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 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.

Objective To investigate artemin and its receptors GFRα3 expression in human pancreatic ductal adenocarcinoma and its significance. Methods Expression and distribution of artemin and GFRα3 in 100 cases of human pancreatic ductal adenocarcinoma(PDAC) and 40 cases of normal pancreatic tissue were detected by immunohistochemistry and RT-PCR, quantitative RT PCR. Relations of artemin and GFRα3 with clinicopathological characteristics, especially nerve invasion were analyzed. Results Nerve invasion was detected in 64 out of 100 cases of PDAC, and the rate of nerve invasion was 64%. The ratio of expression of Artemin, GFRα3 protein in PDAC/normal pancreatic tissue was 2.697 ± 0.231 and 2.599 ± 0.588; the ratio of expression of Artemin, GFRα3 mRNA was 7.01 and 4.63. Artemin and GFRα3 expression were associated with tumor location, differentiation degree, TNM staging, nerve invasion node metastasis, but it was not associated with age, sex and tumor size. Artemin and GFRα3 expression was more positively expressed in cancer cells close to nerve tissue than cells far from nerve tissue. Conclusions Artemin and GFRα3 were involved in the development of pancreatic cancer and their high expression was closely related to perineural invasion.

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

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 investigate the value of urinary trehalase (T) in patients with renal proximal tubular damage.Methods 134 patients with kidney disease (male:66 female:68 age:18-59 ; 31cases with acute renal failure,30 cases with chronic renal failure,20 cases with drug-induced renal impairment,21 cases with renal transplantation and 32 cases with nephritic syndrome) and 101 healthy controls (58 males and 43 females) were selected.Urinary T,N-acetyl-D-glucosaminidase (NAG),β2-MG,gamma-glutamyl transferase (GGT) were detected.Data were analyzed by SPSS 11.5,including nonparametric rank test,ROC analysis.Results The level of urinary trehalase in control group was normally distributed (7.1 ± 4.1) μmol/h · g Cr (0-25 μmol/h · g Cr).There was no significant difference between men and women (t =0.63,P =0.53).Urinary T levels were significant higher in all kidney disease groups than in control group (Z =6.80,5.90,5.23,6.00,8.04,P ＜0.01).According to ROC curve,the area of urinary T under the ROC curve (AUC) in 134 patients was 0.9,significantly different with NAG,β2-MG,GGT area (P ＜ 0.01),the AUCs of T were 0.94,0.85,0.90,0.90,0.91 in acute and chronic renal failure group,drug-induced renal impairment group,renal transplantation group and nephritic syndrome group,respectively; Youden index were 0.85,0.65,0.77,0.66,0.72 respectively.Corresponding to the Youden index,sensitivity and specificity were 90.3％ and 95.1％,73.3％ and 92.1％,85.0％ and 92.1％,81.0％ and 85.2％,87.5％ and 84.2％ respectively.Conclusions The Urinary trehalase is better than other markers in the diagnosis of the proximal renal tubular damage.It was better to evaluate the proximal tubular function early in time.The diagnostic value of urinary trehalase played a key role in diagnosis,treatment and prognosis of kidney diseases.

Objective To develop a rapid and accurate technique for pathogens identification from positive blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry ( MALDI-TOF MS) .Methods A total of 266 culture-positive blood samples from clinical laboratory in the Second Affiliated Hospital of Soochow University during January to July 2015 were collected.The blood was transferred into separation-gel tubes, and the bacteria were enriched and purified by differential centrifugation.MALDI-TOF MS was applied to identify the bacteria and the results were compared with conventional bacterial culture. Results Among 266 culture-positive blood samples, 260 were monomicrobial cultures and 6 were polymicrobial cultures.Of 260 monomicrobial cultures, 98.8% (257/260) and 96.2% ( 250/260 ) of organisms were identified at the genus level and the species level, respectively.Of 140 Gram-negative bacterial isolates, 99.3% (139/140) and 97.9% (137/140) were identified at the genus level and the species level, respectively.Of 120 Gram-positive bacteria isolates, 98.3%(118/120) and 94.2% (113/120) were identified at the genus level and the species level, respectively.None of the 6 polymicrobial cultures were identified.Conclusion MALDI-TOF MS can directly identify the bacteria from positive blood cultures, which provides a rapid and accurate method for the diagnosis of bloodstream infection.