Objective:To summarize the nursing experience of a patient with hyperthyroidism-induced liver injury combined with type 1 diabetes complicated by Wernicke encephalopathy.Methods:Patients with hyperthyroidism-induced liver injury, type 1 diabetes and Wernicke encephalopathy co-existing consciousness disorders, contradiction between medication and dietary care, separation anxiety, and specificity of drugs shared by the above three diseases were given appropriate care and discharged health education and continued care.Results:After active treatment and nursing, the patient′s consciousness became clear, nausea and vomiting improved, and liver function and thyroid function indexes gradually returned to normal. The patient was treated with oral 131I and discharged without any adverse effects. Conclusions:The patient′s condition is complex and the clinical care is different from that of ordinary patient. The nurses detect the change of the condition early, adopt a personalized nursing plan for the contradiction between medication and diet of the patient, pay attention to psychological care, reduce the occurrence of complications, and ensure the smooth discharge of the patient.

Objective To detect the expression of T cell immunogloblin and mucin domain-containing molecule 3 (Tim-3) mRNA in peripheral blood mononuclear cells (PBMC) isolated from asthmatic children and asthmatic murine,and to explore the role of Tim-3 in bronchial asthma.Methods Recruiting 97 cases asthmatic children,47 children with acute asthma exacerbation(acute attack group),50 children with asthma remission (remittent group)and 42 children as the healthy control group.The Tim-3 mRNA expression was measured by using reverse transcription-polymerase chain reaction(RT-PCR) method.The levels of interleukin-6 (IL-6) and transforming growth factor-5 (TGF-β)were determined with enzyme-linked immunosorbent assay (ELISA),and to analyze the correlation between Tim-3 mRNA and the level of IL-6.The asthmatic murine models were randomly divided into 2 groups:normal control group and asthma group.There were 10 mice in each group.PBMC in each group were collected.Expression of Tim-3 mRNA was detected by using real-time PCR.The level of CD4 + IL-17 + and CD4 + CD~ + FoxP3 + which reflected Th17 and regulatory T cells(Treg) expression respectively were detected by using flow cytometry,and the correlation between Tim-3 and Thl7/Treg level was analyzed.Results Expression of Tim-3 mRNA in children with acute asthma exacerbation was significantly higher than those in remission stage and healthy control group (all P ＜ 0.05).The expression of Tim-3 mRNA in children with asthma remission was significantly higher than that in healthy control group (P ＜ 0.05),and the level of IL-6 in children with acute asthma exacerbation was significantly higher than those in remission stage and healthy control group (all P ＜ 0.05).In the murine model of asthma group,the level of Tim-3 mRNA in PBMC was significantly higher than that in normal control group (P ＜ 0.01),and in asthma group CD4 + IL-17 + expression was significantly higher than normal control group but CD4 + CD25 + FoxP3 + was significantly lower than that in normal control group (all P ＜ 0.05),and the ratio of Th17/Treg increased in asthma group compared with normal control group (P ＜ 0.05).Tim-3 mRNA expression in PBMC was correlated positively with CD4 + IL-17 + level and Th17/Treg ratio respectively (all P ＜ 0.05),but was correlated negatively with CD4 + CD25 + FoxP3 + level(all P ＜ 0.05).Conclusions The high level expression of Tim-3 mRNA in asthmatic children participated in the airway inflammation,which is associated with IL-6,and animal experiments indicating that Tim-3 is closely related with the imbalance of Th1 7/Treg,indicated that Tim-3 may play a certain role in asthma.

Objective To analyze the current status and influencing factors of job competence of clinical nursing teachers. Methods A total of 673 clinical nursing teachers from 35 second-level and above hospitals in Anhui Province were selected as research subjects using convenient sampling method. Their job competence was evaluated using the Clinical Nursing Teacher Post Competency Evaluation Scale. Results The score of job competence of clinical nursing teachers was 87.1±9.7. The results of multiple linear regression analysis showed that with the increase of service length and clinical teaching years，the job competence score of clinical nursing teachers increased（all P<0.05）. For those who thought the higher the satisfaction with the teaching atmosphere of the hospital，the hospital teaching training can meet their requirements and the higher the willingness to accept the teaching training，the higher their job competence score（all P<0.05）. Conclusion There is still much room for improvement in job competence of clinical nursing teachers in Anhui Province. The length of service，clinical teaching years， hospital teaching atmosphere，teaching training meeting demand，and willingness to accept clinical teaching training are the influencing factors of job competence of clinical nursing teachers.

Objective To establish the rat model of acute stress during chronic heart failure and evaluate it.Methods Male Wistar rats were injected adrimycin(ADR)via abdominal cavity to induce heart failure.Cardiovascular dynamics and heart pathology were measured.Rats with heart failure received bacterial lipopolysaccharide(LPS)0.2 mg/kg by peritoneal injection to induce acute stress,and we measured blood pressure,heart rate and the expression of HO-1 after LPS injection.Results ADR peritoneal injection led to heart failure successfully.Compared with that in normal group,left ventricular function(?LVdp/dtmax)of rats in model group reduced significantly,and myocardial fibrosis and hypertrophy occurred,too.LPS peritoneal injection led to acute stress in rats with heart failure.Heart rate and blood pressure began to rise 0.5 h after LPS injection and reached at 1 h after LPS injection.The expression of myocardium HO-1 increased at 6 h and was significantly higher at 12 h after LPS injection.The expression of HO-1 was higher in model group than in normal group.Conclusion LPS peritoneal injection successfully leads to acute stress in rats with heart failure,providing a reliable model for study of decompensated heart failure.

Objective:To study the clinical features, experiences of diagnosis and treatment, and treatment process of ovarian nonspecific steroid cell tumor. Methods:The clinical materials of one case of ovarian nonspecific steroid cell tumor were retrospectively analyzed,and the related literaturels were reviewed. Results:The patient displayed amenorrhea and masculine characteristics.Preoperative ultrasonography demonstrated the solid tumor of 53 mm ×39 mm on the right ovary,consideration for the right side of ovarian malignant tumor,and laparotomy was performed.The pathologic results showed that the tumor cells were arranged in nests,and the cytoplasm was bright or eosinophilic, and the nucleus were round or oval with nucleolus.The immunohistochemical staining results revealed that calretinin,vimentin and inhibin were positive in the tumor cells.The patient was diagnosed with ovarian nonspecific steroid cell tumor.The postoperative follow-up of 3 months was performed,and there was no recurrence.Conclusion:The diagnosis of ovarian nonspecific steroid cell tumor should be combined with the clinical manifestation and pathologic results,and operion is the main treatment method.

Objective To explore the clinical application value of blood routine examination in judgment of the activity of inflammatory bowel diseases.Methods 102 patients with inflammatory bowel disease were selected as the main research objects,60 healthy persons in the same period were selected as the control group,all of the subjects were received routine testing of blood,C-reactive protein and erythrocyte sedimentation rate,and the relationships between disease and blood routine indexes were compared.Results In UC group,the PLT,WBC RDW index levels of remission were higher than those of the control group,the differences were statistically significant(t =6.75,8.21,5.73,all P ＜0.05).In patients with UC,the HGB,HCTand MPV index levels were lower than those in the remission patients and the control group,the differences were statistically significant(t =8.12,11.03,6.72,9.35,10.23,8.71,all P ＜0.05).But the PLT index was higher than that of patients in remission,the RDW and WBC indexes were higher than those in the control group and the remission period,there were statistically significant differences (t =7.59,8.51,6.03,all P ＜ 0.05).The routine blood indexes of the relief patients of CD group had significant differences compared with the control group(t =6.17,7.29,9.01,10.35,8.27,7.69,8.01,9.91,allP ＜ 0.05),the HCT,MCV,HGB and MPV indexes were lower than those of the control group,the differences were statistically significant (t =9.01,10.35,8.27,9.9i,all P ＜ 0.05),the WBC,PLT,N and RDW indexes were higher than those of the control group,the differences were statistically significant (t =6.17,7.29,7.69,8.01,all P ＜ 0.05).In UC group,the HGB,HCT,MCV and MPV indexes were lower than those in the remission patients and the control group,there were statistically significant differences(t =8.19,6.97,7.53,9.02,all P ＜ 0.05).But the PLT,RDW,WBC and N indexes were higher than those in the remission patients and the control group,the differences were statistically significant (t =9.81,7.94,8.36,7.61,P ＜ 0.05).In the active patients of CD group,the WBC and N indexes were significantly higher than those of UC group,the differences were statistically significant (t =8.15,9.07,all P ＜ 0.05).In the remission patients of CD group,the PLT index was significandy higher than that in the remission patients of UC group,the difference was statistically significant (t =10.35,P ＜ 0.05).Conclusion Indexes of blood routine has obvious significance in activity of inflammatory bowel disease,and it is significant correlation with inflammation index,which can be used as one of the routine clinical method to determine the activity of inflammatory bowel diseases.

Aim To explore the possible anti-inflammation mechanism of paeonol by investigating its effects on the MMP-9 mRNA expression and cytokines production in human dermal fibroblasts induced by TNF-?.Methods The effect of paneonol on the expression of MMP-9 mRNA was detected by semi-quantitative RT-PCR.The modulation of paneonol on the production of IL-1?,IL-6 and IL-8 in fibroblasts was measured by ELISA.Results MMP-9 hardly expressed in human dermal fibroblast.The results also showed that TNF-? significantly induced the expression of MMP-9 in fibroblasts and at the same time paeonol inhibited the expression of MMP-9.TNF-? stimulated the production of IL-1? and IL-8 in fibroblasts,while 10~100 mg?L-1 paeonol inhibited TNF-?-induced IL-1? and IL-8 production in fibroblasts but had nothing to do with the production of IL-6.Conclusions Paeonol can inhibit the expression of MMP-9 mRNA,IL-1? and IL-8 induced by TNF-?.

In surgery operations, wound should be cleaned with warm sterilized saline solution. In order to reach rapidly warming the washing solution from the room temperature during the surgery, we designed a thermostatic medical infusion pump. The present paper mainly presents researches on the two temperature control methods in the standby mode and in the flushing mode of the system. In the standby mode, the traditional proportional-integral-derivative (PID) control algorithm was adopted. In the flushing mode, dynamic characteristics of the system was changed in real time, which made the thermostatic control process more complex, and the fitted control function combined with the PID control algorithm was adopted in this mode. The temperature control parameters were adjusted in real time according to the initial temperature and the flow rate of the washing solution to obtain a constant temperature of the washing solution, no matter how the initial temperature and the flow rate are changed. The experiment results showed that this kind of control system performed well with a high accuracy.
Algorithms ; Equipment Design ; Infusion Pumps ; Sodium Chloride ; Solutions ; Temperature

Objective To decrease radiation induced toxicities especially mucostis in patients with locally advanced nasopharyngeal carcinoma( NPC ) who underwent concurrent radiochemotherapy, the maximum tolerated dose and dose limited toxicities of capecitabine combination with cisplatin were observed. Methods From Aug 2006 to Oct 2007, 24 patients with intensity modulated radiotherapy(IMRT) and concurrent chemotherapy with capecitabine and cisplatin for nasopharyngeal carcinoma(stages Ⅲ-Ⅳ) were enrolled in this study. There were four dose-level groups of Capecitabine[625-1250 mg/(m2 ·d) , d1-14]and fixed cisplatin dose[20 mg/(m ·d) ,d1-5) ]MRI and CT scan were used for evaluation of tumor shrinkage. Treatment related toxicities were evaluated according to the common toxicity criteria( NCI-CTC Version 3.0). Results The acute side-effects include Grade 3 or Grade 4 mucosal toxicity(lasting for at least 5 d) and Grade 3 or Grade 4 non-mucosal toxicity were evaluated. Group 625 mg/m2 and Group 825 mg/m2 had none, Group 1000 mg/m2 had 6 patients and Group 1250 mg/m2 had 3 patients for mucosal toxicity, which were the main dose-limited toxicity and relevant to the dose of capecitabine apparently( P < 0. 05 ). There was also a trend of increase by the dose level of capecitabine for other toxicities. The median follow-up time for all patients was 28. 5 months. The locoregional recurrence occurred in 2 patients and distant metastasis in 2 patients. Two-year overall survival rate and locoregional control rate were 100% and 91.7%, respectively.Complete response and partialresponse were found on MRI or CT scan in patients of 29. 2% at the end of treatment and 83. 3% after three months, respectively. Conclusions The combination regimen of capecitabine and cisplatin is safe and effective according to the preliminary result. Toxicities related to radiochemotherapy for NPC were significantly associated with the dose level of chemotherapy.

Objective To evaluate the alteration of CD4+ regulatory T cells in peripheral blood from patients with ankylosing spondylitis(AS). Methods Seventy-eight AS patients and 50 healthy individuals were included in this study. The proportion of CD4+CD25+CD127lo/- T cell population in CD4+ T cells as well as that cytotoxic T lymphocytes(CTL) and NK cells in lymphocytes was evaluated by flow cytometry. Serum TGF-β and TNF-α were measured by ELISA. The inhibitory function of CD4+CD25+ regulatory T cells was measured by mixed lymphocyte culture. Results The population of CD4+CD25+CD127lo/- T cells in peripheral blood of AS patients accounted for (4.36±1.21)% of CD4+ T lymphocytes, which was significantly lower than that in healthy individuals (P<0.05). The CD4+CD25+CD127lo/- T cells population in AS patients was positively correlated with TGF-β level, but negatively with TNF-α. Compared with healthy individuals, the function of CD4+CD25+ regulatory T cells in the inhibition of alloreactive T cells was lower in AS patients, which was related to the decreased secretion of TGF-β. Conclusion The CD4+ regulatory T cells in peripheral blood of AS patients are significantly decreased and its function is defective, which leads to immune regulatory dysfunction in vivo. It may be one of immune pathogenesis mechanisms of AS.