Primary biliary cirrhosis (PBC)is a chronic disease characterized by progressive destruction of intrahepatic small bile ducts, which may progress to liver cirrhosis.Anti-mitochondrial antibodies,especially anti-M2 antibody,have a high diagnostic value for PBC, but they are unrelated to the severity and prognosis of the disease and are negative in some patients.There have been reports from around the world that anti-nuclear antibodies,especially anti-gp210 antibody,are closely associated with PBC.It showed that anti-gp210 antibody has high specificity and sensitivity for the diagnosis of PBC,especially for the patients with negative anti-M2 antibody tests;in addition,it has a high predictive value for the prognosis and development model of the disease.Anti -gp210 antibody has a high diagnostic value for PBC,with great clinical significance,so its detection holds promise for clinical application.

Objective To observe the effect of Xuebijing injection on blood coagulation in patients with sepsis. Methods 300 patients with sepsis were randomly divided into control group and Xuebijing injection treatment group(each,150 cases). According to the guidelines of treatment for sepsis,the conventional treatment was given to both groups,and additionally Xuebijing injection 50 mL plus normal saline 100 mL intravenous drip was applied in the treatment group,twice a day for consecutive 7 days. Before treatment and after treatment for 3 days and 7 days,platelet count(PLT),four items of blood coagulation〔prothrombin time(PT),thrombin time(TT),fibrinogen (Fib)and activated partial thromboplastin time(APTT)〕,D-dimer levels and disseminated intravascular coagulation (DIC)incidence were observed in the two groups. Results Before treatment,the levels of Fib,PT,TT,APTT, PLT,D-dimer and the incidence of DIC had no significant differences between the two groups(all P>0.05);after treatment,the levels of PT,TT,APTT,D-dimer and the DIC incidence were significantly lower than those before treatment,while Fib and PLT were significantly enhanced after treatment,and on the 7th day after treatment,the changes in Xuebijing group were more obvious〔Fib(g/L):3.02±0.51 vs. 2.53±0.56,PT(s):13.82±1.91 vs. 16.03±1.68,TT(s):13.85±1.94 vs. 16.03±1.65,APTT(s):39.47±4.73 vs. 42.75±5.24,PLT(×109/L):118.10±15.80 vs. 99.77±15.67,D-dimer(mg/L):3.17±0.26 vs. 3.66±0.50,DIC incidence:5.3%(8/150)vs. 14.0%(21/150),P<0.05 or P<0.01〕. Conclusion Xuebijing injection can improve the hypercoagulable state and reduce the incidence of DIC in patients with sepsis.

0.05),and the levels of Fib and D-dimer were obviously higher but AT-Ⅲ was obviously lower in 2 NS groups than those in normal control group(P

Reperfusion injury occurs after return of spontaneous circulation (ROSC) in patients with cardiac arrest (CA), which leads to multiple organ dysfunction, called post-cardiac arrest syndrome (PCAS). PCAS is closely related to the prognosis of CA patients, and is an independent risk factor of survival. Integrated traditional Chinese and Western medicine diagnosis and treatment is critical for improving prognosis of PCAS. In order to guide and standardize integrated traditional Chinese and Western medicine diagnosis and treatment in PCAS among clinicians, nurses and research personnel in China, the Emergency Medicine Professional Committee of the Chinese Society of Integrated Chinese and Western Medicine has established an expert group to determine 14 clinical issues related to the diagnosis and treatment of PCAS with integrated traditional Chinese and Western medicine through clinical survey. The working group formulates a search strategy for each clinical issue according to the PICO principle. Chinese and English literature were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, and Cochrane Library. The grade of recommendations assessment, development and evaluation (GRADE) were used to form the level of evidence and recommendation. When the literature evidence was insufficient, the recommendations and level of recommendation were formed after expert discussion. Combined with the aspects of generalizability, suitability, and resource utilization, the expert consensus developed 28 recommendations around the 14 aspects of three stages of PCAS, including early circulation, respiratory support and reversible cause relief, mid-term neuroprotection, improvement of coagulation, prevention and treatment of infection, kidney and gastrointestinal protection and blood sugar control, post rehabilitation treatment, providing references for the integrated traditional Chinese and Western medicine of the diagnosis and treatment for PCAS.

Objective To investigate the alteration of the cytoskeleton of airway smooth muscle cells in young asthmatic rats with airway remodeling and the effect of RhoA/ROCK signal pathway.Methods Airway smooth muscle cells (ASMCs) were primary cultured and purified from Sprague-Dawley(SD) rats that were induced by ovalbumin (OVA) inhalation for 8w,then incubated by Pho kinase inhibitor Y27632.Real time quantitative polymerase chain reaction (RT-PCR),Western blot,and immunohistochemistry were used to measure the alteration of F-actin,and α-tubulin in the cytoskeleton of airway smooth muscle.Results (1) The asthma group showed a high average gray value of F-actin in ASMC than control groups,especially 8 weeks;and were significantly down in the group after adding Y27632(P ＜0.01).(2) The intension and intensity of fluorescence signal of α-tubulin in asthma groups in 8 weeks were higher than control greup(P ＜0.01),and were significantly decreased in Y27632 group.(3) A higher expression of α-tubulin protein was shown in the asthma group in 8 weeks relative to control group(P ＜0.01),and was significantly down-regulated in Y27632 group(P ＜0.05).Conclusions Alteration of the cytoskeleton of airway smooth muscle exists in young asthmatic rats and the RhoA/ROCK signal pathway possibly plays a significant role.

Objective To understand the current status of nursing patentable invention.Methods The patent literature published in nursing journals from 2010 to 2013 were analyzed to obtain related information.Results The results show an increasing trend in the number of patents of patient care;patent inventor distributed in 25 provinces and municipalities, mainly level 3 hospitals (89.86％), nurses with undergraduate degree (76.76％) and senior nurses (50.28％).The patents focused on the life care appliances (such as improved disease clothing, toilet equipments, the cleaning utensils, cutlery improvement, etc.), infusion, injection therapy appliance (such as infusion sets, syringes, dosing auxiliary device, infusion fixtures, etc.), airway care paraphernalia, washing, and drainage equipments, etc.Of all the nursing patents, utility model patents accounted for majority, and only 3 of them were invention patents.Conclusions The trend of nursing patentable invention show good momentum, but the quality needs to be improved.The innovation training for nurses is necessary;and it is also important to increase support to establish an innovation environment.

Objective To improve the knowledge of paediatric pulmonary arterial hypertension(PAH) and to elevate the level of early diagnosis and treatment.Methods The clinical data of 45 PAH patients admitted in Shanghai Children's Hospital from Jan.2006 to Dec.2012 were reviewed,including clinical manifestation,laboratory examination,diagnosis,treatment and prognosis.Results Of the 45 PAH patients,21 cases (46.7％) were male and 24 cases (53.3 ％) were female,with an average age of 2.5 years old.Among them idiopathic PAH was in 24 cases (53.3 ％) and secondary PAH was in 21 cases [including interstitial lung disease in 4 cases,upper airway obstruction in 3 cases,systemic lupus erythematosus in 3 cases,hepatic disease in 3 cases,including hepatic hemangioma 1 case,liver cirrhosis portal hypertension 1 case and autoimmune hepatic sarcoidosis 1 case,tachycardia induced cardiomyopathy in 2 cases,extensive pulmonary small artery stenosis in 2 cases,human immunodeficiency virus (HIV) infection in 1 case,hypothyroidism in 1 case,and familial PAH in 2 cases].Main clinical manifestations were anhelation after exercise (71.1％),fatigue (68.9％),cough (48.9％),chest tightness (26.7％),chest pain (33.3％),syncope (8.9％),et al.The most common physical signs were splitting of the second sound in pulmonary valve area (93.3％),followed by tricuspid murmur (77.8％),cyanosis (53.3％),hepatomegaly (42.2％),hydropericardium (28.9％),and oedema (11.1％),et al.Twenty-seven cases did cardiac catheterization,compared with idiopathic PAH and secondary PAH,pulmonary artery systolic pressure,mean pulmonary artery pressure,pulmonary capillary wedge pressure,pulmonary arteriolar resistance index had significant difference(P ＜ 0.05).Thirty-one cases' condition improved after treatment,11 cases without any improvement and 3 cases died during follow-up visit.Conclusions PAH is a rare disease with no specific symptom and can be easily misdiagnosed in children.Ultrasonic cardiogram and cardiac catheterization are helpful in diagnosis.Actively looking for the cause can improve the prognosis.