Objective To measure the nursing time that the geriatric patients need daily in a large general hospital in Anhui province,thus to understand the direct and indirect nursing items and time.Methods Timing and recording nursing operations to meet the conditions of the geriatric patients for 7 consecutive days by field recording method were done.Results The average time of each nursing procedures was calculated.Direct nursing time was 146.10 min,accounting for 84.70％ of the total nursing time,including primary care (42.81％) and respiratory/drain management proportion (15.86％); Indirect nursing time was 26.39 min,accounting for 15.30％ of the total nursing time.The actual number of nurse needed was 158,the suitable bed protection ratio was 1 ∶ 0.68.Conclusions Direct nursing time of geriatric patients needed was longer than that of indirect nursing time.To increase direct nursing hours and reduce the indirect nursing time can satisfy the need of elderly patients.In addition,the current nursing staffing cannot satisfy the clinical needs of the elderly,thus,nursing resources allocation should be reasonable arranged as soon as possible.

Objective To evaluate the efficacy of telephone follow-up on glycemic control in patients with diabetes mellitus. Methods Randomized clinical trials that assessed the effectiveness of telephone follow-up in patients with diabetes mellitus were selected in the databases of Cochrane library, JBI, PubMed, Medline, EMBASE, EBSCO, OVID, Springer, China National Knowledge Infrastructure, China Biomedical Literature Database, VIP , Wangfang Data. At the same time manual retrieval of relevant professional information to collect randomized clinical trials that met the inclusion criteria. The searching time was from database establishment to June 2016. RevMan5.2 software was used to analyze the data after quality assessment. Results A total of 12 randomized controlled trials were included in a total of 1905 patients. Meta-analyses showed that, compared with the conventional nursing group, the telephone follow-up could significantly reduce the level of glycosylated hemoglobin (weighted mean difference was-0.49, 95% confidence interval was-0.52--0.46, P<0.01), the level of fasting blood glucose (weighted mean difference was-0.99, 95% confidence interval was-1.16--0.83, P<0.01). Conclusions Telephone follow-up can improve blood glucose control in patients with diabetes, it is worth to be popularized in clinical practice.

Objective To investigate the correlation between prognosis of patients with severe acute pancreatitis and changes of plasma albumin. Methods A total of 235 patients with severe pancreatitis who were admitted into hospital from September 2008 to October 2013 were selected as research object. According to the prognosis, they were divided into the survival group (143 cases who were recovered and still alive) and the death group (92 cases who died of the deterioration of diseases). Retrospectively analyzed the basic situation of the pa-tients and the changes of serum albumin levels in the two groups. And the correlation between prognosis of patients with severe acute pancrea-titis and changes of plasma albumin were evaluated by the logistic regression analysis. Results Compared with the death group,there were significant differences (P<0. 05) in terms of age,APCHEⅡ score,Ranson score,SOFA score,length of hospital stay,duration of mechani-cal ventilation,continuous renal replacement therapy,average serum albumin level,decrease of serum albumin within 24 hours,and variation of serum albumin. And ROC curves suggested the best cutoff value of decrease of serum albumin within 24 hours to predict death in patients within 24 hours was 4. 24 g/L,and the best cutoff value of variation of serum albumin to predict death was 13. 6%. Logistic regression analy-sis showed that the major risk factors of death in severe acute pancreatitis were decrease of serum albumin within 24 hours,variation of serum albumin within 24 hours,average serum albumin level,and the APCHEⅡscore. Conclusion Changes in plasma albumin can reflect the se-verity of severe acute pancreatitis,and the sharp decrease of serum albumin within 24 hours can be used as a risk factor for death.

BACKGROUND: Magnetic therapy has a long history and is used in the treatment of various diseases. To study the protective function of constant magnetic field for ischemic cerebrovascular diseases may provide new clinical foundation for non-medicinal and non-traumatic treatment and develop a novel way for treatment with physical factor.OBJECTIVE: To observe the influence of constant magnetic field treatment on hemodynamics at macroscopic level, RBC membrane fluidity at subcellular level and antioxidase activity at molecular level, as well as NO and NO synthetase activity in rats with ischemic-reperfusion (IR) injury.DESIGN: A completely randomized design.SETTING: Biophysical Teaching and Research Department of Harbin Medical University.MATERIALS: This experiment was carried out at Biophysical Laboratory,Harbin Medical University, between May and November 2002. Forty healthy Wistar rats were adaptively raised for 1 week before randomized into 3 groups, namely, sham-operation group (n=10), model group (n=15)and magnetic therapy group (n=15).METHODS: ① IR model of middle cerebral artery (MCA) was established in rats in model group and magnetic therapy group, but MCA was only tied up without occlusion in sham-operation group. ② In magnetic therapy group, rat necks were exposed to 40 mT constant magnetic field instantly after ischemic injury for 30 minutes, once a day, while rats in sham-operation group and model group were not exposed to magnetic field.Three groups of rats were anaesthetized at postoperative 7 days for obtaining blood from eyeball, and cut off head for obtaining brain.MAIN OUTCOME MEASURES: ① Hemodynamic changes in three groups of rats. ② Changes of RBC membrane fluidity-related parameters.③ Changes of serum glutathione peroxidase and ceruloplasmin content.④ Changes of brain malonedialdehyde (MDA), NO, and NO synthetase activity indexes.RESULTS: Thirty rats were included and all entered the result analysis.① Hemodynamic parameters: Blood high-shearing, blood low-shearing viscosity, fibrinogen and HCT were remarkably higher in model group than in sham- operation group (P ＜ 0.01), but obviously lower in magnetic therapy group than in model group (P ＜ 0.01). ② RBC membrane fluidity: The fluorescence polarization, average microviscosity and aeolotropy were remarkably higher in model group than in sham-operation group (P ＜ 0.01), and the above indexes were lower in magnetic therapy group than in model group (P ＜ 0.05). ③ Serum glutathione peroxidase and ceruloplasmin contents in model group were remarkably lower than those in sham-operation group (P ＜ 0.05), but were higher in magnetic therapy group than in model group (P ＜ 0.01), and slightly higher than sham-operation group. ④ The brain Cu/Zn-SOD, MDA, NO, NO synthetase activities in model group were remarkably higher than in sham-operation group (P ＜ 0.05 or 0.01),but antioxidase activity was remarkably lower than that in sham-operation group (P ＜ 0.01); all parameters were proved to get better in magnetic therapy group after magnetic field treatment, and better than those in model group (P ＜ 0.05, 0.01).CONCLUSION: Constant magnetic field exposure can remarkably improve rat hemodynamic property, increase RBC membrane fluidity and antioxidase activity, and reduce the content of MDA, NO, NO synthetase,thereby improving organic anti-oxidation capability and effectively preventing free radicals and NO-induced neural damage. It possesses certain function of protecting brain IR injury through holding up the pathophysiological development of brain ischemia injury.

To investigate the inhibitive effect of the co-culture supernatant of Toxoplasma gondii on the proliferation of human colon cancer cell line sw480 and/or its induced apoptosis and necrosis in vitro,the co-culture model of sw480 cells (1x10~6) was established with different number of Toxoplasma gondii (the concentration of tachyzoites was 2×10~6,4×10~6,8×10~6,16×10~6 respectively),and the co-culture supernatants were gathered 72 hours later.The sw480 cells were treated for different hours with different models of the co-culture supernatant.The parasitism and proliferation of Toxoplasma gondii tachyzoites in sw480 cells was observed by Giemsa staining,and the growth inhibition rates of these cells were investigated by the CKK-8 method.Meanwhile,the apoptosis and necrosis of sw480 cells were detected with transmission electron microscopy (TEM) and fluorescence microscopy with Hochest 33258 staining to observe the morphological changes of sw480 cells.Agarose electrophoresis was used to detect the DNA change of sw480 cells,and flow cytometric analysis was used for investigation of rates of apoptosis and necrosis of these cells stained with Annexin-v-FITC/PI.It was found that the parasitism and proliferation of Toxoplasma gondii tachyzoites in sw480 cells could be observed;and as demonstrated by the CKK-8 method,the inhibitive effect of the co-culture supernatant depended upon the treatment time,and a maximum inhibition ratio of 44.55% was detected at 48 hours.The karyopyknosis and karyorrhexis in the treated sw480 cells were observed under the fluorescence microscope;and the cellular necrosis were observed under TEM.In addition,the DNA fragments in the treated cells were revealed by agarose electrophoresis.In the flow cytometric analysis,a maximum prophase apoptosis rate of 11.54% was detected at 48 hours after treatment with the supernatants,while the rate of prophase apoptosis decreased,and the rates of advanced stage/necrosis increased markedly at the treatment time beyond 48 hours.It is concluded that the co-culture supernatant of Toxoplasma gondii and human colon cancer cell sw480 cell line can induce inhibition of proliferation,apoptosis and necrosis of this cell line in vitro.

Objective To investigate the clinical value of serum apolipoprotein A-1 (Apo A-1) detection in HBV-related liver cancer.Methods Totally 362 cases of patients with chronic HBV infection were enrolled from January 2010 to December 2014 in our hospital,including 88 cases of chronic hepatitis B,94 cases of HBV-related liver cirhosis,18 cases of HBV-related liver cancer (without cirrhosis) and 162 cases of liver cirrhosis merged cancer.At the same time,45 cases of healthy people were selected for normal control.The serum Apo A-1,AFP and other laboratory markers were detected,and the test results were statistically analyzed.Results The difference of Serum Apo A-1 and AFP levels in all groups was statistically significant (F =29.86,x2 =112.53,P =0.000).As the disease progressed,the serum levels of Apo A-1 gradually decreased (P ＜ 0.05).But the difference of Apo A-1 level between normal control and HBV-related liver cancer group (without cirrhosis),chronic hepatitis B and liver cirrhosis merged cancer group,liver cirrhosis and liver cirrhosis merged cancer group was not statistically significant (all P ＞ 0.05).The liver cancer patients with Child-Pugh score A,B,C had different serum Apo A-1 levels (all P ＜ 0.05);The serum Apo A-1 level of liver cancer patients with Child-Pugh score A was significantly higher than that of liver cirrhosis (t =-3.02,P =0.003),but the differences of serum Apo A-1 levels between liver cancer and liver cirrhosis patients with Child-Pugh score B and C were not statistically significant (t =0.52,1.19,P =0.610,0.240).The serum Apo A-1 levels of liver cancer patients with TNM stage Ⅰ and Ⅱ were significantly higher than those with TNM stage Ⅲ and Ⅳ (t =3.85,P ＜ 0.001).Conclusion The serum Apo A-1 levels of HBV-related liver cancer patients are related with cirrhosis,Child-Pugh score and TNM stage,and the liver reserve function,the body's stress response and many other factors may contribute to the expression of serum Apo A-1.

Objective To investigate the therapeutic efficacy of surgical treatment of myocardial bridge. Methods Fifteen patients with myocardial bridge had been treated in our hospital from January 1999 to October 2006. Thirteen patients who had typical angina had been treated regularly by medication, but their symptom remission was not satisfactory. One patient suffered from acute myocardial infarction, and another 1 patient complained of palpitation and syncope. All the patients were given surgical treatment. Surgical strategies included minimally invasive off-pump surgery in 9 patients (supraarterial myotomy in 3 patients, coronary artery bypass grafting in 2, and coronary artery bypass grafting with supraarterial myotomy in 4) and on-pump surgery in 6 patients (coronary artery bypass grafting with supraarterial myotomy in 5 patients and supraarterial myotomy in 1). Results All the operations were successfully completed. The operative duration of off-pump and on-pump surgery was 2.8?1.9 h and 3.5?1.7 h, respectively. The extracorporeal circulation time was 59?37 min. No surgery related death or complications occurred. At 3 months after operation, all the patients were free from symptoms, and electrocardiogram returned to normal in 11 patients. During a follow-up for 0.5~7 years (1.9?1.2 years), recurrent palpitation was seen in 1 patient and others reported no angina. Conclusions Surgical treatment of myocardial bridge has good immediate and long-term results.

Objective To evaluate the safety of laparoscopic complete mesocolic excision (CME) in radical resection for right colon cancer. Methods From January 2012 to June 2013, laparoscopic CME was performed in 40 patients with right colon cancer. Another group of 38 patients underwent traditional radical resection from January 2011 to December 2011.Surgical outcomes were compared between the two groups . Results The number of lymph nodes retrieved in the laparoscopic group ( 22.1 ±7.8 ) was significantly more than that in the traditional group (18.6 ±4.3, t =2.436, P =0.017).In patients with stage Ⅲ cancer, the laparoscopic group was associated with higher lymph node counts (23.0 ±6.0 vs.18.2 ±5.1, t=2.699, P=0.000), however, there were no significant differences in those with stage Ⅱ cancer between the two groups (t=0.758, P=0.454).There were no differences in operation time and intraoperative blood loss between the two groups (t=0.716, P=0.476;t=-1.547, P=0.126), but in the laparoscopic group the time to pelvic drainage tube removal , time to first flatus, time to liquid diet intake , duration of hospital stay, and postoperative complications were significantly better than those in the traditional group (t=-2.950, P=0.004;t=-5.767, P=0.000; t =-7.817, P =0.000; t =-6.065, P =0.000; χ2 =4.504, P =0.034). Conclusions CME technique in laparoscopic radical right hemicolectomy is feasible , safe, and effective.CME improves the surgical quality with keeping the integrity of mesocolon , more harvested lymph nodes , and not increasing surgical risks and postoperative complications .

Objective To explore the possible mechanism of the apoptosis of hepatoma cell line HepG2 induced by the combination use of GNRs@SiO2-FA and 125I seeds and to discuss its relationship with Bcl-2 and Bax protein expressions so as to provide theoretical basis for clinical treatment of hepatic cancer with interstitial brachytherapy by using 125I seeds. Methods In vitro cultured HepG2 cells were randomly divided into 4 groups: blank control group (not treated), simple GNRs@SiO2-FA group, simple 125I seeds group, and combination group (GNRs@SiO2-FA plus 125I seeds). The apoptosis of HepG2 cells was determined by flow cytometry. The expression of Bax mRNA and Bcl-2 mRNA of HepG2 cells were tested by RT-PCR. The apoptosis-related genes (Bax and Bcl-2) and the tumor proliferation cell nuclear antigen (Ki67) proteins expression on HepG2 cells were examined with immunohistochemistry method. Results The flow cytometry examination showed that the apoptosis rate of HepG2 cells in the simple GNRs@SiO2-FA group and simple 125I seeds group was higher than that in blank control group (P<0.05), and the apoptosis rate of the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group (P< 0.05). The expression level of Bax mRNA in the combination group was higher than that in the simple GNRs@SiO2-FA group and simple 125I seeds group, while the expression level of Bcl-2 mRNA in the combination group was obviously lower than that in the simple GNRs@SiO2-FA group and simple 125I seeds group. Bax protein was expressed on cytoplasm, Bcl-2 protein was expressed on cytoplasm and cell membrane, while Ki67 protein was expressed on nucleus. All of them presented as brown finely granular precipitations. Statistically significant differences in the amount of Bax, Bcl-2 and Ki67 protein expression existed between each other among the four groups (P< 0.05). The positive expression rate of Bax protein in the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, while the positive expression rate of Bcl-2 and Ki67 protein was significantly lower than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, and the differences were statistically significant (P < 0.05). Conclusion The combination use of GNRs@SiO2-FA and 125I seeds can more effectively induce the apoptosis of HepG2 cells. This effect may be accomplished through increasing the expression of Bax protein and inhibiting the expression of Bcl-2 and Ki67 proteins.