Objective To investigate the clinical value of simplified Chinese version NU-DESC in assessment of ICU delirium in domestic ICU,and provide easy ICU delirium assessment tool for clinical nurses.Methods We used simplified Chinese version NU-DESC to assess patients in domestic ICU from July to September 2011,and compared with the gold standard DSM-IV diagnosis results.Their validity,reliability and effectiveness were evaluated to analyze the application value of NU-DESC in ICU.Results The area under the ROC curve of simplified Chinese version of Nu-DESC was 0.951,the sensitivity was 82％,the specificity was 90％,the false negative rate was 18％,the false positive rate was 10％,Youden's index was 0.72,the positive likelihood ratio was 7.99,the negative likelihood ratio was 0.20,the agreement rate was 87％,Kappa value was 0.71,the positive predictive value was 77％,the negative predictive value was 92％.Conclusions The simplified Chinese version NU-DESC can easily be understood,used and accepted by nurses.They can be used as an assessment tool for nurses to judge ICU delirium for ICU patients.

Objective To evaluate the detection efficiency of residual reagent used in electrochemiluminescence immunoassay an-alyzer .Methods Alpha fetoprotein (AFP) ,carcino-embryonic antigen(CEA) and total prostate specific antigen(TPSA) were de-tected by using remaining reagents .The precision and recovery rate of remaining reagents were analyzed .Referring to the document of NCCLS EP9-A2 ,8 clinic samples were detected everyday by residual reagent and new reagent respectively .The test results of to-tal 40 samples were recorded within 5 days .The test results derived from 2 kinds of reagents were analyzed comparatively and their bias was evaluated by using new reagent as a control method and residual reagent as experimental methods .Results The within-run and between-run coefficients of variation(CV) of the 3 items measured by residual reagents in low and high levels of quality control products met the related standard .The recovery rate was variable from 90% to 110% .The test rewults of the 2 kinds of reagents were positively correlated(r2 >0 .95) .Their anticipated biases were within allowed biases on the medical decision level of CEA ,AFP and T PSA .Conclusion Residual reagent of electrochemiluminescence immunoassay analyzer can meet the clinical practice needs , which also can ensure the quality of measurement and the reduction of the cost .

Objective To investigate the clinicopathological significance of transforming growth factor-β1 (TGF-β1), transforming growth factor-β1 receptor Ⅱ (TGF-βRⅡ ), Smad4 and Smad7 protein expressions in gastric carcinomas. Methods 109 cases of gastric carcinomas,28 of high grade dysplasia,20 of low grade dysplasia,30 of chronic atrophic gastritis,29 of intestinal metaplasia, and 21 of normal gastric mucosa were selected for the detection of the expression level of TGF-β1,TGF-βRⅡ , Smad4 and Smad7 proteins by immunohistochemistry. Results The expression of TGF-β1,TGF-βRⅡ and Smad7 proteins in gastric carcinomas and dysplasia (high and low grade) were significantly higher than those in chronic atrophic gastritis, intestinal metaplasia and normal gastric mucosa (all P <0. 001 ) ,whereas the expression of Smad4 was significantly increased in high and low grade dysplasia (cytoplas-mic IS :4.89±2.38,5.80±1.54, respectively; nuclear IS: 3.89± 1.52,3.80±1.33, respectively), and decreased in gastric carcinomas (cytoplasmic IS:2.41±2.27,nuclear IS:2.02±2. 14) (P <0.001 ,P <0.001 ,respective-ly). Meanwhile,the expressions of TGF-β1,TGF-βRⅡ and Smad7 were higher in advanced gastric cancer (4.36± 2.66,3.05±1.93,4.84±3.06, respectively) than those in early gastric cancer ( 2.93±1.85,2. 17±1.87, 4. 14±2.46, respectively) ( P < 0.01, P < 0.05, P < 0. 05, respectively ) ; however the expression of Smad4 protein was much higher in early gastric cancer (P < 0. 001 ). The expression of Smad4 protein was significantly correlated with tumor size( P < 0.05 ), lymph node metastasis ( P < 0. 001 ), T stage ( P < 0. 001 ) and chnical stage ( P < 0.001) ,and the expressions of TGF-βRⅡ and Smad4 proteins were correlated with patients' 5-year survival rate (P<0.05 ,P < 0.01 ). TGF-β1 showed the positive correlation with TGF-βRⅡ and Smad7 (r1= 0.45 ,P <0. 05; r2 = 0.49, P <0. 05), but negative correlation with Smad4 ( r = - 0.21,P < 0.05 ). Conclusion TGF-β1, TGF-βR Ⅱ, Smad4 and Smad7 protein may play an important role in the carcinogenesis of gastric carcinoma,and smad4 is the key in TGF-β pathway. Also, the detection of these proteins expression can be a useful marker for predicting the gas-tile cancer invasion,metastasis and patients' prognosis.

Aim To investigate the effects of allicin on the proliferation and apoptosis of HL-60 cells,and to explore the underlying mechanism.Methods The cell viability and colony formation were detected by MTT assay.Apoptotic cells were tested by means of TUNEL labeling.RT-PCR was used to analyze the bcl-2 mRNA expressions.Results HL-60 cell growth was significantly inhibited by allicin in dose and time dependent manners.Cell colony formation obviously decreased.The typical hypo-diploid pea J apoptotic peaJ appeared in each dose group.Apoptosis occured in a dose-dependent manner.And its later stages were identified by TUNEL labeling methods respectively,and bcl-2/bax was decreased.The expression of bcl-2 mRNA was down-regulated in a time-dependent manner after treatment with allicin at different time points.Conclusion Allicin effectively inhibits growth and induces apoptosis on HL-60 cells,which may be related with the down-regulation of expressions of bcl-2.

Objective To investigate the effect of B7-H3 on human hepatocellular carcinoma cell line HepG2 mediating regulation on human peripheral blood CD8+T cell activation,cell cycle and secretion of IL-17.Methods The expression of the B7-H3 on HepG2 cells was detected by RT-PCR and FCM respectively.B7-H3 was silenced by PGPU6/GFP/neo-B7-H3shRNA plasmid via cathodolyte liposome transfection method.CD8+T cells were sorted from healthy human peripheral blood with immunomagetic beads.The effect of HepG2 cells on activation,cell cycle and cytokine secretion of CD8+T cells which was stimulated by PHA or PMA respectively were analyzed by FCM.Results B7-H3 was highly expressed on HepG2 cells,and PGPU6/GFP/neo-B7-H3shRNA plasmid could effectively block down its expression.Otherwise,HepG2 cells could inhibit the expression of CD69,the early activation phenotype of T cell,blockade B7-H3 on HepG2 cells could significantly attenuate the inhibitory effects.Likewise,blockade B7-H3 on HepG2 cells apparently reversed the inhibitory effects of HepG2 cells on CD8+T cell cycle through down-regulating the cell number in G0/G1 phase and up-regulating the cell number in S phase;Moreover,HepG2 cells caused a sharp increase of IL-17 which was secreted by CD8+T cells and the level of IL-17 was further up-regulated after blocking down B7-H3.Conclusion HepG2 cells highly expressed B7-H3 that could promote the inhibitory the effect of HepG2 on expression of CD69 and cell cycle of CD8+T cells.HepG2 cells were able to up-regulate the level of IL-17 secreted by CD8+T cells,in which B7-H3 played an inhibitory role.

Objective To study the effect of multimedia on the home care to the patients with double lumen catheter.Methods Totally 100 patients with double lumen catheter for dialysis were divided into control group and observation group according to the registration order,50 cases in each group.In the control group,the home care was done to nurse the catheter and in the observation group,multimedia was used to guide home care to the catheter.The incidence of catheter-related complications was compared between two groups.Result The toal rate of catheter-related complications in the observed group was significantly lower than that of the control group (P＜0.05).Conclusion The multimedia for home care to the catheter for dialysis are easy for the patients to master so that the can change better their home care and avoid (or decrease) catheter-related complications.

Objective To evaluate the clinical value of early alterations of carotid arterial intima-media thickness (IMT) and elastic function in patients with hypertriglyceridemia (HTG) using ultrasound radio-frequency technique.Methods 48 patients (triglyceride value ≥ 1.8 mmol/L) were chosen as HTG group.Quantitative intimamedia thickness (QIMT) and quantitative arterial stiffness (QAS) techniques were used to observe the alterations of carotid arterial IMT and elastic index,including diameter of carotid artery (D),distensibility coefficient (DC),compliance coefficient (CC),elasticity coefficient (α),elasticity coefficient (β) and pulse wave velocity (PWV).50 healthy subjects were recruited in control group.Differences of the above-mentioned parameters were analyzed,as well as the elastic index connections between the two groups.Results IMT,α,β,and PWV index of bilateral carotid arteries in HTG group was higher than that of the control group,while the DC and CC index was lower,and the differences was statistically significant (P＜0.05).Within the groups there were differences between the elastic indexes of bilateral carotid arteries.In control group and the HTG group:CCL＞CCR,αL＞αR,βL＞βR,PWVL＞PWVR.CC was negatively correlated to α,β and PWV (P＜0.05).Meanwhile,there was positive correlation among α,β and PWV (P＜0.05).The differences of D between two groups had no statistical significance (P＞0.05).Conclusions The abnormity of arterial occurs earlier than the morphological change,while the ultrasound radio-frequency technique can provide information of earlier alteration of common carotid arteries structure and elastic function in patients with HTG,which is a significant method of testing early alteration of carotid elastic in patients with HTG.

Objective:To analyze the key point of client's change in counseling,and found the cognitive,emotional and other characteristics in the key point of change.Methods:Totally 14 foreign cases and 5 domestic cases with good outcome that came from the published literature in the area of assimilation model were analyzed.The secondary data analysis was used to analyze the cases'data.Results:Analysis revealed that 9 categories were generated from the data,which were understanding the causes of the problems,the accompanying feelings,the emergence of a new awareness,removing the problematic voice's threat,discovering behavior pattern,allowing the coexistence of both original conflicts,directly expressing the problematic voice desired to be expressed,viewing things with different perspectives,finding out the direction of future action.Conclusions:Behind the key point of client's change,changes in cognition could lead to changes in emotion,so that the problematic voice's threat could be removed and the coexistence of original conflict could be allowed,and then bring about the relief of the client's inner conflict.

Two patients with coexistence of thyroid disease and suspected Gitelman's syndrome underwent SLC12A3 gene analysis. The results confirmed that both patients were compound heterozygotes of SLC12A3 gene mutation. Three novel variants of SLC12A3 were found in this study. This report suggests that Gitelman's syndrome may coexist with other disorders associated with hypokalemia, such as Graves' disease.

Objective To explore safety of severe preeclampsia by amniotic infusion therapy.Methods 58 cases with severe preeclampsia during 28 to 34 weeks pregnancy had been practised intravenous infusion as controls(37 cases).Results Ultrasound guided amnioinfusion were all succesful in therapy group,there was no maternal complication.Statistical difference was found in premature infant apgar score between therapy group and control group.The incidence of respiratory distress syndrome was 3.4%,whereas that of the control group was 35.1%(P