Objective To investigate the level and characteristics of working satisfaction of nurses, explore the role of top-up continuing education in clinical nursing work,and provide effective basis for the reasonable nursing post arrangement for nursing administrators. Methods Using cluster sampling method, the general information and the self-designed working satisfaction of clinical nurses questionnaire survey for 926 nurses from 22 three level of first-class hospitals of Guangxi Zhuang Autonomous Region. Results The total score of working satisfaction of the upgraded nurses was higher than that of the junior college nurses. The scores comparison of 6 dimensions which were nursing working identity, the work to be recognized, job autonomy, interpersonal relationship, scientific research and teaching opportunities, personal professional development were (29.25±6.27) points vs. (21.39±5.72) points, (21.96±4.73) points vs. (18.22±3.79) points, (16.67±5.21) points vs. (13.16±4.28) points, (17.83±3.56) points vs. (13.37±4.21) points, (21.32±4.63) points vs. (15.73±5.16) points, (20.51±3.52) points vs. (15.17±4.22) points, the difference was statistically significant (t=3.936, 2.762, 2.936, 3.323, 7.616, 6.215, P<0.05). There was no statistical difference between them in 2 dimensions which were scheduling situation, welfare treatment (P>0.05). Conclusions After upgraded continuing education, the comprehensive quality of nurses has been improved,and the working satisfaction has been improved significantly.

BACKGROUND: Vagus nerve stimulation (VNS) is a neurophysiological therapy (NPT) of refractory epilepsy, which can control the seizure by stimulating the vagus nerve stem in cervical part.OBJECTIVE: To study the effect of intermittent left-side VNS on seizure of epileptic animals, and provide theoretic basis for the interaction of somatic information and that of internal organs.DESIGN: Observation study.SETTING: Department of Neurobiology, Capital University of Medical Science.MATERIALS: The experiment was performed in the Laboratory of Electrophysiology in Department of Neurobiology, Capital University of Medical Science from March 2000 to September 2002. Thirty-four healthy adult SD rats and 8 rabbits, weighting (220-250) g and (2.2-2.5) kg respectively were selected.METHODS: ①Ten rats were intramuscularly injected with (150 000-160 000) U of penicillin (PCN). VNS effects on epileptiform activities of rats were studied by observing the changes in electrocorticogram (ECoG)and behavior of rats before and after VNS.②(0.24-0.48) mg of PCN was injected into the hippocampus of another 8 rabbits to induce epilepsy, and VNS effects on ECoG of epileptic rats were observed. ③Seizures of 16 rats were induced by Kainic acid, and changes in discharge activity of hippocampal neuron, ECoG and behavior of epileptic rats were observed after VNS. ④Seizures of 8 rabbits were induced by cortical injection of strychnine with microinjector, and VNS effects on ECoG of rabbits with epilepsy induced by acute cortical injury were observed.MAIN OUTCOME MEASURES: ①VNS effects on seizure of rats with epilepsy induced by PCN. ②VNS effects on seizure of rats with epilepsy induced by Kainic acid. ③VNS effects on epileptiform ECoG of rabbits with epilepsy induced by strychnine.RESULTS: A total of 34 rats and 8 rabbits were involved in the analysis of results. VNS could remarkably suppress the seizure of epileptic animals,and epileptiform ECoG, epileptiform discharges of hippocampal neuron and behavior significantly changed with the total effective rate greater than 50%. The total effective rate of VNS before seizure was greater than 80%.In epilepsy group indoeed by intramuscular injection of PCN, ECoG and behavior were markedlly aneliorated respectively for 40% and 50% of rats.In epilepsy group induced by injection of PCN in hippocampus, the ECoG was siguificantly ameliorated in 50% rats. In epileptic rabbit group induced by partial injection of strychnine via cerebral cortex, the epilepti form wave iu ECoG was controlled by VNS in 50 % of animals.CONCLUSION: VNS can effectively suppress seizure of epileptic animals. The antiepileptic effect of VNS is associated with cerebral cortical aud hippcampal neurons. Somatic epileptiform activity could be effectively inhibited by the integration of visceral afferent information in cortical and hippocampal parts.

Objective To compare the clinical effect of povidone-iedine cream plus vagina scrubbing with traditional preoperative vaginal preparation method in order to seek a more safe,effective,convenient and efficient method to prepare the vagina.Methods 100 cases of married patients undergoing elective gynecological surgery were divided into the observation group and the control group with 50 patients in each.The observation group adopted povidone-iodine cream plus vagina scrubbing and the control group used traditional method.Two groups were prepared in the vagina before and after taking cervical swabs for bacterial culture to compare the positive rate of bacterial culture.Results Intra-group comparison of vaginal bacterial culture before and after vaginal preparation was significantly different,but no statistical significance was seen between the two groups.Conclusions Vagina preparation with povidoneiodine cream plus vagina scrubbing can not only reduce the workload of nurses but also improve patient comfort degree.

Objective To analyze the outcomes and the prognostic factors of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for acute lymphoblastic leukemia (ALL).Method From Feb.2002 to Feb.2014,a total of 95 patients with ALL were treated with alloPBSCT in our hospital.Of these,73 cases obtained the first CR (CR1),11 cases obtained late CR,7 patients were in relapse and 3 patients suffered from primarily refractory disease (PRD) before transplant.The median age was 26 (4-57) years.Conditioning regimens including total body irradiation (TBI)/ etoposide/semustine/cyclophosphamide or busulfan/semustine/cyclophosphamide were used.Matched sibling transplantation was performed on 68 patients,and matched unrelated donor transplantation was performed on 27 patients.Combination of CsA,MTX and low-dose,short-course mycophenolate mofetil was used for graft-versus-host disease (GVHD) prophylaxis.The average fellow-up was 57 months.Result Hematopoietic reconstitution was achieved in all 95 patients.Five-year estimate of overall survival (OS) was 54.3％,disease free survival (DFS) was 51.2％,relapse rate (RR) was 30.2％ and transplant-related mortality (TRM) was 24.0％.The 5 year OS and DFS were significantly longer in patients with CR1 than in late CR and relapse/PRD patients before allo-PBSCT (P＜0.001).There was no significant difference in OS between the two different conditioning regimens.Multivariate analyses revealed that Ⅱ-Ⅳ aGVHD and cGVHD were correlated with higher TRM,CR1 before allo-PBSCT and TBI were associated with a lower RR,and non Ⅱ-Ⅳ aGVHD and CR1 before allo-PBSCT were favorable factors which were associated with OS and DFS.In the patients with DFS≥1 year after allo-PBSCT,DFS and OS were shorter in patients with cGVHD (P =0.008).Conclusion Allo-PBSCT in adult ALL patients should be performed in CR1.Severe acute and chronic GVHD are not associated with improved survival.

ObjectiveTo study the effect and mechanism of vagus nerve stimulation(VNS) on seizure in animal with epilepsy.MethodsSeizures of 34 rats and 8 rabbits were induced by Penicillin, Kainic acid(KA) and Strychnice respectively. Electrocorticographic(ECoG), electrical activition of hippocampal neurons and behaviour were observed to evidence the effects of left intermittent VNS .ResultsVNS could suppress seizures in animal models with epilepsy. There were significant changes in epileptiform ECoG, discharges of hippcampal neuron and behaviour. ConclusionSomatic seizure can be effectively inhibited by visceral afferent inputs through integration in cortical and hippocampal parts.

Objective To investigate the expressions of regulatory T cell (Treg) and interleukin-35 (IL-35) in patients with cholangiocarcinoma and to explore their clinical significance.Methods Flow-cytometry,PCR,Enzyme-linked immunosorbent assay (Elisa) and immunohistochemistry were used to detect the levels of Treg and IL-35 in peripheral blood and cholangiocarcinoma tissues in 42 patients with cholangiocarcinoma.Healthy volunteers were used as a control group.Result The percentage of Treg cells to CD4 + T cells in patients with cholangiocarcinoma was (5.6 ± 1.7) ％,while that in the normal control group was (2.9 ± 0.8) ％.There was a significant difference between the two groups (P ＜ 0.05).The plasma levels of IL-35 in patients with cholangiocarcinoma was (198.4 ± 81.4) pg/ml,while that in the normal control group was (33.7 ± 18.0) pg/ml.Again,a significant difference was observed between the two groups (P ＜ 0.05).In peripheral blood mononuclear cell,the IL-35 mRNA level was positively correlated with the plasma IL-35 level (p35,R =0.795,P ＜0.05;EBI3,R =0.812,P ＜ 0.05).Immunohistochemical studies showed that FOXP3 + tumor cells and Treg cells increased significantly in tumor tissues.Conclusion Overexpressions of Treg and IL-35 in peripheral blood and tumor tissues of patients with cholangiocarcinoma suggested that they may play important roles in the development of cholangiocarcinoma.

ObjectiveTo study the optimal power of self-made polymeric microcapsules with liquid perfluorocarbon enhancing high intensity focused ultrasound (HIFU) ablation of normal bovine in vitro and the treatment efficacy of HIFU ablation of normal rabbit liver in vivo.Methods The experiment was divided into two parts:the first part was HIFU ablation of bovine in vitro:The bovine was injected different drugs before HIFU ablation to find the optimal power and treatment time.It was divided into four groups:①HIFU + 0.9％ NaCl(NACL) group; (② HIFU + poly( lactic-co-glycolic acid) (PLGA) group; ③ HIFU + perfluorohexane(PFH) group; ④ HIFU + PLGA + PFH group; The second part was HIFU ablation of normal rabbit liver.Similarly,It was also divided into four groups as above.Each group was undergone HIFU ablation with same parameters after ear vein injection of drug.Then the ultrasonographic changes and its value,and the actual situation of liver damage in target areas of each group were observed and compared before and after the ablation area.ResultsIn experiments of vitro bovine,gray scale changes and coagulation necrosis could be seen in the liver in group 2,3,4 with HIFU power of 150 W and treatment time of 2 s.In experiment of normal rabbit liver,the average gray-scale of group 3 and 4 were larger than that in group 1 and 2,the difference was statistically significant (P ＜0.001),and its gray change area gradually reduced with time elapsed.While there was no statistically significant difference between group 3 and 4 ( P ＞0.05).In pathological specimens,there was no significant liver damage in group 1 and 2.There was hemorrhagic necrosis and white coagulation necrosis in group 3 and 4.Conclusions The polymeric microcapsules with liquid perfluorocarbon can effectively enhance the efficacy of HIFU ablation and be used as a good synergist for HIFU.

BACKGROUND:Previous experiments have prepared shape memory polymer based on D,L-poly(lactic acid). According to domestic technical requirements for biological y evaluating biomaterials and medical equipments, tissue-engineered grafts must be subjected to preclinical experiment for biosecurity and cytocompatibility evaluation.
OBJECTIVE:To observe the biosecurity of the shape memory polymer based on D,L-poly(lactic acid).
METHODS:(1) Bacterial endotoxin test:polymer extract, endotoxin working standard solution and checking
standard water were added into limulus reagent, respectively. (2) Sensitization test:Polymer extract+Freund’s complete adjuvant+physiological saline and Freund’s complete adjuvant+physiological saline were injected into the scapula of Kunming mice. After induction by intradermal injection, local induction and excitation, stimulate skin erythema and edema degree were observed in animals. (3) Acute toxicity test:Kunming mice received intraperitoneal injection of 100%, 50%, 25%polymer leaching solution and physiological saline, respectively. (4) 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay for cel proliferation:The direct method was that human umbilical cord vascular endothelial cel s were inoculated onto the polymer film, lactic acid and glass, respectively;the indirect method was that human umbilical cord vascular endothelial cel s were inoculated into the polymer leaching solution, acrylamide solution and 1640 culture solution.
RESULTS AND CONCLUSION:This shape memory polymer based on D,L-poly(lactic acid) is free of bacterial contamination in compliance with the biosecurity standards, and it has no al ergenic and toxicity but has good cytocompatibility.

Objective To observe the effects of Salvia injection on the brain pathology,expression of synaptophysin and the synaptic ultrastructure at different time points in neonatal rats after hypoxic-ischemic brain damage (HIBD).Methods One hundred and fifteen healthy newborn SD rats of 7-day-old were randomly divided into normal group,sham group,Salvia high dose group,Salvia low dose group,and the HIBD model group.The HIBD model was prepared by ligation of the left carotid artery combined with hypoxic environment.The rats(in normal group,sham and HIBD model groups) were injected with sterile saline[9.0 mL/(kg · d)],while the rats in high and low dose groups were injected with Salvia injection [9.0 mL/(kg · d) and 4.5 mL/(kg · d) respectively].The intraperitoneal injec tion lasted for 7 and 14 days.The rats' brains were collected at one day,7 days and 14 days after the modeling respec tively.The specimens of brain tissue were observed through hematoxylin-eosin (HE),the expression of synaptophysin (SYP) was determined by using immunohistochemistry method,and the synaptic ultrastructure in the frontal cortex was observed through transmission electron microscope.Results Finally,106 newborn rats were included in statistics analysial.(1)General observation:after HIBD modeling,the neonatal rats were mostly in the left-lateral position,with difficulties in turning over,balance abnormalities,limb shaking and other abnormal behaviors,and the delay of eyes open with the left upper eyelid ptosis.(2) Pathology:the disordered and deep stained nerve cells,the degenerated and necrotic neurons were observed in the brain tissues of the HIBD model group.(3) Expression of synaptophysin:mean density of SYP in the HIBD model group was significantly lower than the normal group on day 1,day 7,and day 14 (P ＜0.05);the SYP expression in the Salvia intervention groups increased compared with the HIBD model group(P ＜ 0.05).(4) Synaptic ultrastructure:the incomplete structure of the frontal cortex neurons,the swelling organelle and the synaptic structure damage were observed in the HIBD rats.Compared with the HIBD model group,the neuronic and synaptic ultrastructure were improved by the intervention treatment of high and low dose Salvia injection.Conclusions The mechanism of Salvia injection in treatment of neonatal rats with HIBD may be associated with the improvement in neuronal ultrastructure and synaptic reorganization.

Objective To assess the patient enablement level in a general hospital and its related factors,to investigate the relationship of patient enablement with patient's overall satisfaction and doctor's empathy levels.Methods Patients attending the Family Medicine Clinic of HKU-Shenzhen Hospital in September 2014 and met the inclusion criteria were asked to complete a questionnaire survey which included general characteristics,overall satisfaction;the Patient Enablement Instrument (PEI) and the Consultation and Relational Empathy Measure Scale (CARE) after the consultation.Results Total 2 326 questionnaires were issued and 1 818 were retrieved,of which 1 478 were qualified questionnaires.The qualified rate of PEI was 81.3％ and the qualified rate of patient overall satisfaction was 96.28％.The positive rate of patient enablement was 97.70％ (1 444/1 478),and the mean score of PEI was 8.21 ±3.33.Multivariate linear regression analysis showed that the PEI scores were not influenced by gender and education level of the patients,gender of the consulting doctors and initial/follow up consultation.The PEI scores were influenced by the age of the patients,the types of clinic (general practice/chronic practice clinic) and the reasons for consulting (P ＜ 0.05).There were correlations between PEI score and overall satisfaction of patients (r =0.383,P ＜ 0.001),patient's recommendation of the clinic (r =0.595,P ＜ 0.001) and CARE scores (r =0.546,P ＜ 0.001).Conclusion The results show that the PEI scores of patients visiting family medicine clinic of this hospital are higher than those reported in other studies.The PEI score may be influenced by the age of the patients,the types of clinic and the reasons for consulting.Positive correlations between patient enablement and the overall satisfaction,patient's recommendation and doctor empathy were observed.