Objective: To establish the determination method for meropenem in urine by fluorescence resonance energy transfer spectroscopy. Methods:An LS-55 fluorescence spectrophotometer was used. The solution of meropenem, fluorescein, eosin Y, BR buffer and cetyl trimethyl ammonium bromide was respectively added into a 10 ml colorimetric tube. At λex of 455 nm and λem of 547 nm, the fluorescence intensity F and F0 of the system and the reagent blank sample was detected. Using ΔF = F-F0 as signal re-sponse value for meropenem, the content was calculated. Results: The linear regression equation of meropenem in urine was as fol-lows:ΔF=33. 8C+53. 4 (r=0. 991 7), the linear range was 0. 5-10 μg·ml-1 with the detection limit of 0. 13 μg·ml-1, the re-covery of 98. 9%-103. 0% and RSD of 0. 3%-0. 4%. Conclusion:The method is rapid and accurate, which can be used in the phar-macokinetic study of meropenem.

Objective To discuss correlation of hypertension grading and hemorrhinia and the corresponding nursing measures. Methods Retrospective analysis was carried out in 151 cases of hypertension patients. Results 94 patients (62.3%) among 151 cases of hypertension patients occurred hemorrhinia, 42 patients (27.8%) were in grade 3 hypertension, male 30, female 12. 2 37 patients (24.5%) were in grade 2 hypertension, 22 males, 15 female; 15 cases (9.9%) were in grade 1 hypertension, 9 males and 6females. Hypertension grading was correlated with hemorrhinia, but not with the sexual distinction of hemorrhinia patients. Conclusions Hypertension grading is correlated with hemorrhinia, so we should treat hypertension actively, decrease hypertension grading in order to lower the incidence of hemorrhinia.

Objective To explore problems of chemical indicative cards and adhesive tapes in the disinfection,and find out some measures for improving the sterilizing effect of the pressure steam sterilizer.Methods 100 stoves of time with various package,dressing and storage tank were disinfected by pulse pressure steam sterilizer and chemical indicative cards of 3M1250 pressure steam sterilizing package at the same pressure,time and temperature.All test wraps were examined and the real conditions were recorded after the sterilization.Results The discoloration of chemical indicative cards in 10 test wraps was not standard before the measures were taken.While after that,it didn't occur again.Conclusion The nonstandard discoloration of chemical indicative cards of 3M1250 pressure steam sterilizer is influenced by condensed water of steam during the steam sterilization.In order to make the chemical indicative cards change into standard black,the accurate using of chemical indicative cards,the standard stuff package and correct using of disinfector are required.

Objective:To establish a RP-HPLC method with pre-column derivation for determining the content of stilbene glyco-sides in Yening granules. Methods:DNS-Cl was used as the derivation reagent, a Wondasil-C8 column (250 mm × 4. 6 mm, 5 μm) was used as the stationary phase and 30mM ammonium phosphatere gulation (pH 3. 5)-acetonitrile (78∶22) was applied as the mobile phase, a fluorescence detector (λex=370 nm,λem=560 nm) was used, the flow rate was 1. 0 ml·ml-1 , the column temperature was 30℃ and the injection volume was 20 μl. Results: There was no interference from the other substances in the preparation. The linear range of the two stilbene glycosides was 0.071-27.280 mg·ml-1(r=0.999 9). The average recovery was 99.04%(RSD=0. 1%, n= 9). Conclusion:The method is simple, quick, sensitive and accurate, which can be used for the quality control of Ye-ning granules.

ObjectiveTo explore the role of risk management in reducing the nursing risk of junior nurses in operation room. Method The risk management was implemented among junior nurses in operation room including establishing training groups for risk management,establishing instructor system,classifying nursing risk events and formulating operation room nursing risk monitoring. Result After risk management,the rate of risk events in the junior nurses was lowered as compared to pre-enforcement of the risk management(P<0.001).Conclusions The risk management can improve the risk awareness of junior nurses in operation room and reduce the incidence of nursing risk events.

Objective: To observe the effect of yoghurt supplementation on the growth rate of preschool children in Beijing suburb. Methods: 402 healthy children (217 males, 185 females), aged 3-5 years old, were selected as subjects with height and/or weight less than WHO standard from 7 kindergartens in Beijing suburb. The children were divided randomly into control group (CG 201) and yoghurt supplemented group (YG 201). Children in YG were supplemented with yoghurt (125g) for 5d per week for 9 mo, and children in CG not supplemented. Height, weight and upper-arm circumference were measured every month. Blood biochemical parameters (Hb,TP) were detected every 3 mo. Results: Calcium, zinc and VB2 were consumed more in YG than CG. Hb in YG was also higher than CG . The height incease and weight gain of YG was significantly higher than CG during 3, 6 and 9mo. Conclusion: Yoghurt supplementation for 9 months can increase calcium, zinc and VB2 intake, and improve preschool childrens nutritional status, therefore increase their height increase and weight gain.

ObjectiveTo investigate the association between CD4+/CD8+ ratio in peripheral blood and patient prognosis after hepatectomy for liver cancer. MethodsThe clinical data of 150 patients who received partial hepatectomy for liver cancer in the 180 Hospital of PLA from October 2008 to November 2011 were analyzed retrospectively. CD4+/CD8+ ratio in peripheral venous blood was measured before surgery, and the patients were divided into low-CD4+/CD8+ group (CD4+/CD8+ ratio ≤1, 52 patients) and high-CD4+/CD8+ group (CD4+/CD8+ ratio ＞1, 98 patients). Clinical indices were compared between the two groups, and outpatient follow-up and telephone follow-up were applied to record survival rate and tumor recurrence. The chi-square test was applied for comparison between the two groups, and Kaplan-Meier method (log-rank test) was applied for survival analysis. Univariate and multivariate logistic regression analyses were performed for clinical factors to determine the related risk factors for recurrence after hepatectomy for liver cancer. ResultsThe low-CD4+/CD8+ group had significantly lower 1-, 3-, and 5-year survival rates than the high-CD4+/CD8+ group (χ2=36.473, 41983, and 55.214, respectively; all P＜0.001), and the 5-year survival rate differed significantly between the two groups (χ2=81.471; P＜005); the low-CD4+/CD8+ group had significantly higher 1-, 3-, and 5-year tumor recurrence rates than the high-CD4+/CD8+ group (χ2=44.041, 68.234, and 55.157, respectively; all P＜0.05). Univariate analysis showed that CD4+/CD8+ ratio, tumor diameter, existence of satellite lesions, hepatitis B virus infection, depth of tumor invasion, microvascular invasion, lymph node metastasis, and degree of tumor differentiation were high risk factors for recurrence after resection of liver cancer. Multivariate analysis showed that CD4+/CD8+ ratio, tumor diameter, degree of tumor differentiation, lymph node metastasis, and microvascular invasion were independent risk factors for recurrence after resection of liver cancer. ConclusionThe patients with a CD4+/CD8+ ratio of ≤1 before resection of liver cancer have poor prognosis and high recurrence rates, and CD4+/CD8+ ratio has a certain predictive value for prognosis after resection of liver cancer.

ObjectiveTo explore the clinical application of preoperative biliary drainage in the treatment of patients with malignant obstructive jaundice (MOJ) with acute cholangitis (AC). MethodsA retrospective study was performed on the clinical data of 74 patients with MOJ and AC who were treated with preoperative biliary drainage in our hospital from January 2010 to December 2014. In those patients, 29 patients treated with percutaneous transhepatic biliary drainage (PTCD) were assigned to PTCD group, and 35 patients treated with endoscopic retrograde biliary drainage (ERBD) were assigned to ERBD group. The levels of total bilirubin (TBil), direct bilirubin (DBil), and alanine aminotransferase (ALT) before and after treatment, total hospitalization cost, average duration of hospitalization, and postoperative complications were compared between the two groups. The advantages and disadvantages were compared between the two preoperative biliary drainage approaches. Between-group comparison of continuous data was made by t test, and between-group comparison of categorical data was made by χ2 test. ResultsIn both groups, the levels of TBil, DBil, and ALT were significantly reduced after treatment (all P＜0.05). The ERBD group had significantly larger decreases in the levels of the three biochemical indices than the PTCD group (all P＜0.05). The ERBD group had significantly shorter average duration of hospitalization and significantly lower total hospitalization cost than the PTCD group (t=3.172, P＜0.05; t=2.562, P＜0.05). The incidence of acute pancreatitis in the ERBD group was significantly higher than that in the PTCD group (14.28% vs 3.45%, P＜0.05); however, the incidence rates of biliary tract bleeding, biliary tract infection, and resection or puncture site infection were significantly lower in the ERBD group than in the PTCD group (all P＜0.05). ConclusionPreoperative biliary drainage can substantially control AC symptoms and improve liver function. Compared with PTCD, ERBD achieves shorter duration of hospitalization, lower total hospitalization cost, and lower incidence rates of complications after treatment, which can be taken as the first choice for the treatment of MOJ with AC.

Objective:To investigate the effect of nurse-led stress inoculation training on fear of self-injecting and self-testing and self-management behaviors in elderly type 2 diabetic patients and provide reference for diabetes nursing care.Methods:A total of 110 elderly type 2 diabetic patients of Department of Endocrinology of Hainan People′s Hospital from January 2018 to January 2020 were divided into experimental group and control group according to odd and even numbers, with 55 patients in each group. The control group received routine nursing care, while the experimental group implemented nurse-led stress inoculation training for 4 weeks. The intervention effect was assessed by Diabetes Fear of Injecting and Self-testing Ouestionnaire (D-FISQ) and Diabetes self-management behaviors among older (DSMB-O), respectively.Results:In the study, one patient in the experimental group fell off, and finally included 54 cases in the experimental group and 55 cases in the control group. After intervention, the fear of self-injecting scores, fear of self-testing scores, and total D-FISQ scores were 13.15 ± 3.02, 15.67 ± 3.59 and 28.81 ± 5.08 in the experimental group, significantly lower than those in the control group (15.25 ± 3.18, 17.56 ± 3.92 and 32.82 ± 4.89), the difference was statistically significant ( t=3.55, 2.63, 4.19, P<0.05). Active exercises, current medication, blood glucose monitoring, dealing with problem, active response, reducing risks scores and total DSMB-O scores were 2.39 ± 0.49, 2.39 ± 0.49, 2.20 ± 0.81, 4.41 ± 0.92, 4.70 ± 1.13, 5.06 ± 0.79 and 25.28 ± 2.57 in the experimental group, significantly higher than those in the control group (3.95 ± 0.85, 2.11 ± 0.85, 1.51 ± 0.50, 3.95 ± 0.78, 4.13 ± 1.43, 4.38 ± 1.16 and 22.09 ± 2.24), the difference was statistically significant ( t values were 2.10-6.90, P<0.05). Conclusions:Nurse-led stress inoculation training can effectively alleviate fear of self-injecting and self-testing and promote self-management behaviors of elderly patients with type 2 diabetes.

BACKGROUND:There is still controversy whether human bone marrow mesenchymal stem cells can maintain their biological characteristics,energy metabolism patterns,and multidirectional differentiation potential after long-term expression in vitro.Further comprehensive and systematic research is needed. OBJECTIVE:To evaluate the effects of long-term expansion in vitro on the biological characteristics of mesenchymal stem cells. METHODS:Human bone marrow mesenchymal stem cells cultured to passage 5,10,and 15 in vitro.MTT assay was used to detect cell proliferation ability.Flow cytometry was used to detect cell cycle.The multi-differentiation potential of mesenchymal stem cells was detected by inducing to adipogenic,osteogenic and chondrogenic differentiation.Cell migration and invasion abilities were detected by scratch test and Transwell assay.The mitochondrial oxidative phosphorylation and glycolysis function were analyzed using energy metabolism analyzer.The cell senescence was detected by senescence-associated β-galactosidase staining.The expression levels of p21,p16,and p53 proteins were detected by western blot assay. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells at passages 5,10,and 15 grew adherently;the volume of passage 15 mesenchymal stem cells increased and its proliferation ability decreased;the percentage of S-phase cells decreased(P<0.05).With the increase of culture passages,the migration and invasion abilities decreased gradually(P<0.05).There was no significant difference in the differentiation potential,demonstrated by adipogenic,osteogenic and chondrogenesis induction.The ability of oxidative phosphorylation of mitochondria and glycolysis decreased gradually(P<0.05).The number of senescence-associated β-galactosidase-positive cells increased with the increase of passages(P<0.05),and the expression of senescence protein p21,p16,and p53 increased gradually(P<0.05).The results indicated that the biological characterization of mesenchymal stem cells changed after long-term in vitro expansion.Mesenchymal stem cells cultured over 10 passages may have a reduced activity due to increasing senescence.Therefore,bone marrow mesenchymal stem cells cultured less than 10 passages are suitable for clinical research/therapy.