Objective To analyze and summarize the clinical effect of peripherally inserted central catheters (PICC) guided by B-ultrasound,and to discuss the catheterization skills of PICC guided by B ultrasound.Methods Retrospectively analyzed the clinical data of 102 patients recieved PICC guided by ultrasound in neurosurgery department of Chongqing emergency medical center from January 2016 to May 2017.The success rate of one-time puncture, the success rate of one-time catheter delivery and the number of complications were analyzed, and the causes and treatment methods of complications were analyzed.Results Of the 102 cases,94 cases were successfully punctured in one time,6 cases were punctured twice,and 2 cases were punctured more than 2 times.The one-time puncture success rate was 92.16%.Catheter misplacement occurred in 5 patients,and postoperative complications occurred in 2 patients.Conclusion Mastering the related angiotomy and imaging knowledge of PICC and using the B-ultrasound guidance system to insert the catheter can improve the success rate of catheterization and reduce the postoperative complications.

Objective To construct an objective,comprehensive core competence evaluation index system for nursing postgraduates,and to provide evidence for postgraduates nursing education.Methods According to literature review,expert interviews,focus group discussions,Delphi and other research methods,we conducted two rounds of 32 experts consultation in 18 cities from 10 provinces to establish the final core competence evaluation index system.Results The two experts consultation derived core competence evaluation index system including 7 level-1 indexes,20 level-2 indexes and 53 entries.Level-1 indexes:theoretical knowledge and skills,critical thinking ability,research ability,clinical care ability,teaching skills,interpersonal communication skills,professional development skills.Conclusions This program is rigorous and reliable,with some theoretical and practical significance of its results,which provide a reference for the training program,evaluation of the quality,assessment of postgraduate nursing education.

BACKGROUND: Astragalus membranaceus plays an important role in the adjustment of immunological function. Whether does it have protective effect on neuron in the intervention of acute craniocerebral injury and what is the pathway in effect?OBJECTIVE: To observe the effect of astragalus membranaceus on activity of nitric oxide synthetase after brain injury.DEDIGN: Randomized controlled trial.SETTING: Neurosurgery institute of Lanzhou Military Area Command of Chinese PLA.MATERIALS: This experiment was completed in the Laboratory of Neurosurgery Institute of Lanzhou Military Area Command of Chinese PLA. Fifty-four healthy SD rats were divided randomly into 3 groups: brain injury group( n=24), astragalus membranaceus group( n = 24) and control group( n = 6). Injury and astragalus membranaceus groups were sampled at 4different time points(0.5 hour, 2 hours, 6 hours, and 24 hours) after injury,6 rats were sacrificed at each time point.METHODS: The brain injury and astragalus membranaceus groups were prepared by improved Feeney' s free falling method. Bone windows were opened for the control group, but no brain injury produced. After injury, rats in astragalus membranaceus group were immediately injected 200 mg/kg astragalus membranaceus intraperitoneally rat cerebral injury models were established and the nitric oxide synthetase concentration was tested at different time points.MAIN OUTCOME MEASURES: Activity of nitric oxide synthetase in the brain tissue of rats in each group.RESULTS: All 54 rats entered the final analysis. Nitric oxide synthetase activity in brain injury and astragalus membranaceus groups increased sharply contrasting with control group at 30 minute after injury [ (46.44 ± 13.45),(43.15 ± 12.43), (40. 46 ± 12. 85) nkat/L, P ＜0.05], reaching the peak at 2hours[ (67.49 ± 22.45), (64. 26 ± 19.78) nkat/L, P ＜ 0.01 ], starting to drop from6 hours [(63.46±24. 68), (52.91 ±21.36) nkat/L, P ＜0. 01], and getting to basic level at 24 hours[ (41.23 ± 12. 57), (40.92 ± 12. 25) nkat/L,P ＞ 0.05 ]. In the astragalus membranaceus treated group, nitric oxide synthetase activity dropped at 2 hours and 6 hours after injury contrasting with injury group( P ＜ 0. 05, P ＜ 0. 01 respectively).CONCLUSION: Nitric oxide synthetase activity increases in the injured brain tissue and astragalus membranaceus can protect injured neuron by inhibiting nitric oxide synthetase activity.

ObjectiveTo explore the effect of sodium selenite on gentamicin-induced ototoxicity.MethodsTwenty guinea pigs were randomly divided into the experimental group and control group with 10 animals in each group. The animals were treated with i.m injection of gentamicin (200 mg/kg/d for 8 consecutive days, and at same time, the experimental group was added with p.o tablet of sodium selenite (1 mg/kg/d). Before and after the administration, hearing function was evaluated by examination for auditory brain stem responses (ABR). The cochlear outer haircells were observed by scanning electronic microscope (SEM) and transmission electronic microscope (TEM).ResultsABR threshold of the control group was about 30 dB above that of the experimental group (P<0.01). The latency of waveⅠof the control group was about 0.23 ms above that of the experimental group (P<0.01). Under SEM, the cilia of the majority outer hair cells of the control group lodged even disappeared, while that of the experimental remained regular. Under TEM, in outer hair cells of the control group, mitochondrial crests were obscure, out-membrane was damaged and local protruding, the number of secondary lysosomes was increased, myeloid bodies appeared, but in the experimental group, outer hair cells basically remained normal.ConclusionSodium selenite has antitoxic effect on guinea pig cochlea injury induced by gentamicin in vivo.

AIM AND METHODS: To explore the effects calcitonin gene-related peptide (CGRP) and endothelin-1(ET-1) on the mechanisms of hypoxic pulmonary hypertension (HPH),the contents of CGRP and ET-1 in plasma of pulmonary artery and thoracic aorta and in extractives of lung and ventricular tissues of the chronic hypoxic rats were determined by radioimmunoassay. The changes of their hemodynamic indices and right heart hypertrophy index were monitored simultaneously. RESULTS: The level of pulmonary artery plasma CGRP was significantly higher than that of thoracic aorta plasma,but just the reverse was ET-1 or the ratio of ET-1 and CGRP in control rats( P

Objective To observe the effect of scalp acupuncture and rehabilitation training on the regulation of neuro-plasticity-associated protein MAP-2 in gerbils modelling cerebral ischemia and reperfusion.Methods Cerebral ischemia and reperfusion were modelled into thirty-six male gerbils.They were then randomly divided into a model group (A),a scalp acupuncture and rehabilitation training group (B) and a rehabilitation training group (C),each of 12 cases.The scalp acupuncture and rehabilitation training were administered daily to the gerbils in group B beginning 24 h after modeling,for 14 d.Any changes in Bederson scores were observed after one,7 and 14 days.On the 14th day the expression of MAP-2 around the infarct focus was detected using western blotting in all 3 groups.Results On the 7th day the average Bederson score in group B (1.81 ± 0.52) was not significantly different from that in group A (2.13 ± 0.49) or group C (2.00 ± 0.31) (P ＞ 0.05).At the end of the treatment,however,there were significant differences between the groups,with group B (0.47 ± 0.31) scoring significantly better than groups C (1.04 ± 0.63) and A (1.46 ± 0.72) (P ＜ 0.05).Group C was also significantly better than group A (P ＜0.05).The expression of MAP-2 as measured as integrated optical intensity (IOD) in group B (0.91 ±0.18) was significantly higher than that in group A (0.43 ± 0.21) and group C (0.67 ± 0.24) (P ＜ 0.05) ; so was group C compared to group A (P ＜0.05).Conclusion The scalp acupuncture combined with rehabilitation training can improve the recovery of motor function and enhance the expression of neuro-plasticity-associated protein MAP-2 in gerbils with after cerebral ischemia and reperfusion.

Objective To investigate the application of using urine ACR at different time points instead of 24-hour urinary albumin (24 h UA) for screening of early renal injury in patients with type 2 diabetes. Methods The 24-h urine samples at different time pointsfrom 89 hospitalized patients were collected. The correlations of the ACR of urine samples at different time points were compared with the 24-h UA. When the 24-h UA was taken as the standard,the receiver operating characteristic (ROC) curves of urine ACR at different time points were established and analized. Results No significant differences in urine ACR between the morning urine group [ACR 9.02 (5.69~ 11.64)mg/mmol] and the random urine group [ACR 8.65 (5.80 ~ 11.83) mg/mmol] (P > 0.05). A positive correlation was observed between the morning urine ACR and the random urine ACR (r = 0.951,P < 0.01), however, the ACR of the morning and the random urine group were all positively correlated with the 24-h UA (r=0.886, 0.859, P<0.01). There were no significant differences in the sensitivities and the specificities between the morning and the random urine specimens in screening for albuminuria (92.6%vs 90.1%, and 87.5%vs 87.5%, respectively). When the 24-h UA was taken as the standard,the area under the ROC curves of the ACR in the random urine specimens and the morning urine specimens were 0.954 ± 0.022 and 0.960 ± 0.021 , respectively. There were no statistical differences between these two groups. Conclusions The morning urine and the random urine ACR , instead of the 24-h UA , could be used for both the early screening and monitoring of the renal injury , and the random urine ACR detection is simple ,convenient and accurate for patients.

Objective To investigate the distribution and molecular epidemiology of Candida strains isolated from vulvovaginal candidiasis in Shanghai,and conduct molecular phylogenetic analysis of the strains.Methods Candida pathogens were collected from the patients with vulvovaginal candidiasis during the period from August 2015 to February 2016 in Obstetrics and Gynecology Hospital of Fudan University,Shanghai First Maternity and Infant Hospital,and Intemational Peace Matemity and Child Health Hospital.All the strains were identified and statistically analyzed.ATB FUNGUS 3 kit was used to determine the minimum inhibitory concentration of antifungal agents against these strains in vitro.Molecular typing was conducted using multilocus sequence typing (MLST) method.Phylogenetic analysis was carried out by eBURST and MEGA 6 software.Results Of the 2 185 strains of Candida,1 988 were identified as Candida albicans,149 Candida glabrata,20 Candida tropicalis and 28 other Candida species.Overall,6.5％ of the Candida albicans strains were resistant to fluconazole.Twenty-six diploid sequence types (DSTs) were identified among the 93 strains of Candida albicans analyzed,including 50 fluconazole-susceptible strains with sporadic genotypes,but 43 fluconazole-resistant strains clustered as one clonal complex (CC 69) on the same branch (MLST Clade 1) of phylogenetic tree.Conclusions Candida albicans was the main pathogen of vulvovaginal candidiasis in the three obstetrics & gynecology hospitals in Shanghai,which showed slightly higher resistance to fluconazole.It is necessary to monitor the spread of fluconazole-resistant Candida albicans in these hospitals,especially clonal dissemination of CC 69 clone.

Background and purpose:The risk of recurrence for colorectal cancer after curative surgery is up to 30%-40%. We aimed to evaluate the relationship between time to relapse (TTR) of colorectal cancer with clinical pathological parameters and overall survival after recurrence. Methods:We carried out the analysis of clinical data, pathological examination and follow up information of 375 colorectal cancer patients who admitted to Liaoning Cancer Hospital. Patients were categorized into relapse at<2, 2-5 and>5 years following their initial surgery. Results:TTR was associated with the clinical stage at diagnosis and liver or lung metastasis status. Short TTR (<2 years) was positively associated with survival. However, there was no significant difference in survival between patients who relapsed at 5 years or later compared with those who relapsed between 2 and 5 years. Conclusion:TTR within 2 years is an important predictor of shorter survival for colorectal cancer patients who experienced a relapse.

BACKGROUND: Research has been reported that serum soluble CD146 (sCD146) expression was improved on the surface of endothelial cells and activated T cells by the stimulation of inflammatory factor. Therefore, it predicts that CD146 may participate in inflammatory reaction of tissue.OBJECTIVE: To investigate the expression and clinical significance of serum sCD146 in peripheral blood from patients with ankylosing spondylitis.METHODS: A total of 62 patients with ankylosing spondylitis were selected from the Sixth People's Hospital AffiUated to Shanghai Jiao Tong University. All patients were divided into two groups: active group (n=46) and inactive group (n=16); while, 20 healthy subjects were selected as the control group. Indicators including Bath Ankylosing SpondyUtis Disease ActivityIndex (BASDAI),Bath Ankylosing Spondylitis Functional Index (BASFI), patient's global assessment (PGA), night pain, visual analogue scale (VAS),morning stiffness time, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured in all patients. The serum concentration of sCD146 from 62 patients with ankylosing spondlitis and 20 healthy controls was measured by enzyme-linked immunosorbent assay. Westergren method was used to measure ESR and immunoturbidimetry for CRP. Clinical data of the patients were collected as well.RESULTS AND CONCLUSION: sCD146 levels of patients with ankylosing spondlitis were significantly higher than normal control group (P ＜ 0.05). The sCD146 expression in the active group was significantly higher than inactive and normal control groups (P ＜0.05). Positive correlations were observed between sCD146 and BASDAI index of patients with ankylosing spondlitis (P ＜ 0.05).The sCD146 levels of ankylosing spondUtis patients with peripheral joint involvement were significantly higher than the patients with axial involvement alone or the normal controls (P ＜ 0.05).The expression level of sCD146 in peripheral blood was positively correlated with disease activities of patients with ankylosing spondlitis. It may play important roles in the pathogenesis in ankylosing spondlitis.