ObjectiveTo study the application of glucose descriptive chart in monitoring of stress hyperglycemia,and provide continuous,dynamic change of blood glucose levels for clinic. Methods80 patients with stress hyperglycemia who adopted intensive insulin therapy were randomly divided into the experimental group and the control group with 40 cases in each group.The experimental group used glucose descriptive charts to record blool glucose,the control group used the traditional registration form to record blood glucose.The incidence of hypoglycemia and evaluation of medical staff for the glucose descriptive chart were compared between two groups. ResultsThe incidence of hypoglycemia in the experimental group was significantly lower than the control group.The medical staff considered that glucose descriptive chart helped understand the dynamic change of blood glucose,and provided a more comprehensive basis for regulating the use of insulin. ConclusionsApplication of glucose descriptive chart in monitoring of stress hyperglycemia can provide continuous and dynamic change of blood glucose,which facilitates the medical staff to monitor the blood glucose and decrease the incidence of hypoglycemia.

Objective To investigate the main risk factors influencing the pre-hospital delay of patients with acute ischemic stroke (AIS) for preventing methods.Methods A retrieval was done across the epidemiologic studies on pre-hospital delay of AIS patients during 2004 to 2015 using the key words of ischemic stroke,prehospital delay,treatment delay.According to the inclusion and exclusion criteria,the literature was collected and the literature quality was assessed.The data were extracted for meta-analysis by RevMan software.Results Sixteen epidemiologic studies were included.Totally,there were 2,966 cases of prehospital delay and 2,468 cases of non-delay.The pooled OR values and 95％ CI by multivariate analysis were as follows:the degree of awareness of stroke was 0.5 (0.3,0.82),emergency medical service (EMS) was 0.49 (0.29,0.85),National Institute of Health Stroke scale (NHISS) score 0.58 (0.36,0.95),outpatient visit as first visit 4.28 (1.44,12.74),distance 0.76 (0.61,0.95),medical history of ischemic stroke 0.37 (0.18,0.79) (with significant differences in OR value,P＜0.05).Conclusions The protective factors for pre-hospital delay of acute ischemic stroke patients include:strengthened awareness of stroke,effective EMS,high NHISS score,short distance,medical history of ischemic stroke.The main risk factor is that their outpatient visit is their first visit for medical treatment.Therefore,we need to enhance the health education to the patients and their families about awareness of stroke,improve the use of EMS and build complete and efficient green path for the stroke patient.

Objective To explore the relationships among nurses’intent to stay,occupational commitment and managers’ leadership styles in emergency department.Methods A total of 130 nurses in emergency department were recruited by convenience sampling method from three tertiary hospitals in Guangzhou.They were investigated by using Nurses’Intent to Stay Questionnaire, Nurses’Occupational Commitment Questionnaire and Multifactor Leadership Questionnaire(MLQ).Results The score of nurses’ intent to stay and occupational commitment were(20?19±3?74)and(76?16±12?13),respectively;both were at medium levels and occupational commitment,transformational leadership style were positively correlated with nurses’intent to stay(P<0?05).Nurses perceived their managers as transformational leaders more often than transactional leaders.Conclusions Both the current nurses’ intent to stay,occupational commitment were at medium levels.The influential factors of nurses’intent to stay in emergency department included emergency work experience,emotional commitment and normative commitment.In order to increase nurses’retention and stabilize the healthy development of nursing personnel,nurse managers should improve the level of nurses’occupational commitment.

Objective To investigate the anti-hepatocarcinoma(anti-HCC) function of HLA-A2-restricted point-mutated Survivin peptide induced CTLs.Methods The HLA-A2-restricted Survivin nonapeptides were evaluated using bioinformatics software.The binding affinity of Survivin peptide to HLA-A2 molecular was determined with flow cytometry analysis.After peptide-induced CTLs were generated in vitro,flow cytometry and ELISA were performed to detect the levels of IFN-γ,which were secreted by reactive CTLs.Peptide-induced CTLs were co-cultured with hepatoma cell lines HepG2 and BEL-7402.The rates of tumor cells lysis were assayed using CytoTox 96(R) and the morphological changes of tumor cells were observed with inverted phase contrast microscope.Results Point-mutated Survivin nonapeptide Sur79M2 (KMSSGCAFL) was filtered out,which was shown higher scores compared with the wild-type peptide Sur79.Consistent with the results of software analysis,Sur79M2 showed higher binding ability in T2 binding assays.At the same time,Sur79M2-induced CTLs could release a large number of IFN-γ after incubated with target cells rather than Sur79.When co-cultured with HCC cell lines HepG2 and BEL-7402,Sur79M2-induced CTLs effectively lysis HepG2 on HLA-A2-restricted manner without killing effect on BEL-7402 that do not express HLA-A2 molecules.Conclusion Sur79M2 could elicited specific cytotoxic T lymphocytes in vitro,which were able to specifically kill HCC cell lines on HLA-A2-restricted manner.

Objective For Genistein has been reported to inhibit many tumors ,we investigate the role of autophagy in the proliferation inhibition to Hela cells by Genistein and the machanism of autophagy plays in this process.Methods Human cervical cancer Hela cells were divided into control group,Genistein group and 3-MA+Genistein group,the control group were cultured in RPMI 1640 medium supplemented with 10% fetal bovine serum(FBS),Genistein group were cultured in various concentrations Genistein(25,50,100μmol/L),3-MA+Genistein group were treated with 5mmol/L 3-MA for 1h before cultured in 100μmol/L Genistein.The proliferation inhibitory rate of Hela cells was detected by MTT method.The ultrastructure changes of Hela cells was observed under transmission electronic microscope(TEM).The levels of autophagy-associated protein P62 and Beclin-1 were detected by Western blotting analysis.The expressions of autophagy-associated proteins LC3A/B in Hela cells were determined by fluorescent staining to analyse the autophagy induced by Genistein in Hela cells.Results Compared with control group ,the proliferation inhibitory rate of Hela cells was 20.9%±1.3%,33.5%±1.6% and 46.5%±3.2% when cultured in 25,50,100μmol/L Genistein(P<0.01).After treated with various concentrations Genistein for 48h, we observed a dose-dependent increase in the expression of Beclin-1 and decrease of P62.Confocal laser scanning microscopy confirmed the fluorescent density of LC3A/B expression in Hela cells treated with 100μmol/L Genistein increased significantly as compared with control group.TEM showed there are many vacuoles and double-membrane autophagosomes which involved cytoplasmic components in Hela cells treated with 100μmol/L Genistein.The proliferation inhibitory rate of Hela cells of Genistein group is decreased as compared with those in 3-MA+Genistein group[(46.5±3.2)% vs (58.2±2.2)%,P<0.01].Conclusion Genistein could inhibit Hela cells proliferation and induce autophagy.

Objective To establish a method for simultaneous determination for the contents of four flavones (ononin, calycosin, genistein and formononetin) of Hedysari Radix in Gansu Province with quantitative analysis of multi-components by single-marker (QAMS); To prove its feasibility and accuracy. Methods Calycosin was taken as internal standard substance. Relative correction factors (RCF) of ononin, genistein and formononetin to calycosin were established. The contents of ononin, calycosin, genistein and formononetin were determined to realize QAMS. Results RCF was with good repeatability. The results of QAMS were consistent with the results of the external standard method. Conclusion The method that determines the contents of ononin, genistein and formononetin with calycosin as internal standard substance, can be used for quantitative analysis of Hedysari Radix.

Objective To study the effects of total lignans of Schisandra chinensis on memory impairment in rats with Alzheimer's disease, and to discuss its mechanism of action. Methods The rats were randomly into the blank control group, the sham injury group, the pathological model group, the low dose group of Schisandra chinensis and the high dose group of Schisandra chinensis with 15 rats in each group. The animals were given medicine at 3 days after the model establishment. The ainimals of the pathological model group, the low dose group of Schisandra chinensis and the high dose group of Schisandra chinensis established the AD model by D-gal intraperitoneal injection of compound Aβ hippocampal localization injection. The low dose group of Schisandra chinensis and the high dose group of Schisandra chinensis were administrated by means of intragastric administration 1mL physiological saline containing Schisandra chinensis total lignans 50 mg×kg-1×d-1 and 100 mg×kg-1×d-1, and the blank control group, the sham injury group, the pathological model group were administrated 0.9% Sodium Chloride Injection 1 ml×d-1by means of intragastric administration. After two weeks of continuous administration, the behavioral tests were carried out on the experimental animals, and the expressions of caspase-3, Bax, Bcl-2 and mRNA in the hippocampus of rats were measured by RT-PCR. Results Compared with the pathological model group,the escape latency shortened of the low dose group and the high dose group of Schisandra chinensis were significantly shortened (P<0.05). The number of traversing platforms (3.82 ± 1.23, 5.82 ± 1.18 vs. 2.13 ± 1.48), the percentage of swimming time (39.43% ± 7.12%, 48.63% ± 7.15% vs. 59.98% ± 6.13%) of the low dose group and the high dose group of Schisandra chinensis significantly decreased (P<0.05). Compared with the pathological model group, the expression of caspase-3(6.11 ± 1.25,4.42 ± 1.13 vs.7.88 ± 1.28)and Bax mRNA(5.84 ± 1.62,4.63 ± 1.51 vs.7.54 ± 2.14) significantly decreased (P<0.05), and the expression of the Bcl-2 mRNA(1.73 ± 0.82, 3.04 ± 1.29 vs. 0.93 ± 0.62) wese increased (P<0.05). Conclusions The diatomite Soxhlet extraction method is suitable for the isolation and purification of total lignans from Schisandra chinensis, and the total lignans of Schisandra chinensis can up-regulate the expression of Bcl-2, down-regulate the expression of caspase-3 and Bax, inhibit the apoptosis of neurons induced by A beta, improve the memory impairment of AD animal models, and the intervention effect is dose dependent.

Objective:To explore the application of PDCA cycle combined with project management method in the assessment and management of special skills training in clinical skills center.Methods:From January to December in 2018, the PDCA cycle combined with project management method was used to manage the special skills training project team. The utilization rate of special skills simulation equipment before and after management was compared. A questionnaire survey was conducted to investigate the satisfaction with the management model among the students involved in the special skills training in 2018.The data was analyzed by SPSS 13.0.Results:The utilization rate of special skills simulation equipment was significantly improved, and the students were highly satisfied with the management model.Conclusion:Using PDCA cycle combined with project management method, this paper explores a management model of special skills training and assessment in clinical skills center, which improves the quality of special skills training and assessment management in clinical skills center, and is worthy of further exploration and practice.

Objective To compare the safety and efficacy of different methods for nasal jejunum tube placement in patients with mechanical ventilation.Methods From March 1,2015 to August 31,2017,patients with mechanical ventilation needed nasal jejunum tube placement were randomly divided into three groups,and three groups were provided with supine position(Group A),head forward flexion (Group B) and head back position(Group C),and nasal jejunum tubes were inserted by the same person.Time of reaching stomach,time of stomach to jejunum,and number of successful cases were recorded.Results In Group C,time of reaching stomach was significantly shorter than that in Group A and Group B(P＜0.01),time of stomach to jejunum in Group B was significantly shorter than that in Group A and Group C(P＜0.01).There were no statistically significant differences among three groups in number of successful cases in stomach and in jejunum(P＞O.05).Conclusion The method of head elevation and head back position is easy for nasal jejunum tube to pass through the throat with spiral movement;right lateral position together with uniform continuous advancing of nasal jejunum tube can have higher successful rate,which is conducive to the establishment of early enteral nutrition in patients with mechanical ventilation.

Treatment of advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) can achieve good disease control, but it will inevitably produce drug resistance. About 3%-10% of the resistance mechanism is small cell transformation. Two cases of stage IV lung adenocarcinoma with EGFR mutation were reported and the disease was controlled after EGFR-TKIs treatment. In case 1, progression-free survival (PFS) before small cell carcinoma transformation was 16 months, and in case 2, PFS before small cell carcinoma transformation was 24 months. Subsequent biopsy after disease progression indicated a shift to small cell lung cancer. Case 1 PFS after small cell carcinoma transformation was 6 months, and case 2 PFS after small cell carcinoma transformation was 8 months, and overall survival (OS) was 36 months, which significantly prolonged the patient's survival. At the same time, the literature of such drug resistance mutations was reviewed. For patients with advanced NSCLC with sensitive mutations, it is necessary to conduct secondary histopathological tests after TKIs treatment resistance, and select subsequent treatment according to different resistance mechanisms for the whole course of disease management.
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Humans ; Carcinoma, Small Cell ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Adenocarcinoma/genetics* ; Small Cell Lung Carcinoma/genetics* ; ErbB Receptors/genetics*