Objective To describe nursing occupational protection status of clinical nurses in China.Methods We made a survey of 2142 clinical nurses in grade two and grade three hospitals in Fujian from June to December 2006.With self-developed evaluation questionnaire of appropriate protection level of nursing occupation to collect the general information of the status of nursing occupational protection.Results The score of occupational protection level was(121.31±28.26).The occupational protection level was generally optimistic,nearly grade 3 level,the execution of the grade 1 protection,grade 2 protection and grade 3 protection weakened gradually.Conclusions All pertinent sections should pay attention to occupational protection level of clinical nurses.The government should increase financial input,the hospital need to prepare adequate protective equipment and solve the human resources problems in order to improve the level of occupational protection.

Objective To investigate the correlation of gestational diabetes mellitus and preeclampsia and its influence on delivery outcome.Methods A retrospective analysis of 4 636 pregnant women were made,who were sin-gleton pregnancy and gestational age≥32 weeks,and the data of GDM,PE,delivery outcome were collected.Then,the incidence of PE in GDM or non-GDM were compared,the delivery outcome in pregnant women without interval med-icine comorbidity ( A group) ,GDM pregnant women( B group) ,PE pregnant women( C group) ,pregnant women com-bined GDM and PE(D group) were analyzed.Results The incidence rate of GDM was 3.71%(172/4 636) in the whole,the incidence rate of PE was 5.65% (262/4 636).The incidence rates of PE among GDM and non-GDM pregnant women were 11.63%(20/172) and 5.42%(242/4 464),the difference was statistically significant(χ2 =5.983,P<0.05).The average pre-pregnant body mass index(BMI),Apgal scores at 1 minute and 5 minutes were compared,and the differences among the four groups were statistically significant( F=29.142,16.074,35.415,all P<0.01),and those in C group,D group were significantly lower than in group A and group B [t(C-A) =5.386, 4.821,5.224,t(C-B) =5.023,4.456,6.278,t(D-A) =6.753,5.012,6.443,t(D-B) =6.475,4.727,7.622,all P<0.01].The rates of neonate intensive care,giant baby natality,small-for-gestational-age children,premature labor were compared,and the differences among the four groups were statistically significant (χ2 =157.290, 96.129, 46.969,27.005,all P<0.1),the rates of neonate intensive care in C group and D group were higher than in A group and B group[χ2(C-A) =47.294,χ2(C-B) =15.547,χ2(D-A) =17.280,χ2(D-B) =7.088,all P<0.01],the rates of giant baby natality in B group were higher than A group,C group [χ2(B-A) =29.445,χ2(B-C) =6.597,all P<0.05],the rates of small-for-gestational-age children and premature labor in D group were higher than A group,B group and C group[χ2(D-A) =42.676,26.261,χ2(D-B) =9.070,10.879,χ2(D-C) =25.117,8.653,all P<0.01].Conclusion Pregnant women with GDM might have higher risk of suffering PE than those non-GDM gravidas,the PE,GDM com-bined with PE seriously influence perinatal outcome,pregnancy care should be strengthened to prevent and treat.

Objective: Tracing the 15 leads electric signal of canine myocardial infarction by means of VCG and ECG ,compar-ing the diagnose standard of VCG and ECG ,confirm the difference of diagnose standard of canine myocardial infarction ,vali-date the diagnosing specificity of canine myocardial infarction. Methods: Make an operation of coronary artery ligation on 30 healthy dogs to make a myocardial infarction model, record the 15 leads information of ECG and VCG from body surface ,then contrast and analyse them. Results: The sensitivity diagnosing to canice myocardial infarction by VCG is much higher and more specific than that by ECG. Conclusions: Diagnosing early by means of VCG and ECG, VCG is more specific to diag-nose myocardial infarction than ECG.

Objective The therapeutic effect of epigallocatechin-3-gallate (EGCG) on the collageninduced arthritis model (CIA) was observed and its immunological mechanism was analyzed. Methods EGCG was administered to CIA mice and PBS was admitted as negative control. The severity of CIA was evaluated by clinical scores and histopathological assessment (H-E staining). Immunological mechanisms inv-suppressive effect on IL-17 secretion of CD4+T cells (EGCG group: 0.41%; PBS group: 4.05% ) and inhibitive activity of C Ⅱ -reactive splenocytes proliferation. There was statistical significant difference between IKB expression and down-regulate phosphorylated IKB expression in lymph node cells of CIA mice.Conclusion EGCG can significantly ameliorate the severity of CIA. The therapeutic mechanisms may be related to inhibition of C Ⅱ -reactive splenocyte proliferation and IL-17 secretion and via inhibiting the activity of NF-κB by inducing the expression of IKB and by suppressing the expression of phosphorylated IKB in CIA mice.

Objective To explore the efficacy of different bulbourethral sling procedures in the treatment of male acquired urinary incontinence.Methods A retrospective study of 105 patients with acquired urinary incontinence was performed.The patients underwent 3 different bulbourethral sling procedures under urodynamic monitoring between October 2000 and June 2013.Mean age was 54 years (range 15-81).Urinary incontinence was secondary to post-prostatectomy in 70 patients and posterior urethroplasty in 35.Preoperatively,10 patients were completely urinary incontinence and 95 patients were stress urinary incontinence.Mean duration of urinary incontinence was 3 years (1-12).The surgical techniques were composite device suspension in 54 patients,pedicled rectus abdominalis muscle and fascial flaps suspension in 10 and transobturator sling in 41.Results The patients were followed up for 3-128 months (mean 54 months).The urethral catheter was left in situ for 5-7 days in 103 patients.Of the 103 patients,5 patients were difficulty in voiding but corrected by indwelling of urethral tube for another 1 week in 4 patients and transurethral bladder neck resecting in 1.In the remainder 2 patients,the maximum urethral pressure was 110 and 158 cm H2O (1 cm H2O=0.098 kPa) at the end of surgery and both patients were able to void on day 14 and 21 respectively and achieved complete continence.In this study,complete continence was achieved with good voiding in 74 patients (70.5％),completed control of urination rate was 81,4％ (57/70) in group of prostate and 48.6％ (17/35) in group of posterior urethroplasty.Twenty-six patients were improved and 5 patients were failed.Conclusion Bulbourethral sling procedure under urodynamic monitoring is an effective option in the treatment of male acquired urinary incontinence,especially for patients of incontinence of post-prostatectomy.

Through the analysis of the present problems of the quality of medical device standards in China, combined with the development trend of the last ten years of medical devices, the paper made proposals on the medical device standards quality evaluation system, so as to improve the medical device standards management level and the quality of medical device standard in our country.
China ; Equipment and Supplies ; standards

The effects of epigenetic modification on the differentiation of islet cells and the expression of associated genes (Pdx-1, Pax4, MafA, and Nkx6.1, etc) were investigated. The promoter methylation status of islet differentiation-associated genes (Pdx-1, Pax4, MafA and Nkx6.1), Oct4 and MLH1 genes of mouse embryonic stem cells, NIH3T3 cells and NIT-1 cells were profiled by methylated DNA immunoprecipitation, real-time quantitative PCR (MeDIP-qPCR) techniques. The histone modification status of these genes promoter region in different cell types was also measured by using chromatin immunoprecipitation real-time quantitative PCR methods. The expression of these genes in these cells was detected by using real-time quantitative PCR. The relationship between the epigenetic modification (DNA methylation, H3 acetylation, H3K4m3 and H3K9m3) of these genes and their expression was analyzed. The results showed that: (1) the transcription-initiation-sites of Pdx-1, MafA and Nkx6.1 were highly methylated in NIH3T3 cells; (2) NIH3T3 cells showed a significantly higher level of DNA methylation modification in the transcription-initiation-site of Pdx-1, Pax4, MafA and Nkx6.1 genes than that in mES cells and NIT-1 cells (P<0.05); (3) NIT-1 cells had a significantly higher level of H3K4m3 modification in the transcription-initiation-site of Pdx-1, Pax4, MafA and Nkx6.1 genes than that in mES cells and NIH3T3 cells (P<0.05), with significantly increased level of gene expression; (4) NIH3T3 cell had a significantly higher level of H3K9m3 modification in the transcription-initiation-site of Pdx-1, Pax4, MafA and Nkx6.1 genes than that in mES cells and with NIT-1 cell (P<0.05), with no detectable mRNA expression of these genes. It was concluded that histone modification (H3K4m3 and H3K9m3) and DNA methylation might have an intimate communication between each other in the differentiation process from embryonic stem cells into islet cells.

Objective To retrospectively analyze the clinical epidemiology features of adult idiopathic membranous nephropathy (IMN) in Zhongshan Hospital,and to investigate their therapeutic effect and its possible influence factors.Methods A total of 183 patients admitted to the Zhongshan Hospital of Fudan University and diagnosed as IMN by renal biopsy from January 2013 to December 2015 were involved.Their baseline information including demographics and pathologic was collected.Patients were followed up for at least 12 months.Serum albumin ＜ 30 g/L and 24 h urine protein ＞ 3.5g were defined as nephrotic syndrome (NS).IMN patients were divided into NS and non-NS groups and compared.Furthermore,the baseline data of remission and no remission patients were compared,and the correlations of their baseline data with conservative and immunosuppressive therapy were assessed by logistic regression analysis.Results (1) IMN accounted for 11.1％ of renal biopsy cases in our hospital,with an average age of 57 years and 59.6％ male patients.(2) Compared with patients without NS,IMN patients with NS were older,had a shorter time from the onset to receive renal biopsy,lower estimated glomerular filtration rate,and higher total cholesterol,low density lipoprotein cholesterol,triglyceride and serum creatinine (all P ＜ 0.05).(3) The effective rate of conservative treatment in IMN patients without NS was 65.7％,and the ineffective group had higher triglyceride compared with the effective group (P=0.019).(4) The effective rate of immunosuppressive therapy in IMN patients with NS was 81.2％,and low serum albumin was an independent risk factor for the poor efficacy of immunosuppressive therapy (OR=1.202,95％ CI 1.003-1.440,P=0.046).(5) The effective rate of conservative treatment in IMN patients with NS was 55.5％,and low serum albumin was an independent risk factor for the poor efficacy of conservative treatment (OR=1.629,95％CI 1.047-2.536,P=0.023).Conclusions The detection rate of IMN is increasing year by year,but the remission rate of conservative treatment is still not low in mild and moderate patients.For the patients without NS,high triglyceride may predict a poor effect of conservative treatment.Hypoproteinemia is a predictor of poor effect,no matter what a NS patient takes immunosuppressive therapy or conservative treatment.

Objective To evaluate the early change of left ventricular (LV) systolic function in patients with type 2 diabetes mellitus(T2DM) by ultrasound speckle tracking imaging. Methods Ninety-five subjects were included:40 T2DM with normal LV ejection fraction (LVEF≥50% ,group A),20 T2DM with abnormal LVEF (LVEF<550 %) (group B), and 35 normal controls. Two-dimensional strain images were acquired from LV short-axis view. LV peak systolic global and segmental radial strain and circumferential strain at the levels of mitral annulus, papillary muscle and apex, and LV systolic global and segmental rotation at the levels of mitral annulus and apex and LV peak systolic global twist were assessed. Results In group A, compared with control group, LV peak systolic radial strain parameters were not significant difference (P >0.05), peak systolic circumferential strain of part segments, average peak strain of each plane and global strain were reduced (P <50.05～0.001) ,and LV peak systolic rotation of all apical segments, peak systolic global rotation at the levels of mitral annulus and apex,and peak systolic global twist were significantly increased (P <0.05～0.001). Compared with control group and group A,all LV systolic radial strain and circumferential strain parameters, LV systolic global and segmental rotation and peak systolic global twist in group B were significantly reduced (P <0.05 ～ 0.001). Conclusions Speckle tracking imaging could be used to evaluate the early change of LV torsional deformation and LV systolic function in T2DM.

Objective To investigate the genotype of Trichophyton rubrum isolated from children and adults with dermatophytosis,and to explore the relationship between the genotype and location of lesions as well as drug susceptability of T.rubrum.Methods Dermatophytes were isolated from 67 children and 88 adults who had been diagnosed with dermatophytosis by microscopy and fongal culture.DNA was extracted from the clinical isolates of T. mbrum and random amplification of polymorphic DNA(RAPD)assay was performed with two random primers.i.e.,OPA11 5'ACCCGACCTC3'and OPD18 5'GAGAGCC AAC3',respectively.PCR products were subjected to electrophoresis to identify the genotypes of clinical isolates.Broth microdilution method was applied to assess the in vitro susceptibility of T. rubrum isolates to eight antifungal agents:fluconazole,itraconazole,terbinafine,ketoconazole,liranaflate,butenafine,econazole and bifonazole.Results T. rubrum was isolated from 47 children and 62 adults with dermatophytosis.RAPD assay yielded clear and stable DNA band profile.With primer OPA 11,these T.rubrum isolates were classified into 4 genotypes,i.e.,Ⅰ a,Ⅱ a,Ⅲa and Ⅳa.Both type Ⅰ a and Ⅲa represented 41.94%of the T. rubrmn isolates from adults,while type Ⅰa 65.96%of those from children;there was a significant difference in the genotype distribution between the two groups(P＜0.05).Also,the genotype distilbution was statistically different for tinea corporis and tinea pedis(P＜0.01,＜0.05 respectively)between adults and children,however,no significant difierence was observed for onychomycosis and tinea cruris(both P＞0.05).In vitro susceptibility test showed that all antifungal agents were effective against these T. rubrum isolates.Among these antifungals,terbinafine had the highest efficacy,and fluconazole exhibited the lowest effect against these isolates.Moreover,a higher efficacy was observed for ketoconazole and fluconazole against T. rubrum of type Ⅰ a than against other types of T. rubrum,and for bifonazole against T. rubrum isolates of type Ⅱ a than against other types.while the efficacy of itraconazole was lower against T. rubmm isolates of type Ⅲ a than against other types.Conclusions T. rubrum is the main pathogenic microorganism in adults and children with dermatophytosis.In adults,Ⅰ a and Ⅲ a are the predominate types of T. rubrum associated with dermatophytosis,while Ⅰ a is the common type in children.All the 8 antifungals tested have a good efficacy for various genotypes of T. rubrum,whereas the efficacy of fluconazole,itraconazole,kctoconazole,terbinafine and bifonazole varies with the genotypes of T. rubrum.