In order to improve the utilization efficiency of nursing human resources, stable nursing troop and enhance the quality of care, at present, the post management experiences for nurses of domestic and international are adopted by many hospitals and certain results are achieved. Study about nurses stratified management is reviewed, the approach, basis, effects, features and the advantages and disadvantages of hierarchical management experiences for nurses in different countries and regions is summarized and some thinking and prospect in studying is proposed in this article, as well as the follow-up research, to explore a constructive policy of further promoting the development of the level management for nurses.

BACKGROUND:Tumor recurrence results from the incomplete removal of cancer stem cel s with self-renewal characteristics, and then how to label and eliminate cancer stem cel s becomes the key to cancer treatment. OBJECTIVE:To observe the morphology,distribution and number of CD44+/C-myc+METHODS:Pathological tissues from 150 patients with colorectal cancer were taken to prepare tissue microarray, in order to observe and count CD44 cel s in colorectal cancer, and to explore the relationship between the expression and postoperative metastasis.+/C-myc+cel s by using immunohistochemical double staining. Patients were fol owed up through mobile phones , letters , and so on, and the relationship between the expression of CD44+/C-myc+cel s and postoperative metastasis were statistical y recorded.RESULTS AND CONCLUSION:There was no CD44+/C-myc+cel s in normal tissue and little in adenoma. A smal number of CD44+/C-myc+cel s distributed as dots or focal lesions in adenocarcinoma. The number of CD44+/C-myc+cel s was related to the degree of adenocarcinoma differentiation, depth of invasion, and lymph node metastasis (P<0.05). The univariate analysis showed that the overal survival rate and progression-free survival rate were associated with the number of CD44+/C-myc+cel s, lymph node metastasis and Ducks staging in adenocarcinoma (P<0.05). The multivariate analysis showed that the overal survival rate was related to CD44+/C-myc+cel amount and the progression-free survival rate was related to CD44+/C-myc+cel amount and the Ducks staging. Therefore, CD44+/C-myc+cel s are probably cancer stem cel s, and Ducks staging and CD44+/C-myc+cel amount are important prognostic factors for colorectal cancer.

Background and purpose: As one of the important epigenetic phenomena, DNA methylation plays an important regulatory function for the expression of genes. Study shows that abnormal changes of DNA methy-lation patterns of normal tumor cell genome leads to dysfunction of cancer related gene, and this may be associated with tumor occurrence and development. The study investigated the promoter methylation and expression of caveolin-1 (CAV-1) gene in esophageal squamous cell carcinoma (ESCC), and to elucidate its role in ESCC. Methods:We used MSP approach, RT-PCR, and immunohistochemistry method respectively to examine the methylation status of the 5’CpG island of CAV-1 gene and its expression at mRNA and protein levels in tumors and corresponding normal tissues. Results: CAV-1 mRNA expression in tumor tissues (0.86±0.56) was signiifcantly higher than that in corresponding normal tissues (0.40±0.36, P<0.05). The mRNA expression of CAV-1 was correlated with status of lymphatic metastasis and TNM stage of ESCC patients (P<0.05). The protein expression of CAV-1 in tumor specimens (66.7%, 34/51) was signiifcantly higher than that in corresponding normal tissues (15.7%, 8/51, P<0.01). The protein expression of CAV-1 was signiifcantly associated with lymphatic metastasis of ESCC (P<0.05), however, it was not associated with differen-tiation and TNM stage (P>0.05). The promoter methylation frequency of CAV-1 in tumor specimens was 2.0%(1/51), and the methylation phenomenon has not been found in corresponding normal tissues. The promoter methylation fre-quency of CAV-1 in tumor specimens showed no signiifcant difference compared with the corresponding normal tissues (P>0.05). Conclusion:The mRNA and protein expression of CAV-1 in tumor specimens was signiifcantly higher than that in corresponding normal tissues. Aberrant high expression of CAV-1 has played a certain role in promoting tumori-genesis and lymph node metastasis. The expression both in ESCC and corresponding normal tissues has no correlation with the promoter methylation status.

Objective: To investigate the candidal infection status in puerperas in Lanzhou, and the candidal transmission from mothers to their newborn infants. Methods: Vaginal fluid and saliva samples from 104 puerperas, as well as 104 saliva samples from their newborn infants were collected. The Candida species were cultured, isolated and identified using CHROMagar media. Further identification was done using molecular biological method. Results; In 81 of 312 specimens (104 x2 from mothers and 104 from infants), Candida species were found. 39.42% (41 cases) was observed in the vaginal fluid and 33.65% (35 cases) was in saliva of puerperas respectively, and 21. 15% (22 cases) in both vagina and oral cavity. 4.81% (5 cases) was found in oral cavities of newborn infants. The distribution of Candida species were 53 Candida albicans, 33 Candida glabrata, 2 Candida krusei and 1 Candida tropical. In 2 pairs of mother-infant, the same genotype of Candida ablicans was identified using PCR method. Conclusion; The Candida detection rate of newborn infants and transmission rate from mothers to their neonates in Lanzhou are higher than that reported in other areas. The colonization of Candida in newborn infants is relevant to both horizontal and vertical transmission. It can decrease the possibility of Candidal infection in newborn infants by controlling the Candidal transmission in hospital and preventing the infection in pregnant women.

To study the chemical constituents of Saxifraga stolonifera (L.) Meeb., chromatographic techniques were applied to separate and purify the compounds, and their structures were confirmed on the basis of physicochemical properties and spectral data. Ten compounds were isolated and identified as 5-O-methylnorbergenin (1), 3, 4-dihydroxyallylbenzene-4-O-beta-D-glucopyranoside (2), (7R, 8S)-4, 9, 9'-trihydroxyl-3-methoxyl-7, 8-dihydrobenzofuran-1'-propylneolignan-3'-O-beta-D-glucopyranoside (3), quercetin-3-O-beta-D-xylopyranosyl-(1 --> 2)-beta-D-galactopyranoside (4), kaempferol-3-O-alpha-L-rhamnopyranoside (5), (3S, 5R, 6R, 7E, 9R)-3, 5, 6, 9-tetrahydroxy-7-megastigmane (6), benzyl-O-alpha-L-rhamnopyranosyl-(1 --> 6)-beta-D-glucopyranoside (7), p-hydroxyacetophenone (8), pyrogallic acid (9) and p-hydroxyphenol (10). Compound 1 is a new compound. Compounds 2-10 were isolated from this plant for the first time.

Objective To observe efficacy and safety of Yiqi Gubiao Pill combined with Pingchuan External Application Ointment for the treatment of COPD (lung-spleen qi deficiency type) at a stable stage. Methods A randomized, double-blind, and placebo-controlled method was used. Totally 266 cases of patients diagnosed with COPD lung-spleen qi deficiency syndrome were randomly divided into four groups. Experimental Ⅰ group (72 cases) was given Yiqi Gubiao Pill, 10 pills each time, three times a day, orally; at the same time, experimental Ⅰ group was given simulated Pingchuan External Application Ointment (blank medical bag), for Feishu (BL13), danzhong (RN17), Pishu (BL20), Fengmen (BL12), and Dingchuan, external application at 11am each day, external heating stickers, 4-6 h each time, twice a week. Experimental Ⅱ group (64 cases) was given simulated Yiqi Gubiao Pill combined with Pingchuan External Application Ointment. Experimental (64 cases) was givenⅢ Yiqi Gubiao Pill combined with Pingchuan External Application Ointment. Control group (66 cases) was given simulated Yiqi Gubiao Pill combined with simulated Pingchuan External Application Ointment. The treatment lasted for three months, and the follow-up was three months. TCM symptom scores, FEV1%, FVC%, CAT, BODE index, mMRC, and 6MWT were observed. Results After three-month treatment and three-month follow-up, the improvement of TCM symptom scores of the 3 experimental groups was better than the control group (P<0.05). The improvement of CAT, mMRC, BODE index, 6MWT, mMRC in the three treatment groups were better than the control group (P<0.05). The improvement of mMRC and BODE in experimental Ⅰ and Ⅱ groups were better than those of experimental group (Ⅲ P<0.05). After three-month treatment, the improvement of FVC% in the three experimental groups was better than the control group (P<0.05). The improvement of FEV1% in the experimental Ⅱ and groups was better than the control groupⅢ(P<0.05). Conclusion Yiqi Gubiao Pill combined with Pingchuan External Application Ointment has obvious efficacy for the treatment of COPD with lung-spleen qi deficiency type.

Objective To explore the hematology adverse reactions of imatinib mesylate (IM) in the treatment of chronic phase (CP) of chronic myeloid leukemia (CML).Methods The clinical data of 435 CML-CP patients treated with IM were analyzed respectively in the Affiliated Cancer Hospital of Zhengzhou University from Jan 2013 to Jan 2015.The hematology adverse reactions were followed up regularly and the incidences in different groups with various factors were compared.Results Until the end of follow-up,74 (17.0 ％) patients had hematology adverse reactions.61 (14.02 ％) patients had neutropenia,including 9 (14.75 ％) patients who had level Ⅲ-Ⅳ neutropenia.60 (13.79 ％) cases had thrombocytopenia including 11 (18.33 ％) patients with level Ⅲ-Ⅳ thrombocytopenia.Anemia occurred in 50 (11.49 ％) patients,of whom 5 (10.00 ％) cases were grade Ⅲ-Ⅳ anemia.33 (7.59 ％) cases experienced pancytopenia.The incidence of hematology adverse reactions was influenced by nine factors,including the course before treatment,the size of spleen,Sokal scores,the use of interferon,fusion genes,chromosomes,complete cytogenetic response,main molecular reaction and Karnofsky scores (all P ＜ 0.05),while it was not influenced by age,gender,BMI,smoking and drinking (all P ＞ 0.05).Conclusions During the initial treatment of CML-CP,if patients experienced level Ⅰ-Ⅱ hematology adverse reactions,they can continue to taking IM.However,when level Ⅲ-Ⅳ hematology adverse reactions happened,they need to reduce the dose or stop taking,and one month later,hemocyte will get well.In the long-term treatment of CML,once level Ⅲ-Ⅳ hematology adverse reactions occur,the patients need to receive some related inspections,such as bone marrow morphology and molecular biology detection,to clear the disease stage.When it is necessary,the patients can take the second generation of tyrosine kinase inhibitors.

Objective To compare the clinical outcomes of two D3 embryo and single blastocyst transfer in patients retrieving different oocytes, so as to provide data support for selecting a clinical transfer strategy. Methods We made a retrospective analysis of patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)between January and December 2014 in the Reproductive Medicine Center,the Third Affiliated Hospital of Zhengzhou University.The patients were divided into three groups according to the number of oocytes received:Group A (5-9 oocytes),Group B (10 - 14 oocytes)and Group C (≥ 1 5 oocytes).Patients in each group all received four different transfer methods as follows:transfer of two fresh D3 embryos (a ),transfer of one fresh blastocyst (b ),transfer of two D3 frozen embryos (c ),and transfer of one frozen blastocyst (d ).We compared the 2PN fertilization rate of oocytes,rate of available embryos and rate of good embryos among the three groups.We also compared the embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate, multiplets rate and abortion rate among the four transfer methods in each group.Results ① There were 667, 573,and 479 transfer cycles in Group A,Group B and Group C,respectively.The 2PN fertilization rate of IVF and available embryos rate was significantly higher in Group A than in Group B and Group C (P =0.003/P <0.001).② There was no significant difference in biochemical pregnancy rate,clinical pregnancy rate or abortion rate with the four transfer methods in Group A (P >0.05),but the implantation rate of c was significantly lower than that of a and d (P =0.027/0.020),d had a higher implantation rate than a and c in Group B (P =0.005/0.001).In Group C,the biochemical pregnancy rate and clinical pregnancy rate of d were significantly higher than those of a (P =0.048/0.027)and c (P =0.003/0.001).Patients in Group C also had a higher implantation rate than D3 embryos (P <0.05).③ The multiple pregnancy rate of single blastocyst transfer decreased compared with D3 embryos transfer in the three groups (P <0.05).Conclusion Single blastocyst transfer has both higher implantation rate and lower multiple pregnancy rate in high response patients (1 5 or more oocytes received).For patients who received 5-9 and 10-14 oocytes,D3 embryos have a similar clinical pregnancy rate with that of single blastocyst but a higher multiple pregnancy rate.Single vitrified-warmed blastocyst transfer has a higher clinical pregnancy rate.It is the best transfer method for patients who received more than 10 oocytes.

Purpose To investigate the expression of Cav-1 in gastric cancer ( GC) cell lines and GC samples, and to analyze the pos-sible effect of gene methylation in expression of Cav-1. Methods Methylation specific PCR ( MSP) method was applied to examine the CpG methylation of the Cav-1 promoter in GC cell lines (AGS, MKN45, BGC-823) and 104 samples of GC and corresponding ad-jacent tissues. RT-PCR method was applied to examine the mRNA expression in GC cell lines. IHC were applied to examine the pro-tein expression of Cav-1 in the GC tissues. Results The expression level of Cav-1 mRNA was obviously increased after treated with 5-aza-2’-deoxycytidine (5-Aza-Dc, a demethylation agent) in AGS cell line. We detected the positive expression of Cav-1 gene in MKN45 and BGC-823 cell lines before and after treated with 5-Aza-Dc. The level of Cav-1 mRNA expression was no any change in AGS, MKN45 and BGC-823 cell lines treated with trichostatin A (TSA). MSP results showed that it can be amplified methylated bands in AGS cell line, and the methylated bands disappeared after treated with 5-Aza-Dc. MKN45 and BGC-823 cell lines were no any methylated bands amplified before and after treatment. The methylation frequency of Cav-1 gene was 29. 8% (31/104), which was significantly higher than that in adjacent tissues (P=0. 000). Furthermore, Cav-1 gene hypermethylation status was correlated with lymph node metastasis and family history of upper gastrointestinal cancers ( UGIC) , but not with pathological grade and clinical stage (P>0. 05). The positive frequency of Cav-1 expression was 51. 9%(54/104) in GC, which was significantly lower than that in adja-cent tissues (P=0. 000). The expression of Cav-1 was correlated with the frequency of gene methylation in GC tissues (P=0. 000). Conclusion The expression of Cav-1 was reduced in GC tissues and the gene hyermethylation may be one of the mechanisms causing Cav-1 gene silencing.

Objective To evaluate the long-term effect of hepatic arterial embolization with pingyangmycin-lipiodol emulsion (PLE) in patients with cavernous hemangiomas of the liver (CHL)and its influence factors.Methods One hundred and fifty-six hemangiomas that were diagnosed by imaging examinations or confirmed pathologically by surgery in 105 patients with integral follow-up data were analyzed retrospectively in this paper.All hemangiomas were divided into 4 groups according to their size (the largest size of hemangioma)by the authors as follows; A group(≤3 cm, n=25); B group(>3 cm and<5 cm, n =32) ;C group(≥5 cm and<10 cm, n=58); and D group(> 10 cm, n=41) .According to the number of abnormal sinusoids filled with the contrast medium in the angiography, 156 hemangiomas of this series were further classified as three types: abundant type (n=90) ; sparse type (n=9) and the middle type (n=57) .Hepatic arterial embolization with PLE was performed in the 105 patients with total 135 procedures (including single procedure in 75 patients, twice procedures in 30 patients).All of the 105 patients were followed up 3 to 8 years(mean 4 years) using US, CT or MRI or DSA.The criteria for the evaluation of curative effect were classified as best, good, recovery and no change in this series, and the sum of best and good effects were defined as the total effective rate.Then, the total effective rate of single procedure between the A, B groups and C, D groups; and the total effective rate of single procedure and twice procedures in the D groups, were compared statistically by X~2 test respectively.And the influence factors, included of the variant size of hemangiomas, abundant or sparse of abnormal sinusoids and the number of treatment procedures, were also analyzed and evaluated respectively.Results The total effective rate of the 156 hemangiomas in 105 patients was 92.95% (145/156).After single procedure of hepatic arterial embolization with PLE, the total effective rate of A and B groups were 100% (57/57), that of C and D groups were 85.86% (85/99), and the difference reach significant (X ~2=8.8553, P<0.01).In the D group, the total effective rate in group with twice procedures (100.00%,30/30) was significant higher (X~2 =5.2642,P<0.05) than those of group with single procedure (72.73%,8/11).Of this series, during the period of following-up, no recurrent or severe complications were observed.Conclusions A best long-term curative effect (complete cure) is usually obtained in the small hemangiomas with abundant abnormal sinusoids, and a satisfactory long-term curative effect can also be achieved in the larger or multiple hemangiomas, particularly in those hemangiomas with abundant abnormal sinusoids by using the repeat procedures of hepatic arterial embolization with PLE.