Objective To explore the outpatients′experience of caring and provide references for improving their experience of medical care.Methods The phenomenology research method was adopted in this study,and twenty-one outpatients were subject to an in-depth interview to learn their outpatient experiences.Results Ten themes of experience with caring were extracted as follows:passionate and patient,careful and considerate,respect for others,offers to help,encouraging and comforting,apologies and courteously,humor,truthful considerations,conscientious and responsible,and a caring environment setup.Five themes of experience without caring were extracted as follows:impatient communication, careless seeing of outpatients,delayed service,passive reminders,and facilities without enough details. Conclusions The outpatients may have abundant experiences of caring at the outpatient clinic,also lack of caring sometimes as well.Outpatient managers should keep an eye on outpatients′needs and satisfaction of caring from time to time,to improve the quality of outpatient service.

Object To investigate the main risk factors of ICU sydrome,and establish Logistic regression model to evaluate the accuracy rating、sensitivity and specificity for predicting ICU sydrome.Methods Investigated all patients hospitalized in ICU from June to July of 2007.Data collected include age,gender,religion,family income,education degree,primary disease,character type,APACHE II score and et al.Case-control study Was used to retrospectively investigate the clinical data of ICU sydrome.Firstly,sillgle factor analysis was used in 21 clinical variables.Then,Multivariate Logestic regression analysis was used in selected variables.Results Twelve clinical variables,including age,gender,family income,health care cost wiping out degree,whether or not having family member'death,whether or not encountering other patients'death,length of stay in ICU,whether or not receiving ventilator theraphy,sleep quality,score of APACHE II,time with disease,character type.By Logestic regression analysis,it WSS revealed that there were 6 significant factors for ICU sydrome in diminishing sequence as whether or not receiving ventilator theraphy,length of stay in ICU,sleep quality,gender,time with disease and whether or not encountering other patientsMeath.Logestic regression equation was as following:P=1/[1+Exp∑(31.425+2.611X1+8.188X2-2.677X3+7.474X4+4.312X5+6.153X6)].The accuracy rating、sensitivity and specificity of the Logestic model was 82.37%.79.42% and 85.13% respectively.Conclusions Whether or not receiving ventilator theraphy,length of stay in ICU,sleep quality,gender,time with disease and whether or not encountering other patients'death were the main risk factors of ICU sydrome.The Logestic regression model based on these factors is reliable in predicting ICU sydrome.

Objective To analyze the effect of perioperative blood transfusion in orthopedic surgery.Methods A total of 201 patients who underwent an orthopedic surgery in our hospital in October 2015 to September 2016 were reviewed.Hemoglobin concentrations,hematocrit,postoperative hospital stay,infection and other related data were analyzed.Results 90 patients were transfused with blood and in 111 patients were not during orthopedic surgery (massive blood transfusion group including 17 cases;non massive blood transfusion group including 94 cases).Hemoglobin concentrations of transfusion group (103.09±16.37)g/L was lower than the non transfusion group (115.79± 13.68)g/L before liying hospital,postoperative hospitalization time of transfusion group (12.012±8.36) was longer than that of non transfusion group (16.14 ± 10.47)days.Postoperative infection rate in non transfusion group was 1.11％,and in transfusion group was 15.32％,in massive transfusion group is 52.94％.Conclusion Perioperative blood transfusion is not conducive to the recovery of hemoglobin level patients in orthopedic surgery,prolong hospital stay and increase the rate of infection after surgery.Perioperative blood transfusion makes it difficult to support the outcome of the disease

Objective To evaluate the effect of fentanyl on the expression of vascular endothelial growth factor A (VEGF-A) and matrix metallopeptidase-9 (MMP-9) in the subcutaneous tumor of human gastric cancer in nude mice.Methods Thirty SPF male BALB/C nude mice,aged 4-5 weeks,weighing 15-20 g,in which the model of subcutaneous tumor of human gastric cancer cell line MGC-803 was established,were randomly divided into 6 groups (n =5 each) using a random number table:control group (C group),normal saline group (NS group) and fentanyl 0.05,0.10,0.20 and 0.40 mg/kg groups (F1-4 groups).The mice in group C received no treatment.Fentanyl 0.05,0.10,0.20 and 0.40 mg/kg were intraperitoneally injected once a day for 14 consecutive days in F1 4 groups,respectively,while the equal volume of normal saline 1.5 ml/kg was given instead of fentanyl in group NS.The nude mice were sacrificed on 1 day after the end of administration,and the tumor tissues were obtained for examination of the ultrastructure of subcutaneous tumor (with a transmission electron microscope) and for detection of the expression of VEGF-A and MMP-9 (by immunohistochemistry and Western blot) and expression of VEGF-A and MMP-9 mRNA (by real-time reverse transcriptase polymerase chain reaction).Results No abnormality in the morphology of the subcutaneous tumor cells was observed in C and NS groups.The swollen nucleus,chromatin margination,nuclear fragmentation and apoptotic bodies were found in the subcutaneous tumor cells in F1-4 groups.Compared with group C,the expression of VEGF-A and MMP-9 protein and mRNA was significantly down-regulated in F1-4 groups (P＜0.05),and no significant change was found in each parameter mentioned above in group NS (P＞0.05).There was no significant difference in the expression of VEGF-A and MMP-9 protein and mRNA among F1-4 groups (P＞0.05).Conclusion The mechanism by which fentanyl inhibits the growth and metastasis of subcutaneous tumor cells of human gastric cancer is related to down-regulation of VEGF-A and MMP-9 expression in nude mice.

Objective To evaluate the effect of morphine on the growth of subcutaneous tumor of human gastric cancer cells in nude mice.Methods Thirty SPF male BALB/C nude mice,aged 4-5 weeks,weighing 15-20 g,in which the model of subcutaneous tumor of human gastric cancer cell line MGC-803 was established,were randomly divided into 3 groups (n=10 each) using a random number table:control group (group C),normal saline group (group N),and morphine group (group M).The mice in group C received no treatment.Morphine 20 mg/kg was intraperitoneally injected once a day for 14 consecutive days in group M,while normal saline 1.5 ml/kg was given instead of morphine in group N.The caliper was used to measure the tumor size every 2 days starting from 3 days after beginning of administration,and the relative tumor volume was calculated.The nude mice were sacrificed on 15th day,and the tumor tissues were obtained for determination of nuclear factor-kappa B activity and Bcl-2 and Bax protein and mRNA expression by real-time reverse transcriptase polymerase chain reaction and Western blot.Results Compared with group C,the relative tumor volume was significantly decreased,the activity of nuclear factor-kappa B in tumor tissues was significantly decreased,the expression of Bcl-2 protein and mRNA was significantly down-regulated,and the expression of Bax protein and mRNA was significantly up-regulated at each time point in group M (P＜0.05),and no significant change was found in each parameter mentioned above in group N (P＞0.05).Conclusion Morphine can inhibit the growth of subcutaneous tumor of human gastric cancer cells in nude mice,and the mechanism is associated with promotion of apoptosis in tumor cells.

Objective To study the immuno-protective effect against Schistosoma japonicum challenge of the positive monoclonal phages which were screened from the 12 mers-phage random peptide library by the new model rabbit serum. Methods The new model was established by injecting the Schistosoma japonicum infection rabbits with inhibitor of phenol oxidose. Positive clones immunoscreened with the new model rabbit sera were absorbed by SEA immune rabbit sera, and 14 clones selected randomly from them were compared and their antigenic ability was identified by ELISA. The two best positive monoclonal phages (No.8, No.13) recognized by the new model rabbit sera were selected to immunize Kunming mice by subcutaneously injecting 1?10~15 pfu positive phages at 0, 2nd, 4th week respectively. After 4 weeks of the last immunity,each mouse was challenged with 40?1 S.japonicum cercariae. All mice were sacrificed after 42 days and the reduction rates of adult worms and the liver eggs were investigated. Results The positive phage clones after immune absorption were weakly recognized by the SEA immune rabbit sera. The 14 monoclonal phages were recognized by the rabbit sera of the new model and the normal model. Especially No.8, No.13 were strongly recognized by the rabbit sera of the new model,while weakly recognized by the SEA immune rabbit sera. The reduction rates of adult worms and liver eggs induced by the monoclonal phage No.13, the monoclonal phage No.8 and the original peptide library were 35.81% and 63.32%, 32.09% and 52.02%, 14.90% and 30.64%, respectively. Conclusion Most clones of simulated epitopes of SEA can be removed by absorbing positive clones with SEA immune rabbit serum .The 14 monoclonal phages from the new model contain the simulated S.japonicum epitope. The two monoclonal phages have higher reduction rates of adult worms and eggs than original 12 mers-phage random peptide library and the positive polyclonal phages.[

Objective: To develop a headspace gas chromatography ( HS-GC ) assay for simultaneous determination of dichloroacetic acid ( DCA ) and trichloroacetic acid ( TCA ) in urine. Methods: Urine samples (5 mL) were transferred to a 22 mL headspace bottle, added with 0.5 mL 10% sodium acetate solution , immediately sealed, and shaken evenly. The bottle was placed in the HS-GC system, and equilibrated at 90 ℃ for 60 minutes. The mixture was separated with the HP-INNOWAX chromatographic column, and the DCA and TCA concentrations were detected with the hydrogen flame detector. Results: Under the optimal experimental conditions, the correlation coefficient of DCA and TAC was both > 0.999 0 within the range of 10-500.0 μg/L, and the lowest detection limits of DCA and TAC were 2.0 and 3.5 μg/L, with the spike recovery rate of 87.40% to 101.44%, and relative standard deviations of 1.89% to 3.25%. Of the 35 urine samples sampled from occupational populations, DCA and TCA were not detected. Conclusions The establishment of the HS-GAS assay through addition of sodium acetate and optimization of the headspace conditions, has high recovery and precision, which is effective to meet the requirements for daily determination of DCA and TCA in urine samples.

Thoracic-abdominal junctional zone is an area from the inferior chest to superior belly. The inferior chest contains inferior pulmonary lobes, pulmonary ligament, inferior mediastinum and lower thoracic cavity,while the superior belly contains upper abdominal cavity, spatium retroperitonaeale, abdominal aorta, inferior vena cava, liver, stomach, adrenal glands, kidneys and spleen. This article is to review the CT manifestations and anatomy of diseases such as infection, trauma, hemorrhage, hernia and tumor involving this area. It could provides anatomic and pathological information for instituting clinical treatments.
Abdominal Cavity ; anatomy & histology ; diagnostic imaging ; Diaphragm ; anatomy & histology ; diagnostic imaging ; Humans ; Radiography, Thoracic ; Thoracic Cavity ; anatomy & histology ; Tomography, X-Ray Computed

Objective&Methods The mutagenicity of natural Borneol and synthetic Borneol was studied by using Ames test.Results Natural Borneol and Synthetic Borneol in the dose range of 0.4～250.0 ?g/plate had no effect in reducing the reversion frequencies of Salmonella Typhimurium histidine auxotrophic mutant(TA97,TA98,TA100,TA102)whether if metabolic activation system(S9mix)existed or not.Moreover,the backward mutant colony had normal background.Conclusion Natural Borneol and Synthetic Borneol do not possess evident mutagenicity under experimental condition.

Objective To investigate the roles of transforming growth factor(TGF)-β1 gene polymorphisms in severe acute respiratory syndrome-coronavirus(SARS-CoV)infection and the interstitial lung fibrosis after recovered.Methods Sixty-five recovered SARS patients,37 health care workers and 66 healthy controls were enrolled in this case-case study.The association between genetic polymorphisms of TG F-β1 and suscept ibility to SARS or interstitial lung changes after SARS reco,vered was carried out.Polymerase chain reaction-sequencing based typing(PCR-SBT)method was used to determine the polymorphisms of TGF-β1 gene at locus+869 and+915.Data were analyzed using t test and chi square test.Results There was no significant association of TGF+β1 gene polymorphisms at locus+869 and+915 in recovered SARS patients,health care workers and heahhy controls.And gene linkage of this two loci was not related with SARS-CoV susceptibility.Furthermore,no association between interstitial lung changes in recovered SARS palients and TGF-β1 gene polymorphisms or genetic linkage of this two loci.Conclusions It may not be related between TGFβ1 gene polymorphisms at locus+869 and+915 and SARS-CoV susceptibility.And interstitial lung changes in recovered SARS patients may not be influenced by TGF-β1 gene polymorphisms.