Objective:To translate the English version of Edmonton Frail Scale into Chinese version and to test its reliability and validity.Methods:The translation and cross-cultural adaptation of the English version of Edmonton Frail Scale were generated by Beaton's translation and back-translation method. From April to August of 2019, at the department of geratology of the First affiliated Hospital of China Medical University in Shenyang, a sample of 303 hospitalized elderly adults who met the inclusion and exclusion criteria were selected via convenience sampling method to test its psychometric properties.Results:The scale level content validity index and item level content validity index of the Chinese version of the Edmonton Frail Scale were both 1.0. The criterion validity between the Chinese version of Edmonton Frail Scale and the Tilburg Frailty Indicator was 0.723 ( P<0.01), confirmed by Pearson correlation coefficients. Using the Tilburg Frailty Indicator as an external criterion, the Edmonton Frail Scale showed satisfactory diagnostic accuracy for frailty (area under the curve=0.924). The optimal cut-point for frailty was 6 (sensitivity: 77.6%, specificity: 94.7%). More frail individuals were recognized by the Chinese version of Edmonton Frail Scale among older and female participants than their counterparts( P<0.05). The Cronbach'α of the Chinese version of Edmonton Frail Scale was 0.599, the test-retest reliability within a 7-day interval of the scale was 0.822. Conclusions:The Chinese version of Edmonton Frail Scale presents good validity and reliability and can apply to Chinese hospitalized elderly people.

Objective Transcutural nursing has been the important part in modern nursing.Developing of the measurement instrument of cultural sensitivity of nursing undergraduates is the basic step in the research of transcultural nursing.Methods On the basis of the composition of cultural sensitivity of the nursing graduates,efforts were undertaken tO develop an instrument to classify cultural sensitivity to different levels through determination of nursing expert panel,and items were selected by trials through factor analysis.Results The scale consists of 41 items and includes three domains:cultural awareness.cultural understanding,cultural reaction,education background.The Cronbach's α was 0.849381.Items were selected by trials through factor analysis and the factor load was between 0.398～0.785.Conclusion The good validity and reliability were confirmed.The instrument Can evaluate the cultural sensitivity.

OBJECTIVE:To establish a RP-HPLC method for the determination of nitrochlodipine in rabbit plasma.METH-ODS:Chromatographic conditions and extractive conditions were optimized with orthogonal design,internal standard:felodipine,solid phase extract column:C18,column size:NOVA-PackC18(4.6mm?250mm),detection wavelength:237nm.RESULTS: The optimal chromatographic conditions were:mobile phase acetonitrile-water(55∶45),flow rate 1.0ml/min,column temperature 45℃.The extraction conditions were A1 B1 C3.The calibration curve was linear within the range of 6.25～400?g/L(r=0.9 996) and the minimum limit of detection was 2.5?g/L.The average RSD of within-day ranged from 3.81% to 5.58% and that of day-to-day from 4.60% to 8.76%.The average recovery ranged from 100.7% to 101.8%.CONCLUS-ION:The method is simple,rapid,highly accurate and precise.It can be used for the quantitative determination of nitrochlodipine in plasma.

Objective To describe the effect of loop diuretic on renal function in patients with chronic heart failure.Methods Data were of 211 impatients diagnosed as HF collected in a nested case-control study.The association of application of loop diuretic with renal function was assessed to identify whether loop diuretic was an independent risk factor of worsening renal function(WRF).To identify WRF,we defined serum creatinine level as a rise ≥26.5 μmol/L compared to the level at admission.Therefore,the subjects were divided into case group(serum creatinine level ≥ 26.5 μmol/L,n =66)and control group(serum creatinine level ＜ 26.5μmol/L,n =145).Results The doses of loop diuretic were higher in the case group([385.17 ± 49.37]mg)than the control group([244.50 ± 34.82]ag)(P ＜ 0.05),but it was not independent risk factor of WRF (P＞0.05).Creatinine level and NYHA class at admission were independent risk factor for WRF,with OR of 2.248(95 ％ CI:1.088-4.647)and 2.485(95 ％ CI:1.385-4.459)respectively(Ps ＜ 0.05).Conclusion The doses ofloop diuretic were not independent risk factor of WRF,creatinine level and severity of HF at admission are the most important predictors of the occurrence of WRF.

Objective To probe into the medical practicing of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in Shanghai, discovering measures and suggestions for improvement Methods Such methods as onsite inspection and questionnaires were called into play to study the practice of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in 68 secondary and tertiary hospitals. Results Such three disciplines in the 68 hospitals have in total 3288 beds, 1142 medical practitioners, 19 assistant medical practitioners, and 1983 nurses. In 10 of the 68 hospitals, the medical space for these disciplines is non-standard; In 3 hospitals, personnel use is non-standard in general; 8% of the medical records are incompliant in generals 15% of the prescriptions are incompliant in general. Conclusion Medical practicing of neurosurgery, thoracic surgery, and cardiac and great vessels surgery in Shanghai is found to be legally compliant in general. However, there exist defects in medical space, personnel use, as well as medical records and prescriptions. In this regard, enhanced management and inspection are recommended.

Objective To study the cytotoxic activity of Chinese compound prescription (Xiaozheng Yiliu Decoction) combined with cisplatin on human ovarian cancer OVCAR/DDP cells and its molecular mechanism. Methods The xenograft model was established by injection of OVCAR/DDP cells. Forty nude mice were randomly allocated into four groupsincluding control group, cisplatin treatment group, low-dose Xiaozheng Yiliu plus cisplatin treatment group,and high-dose Xiaozheng Yiliu plus cisplatin treatment group.The apoptosis was determined by TUNEL analysis.The survivin expression was detected by RT-PCR analysis.Results The inhibit rates in cisplatin treatment group, low-dose Xiaozheng Yiliu plus cisplatin treatment group,and high-dose Xiaozheng Yiliu plus cisplatin treatment group,were(5.56±1.14) ％,(18.42±7.73) ％,and (31.59±12.58) ％,respectively,and there were significant differences among the groups(F=8.64,P＜0.01 ).The TUNEL analysis showed that the percentages of cell apoptosis were(2.35±1.04) ％,(4.56±1.61) ％,(12.42±3.68) ％,(21.59±5.17) ％ in four different groups,respectively.After treated by Xiaozheng Yiliu Decoction,the mRNA expression of survivin was found to be down-regulated by RT-PCR analysis. Conclusion Xiaozheng Yiliu Decoction could iucrease the cytotoxic activity of cisplatin on ovarian cancer OVCAR/DDP cells, which may be related to the down-regulation of survivin gene expression.

Objective To investigate the amino acid patterns in penicillin-binding protein 2(PBP2)in Neisseria gonorrhoeae isolates with reduced susceptibility to ceftriaxonc.and the relationship between the amino acid patterns and reduced ceftriaxone susceptibility.Methods DNA was extracted from 13 clinical isolates of N.gonorrhoeae.including 11 strains with decreased susceptibility to ceftriaxone and 2 sensitive isolates.The full-length penA gene encoding the penicillin-binding protein 2 was amplified and sequenced.BLASTn and BLASTx programs were used to assess the insertion and substitution patterns of nucleotides in penA gene and of amino acids in PBP2,respectively.Results BLASTn analysis revealed insertion or substitution of 18-38 nucleotides in the penA gene of gonococcal isolates with reduced ceftriaxone susceptibility.As shown by BLASTX analysis.there were five patterns of amino acid substitution or insertion in PBP2 of the 11 isolates with reduced ceftriaxone susceptibility.However.mosaic structure of PBP2 was not found in any of these isolates.Conclusion Mosaic PBP2 seems not to be the major factor contributing to the decrease in susceptibility of N.gonorrhoeae to ceftriaxone.

Objective The rapid multiplex PCR (MPCR) system for detection of genes encoding aminoglycoside resistance in Staphylococcus aureus was developed. The distribution of antibiotic resistant genes acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in Guangzhou was analyzed using the established system.Methods S. aureus strains were identified and susceptibility tests were performed using VITEK-60 or PHOENIX-100 system as recommended by the manufacturer. Aminoglycoside resistance was determined by disk diffusion method. MPCR system for detection of antibiotic resistance genes was optimized.Results The MPCR assay was established successfully. The prevalence of acc(6')-Ie+aph(2″), aph(3')-Ⅲa and ant(4')-Ia in the 124 clinical S. aureus isolates was 62.1%, 32.3% and 1.6%, respectively as analyzed by MPCR. Good correlation between antibiotic resistance phenotypes and genotypes was observed. One or more of the genes encoding aminoglycoside modifying enzymes could be detected in all gentamicin- or netilmicin- or amikacin-resistant isolates. The acc(6')-Ie+aph(2″) gene was identified in 72 of 74 mecA-positive isolates.Conclusions This MPCR system could be used for rapid and reliable analysis of the antibiotic-resistant genotypes of clinical S. aureus isolates. The gene acc(6')-Ie+aph(2″) may be the predominant determinant of aminoglycoside resistance, followed by gene aph(3')-Ⅲa. The prevalence of ant(4')-Ia gene is relatively low.

Objectives To investigate the effects of lipoxin receptor agonist BML-111 on IFN-βand IE86 mRNA expression of macrophages infected by human cytomegalovirus (HCMV). Methods Macrophages were infected with HCMV (MOI=0.5), and the cultured cells were randomly divided into control group, HCMV group, HCMV+BML-111 group, and HCMV+MP group. The cells were collected at 0,1,2,4,8 and 12 h after infection, and the levels of IFN-βand IE86 mRNA were tested by real-time PCR. Results Compared with HCMV group, the levels of IFN-βmRNA in HCMV+BML-111 group increased significantly (P < 0.05), while the levels of IFN-βmRNA in HCMV+MP group decreased significantly (P < 0.05); Compared with HCMV group, there were no significant differences of the levels of IE86 mRNA in HCMV+BML-111 group (P>0.05), while the levels of IE86 mRNA in HCMV+MP group increased significantly (P < 0.05). Conclusion BML-111 exerts antiviral activity by promoting the expression of IFN-βmRNA at the early stage of HCMV infection.

Objective To discuss the prevention and management method for chylous fistula after neck lymph node dissec‐tion .Methods Totally 1 793 cases of neck lymph node dissection in this department from January 2005 to September 2014 were retrospectively analyzed .The clinical data in the cases of chylous fistula occurred after operation were summarized .Results Twenty one cases of chylous fistula occurred ,accounting for 1 .17% ,in which 13 cases were cured by the local compressed bandaging and continuous negative pressure drainage;5 cases adopted the conventional method for 2-3 d ,but under the ineffective condition ,then they were treated by combining with somatostatin pumping (somatostatin 6 mg+0 .9% normal saline 48 mL ,2 mL/h ,lasting for 24 h ,for successive 2-3 d) and finally cured;3 cases were cured after reoperation .Conclusion Prevention is the best treatment for chylous fistulas ,local compression bandage plus continuous negative pressure drainage is the main method for treatment of chylous fistulas after neck dissection .The combined therapy with somatostatin can increase the close rate of chylous fistulas;for the patients with long persistent time ,large drainage volume and invalid conservative therapy should adopt the remedial measure of operation .