Glucocorticoids(GC) play definite and effective roles in the management of chronic pain,but their toxic and side effects also make them controversial agents.This review discusses various aspects of glucocorticoids including their action mechanism,toxic and side effects,different types of pharmaceuticals and ways of administration.It also ventures some suggestions on rational medication of steroids.

Objective To investigate and compare the clinical value of the elastic grades score evaluation method and ultrasound elasticity imaging strain ratio method in identifying thyroid nodules.Methods A total of 120 cases confirmed by operation and pathology of the patients with thyroid nodules in our hospital were underwent ultrasound elasticity imaging detection,the thyroid nodules were identified with the elastic grades score evaluation method and ultrasound elasticity imaging strain ratio method respectively,and were compared with pathological results separately.Results The sensitivity,specificity and accuracy rate were 79.4％,81.3％,81％ with the elastic grades score evaluation method,the sensitivity,specificity and accuracy rate were 91.2％,90.3％,93.3％ with ultrasound elasticity imaging strain ratio method,of which was significantly higher with ultrasound elasticity imaging strain ratio method than with the elastic grades score evaluation methodby statistical analysis(x2 =28.170,P =0.000;x2 =34.219,P =0.000; x2 =17.928,P =0.000).Conclusion Ultrasound elastography strain ratio and rating score evaluation method can be used as an effective method in differentiating malignant from benign thyroid nodules,which can effectively improve the accuracy rate of the differential diagnosis of thyroid nodules and effectively remedy the diagnostic error band to cognitive differences with traditional ultrasound evaluation.The method of ultrasound elastography strain rate ratio was better with advantages of easy to operate,easy to learn and master,and easily accepted by patients,which is worthy of clinical application.

OBJECTIVE To discuss how to strengthen detail management to control hospital infection in operating room. METHODS The consciousness of controlling hospital infection,detail management as the key,integration of daily supervision examination with periodic inspection test and assessment,perfecting the detail management mechanism of hospital infection,and executing operation rules strictly were carried out. RESULTS The knowledge of hospital infection in staff members was improved,working efficiency raised,nursing level increased obviously,and the sterile operation infection rate dropped down. CONCLUSIONS Strengthening detail management is good for hospital infection control in operating room.

OBJECTIVE: To optimize the preparation process of Xiangsha Liujun Granule. METHODS: By the orthogonal design. taking the rates of recovery of volatile oil, Ginsenoside Re and qualified granules as the indexes, we optimized the oil extracting conditions, the decocting conditions and the conditions of granulation by spayer. RESULTS: The optimum oil ex- tracting conditions for four kinds of herbs(Pericarpium Citri Reticulatae etc.) were that water was 30 times of herbs in weight, soaking time was 3 hours and extracting time 15 hours. The optimum decocting conditions for four kinds of herbs(Fuling etc.) were that water was 15 times of herbs in weight, soaking time was 3 hours and decocting time 4 hours, herbs were decocted twice. The optimum conditions of granulation by sprayer were that the fliud extract was 2 times of Dextrin in weight, the rel- ative density of the fliud extract was 1. 30(measured at 25℃), the voltage of sprayer was 120 volts, the period of shaking bag was 65 times(shaking bag back and forth twice in each period). CONCLUSION: The results of the experiment make it clear that the preparation process of Xiangsha Liu jun Granule is stable and feasible.

Purpose　To investigate the role of urokinase plasminogen activator (uPA),uPA receptor (uPAR),tissue type plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) in the invasiveness of human breast cancer cells.　Methods　Three human breast cancer cell lines with different invasive ability were taken as research targets.RT-PCR and milk plates methods were used to detect the expression of uPA system members and the PA activities,respectively.Modified Boyden's chamber model was employed to detect the invasive ability of cancer cell.　Results　MDA-MB-231 could express high level of uPA,uPAR,PAI-1 and low level of tPA.MDA-MB-435 could express lower level of uPA and hight level of tPA,but no PAI-1 and uPAR were detected.MCF-7 could express lower level of uPAR and high level of PAI-1,but no uPA and tPA were detected.MDA-MB-231 cells showed the highest total PA and uPA activity.MDA-MB-435 cells also showed high total PA activity,but almost all the activity owed to tPA.MCF-7 showed almost no PA activity.Correlated with their PA activities,MDA-MB-231 was found the most invasive in vitro,followed by MDA-MB-435,and MCF-7 almost had no invasive ability.The antibodies against uPA and uPAR were significantly effective in reducing the matrigel invasiveness of MDA-MB-231 by approximately 83.1% and 43.9% respectively (P<0.05).　Conclusions　Co-expression of uPA,uPAR and PAI-1 in human breast cancer highly correlates with the invasiveness in vitro.

Objective To investigate the value of global longitudinal strain (GLS) in detecting severe coronary artery stenosis (SCAS) in patients with coronary artery disease. Methods Fourty-two patients with SCAS confirmed with coronary arteriongraphy (CAG) underwent two-dimensional strain echocardiography. GLS, wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) were obtained. Taking CAG as gold standard, the sensitivity, specificity and areas under the ROC curve (AUC) of definition of SCAS with GLS, WMSI and LVEF were calculated, respectively. Fifteen healthy volunteers were recruited as control. Results ①Definition of one or more branches with severe stenosis: The sensitivity and specificity was 77.51% and 100% with GLS of -17.50% as a cutoff value, 70.01% and 100% with WMSI of 1.00, and 57.51% and 100% with LVEF of 59.21%. ②Definition of two or more than two branches with severe stenosis: The sensitivity and specificity was 62.52% and 80.81% with GLS of -11.05% as a cutoff value, 56.22% and 65.31% with WMSI of 1.60 and 56.21% and 65.42% with LVEF of 54.31%. ③The correlation coefficient was 0.78 between GLS and LVEF, and -0.82 between WMSI and LVEF. The AUC of detecting one or more branch with severe stenosis with GLS, WMIS and LVEF was 0.87, 0.80 and 0.78, respectively, and AUC of GLS was more than that of LVEF (P＜0.01). AUC of detecting two or more than two branches with severe stenosis with GLS, WMIS and LVEF was 0.76, 0.64 and 0.64, AUC of GLS was more than that of LVEF and WMSI (all P＜0.01). Conclusion GLS can be used in detecting SCAS, and the value of GLS is better than that of WMIS and LVEF.

Objective To prepare an occupation well-being scale for nurses, and test its reliability and validity. Methods After literature review and semi-structured interviews, the item pool of the occupation well-being scale for nurses was created based on theory of structure of the subjective well-being. After group discussion, and evaluation by the specialists, a pilot scale was obtained. A total of 350 clinical nurses were selected by using stratified sampling method, and their occupation well-being were surveyed by the scale. The data were used to assess the reliability and validity of the scale. Results The occupation well-being scale for nurses had 3 dimensions, including 8 exploring factors. The values of Cronbach Alpha and the split half reliability coefficient of the total scale, endogenous exogenous satisfaction, satisfaction of nurses occupation happiness were all larger than 0.9, which meaned the internal consistency was good. In the emotion dimension, the value of Cronbach Alpha and the split half reliability coefficient were less than 0.7, which meant the internal consistency was not so good. The reliability coefficient of repeated measurement of the whole scale and each dimension were greater than 0.7, suggesting the external consistency of the scale was good. The content validity index of 3 dimensions were all larger than 0.9,and the cumulative ex-planatory variables were all larger than 55%. Conclusion The occupation well-being scale for nurses proposed in this study has good reliability and validity, and can be used to evaluate the occupation well-being of the nurses.

BACKGROUND: Key point for subculture of human embryonic stem cells (hESCs) is to inhibit spontaneous differentiation and make sure totipotency of cells. Although mouse embryonic fibroblasts (MEF) or human foreskin fibroblasts (HFF) used as the feeder layer can maintain undifferentiated state of embryonic stem cells, cell clone is still imperfect and parallel arranged. OBJECTIVE: To establish mixed feeder layer of mouse embryonic fibroblasts plus human foreskin fibroblasts and to observe the hESCs growth.DESIGN: Multi-sample observation and comparison.SETTING: Medical Center of Reproduction, the Affiliated Hospital of Hainan Medical College. MATERIALS: This study was performed at the Medical Center of Reproduction, the Affiliated Hospital of Hainan Medical College from April 2006 to July 2007. Foreskin was derived from the children who underwent circumcision and came from Urinary Surgery, the Affiliated Hospital of Haihan Medical College. The children's family members provided the informed consent, and the experiment received confirmed consent from the local ethic committee. hESCs line HN-1 was separated from human blastula. Eleven 12.5-14.5-day-old fetal mice of clean grade were selected in this study. The experimental animals were disposed according to ethical criteria. METHODS: Heads, four extremities, and viscera were removed from fetal mice under anesthesia. Subsequently, cell suspension was prepared using routine trypsinase digestion and inoculated. When cells were cultured in confluent monolayer, some primary cells were frozen, processed with mitocin-C for 2.0-3.0 hours, and inoculated based on the density of 1×108 L-1 in gelatin-coated dish, I.e., MEF feeder layer. The HFF separation and culture and the preparation of HFF feeder layer were the same as above-mentioned processing. In addition, the two fibroblasts were respectively counted and mixed together according to the ratios of 1∶0, 3∶1, 1∶1, 1∶3, and 0:1. And then, the mixture was inoculated based on the density of 1×108 L-1 in gelatin-coated dish, I.e., mixed feeder layer. The growth of subcultured hESCs in vitro was observed in three different feeder layers, and hESCs in the mixed feeder layer underwent alkaline phosphatase test, OCT-4 expression immunohistochemical measurement, and OCT-4 and telomerase mRNA expression RT-PCR detection. Finally, differentiation in vitro of hESCs was observed after removing the feeder layer.MAIN OUTCOME MEASURES: ① Growth of hESCs in the three different feeder layers; ② Growth of hESCs in the mixed feeder layer based on different mixed ratios; ③ undifferentiated state of hESCs in the mixed feeder layer; ④ differentiation in vitro.RESULTS: ① hESCs clone in the MEF and HFF feeder layers was thin and flat and imperfect, but hESCs clone in the mixed feeder layer was perfect and thick and solid. Apparently, the clone form in the mixed feeder layer was superior to MEF and HFF feeder layers. ② When MEF and HFF was mixed together according to the ratio of 1∶1, hESCs grew in apparent accumulation; clone border was clear; eminentia was apparent and perfect. However, there were no changes according to the ratio of 1∶3. The ratio of 1∶1 was superior to the ratios of 1∶0, 3∶1, and 0∶1. ③ Alkaline phosphatase staining and OCT-4 antigen expression were strongly positive. Specific straps of OCT-4 and telomerase mRNA expression were observed at 200-300 bp and 300-400 bp, respectively. ④ Embryoid bodies were formed. hESCs could differentiate into multi-morphological cells after attachment.CONCLUSION: ① The mixed feeder layer may well support in vitro subculture of hESCs to acquire excellent clone form compared to MEF or HFF feeder layer. ② The mixture of MEF and HFF has excellent effect according to the ratio of 1∶1.

Objective:Studies on the immune-enhancing activity of Polysaccharides from the fruits of Borojoa sorbilis cuter ( polysaccharides BSCP) in vivo.Methods:54 male BALB/c mice were randomly divided into six groups.The immune suppression mice in the three experimental groups,which were induced by cyclophosphamide ( CY) at 80 mg/kg/d via intraperitoneal injection, were perfused with 100,200,400 mg/kg/d BSCP for 30 d.The effect of BSCP on cellular immune function,humoral immune function and mononuclear macrophage function were measured.Results:CY-treated mice showed a significant decrease in immune function( P<0.05),humoral immune function(P<0.01) and mononuclear macrophage function(P<0.01).The administration of BSCP was able to overcome the CY-induced immunosuppression,treatment with BSCP-L,BSCP-M and BSCP-H groups significantly enhanced the cellular immune function( each was P<0.05 ) and mononuclear macrophage function ( each was P<0.05 ) , and treatment with BSCP-M and BSCP-H significantly enhanced humoral immune function(each was P<0.01).Conclusion:BSCP could significantly increase immune responses and reduce the side effects of CY in immune system.Therefore,the BSCP could be an immunomodulatory agent.