and increased by the revulsant and inhibitor respectively.Conclusions CYP3A4 recombinant mammalian expression vectors had anti-tumor effect cooperating with CPA, and the effect could be increased and reduced by the revulsant and inhibitor of CYP3A4 respectively.

Clinically, atrial fibrillation (AF) is one of the most common cardiac arrhythmia, and patients with arterial fibrillation carry high risk of stroke. Oral administration of anticoagulation such as warfarin for the prevention of stroke has some risks to induce bleeding; moreover, some patients are not able to tolerate the medication. Percutaneous occlusion of the left atrial appendage is safe and effective for the prevention of stroke in patients with atrial fibrillation, although at present it is only used for the patients who have contraindications to anticoagulation medication. This paper aims to review a variety of left atrial appendage occlusion devices and to analyze the relationship between the different shape design of occluder and the left atrial appendage morphology.

Objective To investigate the distribution of moderate to severe cancer pain and administrated dose of opioid drugs in order to provide the reference for the treatment of moderate and severe cancer pain.Methods Retrospective analyzed the clinical data of 146 patients with moderate to severe cancer pain.The information were recorded including opioid use dose,cancer pain incidence,age,gender,height,weight,body surface area and type of tumor.Results There were no significant difference among patients with opioids drug administration in terms of gender,average daily oral dose(x2 =0.473,Z =-0.185,P ＞ 0.05).Meanwhile cancer incidence rate was same in different age groups (x2 =2.280,P =0.684).The average daily opioid dose in patients with over 80 year old was the lowest among other age groups (Z =-2.745,-1.986,-2.141,-2.162;P ＜0.05).Cancer pain incidence in patients with hepatobiliary pancreatic tumors were 67.50％ (27/40),highest than other different types cancer including metastatic tumor(62.50％ (10/16)),urinary tumor (61.54％ (8/13)),lung cancer (52.63％ (50/95)),breast cancer and gynecological tumor (50.00％ (17/34)),gastrointestinal tumor(41.94％ (26/62)),other tumors 38.46％ (5/13) and head and neck tumor(25.00％ (3/12)),the difference was statistically significant (x2 =23.672,P ＜ 0.05).The average day oral morphine dose of different types tumor were listed as followed from high to low in the order:160 (80,200) mg of metastatic tumors,120 (60,160) mg of breast and gynecological tumor,100 (40,125) mg of lung cancer,90(45,115) mg of urinary tract tumors,80(60,160) mg of other tumors,70(50,90) mg of hepatobiliary pancreatic tumor,60 (40,80) mg of gastrointestinal tumor,55 (40,70) mg of head and neck tumor.There were significant differences in terms of among oral morphine dose per day of different type tumors (H=14.280,P ＜0.05).No correlation was found between pain patients with height,body mass,body surface area and average daily dose of morphine (r =-0.045,-0.042,-0.046 ; P ＜ 0.05).Conclusion No significant differences were found in terms of moderate to severe cancer pain among different type tumors at different and age groups.While there is significant difference in term of cancer pain incidence among different tumor types.The average daily amount of morphine in patients with cancer pain is not related to gender,height,body mass and body surface area.The average amount of morphine of patients with age over 80 years old is significantly lower than that of the other age groups,and the average amount of morphine t is related to cancer type.

In the treatment of facial paralysis in the acute stage and restoration stage by shallow needling technique and penetrating needling technique respectively, totally 106 cases, the effective rate is respectively 98.6% and 83.9%, indicating that the curative rate is high if early treatment is given.

Objective To determine the plasma concentration of cytarabine(Ara-C) in children with leukemia and obtain dynamics parameters, and investigate the relationship between the parameters and clinical effect in order to provide the basis for optimization of Ara-C application. Methods Using highperformance liquid chromatogram (HPLC) to determine the plasma concentration of Ara-C, its metabolite Ara-U and infusion rate in 37 children with acute leukemia, their therapeutic reaction, remission, treatment-related infection, side-effect and long-term treatment effect were analyzed in statistic. Results Ara-C by 1～2 g/m2 intravenous drop infusion for 2 hours, the peak plasma concentration time was 2 h and peak concentration were (14.37-84.44)μmol/L, and the median was (41.42±22.80)μmol/L. The median infusion rate was 869.57at 30 minutes after Ara-C drip completion, its average level was (253.40±81.49) μmol/L, over six-times than Ara-C peak concentration. The median continuous complete remission time in 37 children was 29.8 months (5.0～53.1 months), 3y-DFS was (90.63±5.15)%. The therapy-related infection rate was 56.8 %(21/37),including three children (8.1 %) suffered from severe infection, but there was no therapy-related death and no children were off the protocol due to poor tolerance. Conclusion As post-remission treatment, high-dose Ara-C would not cause cumulation in vivo in children with acute leukemia and side-effect were slight. Ara-C could improve the long-term continuous complete remission rate and clinical cure rate for children with leukemia. Therefore, it was worth to apply in clinical.