Objective To establish the nurse layer classification standard of Henan province.Methods Nursing experts were selected within the scope of Henan province,nursing layer classification standard system was established through two rounds of experts enquiry with Delphi method.Results According to two rounds of consultation,the index system was divided into five layers:the base layer,growth layer,the professional layer,backbone layer and the experts level,which corresponded to the five classes:N0 assistant nurses,N1 registered nurse,N2 primary nurse,N3 specialized nurses/nursing managers,N4 clinical nursing specialist/nursing researchers/nursing management experts.Various levels of nurses had corresponding requirements and responsibilities framework.The various levels of nurses had corresponding requirements.Conclusions This study built in Henan province has good concentration,such as the representation of the expert advice and high credibility,which can provide decision-making reference for the nurse station management of Henan province.

Objective To investigate the detectable significance of multiparameter flow cytometry (MFC) for the first visiting and minimal residual disease (MRD) in the patients with multiple myeloma .Methods MFC was used to identify the plasma cells by the expression of CD138 or CD38 antigen in 74 patients with multiple myeloma .By combining surface antigens like CD45 ,CD56 , CD19 ,CD20 ,CD117 and the cytoplasm Kappa and Lambda light chain ,the aberrant myeloma cells were differentiated from normal plasma cells .Results In the 44 first visiting cases ,the positive expression of CD138 can be detected in all cases ,while the expres‐sion of CD19 was negative and 42 cases (95% ) were negative or weak positive expression for CD45 .The detection rates of CD38 , CD56 ,CD20 and CD117 were 98% ,93% ,45% and 41% ,respectively .The cytoplasm Kappa and Lambda light chains were showed the limited expression .Of the patients with MM ,14 cases were used for evaluating the change of immunophenotype at first visiting and during the treatment process ,among them ,11 cases(79% ) appeared the changes in at least one of aberrant phenotypes .4 cases (29% ) had the significant enhancement of antigen marker fluorescence intensities after chemotherapy and 7 cases (50% ) had sig‐nificant decrease of antigen marker fluorescence intensities after chemotherapy .CD45 ,CD19 and cytoplasm immunoglobulin light chains were the most stable marker ,no obvious antigen marker changes were found during the treatment ,while there was a signifi‐cant antigen density change in 2 cases of CD38 (14% ) ,7 cases of CD56 (50% ) ,4 cases of CD20 (29% ) and 2 cases of CD117 (14% ) .Of the 30 cases for evaluating MRD immunophenotype ,the abnormal myeloma cells were detected in 25 cases .In 5 cases ,no expression of limited Kappa and Lambda light chains was found and the ratio of Kappa and Lambda was 0 .5 - 2 ,which were identi‐fied as negative for MRD .Conclusion The multiparameter flow cytometry has important significance in evaluating the diagnosis , therapeutical effect and prognosis .The detection by adopting cytoplasm immunoglobulin light chains can improve the accuracy in MRD detection .

OBJECTIVE To investigate the epidemic situation of Acinetobacter in lower respiratory tract infection and their drug resistance,in order to provide evidence for clinical anti-infection therapy. METHODS The data of Acinetobacter from the sputum specimens of inpatients in our hospital with lower respiratory tract infection during 2006-2007 were collected and analyzed with the software the software WHONET5.4. RESULTS Among all pathogens in lower respiratory tract infection,Acinetobacter accounted for 9.2% in 2006 and 7.4% in 2007,the rate in deparment of neurosurgery,surgical ICU and respiratory ICU was higher. Acinetobacter had the highest susceptible rate to imipenem and were also susceptible to meropenem and cefoperazone/sulbactam. However,Acinetobacter had higher resistant rate to imipenem and meropenem while higher susceptible rate to cefoperazone/sulbactam in 2007 than in 2006. The susceptible rate of Acinetobacter to the third and forth generation cephalosporins,amikacin,levofloxacin and aztreonam was lower than 50%. CONCLUSIONS The drug resistance mechanism of Acinetobacter is so complicated that many kinds of drugs prove poorly effective. Carbopenems are recommended when single drug is utilized and drug combination based on the clinical and laboratory information can be tried.

Objective To study the effect of network peer education on the 131I treatment adherence in patients with thyroid cancer.Methods A total of 120 patients with thyroid cancer who performing 131 I treatment from April 2012 to April 2014.They were divided into intervention group 61 cases and control group 59 cases according to the hospital ward number.Control group was given routine health education and intervention group was given network peer education.The data from the habits,drug therapy,grasp the situation,the equivalent monitoring of the relevant knowledge of 4 different dimensions of treatment adherence for patients were investigated and compared before discharge by using questionnaire and examination method.Results The incidence of the good habits,drug therapy,grasp the situation,and the equivalent monitoring reaching the standard were 96.7％(59/61),98.4％(60/61),96.7％(59/61),100.0％(61/61) in intervention group,and 54.2％(32/59),76.3％(45/59),79.7％(47/59),89.8％(53/59) in control group,there were significant differences,x2=29.54,13.38,8.47,4.56,P＜0.01 or ＜0.05.Conclusion Network peer education for patients with thyroid cancer during the 131I treatment can effectively improve the patient's treatment adherence,has positive significance for the treatment.

Objective To explore the relationship among nurses′perceptions of patient safety culture, nursing practice environment and the report barrier of nursing adverse event. Methods Totally 513 registered nurses from six hospitals in Zhengzhou were investigated with Patient Safety Culture Assessing Scale, Work Environment Questionnaire and Report Barriers Questionnaire. Results The mean scores of nurses′perceptions of patient safety culture, nursing practice environment and report barriers of nursing adverse events were (3.85±0.55), (3.84±0.53) and (2.47±0.55). The nurses′perceptions of patient safety culture were positively correlated to nursing practice environment (r=0.393,P<0.01), negatively correlated to report barriers of nursing adverse events (r=-0.372,P<0.01). The influencing factors of nurses′perceptions of patient safety culture were colleague relationship, punitive culture, allocation of medical resources, marital status, quality control, significance of report, gender and education, which could explain 33.8 percent for the variances. Conclusions The level of nurses′perceptions of patient safety culture is higher than the average level. The nursing managers should build supportive nursing practice environment and the non-punitive reporting system of nursing adverse events. Cultivate the beliefs and attitudes of nursing safety and focus on the impact of occupational stress to patient safety in order to enhance safety nursing.

Objective To investigate the virological response in hepatitis C virus (HCV)genotype 1b relapsers after 48 weeks of peginterferon/ribavirin (peg-IFN/RBV)combination retreatment,and to explore the predictive value of interleukin (IL )-28B rs12978960 genetic polymorphismon virological response.Methods From 2012 to 2014,genotype 1b chronic hepatitis C (CHC)relapsers in He′nan Provincial People′s Hospital were retreated with combined peg-IFN/RBV for 48 weeks and followed up for 24 weeks off-treatment.Host IL-28B genetic polymorphism was detected.Predictive factors associated with virological response and sustained virological response (SVR)were analyzed.Independent-samples t test was conducted in continuous variables,whileχ2 test or Fisher exact probability test was conducted in counts data.Results A total of 61 patients finished 48 weeks of peg-IFN/RBV combination therapy and were further followed up for 24 weeks off-treatment.Mean age was (46.7 ±12.4)years.Thirty-seven patients (60.7%)were male and 49 were rs12978960 CC genotype.After 48 weeks of retreatment with peg-IFN/RBV and 24 weeks of off-treatment follow-up,40 patients (65 .6%)achieved SVR.Rapid virological response (RVR)and SVR of younger patients were both significantly higher than those of older patients (100.0% vs 67.4% and 85 .0% vs 47.6%,respectively;both P =0.006).IL-28B rs12978960 genotype was predictive to RVR and SVR.Patients with RVR and SVR had higher carriage rates of IL-28B rs12978960 CC genotype compared with those without RVR and SVR (both P <0.05 ).Patients with CC genotype had higher rates of RVR (34.1 % vs 0;χ2 = 10.625 ,P =0.006 ),end-of-treatment virological response (84.1 % vs 70.6%;χ2 =5 .563,P =0.039 )and SVR (77.3% vs 35 .3%;χ2 =9.572,P =0.007)than those with CT/TT genotype.However,there were no statistical differences of extended RVR (34.1 % vs 29.4%;χ2 =0.122,P =0.809)and early virological response (79.5 % vs 82.3%;χ2 =0.612,P =0.964).Conclusions Retreatment with antiviral therapy is necessary in CHC patients with genotype 1b. IL-28B rs12978960 genetic polymorphism is predictive to the SVR of retreatment,especially for patients without RVR,which will provide individualized treatment and optimize the treatment strategy.

The magnetic Illite ( MILT) was firstly prepared by an effective polyol-medium solvothermal method. Based on these 3-( methacryloyloxy) propyl trimethoxysilane ( MILT-MPS), magnetic molecularly imprinted polymers (MMIPs) were further synthesized via atom transfer radical polymerization in a mixture solution of methanol and deionized water. The as-prepared MMIIPs were characterized by FT-IR, TEM), XRD, TGA and vibrating sample magnetometer (VSM), and the results indicated that the MMIIPs exhibited magnetic sensitivity ( Ms =3. 866 emu / g ), thermal stability and a larger specific surface area (109. 58 m2 / g). The batch mode adsorption studies were carried out to investigate the recognition specificity and selective capacity. The Langmuir isotherm model was fitted to the equilibrium data, and the monolayer adsorption capacity of MMIPs at 25℃ was 86. 58 mg / g. The selective recognition experiments demonstrated high affinity and selectivity of MMIPs towards ciprofloxacin ( CIP) over competitive compounds. Combined with high performance liquid chromatographic analysis technology, the prepared MMIIPs were successfully applied to extract and enrich trace CIP in environmental samples with the CIP recoveries from 93. 4% to 98. 3% and the limit of detection of 0. 01 mg / L.

Objective To study the role of the outer membrane protein Rmp of Neisseria gonor-rhoeae strain in immunosuppression and the strategy of eliminating it .Methods The rmp gene of Neisseria gonorrhoeae strain was amplified by PCR and inserted into pMD 19-T vector .The recombinant vector pMD 19△rmp∷Kan containing Kan and the 5′-and 3′-flanking regions of rmp (△rmp∷Kan) was constructed by replacing 200 nucleotide residues of pMD 19-rmp with kanamycin resistance gene Kan and transformed into Neisseria gonorrhoeae WHO-A strain.PCR and Western blot assay were used to screen and identify the re-combinant mutant strains that could not express Rmp .Mice were immunized with mutant strains and bacteri-cidal activities of the immune sera were detected by antibody-mediated complement-dependent cytotoxicity assay.Results The mutant strains that could not encode Rmp were successfully constructed .Antibodies in-duced by mutant strains showed stronger bactericidal activity against Neisseria gonorrhoeae in comparison with those induced by wild strains .Conclusion The recombinant Neisseria gonorrhoeae strain with rmp gene de-letion might eliminate the immunosuppressive effects of Rmp expressed in wild gonococcal strains , which provides a reference for further development of novel live attenuated whole-cell vaccines of Neisseria gonor-rhoeae.

A xylosidase gene, labeled as BH1068 in genome of Bacillus halodurans C-125, was successfully cloned and overexpressed in Escherichia coli JM109. The purified enzyme was thoroughly characterized and its xylosidase function was unambiguously confirmed. It has maximum activities in neutral condition and is stable over a wide range of pH (4.5-9.0). The enzyme has a broad temperature optimal (35 degrees C-45 degrees C) and is quite stable at temperature up to 45 degrees C. The unique pH and temperature profiles of the enzyme should allow a wide range of xylanolytic operational conditions. With high specific activity of 174 mU/mg protein for its artificial substrate (p-nitrophenyl-beta-xylose) and low xylose inhibition (inhibitor constant Ki = 300 mmol/L), this enzyme is among the most active and high tolerant bacterial xylosidase to xylose inhibition. Its high synergy with commercial xylanase has been demonstrated with beechwood xylan hydrolysis, achieving a hydrolysis yield of 40%. Its neutral pH optimal and high tolerance to product inhibition complements well with its fungal counterparts that are only optimal at acidic pH and susceptible to xylose inhibition. In conclusion, this enzyme has high potential in the saccharification of xylan and xylan-containing polysaccharides.
Amino Acid Sequence ; Bacillus ; classification ; enzymology ; genetics ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Hydrolysis ; Molecular Sequence Data ; Recombinant Proteins ; genetics ; metabolism ; Substrate Specificity ; Xylose ; metabolism ; Xylosidases ; genetics ; metabolism

OBJECTIVETo evaluate the application of anti-T-lymphocyte globulin (ATG) based nonmyeloablative but profoundly immunosuppressive regimens followed by donor lymphocyte infusion (DLI) for the treatment of hematologic malignancies.

METHODSThe protocol was designed to minimize the intensity of the conditioning regimen to the range of nonmyeloablative therapies based on ATG with low-dose busulfan (Bu) and Cytoxan (CTX) (15 - 19.5 mg/kg, 8 mg/kg and 80 mg/kg, respectively). The patients received the first lymphocytic infusion from HLA-identical sibling donors on days 28 - 30 after transplant, and the first T cell dosage of 10(6)/kg followed by the escalated dosage in the range of (0.5 - 1.5) x 10(8)/kg. The total number of procedures were performed at a median of 4.2 procedures (range of 2 - 8 procedures).

RESULTSEngraftment was documented in all six patients in the form of donor-recipient hematopoietic cells mixed chimera at early-stage posttransplant, which was converted gradually into complete chimera by DLI in four patients. Graft-versus-host disease (GVHD) developed in three of six cases, only one of which was severe. To date, four patients are disease free and alive.

CONCLUSIONSAllogeneic donor stem cell engraftment into host can be achieved by nonmyeloablative conditioning regimen based on ATG. Transient mixed donor-recipient hematopoietic cell mixed with chimeras may be successfully converted into complete chimerism by DLI posttransplant. GVHD remains major clinical concern in our study.

Adolescent ; Adult ; Antilymphocyte Serum ; therapeutic use ; Female ; Graft vs Host Disease ; etiology ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Testing ; Humans ; Lymphocyte Transfusion ; Male ; Middle Aged ; T-Lymphocytes ; immunology ; Transplantation Chimera ; Transplantation Conditioning