Objective To investigate the pressures from night shifts among nurses from pediatrics department and find the countermeasures.Methods A self-designed questionnaire was used to investigate the pressures from night shifts among 112 nurses from pediatrics department as well as the reasons.Results 110 of the nurses(98.2%) assumed that the pressures from night shifts was intensive.The main reasons for the pressures came out of heavy workload,shortage of staff and stuff and the unsettled balance between job and family.Conclusion Such measures as reasonable distributions of nurses,abound supply of stuff and reduced working links may be effective for the alleviation of the pressures on nurses at night shifts,motivated activeness in them and then the enhancement of nursing quality.

Objective To investigate the effect of stellate ganglion block on the pain and quality of life in patients with lung cancer.Methods 90 patients with lung cancer were divided into observation group and control group according to random number table method.The control group was treated with morphine 10mg,orally,1 time/ 12h.The observation group was treated with stellate ganglion block and morphine.For the patients with poor analgesic effect,50％ doses were added gradually.The analgesic effect,quality of life and changes of immune function were compared between the two groups.Results After treatment,the VAS scores of the two groups were significantly decreased.And the VAS score reduction in the observation group was significantly better than that in the control group [(2.5 ± 0.7) points vs.(3.7 ± 0.9) points],the difference was statistically significant (t =7.060,P ＜ 0.05).The analgesic efficacy of the observation group was significantly higher than that of the control group(91.1％ vs.75.6％,x2 =3.920,P ＜ 0.05),the duration of analgesia of the observation group was longer than that of the control group (t =20.681,P ＜ 0.05).For the total morphine dosage method,the observation group was significantly lower than the control group[(143.5 ± 21.3) mg vs.(238.7 ± 38.3) mg] (t =14.572,P ＜ 0.05).After treatment,the scores of quality of life of the two groups were significantly improved,and the improvement degree of the observation group was significantly better than that of the control group [(86.5 ± 14.3) vs.(79.6 ± 15.7),t =2.179,P ＜ 0.05].After treatment,the TGF-beta level of the observation group was significantly reduced,which was significantly lower than that of the control group[(215.4 ± 38.7)pg/mL vs.(240.5 ± 41.2)pg/mL],the difference was statistically signifi cant (t =2.979,P ＜ 0.05).Conclusion Stellate ganglion block has good therapeutic effect in the treatment of lung cancer patients with pain.

To explore an effective method with few operative complications for treating circumferential mixed hemorrhoids (CMH).Sixty three cases of CMH (Group A) were treated with limited external incision and internal ligation combined with restoration of intervenient skin and 34 cases (Group B) were treated with traditional external incision and internal ligation as control. Anal canal diameter (ACD), anal canal quiescent pressure (ACQP) and anal canal systolic pressure (ACSP) were determined before and after operation. Short term and long term therapeutic effects were also observed and compared in the two groups.Short term and long term therapeutic effects in Group A were better than those in Group B (P

Objective To observe the effect of Chaihushugansan combined with fluoxetine on interleukin -6 ( IL-6 ) , interleukin -1β( IL-1β) , tumor necrosis factor ( TNF-α) in the treatment of patients with postpartum depression.Methods 83 patients from November 2013 to July 2015 in Jiaxing Maternity and Child Health Care Hospital were randomly divided into 41 patients of observation group and 42 patients of control group.The control group were treated with fluoxetine treatment, the obsercation group received Chaihushugansan on the basis of control group.The Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA),IL-6, IL-1β, TNF-α, high-sensitivity C-reactive protein (hs-CRP) and adverse reactions were followed up and recorded.Results The HAMD and HAMA score in observation group post-treatment were (8.31 ±2.05,9.03 ±2.08)points, which were lower than (13.96 ±2.16, 13.61 ±2.14) points in control group (P<0.05).The serum IL-6 and IL-1βlevels in observation group post-treatment were (6.59 ±3.20,5.01 ±2.83)pg/mL, which were lower than (10.64 ±3.86,9.31 ±3.42)pg/mL in control group (P<0.05).The serum TNF-αand hs-CRP levels in observation group post-treatment were ( 9.16 ±2.01 ) pg/mL, ( 3.62 ±1.06 ) mg/L, which were lower than ( 12.30 ±2.37 ) pg/mL, (5.29 ±1.14)mg/L in control group (P<0.05).The total adverse reaction rate in observation group was 7.32%, significantly lower than 23.81% in control group ( P <0.05 ) .Conclusion Chaihushugansan combined with fluoxetine has a good therapeutic effect in the treatment of postpartum depression, could significantly reduce the IL-6, IL-1β, TNF-α levels, with fewer side effects, it is better than fluoxetine alone.

Cationic lipid nanoparticles possessing favorable biocompatibility and controllable particle size has at-tracted increasing attention in the field of non-viral vectors for delivering nucleic acids in vitro and in vivo.1,2-Dilinoleyloxy-3-dimethylaminopropane(DLinDMA)and its derivatives,one of the most important cationic lipid materials,have been widely studied as the mainly composition of cationic lipid nanoparticels.This paper summa-rized the structure,characteristics and clinical application of DLinDMA nanoparticles.

This study is to investigate the inhibitory effect and mechanism of prosapogenin A (PSA) on MCF7. MTT assay was performed to determine the inhibitory effect of PSA on MCF7 cells. PI/Hoechst 33342 double staining was used to detect cell apoptosis. RT-PCR was used to test the mRNA levels of STAT3, GLUT1, HK and PFKL. Western blotting was performed to determine the expression of STAT3 and pSTAT3 protein in MCF7 cells. The results showed that PSA could dose-dependently inhibit cell growth of MCF7 followed by IC50 of 9.65 micrmol x L(-1) and promote cell apoptosis of MCF7. Reduced mRNA levels of STAT3, HK and PFKL were observed in MCF7 cells treated with 5 micromol x L(-1) of PSA. PSA also decreased the level of pSTAT3 protein. STAT3 siRNA caused decrease of mRNA of GLUT1, HK and PFKL which indicated STAT3 could regulate the expressions of GLUT1, HK and PFKL. The results suggested that PSA could inhibit cell growth and promote cell apoptosis of MCF7 via inhibition of STAT3 and glycometabolism-related gene.

Objective:To systematically review the teaching effects of flipped classroom (FC) in undergraduate medical education in China.Methods:Such databases as CNKI, VIP Data, and WanFang, were electronically searched for literature of randomized controlled trials (RCTs) on FC versus lecture-based learning (LBL) applied in medical education in China up to March, 2018. The included literature were evaluated for the quality, and RevMan5.3 software was used for Meta-analysis.Results:A total of 26 RCTs were included in the study, including 4 249 students, of whom the FC group had 2 135 cases, while LBL group had 2 114 cases. The students in FC group got significantly higher scores than those of the students in LBL group in the theoretical scores (WMD = 7.81, 95%CI = 5.18 -10.43, P < 0.05), skills tests (WMD = 4.69, 95%CI = 0.65 -8.73, P < 0.05). Conclusion:The FC can significantly improve the teaching results in undergraduate medical education.

Objective:To observe the anticaries effects of the vaccine gene pcDNA3- PAc against dental caries in BALB/c mice by different routes. Methods: BALB/c mice were immunized with the recombinant plasmid pcDNA3- PAc by the submandibular gland- target injection,the quadriceps femoris injection and the intranasal irrigation respectively. All the mice were immunized two times. The immune interval was two weeks. Saliva and serum samples were collected respectively at 0, 1, 2, 4 weeks after immunization. The specific antibodies were detected by ELISA. Results:The specific antibodies were up at one week after immunization in different routes. The peak time of the antibodies level appeared at 4 weeks.The level of salivary specific anti- PAc IgA induced by submandibular gland- target injection and that of serum IgG induced by thigh bone muscle injection was the highest, respectively. The differences of antibodies level between in experiment groups and negative control group or vacant comparison group were significant(P<0.01). Conclusion: The vaccine gene pcDNA3- PAc effectively induce local mucosal immune response and systemic immune response.

Objective To investigate the relationship between amnestic mild cognitive impairment and functional genes associated with hyperphosphorylated tau protein.Methods One hundred and sixteen amnestic mild cognitive impairment (aMCI) patients and 93 normal controls were recruited for the study.Multi-dimension neuropsychologic tests were used to assess the cognitive function extensively.MassARRAY and iPlex systems were used to measure candidate SNP polymorphisms,analyze genotypic,allelic or haplotypic distributions and their interaction with ApoE ε4 and the correlation with the cognitive function in the subjects.Results ( 1 ) The scores of neuropsychologic tests in memory domain ( Auditory Verbal Learning Test (AVLT)-first immediate recall,AVLT-second immediate recall,AVLT-second immediate recall,AVLT-5 minute delayed recall,AVLT-20 minute delayed recall,AVLT-recognition,Rey-Osterrich Comolex Test-delay) in aMCI patients ( 3.0 ( 0-7.0 ),5.0 ( 1.0-10.0),6.0 ( 1.0-11.0 ),4.0 (0-11.0),3.0(0-10.0),20.0(8.0-24.0),11.2 ±8.3) were significantly lower than those in the normal controls(4.0(0-9.0),7.0(2.0-11.0),9.0(3.0-12.0),8.0(0-12.0),8.0(0-12.0),22.0 (10.0-24.0),16.1±8.0) (Z=-3.592,-6.802,-6.408,-8.173,-8.533,-5.647 andt=4.216 respectively,all P ＜0.01 ) ; (2) Genotypic distributions of rs242562 GG in aMCI (7.826％ ) were significantly lower than those in normal controls (20.65％,OR =0.3525,95％ CI 0.1411-0.8807,P =0.024 98),however there were no differences in the genotypic,allelic or haplotypic distributions between aMCI patients and controls of glycogen synthase kinase-3β,cyclin dependent protein kinase-5,calcium and calmodulin-dependent protein kinase-Ⅱ,cell division cycle 2,dual-specificity tyrosine-phosphorylation regulated kinase 1A and low density lipoprotein receptor-related protein 6; (3) MAPT/STH rs242562 genotype was correlated with AVLT-immediate recall,AVLT-delayed recall,Rey-Osterrieth Complex Test,Rey-Osterrieth Complex Test-delayed recall and Clock Drawing Test (H =9.763,12.258,10.508,9.624,10.767,F =3.700,3.123 and H =6.591 respectively,all P ＜ 0.05 ) ; (4) There were no differences in the distributions of MAPT/STH rs242562 GG genotype and ApoE ε4 haplotype between aMCI patients and normal controls.Conclusions MAPT/STH rs242562 GG genotype decreases the genetic risk of aMCI,which might have important role in memory function in aMCI.The interaction between rs242562 GG and ApoE ε4 doesn' t affect the susceptibility to aMCI.

Objective:To generate sex hormone binding globulin(SHBG) conditional knockout mice model.In order to investigate the physiological function of SHBG in vivo and to provide experimental means for the study of the relationship between SHBG and gestational diabetes mellitus.Methods:The mouse genomic DNA sequence of SHBG was verified through bioinformatic analysis.According to the SHBG genomic DNA sequence,the gene targeting and knockout vector were constructed.Transfection of the vectors to ES cells by electroporation was performed according to common protocol.Positive ES cells were screened and identified by PCR.Therefore,the dual selected ES cells were microinjected into blastula,then blastula transplantations into the host mice.The chimeric mice were mated with C57BL/6J mice,and the Flox mice were obtained after screening.The Flox mice were hybridized with EIIA-Cre transgenic mice,and the progeny of the SHBG gene knockout (SHBG-/-) mice were obtained by autocopuation for several times.Results:Several Flox homozygous mice and SHBG gene knockout mice were successfully obtained.Compared with control mice,homozygous mice of SHBG gene knockout were well developed and had reproductive ability.The growth and development of SHBG knockout mice were not significantly different from that of wild type mice.Conclusion:Homozygous mice model of SHBG gene knockout was successfully established,which laid the foundation for further study of the role of SHBG in the gestational diabetes.The SHBG gene knockout mouse model was successfully established and the preliminary phenotypic analysis was performed,which laid the foundation for further study on the role of SHBG in gestational diabetes mellitus.SHBG gene knockout mice were normal in appearance.Due to the limited number of samples and many unknown biological characteristics of gene knockout mice,it needs further study.