Objective To develop Chinese version of the Manchester patient safety framework, and evaluate the feasibility of its clinical application. Methods The Manchester patient safety framework (MaPSaF) was transformed into Chinese version by translation and back-translation together with inquiries from experts. The trial study was done firstly among 136 nurses in five pilot wards and followed by five times of focus-oriented group interviews. A semi-structured, in-depth interview was then performed in 12 randomly selected participants and acquired data were analyzed by category analysis. Result Two themes were abstracted: Chinese version of MaPSaF showed a good practicability, effectiveness and operability and it was effective for deepened understanding of patient′s safety culture. Conclusion The Chinese version of MaPSaF can be used for safety culture evaluation during nursing process in China.

BACKGROUND: Proximal femoral nail anti-rotation is widely used to treat various intertrochanteric fractures. Although its operation trauma is small, and the blood loss of perioperative period is still large. Tranexamic acid has been gradually used to reduce the bleeding of intertrochanteric fracture. The effectiveness and safety of reducing blood loss during perioperative period were not reported. OBJECTIVE: To explore the safety and efficacy of tranexamic acid on perioperative blood loss in patients with intertrochanteric fracture undergoing proximal femoral nail anti-rotation. METHODS: One hundred and eight patients with intertrochanteric fracture undergoing proximal femoral nail anti-rotation were selected from First Affiliated Hospital, Guangzhou University of Chinese Medicine between January 2015 and January 2017. Among all the subjects, 52 patients who received the operation before January 2016 served as the control group and 56 patients who received the operation after January 2016 were selected as the treatment group. Half an hour before operation, patients in the treatment group received 1 g tranexamic acid dissolved in 250 mL normal saline by intravenous dropping; patients in the control group just received 250 mL normal saline by intravenous dropping. The bleeding volume, blood transfusion volume, hemoglobin, hematocrit, coagulation index, D-dimer levels and complications were compared between the two groups. RESULTS AND CONCLUSION: (1) During perioperative period, actual blood loss, intraoperative blood loss, dominant blood loss, recessive blood loss, volume of drainage, blood transfusion volume and blood transfusion rate were lower in the treatment group than in the control group (P < 0.05). (2) There was no statistically significant difference in the hemoglobin and hematocrit between the two groups before operation (P > 0.05). The hemoglobin and hematocrit of the two groups gradually decreased after the operation, and there was a slight improvement in the fifth day after surgery. At postoperative 2 hours, 1, 3 and 5 days, the hemoglobin and hematocrit of the treatment group were higher than in the control group (P < 0.05). At preoperation and each time point postoperation, prothrombin time, activated partial thromboplastin time, and fibrinogen levels were not statistically significant between the two groups (P > 0.05). Postoperative D-dimer levels in the two groups were significantly higher than preoperation, and there was a return on the fifth day. There was no statistically significant difference between groups at preoperation and each time point of postoperation (P > 0.05). (3) The results suggest that the tranexamic acid can effectively reduce the dominant and recessive blood loss in patients with the intertrochanteric fracture, and it is safe and effective.

OBJECTIVETo compare antiproliferation effects of vinblastine nanopraticles and vinblastine water solution in human glioma cell lines BT325.

METHODVinblastine nanoparticles were prepared by emulsion polymerization process and using dextran as a stabilizing agent. It was characterized by means of morphology, size, drug entrapment efficiency and loading efficiency. Human glioma cell lines BT325 were treated with different concentrations of vinblastine nanoparticles and vinblastine water solution for 48 h, Antiproliferation effect was measured by MTT method. Morphological changes were observed by inverted microscope, transmission electron microscope and scanning electron microscope.

RESULTMean diameter of VLB-PBCA-NP was about 74.4 nm, and drug entrapment efficiency and loading efficiency was 78.47% and 39.24%, respectively. Cell growth inhibition rate of vinblastine nanoparticles group and vinblastine water solution group in a concentration range (5-5 000 g x L(-1)) for 48 h was 41%, 49%, 73%, 83% and 28%, 33%, 54%, 60% respectively. Entrapment of VLB in NPS may distinctly degrade absorbency as compared to free drugs. Glioma cell BT325 which treated with VLB water solution were initial stage of apoptosis, and apoptosis body were forming. But VLB NPS-treated BT325 cells were intermediate or end stage, and missed structure integrality.

CONCLUSIONVLB-PBCA-NP and VLB water solution could inhibit the growth of human glioma cell lines BT325, and VLB nanoparticles have stronger inhibition effect compared with VLB water solution in the same dose. PBCA may be effective as promising carrier for the transport of vinblastine into the glioma cells.

Antineoplastic Agents, Phytogenic ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Microscopy, Electron, Transmission ; Nanoparticles ; Vinblastine ; pharmacology

OBJECTIVETo investigate the adaptor protein CRKL phosphorylation level (p-CRKL) and its significance in chronic myeloid leukemia (CML) treated with imatinib.

METHODSABL kinase domain was amplified by nested RT-PCR, domain point mutations analysis by direct sequencing, BCR-ABL mRNA level by real time-PCR, and p-CRKL level by flow cytometry in 52 bone marrow samples from 35 CML patients, and the relationship of p-CRKL level with ABL kinase domain mutation and with BCR-ABL mRNA level was analyzed.

RESULTSIn the 15 imatinib-resistant patients, ABL domain point mutations were detected in 6 with 4 types of nucleotide substitutions: T315I (n = 3), Y253H (n = 1), E255K and F317L. The incidence of mutations in disease chronic phase (CP), accelerated phase (AP) and blast phase (BP) was 25.00%, 40.00% and 30.00%, respectively. The BCR-ABL mRNA level in newly diagnosed CML was higher than that in imatinib-responded patients (P = 0.01); and so did in imatinib-resistant patients than in imatinib-effective patients (P = 0.03). The level of BCR-ABL mRNA was not significantly different between newly diagnosed CML and imatinib-resistant patients. p-CRKL%, MFI showed a high degree of phosphorylation in newly diagnosed CML and imatinib-resistant patients (P = 5.130; P = 3.178). The level of p-CRKL % and MFI in newly diagnosed group was higher than that in imatinib responded group (P = 0.000; P = 0.01) and also higher in imatinib-effective group than in imatinib-resistant group (P = 0.000; P = 0.02). There was a positive correlation between the level of BCR-ABL expression and p-CRKL% (and the MFI of p-CRKL) (P < 0.05).

CONCLUSIONIt seems that p-CRKL detection might be helpful in predicting imatinib treatment outcomes.

Adaptor Proteins, Signal Transducing ; metabolism ; Adult ; Antineoplastic Agents ; therapeutic use ; Benzamides ; Female ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; metabolism ; Male ; Middle Aged ; Nuclear Proteins ; metabolism ; Phosphorylation ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; Young Adult

A variety of biomarkers have been identified in recent prospective and retrospective reports as being potentially predictive of venous thromboembolis (VTE), particularly idiopathic deep venous thrombosis (IDVT). This study identified a serum tumor biomarker for early screening of IDVT. A total of 128 IDVT patients (54 females and 74 males; average age: 50.9±17.4 years) were included. Carcinoembryonic antigen (CEA), ferritin, β2-microglobulin, cancer antigen (CA) 125, CA 15-3, CA 19-9, squamous cell carcinoma antigen (SCC), alpha-fetoprotein (AFP), prostate specific antigen (PSA), free PSA (f-PSA), and beta-human chorionic gonadotropin (β-HCG) in patients with IDVT were detected. Malignancies were histo- or cytopathologically confirmed. Of the 128 IDVT patients, 16 (12.5%) were found to have malignancies. Serum CEA, CA 125, CA 15-3, and CA 19-9 were found to be helpful for detecting malignancies in IDVT patients. Our study revealed a positive association between these markers and tumors in IDVT patients. On the other hand, SCC and AFP were not sensitive enough to be markers for detecting tumors in patients with IDVT. No significant differences were found in positive rates of ferritin and β2-microglobulin between tumor and non-tumor groups, and no significant difference exists in serum levels of ferritin and β2-microglobulin between the two groups. Carbohydrate antigens, CA 15-3 in particular, may be useful for differential diagnosis and prediction of malignancies in patients with IDVT.

Objective To observe the clinical efficacy of acupuncture combined with rehabilitation training in treating qi deficiency and blood stasis type of hypertensive cerebral hemorrhage in the recovery stage.Methods A total of 132 patients with qi deficiency and blood stasis type of hypertensive cerebral hemorrhage in the recovery period were randomly divided into observation group and control group,with 66 cases in each group,the control group was given western medicine conventional treatment combined with rehabilitation training,and the observation group was treated with acupuncture on the basis of the control group.Both groups of patients were treated for 12 consecutive weeks.After 12 weeks of treatment,the clinical efficacy of the two groups was evaluated.The changes of simplified Fugl-Meyer Assessment(FMA),National Institutes of Health Neurological Impairment Scale(NIHSS),and traditional Chinese medicine(TCM)syndrome scores,as well as the changes of serum interleukin 6(IL-6),homocysteine(Hcy),and endothelin 1(ET-1),serum matrix metalloproteinase 9(MMP-9),and brain-derived neurotrophic factor(BDNF)levels were observed before and after the treatment of the patients in the two groups.The changes of serum serine-threonine protein kinase(AKT),phosphatidylinositol-3 kinase(PI3K),and Bcl-2-related X protein(bax)levels were compared between the two groups before and after treatment.Results(1)After treatment,the serum IL-6,Hcy,ET-1 levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the serum IL-6,Hcy,ET-1 levels,and the difference was statistically significant(P＜0.05).(2)After treatment,the serum MMP-9 and BDNF levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving serum MMP-9 and BDNF levels,with statistically significant differences(P＜0.05).(3)After treatment,the serum AKT,PI3K,bax levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving serum AKT,PI3K,bax levels,and the difference was statistically significant(P＜0.05).(4)After treatment,the FMA score,TCM syndrome scores,and NIHSS score of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the FMA score,TCM syndrome scores,and NIHSS score,and the differences were statistically significant(P＜0.05).(5)The total effective rate was 93.34%(62/66)in the observation group and 81.82%(54/66)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Acupuncture combined with rehabilitation training for the treatment of patients recovering from hypertensive cerebral hemorrhage of qi deficiency and blood stasis type can significantly reduce the patient's inflammatory response,regulate the level of neurofactors,inhibit neuronal apoptosis,and promote the recovery of neurological function,and the clinical efficacy is remarkable.

Objective To study the effect of enalapril folic acid on peripheral blood inflammatory factors in type H hypertensive of rats.Methods Sixty Wistar Spontaneous hypertension male rats were randomly divided into control group,model group,enalapril group and enalapril folic acid group,15 rats in each group.Type H hypertensive rat model were established by feeding with 3％ methionine in model group,enalapril group and enalapril folic acid group.And enalapril folic acid group were given 10 mL · kg-1 enalapril maleate folic acid solution,enalapril group were given 10 mL · kg-1 enalapril solution,and the model group were given 10 mL · kg-1 double distilled water,and 4 groups were intervened for 8 weeks everyday.The serum levels of homocysteine (Hcy),serum tumor necrosis factor alpha (TNF-α),hypersensitivity C reactive protein (hs-CRP)and soluble OX40 ligand(OX40L) were measured by enzyme-linked immunosorbent assay.The nitric oxide(NO)level were measured by End-point assay.The structure of carotid artery was observed under microscope.Results Compared with Hcy(64.22 ±6.82) μ mol · L-1 and NO(41.45 ±5.25) μmol · L-1 in the enalapril group,levels of Hcy(19.75 ±2.14) μmol · L-1 were lower,and NO(57.68 ±6.43) μmol · L-1were higher in the enalapril folic acid group with significantly (P ＜ 0.05).Compared with TNF-α (72.72 ± 6.89) pg · mL-1,hs-CRP (1.15 ±0.12) pg · mL-1,OX40L(5.24 ±0.47) ng · mL-1in the enalapril group,levels of TNF-α(58.18 ±5.76)pg · mL-1,hs-CRP(0.86-±0.11) pg · mL-1,OX40L(3.03 ±0.39) ng · mL-1 were lower in the enalapril folic acid group with significantly(P ＜0.05).Compared with the carotid artery IMT (61.14±7.73) μm,and IMCSA levels(0.12 ± 0.02) mm2 in the enalapril group,the carotid artery IMT (52.74±6.29)μm,and IMCSA (0.10 ±0.01) mm2 in the enalapril folic acid group were lower with significantly(P ＜ 0.05).Compared with the levels of carotid artery LD(951.38 ± 6.08) μm in the enalapril group,the levels of carotid LD (969.79 ± 6.17) μm in the enalapril folic acid group was higher with significantly(P ＜0.05).Conclusion enalapril folic acid can effectively reduce levels of peripheral blood Hey,TNF-oα,hs-CRP and OX40L in type H hypertensive rats,improve levels of NO,reduce inflammation,and improve the structure of carotid artery.

Glucose-regulated protein 78 (GRP78) exerts critical influence on endoplasmic reticulum stress (ER stress),carcinogenesis and tumor progression.Cytochrome P450 (CYP450) enzyme is of great importance in the metabolism of drug and carcinogens.This article reviews recent studies on the interaction between GRP78 and CYP450 in order to provide evidence of novel strategies for cancer treatment.

Objective To investigate the nursing adverse events reporting status and their influence factors of nurses in 3A-grade general hospitals,so as to provide evidence for the developmental measures to improve nursing adverse events reporting.Methods The questionnaires of Patient Safety Culture Assessment Scale about Clinical Nurses and Nurses' Cognitive of Adverse Event Reporting were used to survey 1 866 nurses from six 3A-grade general hospitals in Hunan Province.Results The rate of nurses reported voluntarily adverse events was 24.71％.There were statistically significant in different groups divided by age,educational background,position,professional title,service years,type of recruitment and department(P ＜ 0.05).Logistic regression analysis showed that nurses' perception of patient safety culture,the cognition of nursing adverse event report and nurses' professional title entered into the regression equation with the values OR were 177.004,1.813,1.533,R2 =0.554,P ＜ 0.01.Conclusions The rate of nurses reported voluntarily adverse events is low.With the age growing,the service years lengthening,the position heightening,educational background and professional title raising,the rate of nursing adverse events reporting is upgrade.The rate of nursing adverse events reporting of head nurse is significantly higher than general nurses,formal recruitment nurse is higher than no formal.The rate of nursing adverse events reporting of outpatient department nurse is the highest,and ICU,emergency department,gynecology and obstetrics department nurse is significantly lower than that of others.Nurses' perception of patient safety culture,the cognition of nursing adverse event reporting and professional titles are the main influence factors of nursing adverse events reporting.

Adult ; Anti-Retroviral Agents ; therapeutic use ; DNA, Viral ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; therapeutic use ; Male ; Treatment Outcome ; Viral Load