Objective To compare the hemostatic efficacies of radial artery balloon and spinning hemostat in elderly patients after radial artery intervention.Methods Eighty elderly patients undergoing transradial coronary intervention were randomly divided into balloon and spinning hemostat groups,with 40 cases in each group.After operation,balloons and spinning hemostats were used for hemostasis,respectively.The two groups were compared in terms of hemostatic effect,comfort degree and incidence of complications.Results These was no difference in hemostatic effect between the two groups(P>0.05).The balloon hemostat group was better than the spinning hemostat in respect of comfort degree.The incidences of ischemia and vagal reflex in the balloon hemostat group were significantly lower than the spinning hemostat group(P<0.05).Conclusion The balloon hemostat for radial artery intervention is more suitable for elderly patients undergoing oral treatment.

Objective To com pare and explore the application value of diatom nitric acid digestion method and plankton 16S rDNA PCR method for drow ning identification. Methods Forty drow ning cases from 2010 to 2011 were collected from Department of Forensic Medicine of Wenzhou Medical University. Sam ples including lung, kidney, liver and field water fromeach case were tested with diatom nitric acid digestion method and plankton 16S rDNAPCR method, respectively. The Diatom nitric acid digestion method and plankton 16S rDNAPCR method required 20 gand 2g of each organ,and 15 mL and 1.5 mL of field water, respectively. The inspection time and detection rate were com pared between the two methods. Results Diatom nitric acid digestion method m ainly detected two species of diatom s, Centriae and Pennatae, while plankton 16S rDNA PCR method am plified a length of 162 bp band. The average inspection time of each case of the Diatom nitric acid digestion method was (95.30±2.78) min less than (325.33±14.18)min of plankton 16S rDNA PCR method (P<0.05).The detection rates of two methods for field water and lung were both 100% . For liver and kidney, the detection rate of plankton 16S rDNA PCR method was both 80% , higher than 40% and 30% of diatom nitric acid digestion method (P<0.05), respectively. Conclusion The laboratory testing method needs to be appropriately selected according to the specific circum stances in the forensic appraisal of drow ning. Com pared with diatom nitric acid digestion method, plankton 16S rDNA PCR method has practice values with such advantages as less quantity of sam ples, huge inform ation and high specificity.

Objective To identify the mediators of CDC42 signaling pathway involved in hepatitis B virus X protein (HBx)-mediated cellular transformation.Methods The mass defect-based pseudo-isobaric dimethyl labeling method (pIDL)was used to detect the differentially expressed proteins with a deficiency of CDC42.Furthermore,we conducted a gene ontology (GO)of differentially expressed proteins.Results and Conclusion We totally qualified 3409 proteins and found 220 differentially expressed proteins.Palladin,formin-like 1 (FMNL1)and keratin-19,which were implicated in cytoskeleton organization,were down-regulated with the deficiency of CDC42.Our results have provided candidate genes and proteins that may play an important role in HBx-mediated cellular transformation.

Cell division cycle 42 (CDC42)is a member of Rho guanosine triphosphatase (GTPase) family,which plays an important role in cell proliferation , cell migration and cell transformation .The activity of CDC42 can be regulated by guanine nucleotide exchange factors (GEFs),GTPase activating proteins (GAPs) and guanine nucleotide-dissociation inhib-itors (GDIs).Recently,CDC42 has been reported as abnormally expressed in many human cancers ,suggesting that CDC42 performs complex functions in tumorigenesis .Therefore,this paper aims to shed light on the functions of CDC 42 in cancers in terms of the alteration of CDC42 activity,CDC42 regulators,as well as its effectors.

The early involvement of specialty,case and scientific research were applied to forensic medicine teaching and has achieved significant effect.

Basic knowledge of forensic science is theoretical and abstract,therefore,confir-matory experiment teaching is often adopted in the experiment teaching. International education has become an important topic in medical colleges and universities. Forensic medicine is a compulsory subject for medical international students. This article discussed the exploration and practice in teach-ing forensic medicine for international students at Wenzhou Medical University,which included faculty constructing and training,encouraging whole English teaching by young teachers,applying heuristic interactive teaching and case teaching,establishing strict attendance and appraisal system and con-ducting comprehensive evaluation on medical teaching quality and teaching management.

Purpose: The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties. Methods: The Perinatal Bereavement Care Competence Scale was developed in four phases. (1) Item generation: 75 items were formulated based on a literature review and interviews with midwives. (2) Delphi expert consultation: 15 experts evaluated whether the items were clear/appropriate/relevant to the questionnaire dimensions, and the items were optimized. (3) Pilot test: The comprehensibility, acceptability, and time required to complete the questionnaire by midwives were assessed. (4) Evaluation of reliability and validity: The scale was validated by initial item analysis, exploratory and confirmatory factor analyses, and internal consistency reliability and testeretest reliability. Results: The final scale consisted of six dimensions and 25 items: maintaining belief (three items), knowing (four items), being with (six items), preserving dignity (four items), enabling (five items), and self-adjustment (three items). Exploratory factor analysis yielded a six-factor structure that was consistent with the theoretical framework and explained 70.8% of the total variance. Confirmatory factor analysis indicated a good fit for the six-factor model. Cronbach's a for the scale was 0.931, and the test eretest reliability coefficient was 0.968. Conclusion The Perinatal Bereavement Care Competence Scale is a valid and reliable instrument for measuring the competence of midwives in caring for bereaved parents who have experienced perinatal loss.

The authors introduced the practice of shared governance in ICU nursing management. According to the standard of magnetic hospital, a shared governance committee was established to guide and motivate the clinical front-line nurses in ICU to participate in nursing affairs management and decision-making. After three years of practice, ICU nursing management mode has achieved the goal of participating in shared governance, enhancing nurses′ perception of patient safety culture and improving the level of work engagement.

For ICU patients, a structured dental assessment and recording system can effectively prevent adverse nursing events caused by tooth loss, and eliminate the potential risk of patients' safety. In addition, the structured recording system can effectively speed up nursing document input, facilitate compliance and acceptance of dental assessment improve work efficiency and quality, and eventually improve the informationization management of nursing.

Objective To investigate the effects of a multidisciplinary round electronic checklist in ICU. Methods From October 2016 to September 2017,a total of 1 172 patients were provided with a multidisciplinary round electronic checklist. Another 886 patients with routine rounds between October 2015 to September 2016 were retrospectively analyzed. The duration of mechanical ventilation and ICU stay,the rate of nosocomial infection, the percentages of catheter days(central line catheter days,artificial airway days and urinary catheter days) and clinical staffs' satisfaction with the multidisciplinary collaboration were compared. Results The duration of mechanical ventilation and ICU stay in the intervention group were 1.42(0.68,3.63)days and 3.19(2.48,5.40)days respectively,in the control group were 2.16(1.40, 4.77) days and 4.14(3.46, 6.92) days respectively. The differences between two groups were statistically significant(t=2.084, 2.247, P <0.05). The application of a multidisciplinary round electronic checklist shortened the duration of mechanical ventilation and ICU stay. The percentages of catheter days and the rate of catheter-associated urinary tract infection were 0(0/6 269),60.34%(6 269/10 389)respectively,in the control group were 0.93‰(6/6 485),67.02%(6 485/9 676)respectively.The differences between two groups were statistically significant(χ2=96.187,Fisher's exact test=0.031,P<0.05).Besides,the level of multidisciplinary collaboration in ICU was greatly improved in the intervention group, 3.03 ± 0.11 vs. 4.13 ± 0.39 (t=24.587, P < 0.05). Conclusions A multidisciplinary round electronic checklist in ICU can improve the care quality and multidisciplinary collaboration.