Objective To study the current situation of emergency nurses' structural empowerment,competency,job satisfaction,and their correlative factors.Methods Literature review, interview and questionnaire were used to establish the emergency nurses' structural empowerment and competency model.300emergency nurses were structurally empowered,and their quality of care and job satisfaction was compared before and after.Results The quality of care and job satisfaction after structural empowerment was (98.45 ±1.36) and (98.19 ± 2.63 ),both of which were higher than that before structural empowerment (95.33 ±2.47) and (93.81 ± 4.54),and the differences were statistically significant (t =-4.468,16.136,respectively; P ＜ 0.05).After structural empowerment,there was great improvement in emergency nurses' selfevaluation,as well as their ability of critical thinking,receiving information,communication and health education,while there was little improvement in their ability of social support,logical reasoning and innovation.Conclusions Establishing structural empowerment and competency model for emergency nurses helps them position themselves and promote their development,as well as provides reference to select and train professional nurses for hospitals.

Objective To investigate the proportion and function of CD_4~+ CD_(25)~+ regulatory T cells (CD_4~+ CD_(25)~+ Tr)in unexplained recurrent spontaneous abortion(URSA).Methods(1)Proportion measurement:the proportion of CD_4~+ CD_(25)~+ Tr cells in peripheral blood was measured by double-label flow cytometric analysis.The samples were taken from 15 URSA women,15 normal non-pregnancy women and 13 normal pregnancy women.(2)Function measurement:CD_4~+ CD_(25)~+ Tr ceils and CD_4~+ CD_(25)~+ T ce]ls were extracted from peripheral blood lymphocytes by the microbeads separation.The purity of CD_4~+ CD_(25)~+ Tr cells and CD_4~+ CD_(25)~+ T cells was measured by flow cytometry.The growth inhibitory effect of CD_4~+ CD_(25)~+ Tr cells on CD_4~+ CD_(25)~+ T cells was assessed in vitro.Results The proportion of CD_4~+ CD_(25)~+ Tr cells was decreased significantly in URSA women(6.9?1.8)% than that in normal non-pregnancy women[(10.8?1.1)%] (P0.05).Conclusion The results suggest that decrease in proportion and function of CD_4~+ CD_(25)~+ Tr cells may be associated with URSA.

Objective To investigate the affection of negative life and events coping style to youthful breast cancer patients and their psychological stress state preoperation. Methods 60 youthful breast cancer patients preoperation were investigated with Life Events Scale (LES) and somatization, depression and anxiety in Self-reporting Inventory Symptom Checklist 90 (SCL-90). Results The score of somatization, depression and anxiety were (1.89 ±0.31), (2.28 ± 0.56) and (1.99 ± 0.63). the anxiety and depression were obvious in patients who had lower education level (P < 0. 05). Sematization, depression and anxiety were more severe in patients who was single, divorced and widowed than married (P < 0. 05). The levels of depression and anxiety were higher in patients who had higher income (P < 0. 05). Conclusions The youthful breast cancer patients have severe psychic trauma, and they need humanistic care.

Ovarian cancer is one of the most common gynecologic cancers in the world.Over the past few decades,there has been considerable research reporting on the mechanisms of cancer development and progression,with multiple nerve as well as neurotransmitters involved.Nerve innervation is also found in ovarian cancer.And in ovarian cancer,various nerves and neurotransmitters play different roles.They are involved in ovarian cancer cells'proliferation metastasis,apoptosis and changes in the tumor microenvironment.Further understanding of the role of these nerve endings in the development of ovarian cancer is essential for understanding the mechanisms of cancer progression.This will be important for subsequent research focusing on tumor regulation.While glucocorticoids and sympathetic nerve-released norepinephrine are able to promote ovarian cancer progression,serotonin may inhibit cancer cell growth.Also,parasympathetic and sensory nerves are capable of having either a positive or negative effect on ovarian tumors.These relevant studies offer the possibility of new therapeutic options for oncology,it may be possible to mitigate the progression of cancer with inexpensive receptor inhibitors or agonists.This will facilitate the subsequent exploration of therapeutic possibilities forovarian cancer and other cancer-related treatments.In this review,we also present some insights into the role of the nervous system in the regulation of ovarian cancer,which we hope will provide new insights into the innervation and progression of ovarian cancer.

OBJECTIVE To investigate the effect of puerarin on hyperglycemia in HFD mice and the role of GLP-1R signa-ling in modulating the hypoglycemic effect of puerarin.METHODS HFD induced diabetic mice was used as the subject,GLP-1 receptor antagonist Exendin 9-39(Ex 9-39)was used to block the activation of GLP-1R signaling,and in vivo experiments were performed to further evaluate the role of GLP-1R signaling in the hypoglycemic effect of puerarin.RESULTS The glu-cose homeostasis and the OGTT(oral glucose tolerance tests)of HFD mice were both improved by puerarin,while the effect was impaired by Ex 9-39 significantly.Moreover,puerarin increased serum insulin contents in HFD mice,but such effect was blocked by Ex 9-39 as well.Elevated expression of ki67 inβ-cells was observed in pancreatic sections from HFD mice pre-trea-ted with puerarin using Ki-67/insulin immunostaining,suggesting that puerarin could promoteβ-cell proliferation.The puerar-in effect was inhibited when the GLP-1R signaling activation was blocked by Ex9-39.CONCLUSION The results confirmed that the activation of GLP-1R signaling was critical for the anti-diabetic effects of puerarin on HFD induced diabetic mice.Our finding highlights the potential value of Radix puerariae as a dietary supplement for diabetes care.

Transcription factor EB(TFEB)is a member of the MiTF/TFE family and plays an important role in cell stress,metabolism,cancer and so on.There are relatively few studies on the role of TFEB in renal diseases.TFEB was initially found to be highly expressed in TFEB-fusion renal cell carcinoma and plays a key role in the development of re-nal cell carcinoma.Blocking the downstream signaling pathway activated by TFEB would be a promising treatment for TFEB-fusion renal cell carcinoma.On the contrary,the expression of TFEB in renal intrinsic cells is decreased in diabetic kidney disease,leading to a blockage in the autophagy-lysosome pathway.TFEB enhances the ability of cell stress and self-repair,and then delays the progress of diabetic kidney disease.In cystine nephropathy,TFEB expression is reduced in re-nal tubular epithelial cells and compensatory activation is insufficient as well.TFEB over-expression effectively eliminates intracellular cystine and repairs damaged lysosome,which is expected to alleviate or cure the Fanconi syndrome.In summa-ry,TFEB plays a key role in different kidney diseases,and targeted regulation of TFEB provides new hope for the treatment of kidney diseases.

BACKGROUNDProteasome subunits (PSMB) and transporter associated with antigen processing (TAP) loci are located in the human leukocyte antigen (HLA) Class II region play important roles in immune response and protein degradation in neurodegenerative diseases. This study aimed to explore the association between single nucleotide polymorphisms (SNPs) of PSMB and TAP and Parkinson's disease (PD).

METHODSA case-control study was conducted by genotyping SNPs in PSMB8, PSMB9, TAP1, and TAP2 genes in the Chinese population. Subjects included 542 sporadic patients with PD and 674 healthy controls. Nine identified SNPs in PSMB8, PSMB9, TAP1, and TAP2 were genotyped through SNaPshot testing.

RESULTSThe stratified analysis of rs17587 was specially performed on gender. Data revealed that female patients carry a higher frequency of rs17587-G/G versus (A/A + G/A) compared with controls. But there was no significant difference with respect to the genotypic frequencies of the SNPs in PSMB8, TAP1, and TAP2 loci in PD patients.

CONCLUSIONChinese females carrying the rs17587-G/G genotype in PSMB9 may increase a higher risk for PD, but no linkage was found between other SNPs in HLA Class II region and PD.

ATP-Binding Cassette Sub-Family B Member 2 ; genetics ; ATP-Binding Cassette, Sub-Family B, Member 3 ; genetics ; Adult ; Aged ; Antigen Presentation ; Case-Control Studies ; Cysteine Endopeptidases ; genetics ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; genetics ; immunology ; Polymorphism, Single Nucleotide ; Proteasome Endopeptidase Complex ; genetics

OBJECTIVETo study the feasibility and effect of substituting esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved.

METHODSTwenty-four patients with cervical esophageal carcinoma were retrospectively reviewed. The esophagus was resected and substituted with 19 gastric pull-up and 5 colon interposition. Nineteen patients received radiotherapy postoperatively (dose 50 - 70 Gy).

RESULTSTwenty two patients were follow up over 3 years. The 3- and 5-year survival rates for T2 were 3 and 1, for T3, T4 8 and 3, respectively. The laryngeal function preservation rate was 77% (17/24) and the decannulation rate was 75% (12/16). The complication rate was 29%.

CONCLUSIONSurgical resection of cervical esophageal carcinoma with removal of the extraesophageal invaded tissues while preserving the laryngeal function is possible. The continuity of the esophagus is restored by stomach transposition and colon interposition. Combined with radiotherapy, the survival rate and life quality of the patient might be improved.

Adult ; Aged ; Esophageal Neoplasms ; mortality ; physiopathology ; surgery ; Esophagoplasty ; methods ; Female ; Follow-Up Studies ; Humans ; Larynx ; physiopathology ; Male ; Middle Aged ; Quality of Life ; Survival Rate ; Thoracotomy

Objective To study the epidemiological characteristics of chronic pain following breast cancer surgery and analyze the related factors.Methods Nine hundred and twelve patients following breast cancer surgery were enrolled in the Department of Breast Surgery,Affiliated Hospital,Academy of Military Medical Sciences.The Douleur Neuropathique-4 (DN-4) questionnaire was used to identify neuropathic pain,and the related factors were statistically analyzed.Results The follow-up was completed in 821 patients,including 263 (32％) patients with chronic pain.DN-4 score of 47 (17.9％)patients was over 4 points.There was significant difference between the painful group and the non-painful group in methods of surgery and axillary lymph node dissection (P ＜ 0.05).Conclusion Findings suggest that chronic pain after breast cancer surgery is a significant problem clinically.Proper surgery and psychological buildup are of clinical value in preventing post-surgery chronic pain.

Objective To investigate the practices and experience in the organization and implementation process of prac-tical training drill for medical supply support .Methods To review and comment on the overall design ideas ,specific steps , practical effect and experience of medical supply support in practical training drill .Results Through six years of exploration and practice , we established a training method of implementation of practical training drill for medical supply support . Conclusion It is right and effective in the organization and implementation of practical training drill for medical supply support . It is necessary to continue improving the mode of organization and implementation with combination of practical teaching and re-search .