Objective To calculate the probability of nurses in a city experiencing adverse event and investigate nurses′cognitive and attitude of adverse event reporting ,and to improve the adverse event reporting system for care .Methods Three hundred and seventy five nurses were selected from 15 hospitals in our city and investigated by questionnaire survey .Results There were not statistically significant difference in the probability of nurses experiencing adverse event among all the different levels hospitals (P>0 .05) .There were statistically significant difference among three factors influencing the probability of nurses experiencing adverse event ,including professional title ,different age ,length of service(P<0 .05) .There were statistically significant difference of actively reporting the adverse event among nurses with different length of service (P<0 .05) .Conclusion Nurses′cognitive and attitude to‐wards adverse events report is positive .The length of service ,punishment environment and management expectation are the factors influencing the executive intention of adverse events .Investigating safety problems from the systematic perspective and improving adverse events reporting system could get more information and synthetically analyze the information to avoid nursing risk events e‐ventually .

Objective To investigate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) treatment of patients with alcohol dependence,anxiety and depression,and sleep problems.Methods 80 patients with alcohol-dependent patients were randomly divided into experimental group (40 cases) and control group (40 cases).All patients received routine treatment and care,the experimental group received additional rTMS to stimulate parts of the bilateral dorsolateral prefrontal region (DLPFC) 2 brain regions,each side 15 minutes at frequency of 1Hz,patient motion stimulus,intensity threshold (MT) of 80％,five times a week rTMS treatment,a total of 8 weeks,the control group received stimulation coil.Subjects were interviewed,as the time for the baseline,2 weeks,4 weeks and 8 weeks,assessment tools for the hamilton anxiety scale (HAMA),Hamilton depression rating scale (HAMD),Pittsburgh sleep quality index (PSQI).Results Compared with the pre-treatment,HAMA scores (19.5 ± 6.4,13.8± 5.3,7.3± 5.4 respectively) were significantly lower in 2,4,8 weeks after treatment (t 2 =11.29,P＜0.01;t 4=15.26,P＜0.01;t s =9.40,P＜0.01).Compared with the control group,HAMA scores were significantly lower in the experimental group after treatment (P＜0.01).Compared with the pretreatment group HAMD scores(17.5±6.6,11.2±4.9,6.1±5.2 respectively)were significantly lower in 2,4,8 weeks after treatment (t 2 =15.54,P＜0.01;t 4 =16.68,P＜0.01;t s =18.77,P＜0.01).Compared with the control group,HAMD scores were significantly lower in the experimental group after treatment (P＜0.01).Compared with the control group,PSQI scores were significantly lower in the experimental group in 2,4,8 weeks after treatment (t 2 =26.39,P＜0.01;t4=15.21,P＜0.01;ts=46.35,P＜0.01).Condusion Low-frequency rTMS treatment for alcohol dependence withdrawal symptoms can improve symptoms,such as anxiety and depression,sleep status.

Objective:To analyze the consistency between the histopathological results of routine endoscopy and biopsy in observing the gastric mucosa of patients with non-malignant gastroduodenal diseases,and to evaluate the necessity of biopsy following gastric endoscopy.Methods: From Jan.2005 to Dec.2005,320 patients who received upper gastrointestinal endoscopy and biopsy because of upper abdominal symptoms were included in this study.The patients were selected consecutively according to their disorders diagnosed by macroscopic endoscopy and were divided into 64 groups.The 5 patients in each group had reflux esophagitis,non-atrophic gastritis,atrophic gastritis,gastric ulcer and duodenal ulcer,respectively.Patients in the same group were matched with each other in gender,age and their history of diseases.The results of endoscopy,including the exudation,congestion,erosion,roughness,bile reflux,etc.,were read by 2 experienced endoscopists.The biopsy was performed by an experienced pathologist and pathological variables included active inflammation,chronic inflammation,atrophy,intestinal metaplasia and atypical hyperplasia.The status of Helicobacter pylori(H.pylori) infection was evaluated by rapid urea test,silver staining and histological methods;the result was deemed positive when the results of either 2 tests were positive.Results: Erosion,exudation,roughness,and H.pylori infection were related with active inflammation;erosion and H.pylori infection were related with chronic inflammation;roughness of mucosa was related with atrophy;roughness and H.pylori infection were related with intestinal metaplasia;and obsolete hemorrhage,H.pylori infection,roughness mucosa,and bile reflux were related with atypical hyperplasia.Macroscopic diagnosis rate of atrophic gastritis was 71.9%(46/64) with a false positive rate of 28.2%(18/64) and a false negative rate of 34.38%(22/64).Conclusion: Macroscopic diagnosis is indicative to pathological changes of gastric mucosa,but the predictive value is relatively poor,making biopsy and pathological examination necessary in the diagnosis of gastric mucosa disorders during routine endoscopic examination.

Objective To elucidate the protein expression and gene expression status and the relationship between epidermal growth factor receptor (EGFR) protein expression and EGFR gene status.Methods Tissue microarray containing 72 cervical squamous cell carcinoma tissues was constructed,and EGFR protein expression and gene status were evaluated by immunohistochemical and fluorescence in situ hybridization (FISH) techniques.Results Protein expression of EGFR:69 of 72 cervical squamous cell carcinomas were observed.The results demonstrated it was significant association with invasion depth,lymphnode metastasis and lymph-vessel invasion (x2 =4.998,P ＜ 0.05 ; x2 =4.299,P ＜ 0.05 ; x2 =4.686,P ＜ 0.05) in cervical squamous cell carcinomas.For FISH assessing EGFR gene,64 of 72 carcinomas were observed; 7 of 64 cases showed EGFR gene amplification,and 25 disomy,23 trisomy and 9 polysomy were detected.There were high levels of protein expression in all the EGFR gene amplification cases,and there were significant association between EGFR protein expression and the gene copy number (x2 =13.564,P ＜ 0.05).Conclusions EGFR may participate in the occurrence,progression and metastasis of cervical squamous cell carcinoma.Overexpression of EGFR protein may result from gene amplification and gene copy number increases,which showed that EGFR gene expression status may be a more effective biological indicator of cervical squamous cell carcinoma targeted therapy.

Objective To study the relationship between metabolic syndrome (MS) and anterior circulation infarction (ACI). Methods 271 ACI patients (166 men and 105 women) who fulfilled the diagnostic criteria of China Guideline for Cerebrovascular Disease Prevention and Treatment were enrolled. 147 control subjects (67 men and 80 women) without the clinical signs of cerebral infarction but with detailed case history, physical examination and CT or MRI were also selected. The prevalence and risk of MS were observed in the ACI and control group. MS was defined with the modified criteria in Chinese. Results The prevalence of MS in the ACI group and control subjects was respectively 43.17% and 19.05%. The prevalence of MS was significantly higher in the ACI group as compared with the control subjects (P<0.01). The component level of MS were significandy different between the two groups (P< 0.05). MS was associated with a 3.7 fold higher risk of ACI (P<0.01). Conclusions There is a close relationship between MS and ACI. MS is an important risk factor of ACI.

Objective To study the induction of nitrous oxide(N2 O)and to compare safety and effec-tiveness of conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gas-trointestinal(UGI)endoscopy.Methods A total of 400 patients undergoing UGI endoscopy in our hospital from April 2013 to October 2013 were randomly assigned to two groups,N2 O inhalation group(n=200)and in-travenous propofol group(n=200).The systolic pressures,diastolic pressures,heart rates and oxygen satura-tion,onset time,procedure duration,degree of sedation,recovery time,length of hospital stay,complica-tions,satisfaction ratings of doctors and patients,and the number of patients willing to accept the examination again were analyzed.Results The mean time of ideal anesthesia state for N2 O was (3. 16 ±0. 65 )min and there was no difference between the male and female(3. 16 ±0. 71)min vs.(3. 16 ±0. 58)min,t=0. 006,P>0. 05).The mean concentration was (43. 68 ±5. 05 )%,which was higher in male than that in female [(45. 3 ±4. 99)% vs.(41. 46 ±4. 30)%,t=3. 042,P<0. 05].Compared with before,the systolic pres-
sures,diastolic pressures,heart rates and oxygen saturation of patients in the propofol group significantly re-duced during the procedure(P<0. 05),while the same measurements excluding oxygen saturation for those in the N2 O group significantly increased(P<0. 05 ).Compared with the propofol group,patients inhaling N2 O had significantly shorter recovery and hospital stay time,but a longer onset time and procedure duration(P<0. 05 ).Complications that occurred in some patients of propofol group included hyoxemia,hypotension,brady-cardia,while the major complication in the N2 O group was nausea.The satisfaction ratings of doctors or pa-tients and the number of patients willing to accept the examination again in N2 O group were smaller than those in propofol group(86 ±3. 7 vs.96 ±2. 6,87 ±2. 8 vs.98 ±1. 2,87%vs.99%,P<0. 05).Conclusion Both conscious sedation by N2 O inhalation and intravenous sedation with propofol are effective for diagnostic UGI en-doscopy,but the safety of the former is superior to the latter.The key to complete the conscious sedation by ni-trous oxide inhalation is to accurately identify the ideal anesthesia state of N2 O.It is significant to pay attention to the nine factors concerning safe and effective sedation during operation.

Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.

Humans ; von Hippel-Lindau Disease ; pathology

Objective To explore the expression of neutrophil adhesion molecule CD11b,and plasma level of elastase in patients with anaphylactoid purpura during different clinical phases and their correlation with disease activity.Methods A total of 20 patients with anaphylactoid purpura were recruited into this study,along with 20 normal human controls.Two blood samples were collected from each patients at the first visit(active phase)and after 3～5 weeks of treatment(remission phase).The expression of CD11b was measured by flow cytometry in 12 patients and normal controls,and plasma levels of elastase by ELISA in 20 patients and normal controls.Results Increased CD11b expression and elastase level were noted in patients in active phase compared with those in patients in remission phase(3367.25±434.57 vs 2569.33±411.06.13.98±2.05 vs 4.29±0.80.both P＜0.01).No significant difference was found in CD11b expression between patients in remission phase and normal controls(P＞0.05).while the elastase level was higher in patients in remission phase than in normal controls(4.29±0.80 vs 3.67±0.54.P＜0.05).In active phase of anaphylactoid purpura,the expression of CD11b was positively correlated with the plasma level of elastase(r=0.73,P＜0.01),while no correlation was noticed between them in remission phase(r=0.20,P=0.54).Conclusion Peripheral neutrophils are activated in anaphylactoid purpura,which seems to be more obvious in active phase than in remission phase.

In plants, oxidative stress is one of the major causes of damage as a result of various environmental stresses and it is primarily due to the excessive accumulation of reactive oxygen species. To develop transgenic potato plants with enhanced tolerance to environmental stress, transgenic potato plants (Solanum tuberosum L. cv. Atlantic) expressing the Cu/ZnSOD and APX genes in chloroplasts were generated under the control of the oxidative stress-inducible promoter. To investigate oxidative stress tolerance, transgenic plants were evaluated at the level of leaf discs and plantlets after methyl viologen (MV) and salt treatment. Leaf discs from transgenic potato plants showed 13% less membrane damage compared to non-transgenic (NT) plants suffering 10 μmol/L MV treatment of 48 h, and showed 1.6-fold higher chlorophyll contents than those of NT plants at 1.0mol/L NaCl treatment (31% vs. 19%). In addition, transgenic potato plants maintained higher rooting rates (75%) during 100mmol/L NaCl treatment than those (12%) from NT plants. Moreover, the tolerance to salt stress in transgenic plants was consistent to increased transcript levels and higher activities of SOD and APX compared to NT plants. These results suggest that expression of Cu/ZnSOD and APX in chloroplasts could be used in plants to enhance the tolerance to environmental stresses.