Objective To observe the protective effect of probiotics VSL # 3 on the rats of trinitrobenzene sulphonic acid (TNBS) induced acute colitis, and the effect on the expression of tight junction proteins claudins (claudinl, 2, and 3) in colon mucosa. Methods Rat of colitis model was induced by TNBS one time enema. Since the second day after the model established, 2ml 0.9％ sodium chloride was intragastric administrated into 8 rats each day (TNBS group), 8 rats with 100 mg VSL # 3 (VSL # 3 group ), another 8 rats with 5-aminosalicylic acid (5-ASA) intragastric administration (5-ASA group), and 0.9％ sodium chloride was intragastric administrated daily into 5 no modeling rats as control group. All were treated for 7 days and then sacrificed. Fecal samples were collected for bacterial culturing and detecting the changes of colon bacteria colonies. Disease activity index (DAI was calculated according to diarrhea, hemafecia and weight. The colon tissue was taken for HE staining and the pathological changes were observed under microscope.The changes of myeloperoxidase (MPO) level in colon tissue were examined by enzyme-linked immunosorbent assay (ELISA). The expression and distribution of claudins 1, 2, and 3 in colon tissue was detected by a novel quantum dots immunofluorescence labeling technique. Results Compared with TNBS group,both VSL # 3 and 5-ASA treatment could improve colitis, as well as decreas DAI and colonic MPO level, and lower the inflammatory score of colitis. Compared with control group, the bacteria counting in the colon of colitis rats changed, the expression of Claudins 1, 2, and 3 expression was significantly increased (average density: 66.200±5.737, 71.780±6.670 and 61.300±5. 199,t＝17.237, 27.909and 21.788, all P＜0.01). Compared with TNBS group or 5-ASA group, VSL# 3 could adjust the balance of intestinal bacteria and increase the expression of Claudin 1 and 3 (Claudin 1 : 75. 550 ±8.717, 66.200±5.737 and 67.080±5.401;t＝9.348, 8. 469; all P＜0.05; Claudin-3: 68. 820±7.443, 61.300±5. 199 and 59. 830±5. 930;t＝7. 519, 8. 988, all P＜0.05), however claudin 2 expression was down-regulated (58. 740±6. 457, 71. 780±6. 670 and 66. 870±5. 791; t＝ 13. 033,P＜0.01, t＝8. 123, P＜0. 05). Conclusion Probiotics VSL# 3 may enhance the intestinal mucosal barrier function through changing the claudins expression, and play a role in the relief of inflammatory reaction in acute colitis.

One hundred and sixteen patients with lower limb fracture were screened by Doppler ultrasound for deep vein thrombosis(DVT) of bilateral lower extremities within the first 72 h, d7 and d21 after fracture. Results showed that DVT was detected in 31 (26. 7% ) out of 116 cases within 72 h; at d7 and d21 DVT was detected in 3 and 1 patient respectively with a cumulated DVT rate of 30. 2% in 3 weeks.Serial Doppler ultrasonography is of value in screening for DVT of the lower extremities in patients with lower limb fracture at early stage.

Objective: To explore the value of high frequency probe combined with end scan convex array probe transperineal ultrasonography for diagnosis of anal fistula. Methods: Data of 87 patients with anal fistula who underwent surgical treatment were retrospectively analyzed. All patients were examined with ultrasonography using 5-12 MHz linear array probe combining with palpation and visual examination for detection of external mouth and fistula before operation, also perineum ultrasound using 3-10 MHz end scan convex array probe for detection of internal mouth and typing and location of anal fistula. The consistency between results of ultrasound and surgical operation was analyzed. Results: Among 87 patients, 73 cases were diagnosed as simple anal fistula and 14 as complex anal fistula, with a total of 93 internal mouths, 101 fistula canals and 94 internal mouths were detected with surgical operation. Ultrasound correctly diagnosed anal fistula in 66 patients, missed anal fistula in 15 cases and misdiagnosed 6 cases, the coincidence rate of ultrasound and operation was 75.86% (66/87), the Kappa value was 0.344 (P<0.001).The accuracy of ultrasonography in diagnosing internal mouth, fistula canal and external mouth of anal fistula was 80.65% (75/93), 83.17% (84/101) and 87.23% (82/94), respectively, the Kappa value of consistency with operation results was 0.298, 0.407 and 0.626, respectively (all P<0.001). Conclusion: High frequency probe combined with end scan convex array probe transperineal ultrasonography is helpful to diagnosis of anal fistula.

Objective To investigate the influence of parental compliance on the therapeutic effect of children with epilepsy.Methods Two hundred and sixty children with epilepsy and their parents admitted to the First People's Hospital of Wenling from December 2013 to June 2016 were enrolled,and the classical Morisky medication adherence questionnaire (MMAS-8) was applied to evaluate the compliance of parents for treatment of their children with epilepsy;after the patient taking drug for 3 days,fasting venous blood was collected in the morning,the concentration of the blood drug was tested and the influence of parent compliance on the blood drug concentration of the child with epilepsy was evaluated.Results In 260 patients,122 cases took karma form,and 138 cases took valproate orally.There were parents with good medication compliance in 130 cases (50％),medium medication compliance 80 cases (30.76％) and poor adherence to the doctor order in 50 cases (19.23％).In cases using medication irregularly,there were 26 cases sometimes without taking any drug (10.0％),17 patients' medication being interrupted (6.54％) and 10 cases having excessive medication (3.85％);no relationships were found between parental compliance and each of the following items,family role,occupation and age (all P ＞ 0.05);and the compliance was related to gender,indicating that women's good compliance level was higher than that of males';the education level was positively proportional to the compliance,and the compliance of parents with senior high school or above degree was higher than those with primary school and junior secondary school levels (83 cases vs.9 cases,38 cases,both P ＜ 0.01).Under situation of parents with poor compliance,their children had blood drug concentration higher or lower than proper range of drug level (high in 22 cases,low in 41 cases,higher than the result in good compliance 0 cases and 17 cases respectively),thus seriously affected the safety and efficacy of the treatment;the patients' frequency of irregular medication in parents' good compliance group was significantly lower than that in parents' poor compliance group [3.08％ (4/130) vs.72.0％ (36/50),P ＜ 0.05].Conclusion To improve the therapeutic effect of epileptic children,their parental good cooperation is necessary.

The quality of SCI papers is one of the objective indexes of evaluation on scientific and technological strength and research capabilities.This paper introduced a comprehensive management strategy to promote the publication of SCI papers with high impact factors,in terms of such dimensions ass research orientation,financial and technical support,personnel training,and scientific research management platform.The short and long term effects of the comprehensive management strategy system were analyzed using the SCI papers publication data and IF data from 201 1 to 2014 at the hospital,as a reference for building a scientific management system of SCI papers for the administrators.

ObjectiveTo investigate the temporal features of renal injury in rats with severe heat stroke (SHS) and their relationship with inflammatory response.Methods Fifty-six male Wistar rats were randomly divided into normal control group and SHS for 0, 2, 6, 24, 48, 72 hours group (SHS-0, 2, 6, 24, 48, 72 h groups), with 8 rats in each group. Rats were placed in an artificial climate chamber [temperature (39.5±0.2)℃, humidity (60±5)%] to induce SHS model, and the criterion for successful model reproduction was the onset of lowering peak systolic blood pressure (SBP). Then the rats were transferred to room temperature (23.0±0.2)℃ after successful reproduction of the model. The rats of normal control group were kept in room temperature of (23.0±0.2)℃. Heart blood and renal tissue samples were harvested, and the levels of serum creatinine (SCr) and blood urea nitrogen (BUN) were determined by automatic biochemistry analyzer. The levels of myeloperoxidase (MPO), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) in renal tissue specimens were determined by enzyme linked immunosorbent assay (ELISA). The changes in histopathology in kidney were observed with light microscopy, and Paller scores were used to assess the degree of renal injury.Results Compared with normal control group, the levels of SCr and BUN in serum, and MPO, TNF-α and IL-6 in the renal tissue homogenate were significantly increased in SHS-6 h group [SCr (μmol/L): 174.0±27.0 vs.68.0±11.3, BUN (mmol/L): 12.6±2.3 vs. 4.3±1.2, MPO: (203.0±38.0)% vs. (100.0±1.4)%, TNF-α: (121.0±16.0)% vs. (100.0±1.4)%, IL-6: (118.0±19.0)% vs. (100.0±1.3)%, allP< 0.05], and they peaked at 24 hours [SCr (μmol/L): 489.0±96.0 vs. 68.0±11.3, BUN (mmol/L): 19.3±5.7 vs. 4.3±1.2, MPO: (511.0±41.0)% vs. (100.0± 1.4)%, TNF-α: (399.0±47.0)% vs. (100.0±1.4)%, IL-6: (473.0±56.0)% vs. (100.0±1.3)%, allP< 0.01], then declined to the normal levels at 72 hours. Under light microscopy, tissue edema and necrosis of renal tubules were found, and leukocyte infiltration was found to be most profuse at 24 hours, then they returned to normal levels at 72 hours. Paller scores in SHS-6 h group were significantly higher than those of the normal control group (75.45±9.70 vs. 14.23±3.26,P< 0.01), and it peaked at 24 hours (186.00±14.25 vs. 14.23±3.26,P< 0.01), followed by a gradual lowering, back to normal level at 72 hours.ConclusionThe results suggest that progressive renal damage occurred in the rats with SHS within 24 hours, and it was accompanied with elevated levels of MPO, TNF-α and IL-6 in the kidney homogenate, suggesting that inhibition of neutrophil activation and the release of IL-6, TNF-α may protect the SHS associated renal injury.

Objective To investigate community nurse′s transcultural self-efficacy and analyze the influencing factors. Methods The sample consisted of 467 randomly selected community nurses form 15 community hospitals in Shanghai. The transcultural self-efficacy tool ( TSET, Chinese version) was used to investigate influencing factors and we analyzed the factors. Results The average point of transcultural self-efficacy was (7. 29 ± 1. 60); 3 dimensions′ point from high to low, the average point of them were cognition (7. 53 ± 1. 76), emotion (7. 21 ± 1. 73), communication ability (7. 15 ± 1. 71). Different departments and English levels were correlated with transcultural self-efficacy. The age, professional title, international experience were influencing factors of transcultural self-efficacy. Conclusions The transcultural self-efficacy of community nurses are in medium level in Shanghai. Nursing administrators should take measures to improve the transcultural self-efficacy of community nurses.

Objective To investigate the status of self-management in patients with chronic heart failure (CHF) in Zhejiang province, and to explore the relationship between the self-management level and medical coping styles. Methods From March to September 2016, using the convenient sampling method, a total of 450 aged patients with chronic heart failure from 5 Class Ⅲ Grade A hospitals in 3 districts including Ningbo, Pinghu and Jiaxing of Zhejiang province, who were hospitalized in the Cardiovascular Department, were recruited as research subjects. The Self-Management Scale of Heart Failure Patients and Medical Coping Modes Questionnaire (MCMQ) were applied in the investigation to carry out the correlation analysis. Results A total of 450 questionnaires were distributed, and 437 valid questionnaires were collected. The Self-Management Scale of Heart Failure Patients in the 437 patients were (51.48±10.77) in total score, (18.90±3.10) in facing coping style, (16.12±2.18) in avoiding coping style and (11.85±1.82) in yielding coping style. Pearson correlation analysis showed that the total score of self-management was positively correlated with facing coping style (r=0.303, P＜0.01), negatively correlated with yielding (r=-0.157, P＜0.01), and positively correlated with avoiding coping style (r=0.117, P＜0.01). Multiple linear stepwise regression analysis showed that family monthly income, self-care ability and marriage were the main factors affecting self-management of patients with chronic heart failure. Conclusions Self-management level in patients with chronic heart failure in Zhejiang province is relatively low, and effected by family income, self-care ability, marriage and other factors. Nursing staff should understand different characteristics of different patients to provide personalized health education, improve their self management level, and promote the patients more actively face the disease, reduce and avoid negative medical coping.

bjective? To deeply understand the psychological needs of patients with postpartum depression and to provide a reference for medical and nursing workers to improve preventive healthcare and interventive therapy for patients with postpartum depression. Methods? Totally 12 patients with postpartum depression from the Department of Obstetrics of a Class Ⅲ Grade A general hospital in Shanghai were selected using purposive sampling and interviewed face-to-face in-depth semi-structurally using phenomenological methods in qualitative studies from October 2017 to April 2018. Colaizzi data analysis principle was used to organize and analyze the data and refine the themes. Results? Totally 3 themes were refined, namely, support needs of consistent culture among family members, obtainment needs for care knowledge, and anticipation needs for medical and nursing workers in obstetrics. Conclusions? Patients with postpartum depression show extensive psychological needs. Medical and nursing workers should guide their family members to provide cultural support consistent with the puerpera according to their psychological needs, provide care knowledge from multiple perspectives, maintain beneficial folk care habits, enhance the psychological health service capability of themselves, and set up psychological counselling outpatient service for pregnant women so as to meet the psychological needs of patients with postpartum depression.

Objective:To investigate the clinical effect of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity with non-alcoholic fatty liver disease (NAFLD).Methods:The clinical data of 115 obese patients with NAFLD who underwent LSG surgery at Beijing Tiantan Hospital were analyzed.Results:LSG was successful in a 115 patients, and the body weight and BMI decreased gradually, and were significantly lower than the preoperative level (all P<0.001). EWL% increased and was 73.1%±30.1% at 12 months after operation. The postoperative triglyceride level decreased and was significantly lower than the preoperative level (all P<0.05). Most patients were complicated with abnormal liver function before surgery, and ALT, AST and GGT levels decreased to the normal range 3 months after surgery (all P<0.05). Albumin level was significantly higher 3 months after operation than before operation ( P<0.001). At 12 months postoperatively, the severity grade of fatty liver on ultrasound was significantly lower than that before surgery ( P<0.001). Conclusion:Laparoscopic sleeve gastrectomy can significantly improve lipid metabolism index, liver function index and fatty liver index in NAFLD patients along with weight loss .