Objective To investigate the influence of the establishment of Chest Pain Center (CPC) on the reperfusion treatment and prognosis of patients with acute ST segment elevated myocardial infarction (STEMI).Methods One hundred and eighteen patients with acute STEMI admitted into the Department of Emergency in Weifang People's Hospital from March to May 2016 before the establishment of the CPC were assigned as a control group,and 112 patients with STEMI admitted from September to November 2016 after the establishment of CPC were assigned as a study group.The first electrocardiograph (ECG) of all emergency patients was finished by nurses in the control group,after the cardiology physicians of Emergency Department having examined the patients,those with definite diagnosis of acute STEMI were sent into a resuscitation room immediately,and a loading dose of aspirin 300 mg and ticagrel 180 mg were given orally to each of the patients.The patients who accepted the primary percutaneous coronary intervention (PPCI) were transferred into a catheterization room as soon as possible;the patients who could not accept the PPCI,after the exclusion of contraindications of thrombolysis,were transferred into the emergency intensive care unit (EICU) to receive the intravenous thrombolytic treatment.For the study group,a uniform training was implemented,including the ECG interpretation,the diagnosis and treatment processes of chest pain for all of the medical staff,and establishment of a CPC database.The patients who were diagnosed as acute STEMI entered into the green channel of chest pain.For the patients who accepted the PPCI,the catheterization room was started immediately.The patients who could not accept the PPCI received the intravenous thrombolysis treatment:intravenous drip of urokinase 1 500 kU dissolved in 100 mL physiological saline was finished in 30 minutes.After treatment,the differences in the time from symptom onset to first medical contact (SO-to-FMC),the finished time of the first ECG after admission,the time of visiting doctor to reperfusion treatment[beginning of thrombolysis or ballon dilatation (DTRT)] including the door-to-needle (D2N) time or the doorto-balloon (D2B) time,the incidence of heart failure during hospitalization,the left ventricular ejection fraction (LVEF) measured with color Doppler ultrasound on the 7th day after admission and the in-hospital mortality were compared between the two groups of patients.Results There was no statistically significant difference between the study and control groups in the SO-to-FMC time (minutes:140.3 ± 108.4 vs.139.4 ± 112.7,P ＞ 0.05).The finished time of the first ECG after admission in the study group was significantly shorter than that of the control group (minutes:7.7 ± 1.3 vs.8.9 ± 1.7,P ＜ 0.05),the door to reperfusion time in the study group was also significantly shorter than that of the control group [D2B (minutes):72 ± 13 vs.83 ± 17,D2N (minutes):27 ± 9 vs.33 ± 12,both P ＜ 0.01].The incidence of heart failure during hospitalization of the study group was significantly lower than that of the control group [40.2％ (45/112) vs.53.4％ (63/11 8)].The left ventricular ejection fraction (LVEF) measured at one week after admission in study group was significantly higher than that of the control group (0.54 ± 0.05 vs.0.53 ± 0.04,P ＜ 0.01).The in-hospital mortality of the study group was lower than that of the control group [9.8％ (11/112) vs.14.4％ (17/118)],but there was no statistically significant difference between the two groups (P ＞ 0.05).Conclusion The application of the CPC run mode can further elevate the therapeutic level of reperfusion therapy,shorten the total ischemic time and improve the prognosis of patients with STEMI.

Acidic environment of organelles of eukaryotic cells plays an important role in endocytosis, the secretion of lysoso-mal enzymes and other physiological activities.V-ATPase (vacuolar ATPases) and CLC (chloride channel) family are widely distribu-ted and present in virtually all eukaryotic cells in intracellular membranes and in the plasma membrane.They are responsible for the a-cidification of the vesicular interior.In this paper, the distribution, structure, mechanism of action and physiological and pathological significance of V-ATPase and CLC protein are discussed.

Objective To investigate the effects of Xuebijing injection on T-lymphocyte subgroups and clinical efficacy in treatment of patients with severe pneumonia.Methods 60 patients with severe pneumonia were selected into the study.The patients were randomly divided into Xuebijing group (n =30) and control group (n =30).Patients in the control group were given routine therapy.The Xuebijing group received the treatment of routine therapy combined with Xuebijing injection.The changes of T lymphocyte subgroups and clinical efficacy were compared between the two groups.Results The levels of CD3,CD4,CD4/CD8 after treatment in Xuebijing group and control group were significantly higher than those of before treatment (t =4.95,4.89,4.96,3.13,3.11,3.09,all P ＜ 0.05),those in the Xuebijing group were significantly higher than control group (t =3.89,3.56,3.78,all P ＜ 0.05).The total effective rate in the Xuebijing group was 93.3％,which was significantly higher than 76.6％ in the control group (x2 =4.55,P ＜ 0.05).Conclusion Xuebijing injection combined with routine western medicine is quite effective in treatment severe pneumonia.Xuebijing can improve the immune function of patients.

Objective To investigate the current situation of community nurses′practice environment and work engagement, and to analyze the impact of practice environment on work engagement. Methods Totally 380 community nurses in 26 community health service institutions were investigated with Practice Environment Scale of the Nursing Work Index (PES-NWI) and Utrecht Work Engagement Scale (UWES). Results The effective questionnaires rate was 88.95%(338/380). The total of PES-NWI was 50-120 (90.542±12.095) scores, the different dimension from high to low were medical cooperation,nursing managers' ability and leadership style, high quality nursing service basis, nurses in hospital affairs, staffing and resource adequacy:(3.213 ±0.510), (3.048 ±0.404), (3.015 ±0.419), (2.739 ±0.494), (2.693 ±0.549) scores. The total of UWES was 17-88 (52.189±19.610) scores,the different dimension from high to low were activity, focus, dedication:(3.556±1.380), (3.493±1.389), (3.346±1.475) scores.Nurse practice environment ofnurses in hospital affairs and high quality nursing service basis had significant prediction effect on community nurses′work engagement, P<0.01. Conclusions It exists closely correlation between professional practice environment and work engagement. Community hospital managers should reasonable allocation of personnel and materials, provide equal participations in hospital affairs platform, meet the needs of nurses in different levels of education and learning, and perfecting the community nurses performance appraisal, in order to enhance community nurses' work engagement degree.

AIM: To evaluate the relationships between maternal serum alpha-fetoprotein (MSAFP) levels and middle cerebral artery peak systolic velocity (MCA-PSV) in pregnancies with fetal anaemia and to compare the sensitivities of MSAFP and MCA-PSV for the predicting the risk of fetal anaemia. METHODS: Fifty-five measurements of MSAFP and MCA-PSV were carried out in 32 women at risk of fetal anaemia (4 cases of alloimmunisation, 11 cases of thalassemia, 10 cases of parvovirus infection and 7 cases of placental chorioangioma). The relationship between MSAFP and MCA-PSV was studied, and 19 fetal blood samples, in which MCA-PSV measurements were abnormal, were taken and the fetal heamoglobin were tested in order to evaluate the correlation of MSAFP and MCA-PSV. RESULTS: A correlation between MSAFP and MCA-PSV (n=55, r=0.57, P<0.01) was observed, in which 15 cases of fetal anaemia and 4 cases false positive (non-anaemia) were detected among the 19 fetal blood samples. The MSAFP levels of 4 false-positive cases were normal. The MSAFP levels in 15 fetal anaemia cases were higher than those in non-anaemia. The elevation of MSAFP level was 15-20 d earlier than that of MCA-PSV in the cases of alloimmunisation and thalassemia, and it was 10-12 d later in the cases of parvovirus infection and placental chorioangioma significantly (P<0.05). Both MSAFP (r=-0.87) and MCA-PSV (r=-0.67) were significantly correlated with fetal heamoglobin level. CONCLUSION: The MSAFP level is significantly correlated with both MCA-PSV measurements and fetal haemoglobin. The time and process of the elevations of MSAFP indicate that MSAFP is more sensitive than MCA-PSV to predict and monitor the pregnancies at the risk of fetal anaemia.

Objective To investigate the effect of variation of cesarean sections during labour and their indications on the total cesarean section rate. Methods A total of 458 cases of cesarean section was selected from January to June of 1990,1996,2002. They were divided as indication group and no indication group. The change of the indication and cesarean section rate was compared. Results The ratio of cesarean section during labour in total cesarean sections rised. The ratio was 22.0%, 20.8% and 39.4% in 1990, 1996 and 2002 respectively. The proportion of no indication surgery in 2002(63.37%) showed significant growth as compared with that of 1990 (33.84) and 1996 (32.58). Of all cases of cesarean section having indications, the rate of trial produce failure increased in 2002 (25.81%) while it was 11.45% and 16.67% in 1990 and 1996 respectively. The rate of fetal distress decreased from 25.19% (1990), 21.67% (1996) to 12.90% (2002). Conclusion Ascen ding of cesarean section rates during labour was an important factor that increased cesarean section rate in recent years. To decrease the total rates of cesarean section, many important measures should be done such as paying more attention to social factors, reinforcing propaganda and maternal health care , encouraging spontaneous vaginal delivery, emphasizing company during labour and analgesia or pain free delivery, laying stress on the management and monitoring during first stage of labour as well as psychological care.

BACKGROUND: There are several types of endogenons stem/progenitor cells in lung that develop from either endoderm or mesoderm precursors.To elucidate the characteristics of the intrapulmonary stem ceils wig help to understand their biological behavior in lung injury.OBJECTIVE: To isolate the mesenchymal stem cells (MSCs) from mouse lung tissues,and identify their morphology and growth characteristics,cell surface antigens,differentiation potential in vitro,stem cell properties,and to investigate the protective role in bleomycin challenged lung.DESIGN,TIME AND SETTING: The present randomized controlled in vivo animal experiment based on in vitro observation of cytology was performed at the Laboratory of Cell Biology,Institute of Basic Medical Science,the Academy of Military Medical Science between October 2005 and August 2007.MATERIALS: Male(3-4 weeks) and female C57BL/6 (6-8 weeks) mice were used.Twenty female C57BL/6 mice were randomly and evenly divided into a pulmonary MSCs (PMSCs)-treated group and a myelosuppression group.METHODS: The lungs from male C57BL/6 mice were digested with collagenase Ⅱ,followed by centrifugation over a Ficoll step.The interface fraction was collected and cultured by adherent method.When the monolayer of adherent cells reached 70%-80%confluence,the adherent cells were detected and expanded in culture medium.The mice in the PMSCs-treated and myelosuppression groups were intraperitoneally administered busulfan to inhibit the immigration of bone marrow stem cells.In addition,pulmonary fibrosis injury was induced in these mice with bleomycin.The PMSCs-treated group was intravenously administered 5×105 PMSCs.At the same time,the myelosuppression group received 100 μ L of phosphate buffered saline.After 14 days,the lungs were taken to prepare paraffin-embedded section.MAIN OUTCOME MEASURES: Cell morphology,immunophenotype,specific markers of the induced cells,expression of gene peroxisome proliferator activated receptor γ,osteopontin,osteocalcin,prosurfactant protein C(SP-C),Oct-4 and Nanog,histological alteration of lung tissue sections.RESULTS: MSCs were successfully isolated from mouse lung tissue.The pulmonary MSCs(PMSCs) were fibroblast-like cells,and expanded rapidly in vitro for up to 40 passages.The phenotype of the PMSCs was Scu- 1+ ,CD44+ ,CD29+ ,CD105+ ,CD54+ ,CD34-,CD45-,CD11b,c-kif,and CD31.They did not express alveolar epithelial cell specific markers,such as SP-C,aquaporin-5,and clara cell secretory protein.It was noticeable that stem cell markers octamer-binding transcription factor 4 (Oct-4) and Nanog were expressed continuously in culture expanded cells.They could differentiate into adipocytes,osteoblasts and alveolar epithelial cells in vitro.Colony-forming assay demonstrated that the colony forming efficiency of the PMSCs was nearly 3%.The cells from single colony were capable of differentiating to osteocytes,adipocytes and alveolar epithelial cells.Intravenous administration of PMSCs could alleviate pulmonary injury and fibrosis induced by bleomycin,despite the bone marrow was intact or not.CONCLUSION: The PMSCs are able to extensively propagate in vitro,can efficiently switch to both mesenchymal and alveolar epithelial lineages in vitro,generate adipocytes,osteocytes,and the alveolar epithelial cells,and reduce pulmonary injury and fibrosis in bleomycin challenged lung in vivo,strongly suggesting their promising applications in cellular therapy against the lung injury.

Objective To investigate the effect of rehabilitation nursing in perioperative period of elderly patients with femoral neck fractures undergone supercapsular percutaneously assisted total hip (SuperPATH) arthroplasty.Methods A retrospective cohort analysis was made on 30 patients treated by total hip arthroplasty through the SuperPATH approach from January 2016 to July 2016.There were seven males and 23 females,aged 75-91 years (mean,77 years).Nursing methods contained application of pluralistic education before operation,application of body position management,psychologic support joint pain and sleep multidimensional strengthening nursing intervention and dislocation nursing after operation,and recovery training.Self-rating anxiety scale (SAS),self-rating scale of sleep (SRSS),Barthel index and Harris hip score were used to compare clinical manifestations before and after treatment.Results SAS score was 42.5-66.3 points [(50.0 ± 6.2) points] one day before operation,compared to 33.8-53.8 points [(41.5 ± 5.2) points] five day after operation (P ＜ 0.05).SRSS score was 24-37 points [(29.9 ±3.1) points] one day before operation,compared to 14-34 points [(23.2 ± 5.3) points] five day after operation (P ＜ 0.05).Barthel index was 20-40 points [(38.5 ± 4.4) points] one day before operation,was 35-55 points [(49.7 ± 6.3)points] two day after operation and was 55-70 points [(63.5 ± 5.1)] points five day after operation,showing significant differences (P ＜ 0.05).Harris hip score was 4-25 points [(14.8 ±4.2)points] one day after operation,was 59-75 points[(67.3 ± 5.1) points] two day after operation and was 66-85 points [(79.2 ± 4.3) points] two weeks after operation,showing significant differences (P ＜ 0.05).All incision healed primarily.No complications occurred.Conclusion Perioperative rehabilitation nursing of minimally invasive SuperPATH arthroplasty is effective in alleviating patients' anxiety,improving sleep status and self-care ability,enhancing postoperative rehabilitation effect and reducing risk of in-hospital complications.

Objective To realize the application of mini-PACS based on Web.Methods According to the actuality of our hospital,the reasonable structure of Database,Network Topol and application program are designed.Conclusion The cheap cost and reasonable design is the key of mini-PACS' application to hospitals.

Aim The present study was designed to investigate the contractile responses to vasoconstrictors in artery supplying colon carcinoma.Methods The artery supplying carcinoma was obtained from patients suffering from colonic carcinoma. The artery supplying carcinoma ambient normal tissue from patients with colon carcinoma and normal artery from patients with accident were used to control. Artery were cut into about 1 mm long cylindrical segments. The concentration-contractile curves induced by 4 vasoconstrictors were recorded. Results In the normal artery, the E_max and pEC_50 of contraction induced by noradrenaline (NA) were 97%?19% and 5.94?0.17(n=5), respectively; while in the artery supplying carcinoma, the E_max and pEC_50 of contraction induced by NA were 74%?5% and 5.54?0.21(n=5). In the artery supplying cancer ambient normal tissue, the E_max and pEC_50 of contraction induced by NA were 119%?11% and 5.84?0.09, respectively. The E_max in artery supplying carcinoma induced by NA was lower than that in normal arteries(P