Objective To explore and set up the nurse post ability of the leveling exam plan in a third-grade class-A hospital.Methods The entry of more than one year of nurses will participate in the examination of N1-N4 is divided into four levels.According to different levels to set up the post ability of the leveling exam plan,through the review and interview,evaluate its effects and satisfaction in a third-grade class-A hospital.Results After the post ability of the leveling exam plan,nurses of different levels get more satisfied with the score on the assessment form,specialized knowledge,the core system,emergency plan,communication skills,ability of operation and emergency disposal,which significantly higher than the traditional methods,there were statistical differences between two groups.(t value was as follows:1.46,2.13,1.98,2.57,2.69,1.87,P ＜ 0.05),but the difference of foundation knowledge was not obvious (P ＞ 0.05).The new program get higher scores of nurses in critical thinking,clinical care,ethical,legal practice and professional ability,results were significant differences (t value was as follows:2.18,2.01,1.46,2.78,P＜ 0.05),but the scores in scientific research ability,leadership,interpersonal relationship,education and consulting capacity was not significantly different (P ＞ 0.05).Conclusion It is concluded that nurses of different levels on the leveling exam plan get a higher satisfaction.Through the new program,to assess the level of nurses,effectively improve the capacity on critical thinking,clinical nursing,ethical standards,law practice and professional development.

Commercial production of bioethanol from lignocellulosic hydrolysates requires efficient fermenting strains. The abilities of the strain to converting all types of sugars in the hydrolysate to ethanol in high yield and to effectively tolerating/metabolizing inhibitors are necessary. Genome shuffling is a novel method for breeding, and it has been applied in pharmaceutical and food industry. This review summarized the technique of genome shuffling including principle, process, applications and its prospect for strains improvement in ethanol production from lignocellulosic hydrolysates.

Objective To explore the application value of pulmonary artery monitoring program for intracranial and cervical artery angiography with dual-energy CT.Methods Sixty patients performed intracranial and cervical artery angiography with dual-energy CT were divided into two groups according to the random number table.Group A (optimization group,30 patients):the monitoring points were located in the main pulmonary artery,with threshold 150 HU,trigger delay time 8-9 s,pitch 0.9,and the iohexol (350 mg I/ml) 60-65 ml.Group B (conventional group,30 patients):the monitoring points were located in aortic arch,with threshold 100 HU,trigger delay time 5 s,and the iohexol (350 mg I/ml)60-70 ml.Patients with the body weight less than 75 kg were injected with the flow rate of 4.0 ml/s,and those weight greater than 75 kg or with body mass index (BMI) greater than 27 kg/m2 were 4.5 ml/s,following 40 ml saline solution with the same flow rate respectively.All images were transferred to Siemens Syngo workstation for further processing and analysis.The attenuation values were measured on axial images in the common carotid artery,internal and external carotid artery,vertebral and basilar artery,the horizontal segment of the middle cerebral artery,the subclavian vein of injection side,the proximal,middle and distal segment of jugular vein,the straight sinus and the superior sagittal sinus.Two experienced observers blinded independently evaluated the image quality of CTA,the impact of contrast material residues artifacts of subclavian vein of injected side and the affect of venous return factors on arterial image display.Images of volume rendering technique(VR),the maximum intensity projection (MIP),and curved planar reformation (CPR) were reconstructed using dual energy bone removal and Inspace and 3D software.The mean intraluminal attenuation of contrast material (HU),the volume of contrast material and the mean image quality scores were compared with t test between the two groups.Chi-square test was used to compare of image contrast agents residual artifacts,the absence segments of the root of the neck artery,and the degree of the jugular vein return in two groups.Results The mean CT values were 372-414 HU for each segment of artery showing no significant differences between two groups (P ＞ 0.05).In group A,the CT values of the jugular vein in proximal,middle,distal segment of the two sides were (95 ± 36),(95 ± 36),(131 ±58),(133 ± 57),(174 ± 68),and (180 ± 66) HU respectively.In group B,CT values were (135 ± 58),(137 ±59),(170 ±58),(181 ±58),(218 ±62),and (224 ±68) HU.The CT value of jugular venous in group A was significantly lower than that in group B (t =-3.30--2.54,P ＜ 0.05).Case numbers of contrast agent residual artifacts of injection side subclavian vein and the absence segments of root of the neck artery at the beginning in group A (5,11) were less than that in group B (12,24) (x2 =4.02,5.65,P ＜0.05).The degree of the jugular vein return in group A were lesser severely than that in group B (x2 =6.79,6.37,P ＜0.05).Below the level of carotid artery bifurcation:slight 5 patients,severe 1 patient in group A vs.slight 15 patients,severe 9 patients in group B.Above the level of carotid artery bifurcation:slight 9 patients,severe 6 patients in group A vs.slight 12 patients,severe 17 patients in group B.Image quality scores of group A (3.84 ± 0.40) was higher than that of group B (3.64 ± 0.63) (t =4.26,P ＜0.05).Conclusions Pulmonary Artery Monitoring combines with 60-65 ml contrast material optimization scheme for intracranial and cervical artery angiography with dual energy CT can significantly reduce the degree of jugular venous return and contrast material residues artifacts of subclavian vein of injected side.This technique is helpful to improve the work efficiency and image quality.

Objective:To assess the potential or limitation of MRI for demontrating the pathological cervicallymphnodes. Method :A prospective diagnostic study on cervical lymphnode metastasis from laryngeal carcinomawas performed for 19 cases undergone neck dissection (5 cases undergone bilateral neck dissection, 24 specimensof neck dissection were collected in total). With pathological findings as the criterion, sensitivity and specificityand accuracy were calculated for palpation and MRI examination of all patients. Result:MRI had obviously highersensitivity specificity and accuracy than palpation. Besides the changes in size and shape of the metastaticlymphnodes, the intensity of MRI inside the metastic lymphnodes was showed as mixed hypo-isointensity inT1WI and hyper intensity in T2WI. Conclusion:MRI examination was accurate in detecting cervical lymphnodemetastasis and could image occult lymphnodes which are inaccessible on palpation. Thus, MRI will probably playan important role in the evaluation of malignant lymphnode metastasis.

Objective The aim of the study is to investigate the prevalence of cognitive impairment and frontotemporal dysfunction in Chinese patients with motor neuron disease(MND).Methods 100 Datients diagnosed as MND underwent a series of survey including mini mental state examination(MMSE),neuropsychiatry inventory(NPI),Hamilton depression scale(HAMD)and Hamilton anxiety scale (HAMA).Demographics,site of onset,and disease severity-functional rating scale(FRS)were also investigated.Results The prevalence of mild cognitive impairment determined with MMSE score was 24.2%.Compal ison between patients with normal and abnormal MMSE showed statistic differences in depression state and FRS score.Since patients with anxiety and depression would also have abnormal NPI,a follow uP stndy after 3-month antidepressive therapy for the depression patients was made and 2 patients were found to haye Drobably frontotemporal dysfunction lasting for more than 6 months.Conclusion MND patients might have mild impairmented of cognitive function and some of the patients were neuroethologically abnormal.2 of the patients might have frontotcmporal dysfunction.

OBJECTIVE: To investigate the resistance phenotype of acinetobacter baumannii and the expression of ade efflux pump gene. METHODS: Non-repetitive 51 strains of Acinetobacter baumannii were collected in Peking Union Medical Hospital between Feb. 2004 and Feb. 2005. The active efflux system adeB structural gene and sequence were identified by PCR. RESULTS: The tested strains were not susceptible to common broad-spectrum antibiotics. Multidrug resistant Acinetobacter baumannii carried adeB active efflux pump gene. CONCLUSION: The multiple-drug resistance of Acinetobacter baumannii is independent of ?-lactamase. It maybe related to other drug resistance mechanism. The effect of active efflux system is possibly one of the major mechanisms of multidrug resistance of acinetobacter baumannii.

Searching for new antidiabetic lead compound, 4-(1-aryl-3-oxo-5-phenylpentylamino) benzenesulfonamides were designed and synthesized directly by three component one-pot condensation of 4-phenyl-2-butanone and sulfanilamide with some aromatic aldehydes at an yield of 23%-97%. The chemical structures of the twelve new Mannich bases were confirmed by 1H NMR, 13C NMR, FTIR, ESI-MS and HR-MS. The screening results of antidiabetic activity indicated that most of these title compounds possess alpha-glucosidase inhibitory activity, among which compound le is the strongest one. And compound 11 possesses good peroxisome proliferator-activated receptor response element (PPRE) agonist activity. The structure-activity relationship of these new beta-amino ketones containing benzenesulfonamide unit was also discussed preliminarily.

Objective To conduct a morphologic and anatomic study on nasal cartilages (including nasal alar cartilage, nasal septal cartilage and upper lateral cartilage) in Chinese, and to compare measured parameters with the other races. Methods 20 adult embalmed cadavers were dissected, 40 nasal alar cartilages, 20 nasal septal cartilages and 40 upper lateral cartilages were collected and scanned by CT, and three-dimensional images were reconstructed. As Zelnik' and Ofodile's work, the data of the images were collected. Results The distances from the nostril rim to the caudal boarder of the lateral crus in the series were (4. 54 ±0. 59) mm anteriorly, (5. 54±0. 69) mm in the middle, and (10. 45± 1. 15) mm posteriorly. The length of the lateral crus was (18. 51 ±1. 63) mm, the width was (7. 99±1. 66) mm, and the thickness was (0. 49±1. 28) mm. Conclusion The Caucasian nasal cartilages are the biggest in all races, and the other's were approximately same.

Aim To study the effect of pectin-adriamy-cin conjugate ( PAC) on cardiac toxicity .Methods 50 female SD rats were randomly divided into 5 groups with 10 animals in each group .Adriamycin ( ADM ) group received 3 mg? kg -1 , ip, every other day for 6 times.PAC group received ADM equivalent 1.5,3 and 6 mg? kg -1 , ip, every other day for 6 times.Control group received normal saline parallel to ADM .Rats were sacrificed and the echocardiogram , cardiac en-zymes , the oxidative stress levels in myocardial cells and histopathological changes after 48 h administration were detected.S180 ascites tumor bearing mice models were established to investigate the antitumor activity of PAC.Results The survival rate of ADM group was 50% and that of PAC each group was 100%.PAC could significantly increase body weight ,heart index and immune index and increase HR ,EF,FS,reduce LVIDd, LVIDs.PAC could also significantly increase the AST , LDH, CK, CK-MB level in serum .GSH-Px and SOD activities of PAC group were significantly increased and MDA contents were reduced , and histopathological changes decreased .PAC could effectively inhibit the growth of tumor cells and extend the survival period of mice.Conclusion PAC induces a significant reduc-tion in cardiotoxicity by increasing survival rate , im-mune and cardiac function , improving cardiac en-zymes ,oxidative stress and myocardial cell injury , and also PAC has obvious antitumor effect .

AIM: To investigate the clinical effect for treating bullous keratopathy ( BK ) by anterior corneal stromal acupuncture combined with amniotic membrane transplantation.
METHODS: Totally 35 patients ( 35 eyes ) with bullous keratopathy were treated by corneal stromal acupuncture combined with amniotic membrane transplantation. All patients preoperative and postoperative underwent anterior segment OCT, corneal topography, corneal sensitivity and confocal microscopy. To observe postoperative ocular symptoms in patients with BK, recurrence of bulla, changes in corneal thickness, corneal sensitivity and changes in the organizational structure of the layers of the cornea.
RESULTS: Thirty-five were followed up for 6-18mo. The symptom of pain disappeared in 32 cases ( 91%) in the first day after operation and did not recur during follow-up. The symptom of pain relieved in 3 cases (9%) in the first day after operation and disappeared in 3 days. Corneal epithelium of 9 cases ( 26%) were all healed within 1wk, 21 cases (60%) were all healed within 2wk, and 5 cases (14%) were all healed within 3wk. Following up for 6-18mo, there was no recurrence of symptoms or bulla. A small amount of tiny bubbles in the surrounding area appeared in 2 cases after 3 and 4wk. All patients had no neovascularization, and had smooth corneal surface. The amnions of 30 cases (86%) were thinning after 2mo, partially dissolved and absorped, not seen with the naked eye after 3mo. Thirty-four cases (97%) had no changes in vision, one case (3%) was from the light to front of the manual. After 2mo, corneal sensation decreased in 30 cases ( 86%) , corneal thickness increased from preoperative 788±35μm to 940±43μm. After 12mo, corneal thickness increased to 1060±27μm. Results of confocal microscopy: after 3mo, the number density of the trigeminal nerve fibers under corneal basement membrane reduced, shallow stromal cells became into fibrotic stroma, deep stroma was more loose, and cells swelled significantly. The number of endothelial cells reduced and form swelled more obviously compared with preoperatively.
CONCLUSION: Corneal acupuncture combined with amniotic membrane transplantation can effectively control the symptoms of BK, prevent the recurrence of BK, and especially it is a simple, safe and practical way for patients with poor visual function.