Objective This investigation was to define the occupational security-related factors in community nurses and effective strategies to improve their service awareness and occupational protection ability.Methods A questionnaire was used for 1702 community nurses in Guangzhou to learn occupational security-related factors and occupational protection skills.Results Self-report results found that 21.3% (362/1702) nurses fully understood the occupational security-related factors,12.0% (204/1702) nurses knew the requirement for occupational security,and 12.3% (209/1702) nurse could provide occupational protection.Conclusions These results suggested that most community nurses showed poorer occupational protection awareness and ability.Thus,occupation safety management regulations,standardized performance procedure and emergency response plan should be put forward,and further community nurse training programme need to be initiated.

AIM: To observe the effect of fluvastatin (FV) on left ventricular remodeling and expression of caspase-3 after myocardial infarction (MI) in rats. METHODS: Rats were divided into 4 groups: group Ⅰ (sham), group Ⅱ (sham+FV), group Ⅲ (MI) and group Ⅳ (MI+FV). group Ⅱ and Ⅳ were treated with FV (10 mg?kg -1?d -1) for 4 weeks. The left ventricular structure, echocardiography and hydroxyproline were observed. The expression of caspase-3 was measured by immunohistochemistry and RT-PCR. RESULTS: Compared with MI group, there was a improvement of ultrastructure and index of left ventricular remodeling, and decrease in hydroxyproline in MI+FV group (all P

Objective To explore risk factors for type 2 diabetes mellitus complicated with gallstone disease. Methods The clinical data of 429 type 2 diabetes mellitus patients complicated with gallstone disease (case group) and 2145 type 2 diabetes mellitus patients without gallstone disease (control group) were collected from the Health Center of Peking Union Medical College Hospital from January 2007 to May 2010. According to sure (SBP), diastolic blood pressnre (DBP), fasting blood glucose (FBG), total cholesterol (TC), Triglyceride (TG), high-density lipoprotein cholesterol (HDL-CH), low-density lipoprotein cholesterol (LDL-CH) and body mass index (BMI) were statistically analyzed by fourfold table chi-square test or conditional Logistic regression.Results Univariate analysis showed that there was a significant difference in the levels of SBP, FBG, TC, HDL-CH and BMI between the case group and the control group (x2 =20.323, 4.365, 4.028, 7.049, 7.319, P＜0.05). Multivariate analysis confirmed that SBP, TC, HDL-CH and BMI were risk factors for gallstone disease in patients with type 2 diabetes mellitus (x2 = 18. 047, 6. 905, 12. 884, 7. 557, P ＜ 0. 05). Conclusion Increased SBP, TC and BMI and decreased HDL-CH may be the risk factors for type 2 diabetes mellitus complicated with gallstone disease.

Objective To observe the effects of extracts of ginkgo leaves (EGL) on acute myocardial infarction, acute myocardial ischemia and blood hemorheology.Methods The effects of EGL on acute myocardial infarction were observed in dogs model induced by the ligation of anterior descending branch of left coronary artery; effects on acute myocardial ischemia were observed on rats model caused by intravenous injection of pituitrin and effects on blood hemorheology were observed in rabbits. Results EGL significantly reduced the myocardial infarction area, decreased the activities of lactate dehydrogenase and creatine phosphokinase in dogs, reduced the elevation of ST segment of electrocardiogram in rats with myocardial ischemia and decreased whole blood viscosity and plasma viscosity in rabbits. Conclusion EGL has protective effect against myocardial ischemic injury and can improve the parameters of blood hemorheology in rabbits. Its mechanism may be concerned with the reduction of the myocardial infarction area and infarction degree and the relief of acute myocardial ischemia.

Objective To summarize the clinical and pathological characteristics of incidental gallbladder carcinoma,analyze the factors such as surgical procedures,tumor stages that associated with prognosis,and standardize the diagnosis and treatment strategy of incidental gallbladder carcinoma. Methods Between January 1991 and October 2009,27 incidental gallbladder carcinoma patients were treated in Peking Union Medical College Hospital (PUMCH).A retrospective study was performed based on the clinical data of these patients to evaluate the methods of diagnosis,curative treatment and prognosis. Results Twenty-seven patients were collected (8 male and 19 female) with the mean age of (68.3 ± 1.9)years.Abdominal pain,obstructive jaundice and fever were the main symptoms of incidental gallbladder carcinoma.All the 27 cases underwent open cholecystectomy based on preoperative tentative diagnosis of benign disease,and carcinoma of gallbladder was confirmed by postoperative pathology.In this group(9 lowdifferentiation,9 moderate-differentiation,4 high-differentiation and 5-carcinogenesis from adenoma).Two cases were on the stage of Nevin Ⅰ,5 on Nevin Ⅱ,8 on Nevin Ⅲ,5 on Nevin Ⅳ and 7 on Nevin Ⅴ.The survival terms were of statistic significance between the radical cholecystectomy groups and simple cholecystectomy groups(x2 =4.450,P=0.035); The prognosis of patients on stages Ⅰ、Ⅱ are better than those who are on stages Ⅲ、Ⅳ、Ⅴ (x2 = 6.825,P = 0.014). Conclusion The clinical manifestations of incidental gallbladder carcinoma are diverse,which usually lead to misdiagnosis.Frozen section examination during operation is key to diagnose incidental gallbladder carcinoma.Surgical operation is the first choice of therapy,offering much better prognosis than those received simple cholecystectomy.

Objective To summarize the clinicopathological features of ampullary cancer,and investigate the diagnosis and treatment strategy for ampullary cancer.Methods The clinical data of 187 patients with ampullary cancer who were admitted to the Peking Union Hospital from January 2000 to December 2010 were retrospectively analyzed.According to different surgical procedures applied,patients were divided into pancreaticeduodenectomy (PD) group (162 patients) and local resection group (25 patients).Survival curve was drawn by using Kaplan-Meier method,and the difference in survival rate between the 2 groups was compared by using Log-rank test.All data were analyzed by using t test or chi-square test.Results The positive diagnostic rates of B-ultrasound,computed tomography (CT),magnetic resonance imaging (MRI) and endoscopic retrograde cholangiopancreatography (ERCP) were 9.3％ ( 15/161 ),43.9％ (65/148),21.3％ (19/89) and 83.9％ ( 135/161 ),respectively.There were 87 patients with well differentiated adenocarcinoma,64 with moderate differentiated adenocarcinoma,27 with low differentiated adenocarcinoma and 9 with tubular canceration.There were no significant differences in survival rate between patients with ampullary cancer in T1 or T2 stage who received PD or local resection ( x2 =3.163,P ＞0.05).The prognosis of patients with ampullary cancer in T3 or T4 stage who received PD were superior to those who received local resection ( x2 =6.309,P ＜ 0.05 ).Conclusions Most of the ampullary cancer is well differentiated adenocarcinoma,and ERCP has a higher diagnostic rate than B-ultrasound,CT and MRI.Local resection is an ideal treatment for patients with ampullary cancer in T1 or T2 stage,while for patients with ampullary cancer in T3 or T4 stage,PD is the first choice of treatment.

Visual perceptual learning refers to the special improvement of perceptual performance benefit from repetitive training with a visual task.A typical time course of visual perceptual learning presents an initial rapid improvement,and then gradually processes like an asymptote in gain.During the process of perceptual learning,the influence of critical amount and perceptual learning rules on learning effect,memory consolidation and interference,and the role of sleep on preventing interference and promoting consolidation in perceptual learning,all get involved.This article reviewed the aforesaid content and then elaborated some strategies in application of visual perceptual learning in the treatment of amblyopia.

Objective To study the chemical constituents in the leaves of Mallotus apelta. Methods Constituents isolation and purification were carried out on silica gel and polyamide column. Their structures were identified by physicochemical properties and spectral analysis. Results Five compounds were isolated and elucidated as taraxerol (Ⅰ), ?-sitosterol (Ⅱ), 5, 7-dihydroxy-6-prenyl-4′-methoxy-flavanone (Ⅲ), apigenin (Ⅳ), and apigenin-7-O[WTBZ]-?-D-glucoside (Ⅴ). Conclusion Compound Ⅲ is a new compound named as mallotusin. Compounds Ⅰ and Ⅲ-Ⅴ are isolated from the leaves of M. apelta for the first time.

Objective To compare the various surgical procedures commonly used to treat ampullary neoplasms.Methods The clinical data of 238 patients with ampullary tumor who were admitted to the Peking Union Hospital from January 1995 to June 2012 were retrospectively analyzed.There were 51 patients with benign ampullary adenomas (34 patients treated with local tumor resection,17 patients treated with pancreaticoduodenectomy) and 187 patients with ampullary cancer (25 patients treated with ampulla local excision,162 patients treated with pancreaticoduodenectomy).Results For both ampullary cancer and benign tumor,the group of patients who received local excision was superior to the group of patients who received pancreaticoduodenectomy in operative time,blood loss,hospital stay,and incidence of postoperative complications (all P＜0.05).For benign ampullary adenomas,there were no significant differences in postoperative median survival time between local resection and pancreaticoduodenectomy (P=0.071,x2 =2.003).For stage T1 or T2 ampullary cancer,there was also no significant difference in the postoperative median survival time (P=0.054,x2=3.163).However,the postoperative median survival time of the pancreaticoduodenectomy group was significantly longer than that of the local resection group for patients with stage T3 or T4 ampullary cancer (P=0.041,x2 =6.309).Conclusions Ampullary tumors are characterized by relatively good response to treatment.The results suggested that for patients with benign ampullary adenomas and stage T1 or T2 of ampullary cancer,local resection is a good surgical procedure.For patients with ampullary cancer at more advanced stages (T3 or T4),pancreaticoduodenectomy is the first choice of therapy.

Objective To compare the clinical efficiency of two methods in the open surgery treatment of seconda-ry common bile duet stones: transeytie common bile duet exploration with eholedoehoscope (TCBDE),or traditional eholedoehotomy with T-tube drainage.Methods Retrospectively analysis the treatment of 113 eases with secondary bile duet stones (TCBDE group 58 cases ,T-tube group 45 cases) ; Compare the achievement ratio,operating time; complications,average hospital stay and cost between two groups.Results All procedure is successful,without any severe complications.There are no significant differences of operating time.The TCBDE group has sig-nificantly shorter hospital stay and lower cost.Conclusion TCBDE has significant advantages than the traditional choledochotomy,and should be the predominant method in the open surgery of secondary common bile duet stones.