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 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 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.

AIM: To investigate the roles of nitric oxide/L-arginine(NO/L-Arg) pathway and urotensin-Ⅱ(UⅡ) in the development of pulmonary hypertension induced by chronic hypoxia-hypercapnia in rats.METHODS: Forty male Sprague-Dawley rats were randomly divided into four groups(n=10): normal control group(A),hypoxia-hypercapnia+saline group(B),hypoxia-hypercapnia+L-Arg liposome group(C) and hypoxia-hypercapnia+N-nitro-L-arginine methyl ester(L-NAME) group(D).Contents of UⅡ,UⅡ mRNA and receptor of UⅡ(UT) mRNA in pulmonary arterioles were measured with immunohistochemistry analysis and in situ hybridization,respectively.Change of small pulmonary vascular microstructure was also investigated.RESULTS:(1) The mean pulmonary artery pressure(mPAP) and the weight ratio of right ventricle to left ventricle plus septum [RV/(LV+S)] in B and D groups were all higher than those in A group(respectively,P

AIM: To investigate the effect of chronic hypoxia-hypercapnia and L-arginine (L-Arg) liposome on L-Arg transport in rats pulmonary artery. METHODS: Forty Sprague-Dawley rats were randomly divided into four groups, normal control group (NC), chronic hypoxia-hypercapnia group (HH), chronic hypoxia- hypercapnia group+L-Arg (HL) and chronic hypoxia-hypercapnia group+L-Arg liposome (HP). Changes in pulmonary artery L-Arg transport and pulmonary arterial microscopy were observed. RESULTS: (1) The mean pulmonary artery pressure (mPAP) and weight ratio of right ventricle to left ventricle and septum (RV/LV+S) in HH group were higher than those in NC group, and in HP group was lower than that in HH group and HL group, but there was no significant difference between HL group and HH group; (2) At 0.005 mmol/L, 0.01mmol/L, 0.02mmol/L, 0.05 mmol/L, 0.1 mmol/L and 0.2mmol/L concentration of L-Arg, the velocity of L-Arg transport in HH group was lower than that in NC group, and in HL group higher than in HH group, and in HP group was much higher than that in HH group and in HL group. (3) Light microscopy showed that vessel well area/total area (WA/TA) and media thickness of pulmonary arterioles (PAMT) were much higher in rats of HH group than those in NC group, WA/TA and PAMT in HP group were obviously improved. CONCLUSION: The above results indicated that there existed a functional disturbance in L-Arg transport of pulmonary artery in rats chronically exposed to hypoxia-hypercapnia, and it was obviously enhanced when liposome was used as L-Arg carrier. Thus, it appears that liposome-L-Arg may have clinical perspective in the treatment of chronic hypoxic pulmonary hypertension.

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.

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 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.