Based on JCI standard,conduct nursing practice area activities themed as the Warmness,Safe and Painless in the emergency department and outpatient department,deepen the connotation of nursing service.Use PDCA to achieve improvement simultaneously.In all these ways,we improved nursing quality,decreased sentinel event and increased satisfactory rate of the patients,enhance the nursing staff ＇s overall image,promote harmonious relations between nurses and patients.

OBJECTIVETo discuss the curative effect of traditional treatment and combination therapy for senile hip fracture.

METHODSUsing prospective methods to choose 300 cases of elderly patients with hip fractures from February 2011 to December 2012, which were randomly divided into comprehensive treatment group and conventional treatment group. After screening, 148 case were in comprehensive treatment group,including 62 males and 86 females with an average age of (78.76 +/- 7.32) years old ranging from 60 to 88; 45 cases were intertrochanteric fracture of femur, 103 cases were fracture of neck of femur; Singh index > or = IV in 74 cases, < IV in 74 cases;preoperative Harris score was 39.90 +/- 2.28. There were 146 cases in conventional treatment group,including 60 males and 86 females with an average age of (80.00 +/- 7.06) years old ranging from 66 to 96; 50 cases were intertrochanteric fracture of femur, 96 cases were fracture of neck of femur; Singh index > or = IV in 75 cases, < IV in 71 cases; preoperative Harris score was 40.10 +/- 2.81. Preoperative general situation,leaving bed time and hospital stay, the incidence of postoperative 12 weeks Singh index > or = IV and DPD/Cr value, Harris score at 12 months after operation and the incidence of fracture again of two groups were observed and compared.

RESULTSIn comprehensive treatment group 140 patients were followed up for 12 to 18 months with an anverage of 14.80 +/- 1.85. In conventional treatment group 132 patients were followed up for 12 to 14 months with an average of 12.75 +/- 0.79. There were no significant differences in age, gender, the classification of fracture, preoperative Harris hip score, preoperative Singh index > or = IV level and DPD/Cr value between the two groups (P > 0.05). Comprehensive treatment group had shorter leaving bed time and hospital stay, smaller postoperative 12 weeks DPD/Cr value and higher postoperative Harris score, higher incidence of postoperative 12 weeks Singh index > or = IV level, lower incidence of fracture again than conventional treatment group, there was statistically significant difference between two groups (P < 0.05).

CONCLUSIONFor the anti-osteoporosis effect, the comprehensive treatment group has more advantage than traditional treatment group in elderly hip fracture, which can further improve the elderly hip fracture treatment and provide the reference of evidence-based medicine cooperate with rehabilitation department.

Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Hip Fractures ; surgery ; Humans ; Incidence ; Length of Stay ; Male ; Postoperative Complications ; epidemiology ; Prospective Studies

AIM: (1) To investigate the effect of amniotic membrane transplantation (AMT) on rabbit conjunctival surface reconstruction with severe alkali burns. (2) To evaluate the possibility of AMT treatment for ocular alkali burns during recovering stage.METHODS: Animal models were established on 30 eyes of rabbits by creating severe alkali burns on the conjunctiva from the upper corneal limbus to the upper conjunctival fornix.Preserved human amniotic membrane transplantations and reconstruction of conjunctival fornix were performed at one week after injury (recovering stage). Epithelium growth of burned area after transplantation was observed using light microscope at 1, 2, 3, 4, and 8 weeks. Conjunctival tissue in transplantation area was collected at 1, 4 and 8 weeks. The ultrastructure of the collected tissue was studied by electron microscope. The results were compared with control group,which received only vitamin C subconjunctival injection and antibiotic eye drops as treatment for alkali burn. Exterior eye pictures were also taken at the end of the observation, the width from upper corneal limbus to the edge of upper fornix was measured. Data was analyzed statistically.RESULTS: 1) Tn the transplant group, conjunctival epithelium growth was observed in the area of AMT under both light and electron microscope 1 week after surgery. At 4weeks, conjunctival epithelium with goblet cells that resembled normal conjunctival tissues was observed in the whole amniotic membrane area. At 12 weeks, the conjunctival epithelium on the amniotic membrane was well formed, and the connective tissue under the epithelium was loose at the fornix. No fibrosis was identified. In contrast, conjunctival epithelium necrosis was observed in the control group at 2weeks after alkali burns. Re-epithelization did not occur through the 12-week observation. Severe fibrosis with inflammatory cells infiltration was observed between 4 to 8weeks. At 12 weeks, fibrosis of the connective tissue at the fornix developed and there were no conjunctival epithelium covering the burned area. 2) In the transplant group, the conjunctiva in transplanted area had no scarring and appeared smooth at 12 weeks. Upper fornix was reconstructed. The depth of fornix was 7.9±0.3mm (7.6-8.2mm), which was approximate to the normal depth 8.2±0.2mm (8.0-8.4 mm,P＞.05). While in the control group, the burned area appeared rough with granuloma formation and severe scarring. Upper fornix became shallow. The depth of fornix was 3.1±1.7mm(1.0 to 4.5mm.), and significant difference was found between control and transplant group (P＜0.01).CONCLUSION: Human amniotic membrane preserved in glycerin can promote cell adhering, migrating and differentiating of normal conjunctival epithelium.Reconstruction of conjunctival surface in early stage of alkali burn can be achieved by AMT. AMT can effectively prevent symblepharon formation.

Objective To evaluate the effect of pretreatment with botulinum toxin A injected intrath?ecally or locally at the incision site on the neurokinin?1 ( NK?1) receptor internalization in the spinal dorsal horn in a rat model of incisional pain. Methods Male Sprague?Dawley rats, weighing 280-300 g, aged 6-8 weeks, were used in the study. The experiment was performed in two parts. ExperimentⅠ Twenty?seven rats with no sign of nerve injury at day 7 after successful catheterization were selected and divided into 3 groups (n=9 each) using a random number table: control group (C1 group), incisional pain group (IP1 group) and intrathecal botulinum toxin A group (BoNT∕A1 group). At 24 h before operation, botulinum tox?in A 0.5 U ( in 10μl of normal saline) was injected intrathecally in group BoNT∕A1, and normal saline 10μl was injected intrathecally in group IP1. ExperimentⅡ Twenty?seven rats were selected and divided into 3 groups (n=9 each) using a random number table: control group (group C2), incisional pain group (IP2 group) and locally injected botulinum toxin A at the incision site group (BoNT∕A2 group). At 24 h before op?eration, botulinum toxin A 2 U ( in 0.4 ml of normal saline) was injected subcutaneously at the incision site and into the plantar surface, and normal saline 0.4 ml was injected subcutaneously at the incision site and into the plantar surface in group IP2. Six rats in each group were selected, and the cumulative pain score (CPS) was recorded, and the mechanical paw withdrawal threshold ( MWT) in the right hindpaw was measured be?fore administration, before operation, and at 3 h and 1, 3, 5 and 7 days after operation. At 3 h after opera?tion, 3 rats in each group were selected and sacrificed, and the lumbar segment ( L4,5 ) of the spinal cord was removed for determination of the expression of NK?1 receptors in the spinal dorsal horn by immunofluores?cence. Results ExperimentⅠ Compared with group C1, the CPS was significantly increased at 3 h and 1, 3, 5 and 7 days after operation, the MWT was significantly decreased at 3 h and 1 and 3 days after opera?tion, and the expression of NK?1 receptors in the spinal dorsal horn was significantly up?regulated in group IP1, and the CPS was significantly increased at 3 h and 1, 3 and 5 days after operation, the MWT was sig?nificantly decreased at 3 h after operation ( P<0.05) , and no significant change was found in the expression of NK?1 receptors in the spinal dorsal horn in group BoNT∕A1 (P>0.05). Compared with group IP1, the CPS was significantly decreased, and the MWT was significantly increased at 3 h and 1, 3, and 5 days after oper?ation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly down?regulated in group BoNT∕A1 (P<0.05). ExperimentⅡ Compared with group C2, the CPS was significantly increased at 3 h and 1, 3, 5 and 7 days after operation, the MWT was significantly decreased at 3 h and 1, 3, 5 and 7 days after operation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly up?regu?lated in group IP2, and the CPS was significantly increased at 3 h and 1, 3, 5 and 7 days after operation, the MWT was significantly decreased at 3 h after operation ( P<0.05) , and no significant change was found in the expression of NK?1 receptors in the spinal dorsal horn in group BoNT∕A2 ( P>0.05) . Compared with group IP2, the CPS was significantly decreased at 3 h and 1, 3, and 5 days after operation, the MWT was signifi?cantly increased at 3 h and 1 and 3 days after operation, and the expression of NK?1 receptors in the spinal dorsal horn was significantly down?regulated in group BoNT∕A2 (P<0.05). Conclusion Pretreatment with botulinum toxin A injected intrathecally or locally at the incision site can inhibit the internalization of NK?1 re?ceptors in the spinal dorsal horn in a rat model of incisional pain.

Objective To investigate the relationship between pleural resonance features and the chest volume and vital capacity in young male adults .Methods A total of 60 healthy young male adults were included in this study .Energy distribution of pleural resonance was measured with the multi-channel voice analysis system when they pronounced /a:/.The frequency spectrums were 0~999 Hz (FR1 ) ,1 000~1 999 Hz (FR2 ) ,2 000~2 999 Hz (FR3 ) ,3 000~4 000 Hz (FR4 ) .Fast 3D reconstruction of chest was detected by multi slice spiral CT to calcu‐late the chest volume .The vital capacity was evaluated by aerodynamics system .SPSS 18 .0 software was used to analyze the data .Results The vital capacity in healthy young male adults was 4 .31 ± 0 .63 L ,the chest volume was 5 .69 ± 0 .52 L .The frequency spectrum of FR1 was 53 .38% ± 2 .14% ,FR2 was 30 .72% ± 1 .59% ,FR3 was 10 . 53% ± 2 .75% ,FR4 was 5 .35% ± 2 .32% ,respectively .There was a highly positive correlation between the chest volume and FR1 (r=0 .854) ,moderately positive correlation between the volume and FR2 (r=0 .740) ,moderately negative correlation between the volume and FR3 (r= -0 .587) ,moderately negative correlation between the volume and FR4 (r= -0 .565);There was a highly positive correlation between the vital capacity and FR1 (r=0 .744) ,mod‐erately positive correlation between the volume and FR2 (r=0 .699) ,moderately negative correlation between thevolume and FR3 (r= -0 .632) ,weakly negative correlation between the volume and FR4 (r= -0 .429) .Conclusion There was a high correlation between the chest volume and pleural resonance ,high correlation between vital capacity and pleural resonance in young male adults ,which may be a influencing factor of pronunciation effect .

Objective To explore the expression and function of miR-125b, miR-30b and miR-424 in endometrial cells. Methods Human endometrial samples were obtained in natural cycles and stimulating cycles. Endometrial epithelial cells (EECs) and endometrial stromal cells (ESCs) were isolated and confirmed by immunofluorescence. The expressions of miR-125b, miR-30b and miR-424 were detected by real-time PCR. Results The expression levels of miR-125b, miR-30b and miR-424 were higher in proliferative phase in ESCs than those in EECs. And in EECs, the expression levels of miR-125b, miR-30b and miR-424 were significantly up-regulated in secretory phase than in proliferative phase, while it was stable in ESCs. In addition, the expressions of miR-125b in EECs and miR-30b were increased in ESCs in women with elevated progesterone on the day of HCG administration than those of the control. The target genes of miR-125b, miR-30b and miR-424 mainly participated in cell migration and motion, cell-cell adherens junction and Wnt signaling pathway. Conclusion miR-125b, miR-30b and miR-424 were differently expressed in endometrial cells in different phases, and may participate in regulation of endometrial receptivity.

Objective To study the effect of different concentration of 1,25-dihydroxyvitamin D3[1,25(OH)2D3] on cell proliferation,differentiation and the expression of vitamin D receptor (VDR) in mouse MC3T3E1 osteoblast.Methods Osteoblast were cultured in medium with different concentrations of 1,25(OH)2D3.Incubated for 48 h,cell proliferation of osteoblast were examined by MTT reduction assay (mono-nuclear cell direc cytotoxicity assay),the osteocalcin (OC) levels in cell medium were detected by ELISA,and the expression of VDR mRNA and protein were examined by using SYBR Green real-time PCR and Western blot,respectively.Results 1.After incubation with 1,25(OH)2D3 for 48 h,the number of MC3T3E1 osteoblast was significantly less than that in control group(P0.05).3.SYBR Green real-time PCR and Western blot results showed that the expression of VDR mRNA as well as VDR protein of osteoblast in 10-8,10-9 mol/L experimental groups were significantly higher than those in control group (Pa0.05).Conclusions Cell proliferation of mouse osteoblast can be inhibited,while the cell differentiation was promoted by 1,25(OH)2D3.1,25(OH)2D3 up-regulated the expression of VDR in mouse osteoblast,which suggested that the VDR signal pathway may play some role in proliferation and differentiation of osteoblast.

Objective:To observe the effect of acupuncture in the treatment of accommodative myopia in children.Methods:A total of 76 children with accommodative myopia who met the inclusion criteria were divided into a control group or a test group according to the random number table method,with 38 cases in each group.The control group was given education on eye hygiene,and the test group was treated with acupuncture twice a week for 2 months in addition to the intervention used in the control group.The patient's uncorrected visual acuity(UCVA),refraction,and axial length(AL)were measured before treatment and 1 month and 2 months after treatment.Results:After 1 month of treatment,there was no significant difference in the UCVA between the two groups(P＞0.05);after 2 months of treatment,the UCVA of the test group was better than that of the control group(P＜0.05).After 1 and 2 months of treatment,the refraction of the two groups was significantly different from that before treatment(P＜0.01),but there was no significant difference between the two groups(P＞0.05).After 1 and 2 months of treatment,the AL in the control group was increased compared with that before treatment(P＜0.05),while there was no significant change in the test group(P＞0.05),and there was no significant difference between the two groups(P＞0.05).Conclusion:Acupuncture treatment can improve UCVA in children with accommodative myopia.

OBJECTIVETo evaluate the effects of policosanol on serum lipid and heme oxygenase-1 (HO-1) in patients with hyperlipidemia.

METHODSThis randomized, open study included 72 patients with hyperlipidemia. The patients were randomly assigned to treatment group (policosanol, 20 mg/d, n = 36) or placebo group (placebo, two tablets/d, n = 36). The levels of serum lipids, hypersensitive C-reactive protein (hs-CRP), HO-1 were assessed before and after 16 weeks treatment. Drug-induced adverse effects and events were recorded during the observation period. The serum HO-1 was measured by ELISA.

RESULTS(1) After 16 weeks, all parameters remained unchanged in the placebo group; the level of TC decreased from (7.01 ± 1.03) mmol/L to (5.66 ± 0.83) mmol/L (-19.4%, P < 0.01), the level of LDL-C decreased from (4.78 ± 0.72) mmol/L to (3.70 ± 0.69) mmol/L (-22.5%, P < 0.01) in the treatment group. TG and HDL-C levels remained unchanged (P > 0.05) while the level of HO-1 significantly decreased from (1.82 ± 1.08) µg/L to (1.45 ± 0.81) µg/L (P < 0.01) and the level of hs-CRP decreased from (3.40 ± 3.64) mg/L to (1.86 ± 2.02) mg/L (P < 0.01) in the treatment group. (2) Safety index was similar between placebo and treatment groups (P > 0.05) and there was no adverse events including allergic reaction, muscle pain in all subjects during the observation period.

CONCLUSIONThe short-term data obtained from this small hyperlipidemia patient cohort suggest that policosanol is a safe lipid-lowering and anti-inflammatory agent for hyperlipidemia patients.

Anti-Inflammatory Agents ; adverse effects ; therapeutic use ; Anticholesteremic Agents ; adverse effects ; therapeutic use ; Fatty Alcohols ; adverse effects ; therapeutic use ; Female ; Heme Oxygenase-1 ; metabolism ; Humans ; Hyperlipidemias ; blood ; drug therapy ; Lipids ; blood ; Male ; Middle Aged

Full-length NS5A gene of the hepatitis C virus was amplified by PCR using plasmid pBAC25 containing HCV nonstructural gene as template. The amplified fragment (about 1.34 kb) was cloned into plasmid pQE32, and the recombinant plasmid pQENS5A was expressed in JM109 strain. The NS5A protein was purified by NiSO4 metal chelating resin, and characterized by Western-blot. Its antigenecity was determined by ELISA. The positive detection rate of anti-NS5A was 75% (69/92) in ninety-two clinic sera. The positive rate of anti-NS5A was 82.5% (33/40) in fourty positive standand sera, and the negative rate of anti-NS5A was 100% (40/40) in fourty negative standand sera. The results showed that the Full-length NS5A proteinn had the higher sensitivity and specificity in the detection of HCV antibody in sera, we suggested that NS5A protein was a useful antigen for blood screening.