Objective To investigate the nursing intervention on the effect of diagnosis and treatment of emergency patients with urolithiasis. Methods 98 patients with urolithiasis in emergency department of our hospital from January 2009 to January 2011 were randomly assigned into the observation group and the control group with 49 cases in each group. The control group received routine care, on this basis the observation group was given systemic nursing intervention. The tolerance, SAS score and satisfaction degree was compared. Results 40 patients in the observation group was well tolerated, accounting for 81.6%, significantly higher than 63.3% of the control group. SAS score and satisfaction degree of the observation group were significantly better than the control group. Conclusions Nursing intervention for emergency patients with urolithiasis can significantly reduce pain, improve the mental state and increase their satisfaction degree, which is worthy of clinical application.

Objective To investigate the effect of inhaled pravastatin on the acute inflammation of lung in smoked rats.Methods 32 male SD rats were randomly divided into four groups(n=8 per group),as the controls,cigarette-smoking exposure group,saline or pravastatin treatment groups.The rats in the control group were treated routinely,the other groups were exposed to cigarette smoking for one week.Rats in saline or pravastatin group were treated with saline or pravastatin inhalation respectively.During smoking exposure period rats were weighted before and after the treatment,executed at day eight,blood,bronchoalveolar lavage fluid(BALF),and lung tissue were collected.The morphological alternations of lung tissue were observed.Total cell numbers in BALF were counted.Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of serum IL-10 and IL-17 content.Results The increase of body weight of smoke-exposed rats were less than that of the controls.In smoking-exposed rats,acute inflammatory changes were remarkable in the lung.The total cell numbers in BALF and levels of IL-10 were increased significantly(P<0.05).These changes were mitigated in pravastatin treated rats and an IL-10/IL-17 rebalance was observed.Conclusion Inhalation of pravastatin sodium has a certain inhibitory effect on cigarette smoke-induced acute lung inflammation in rats.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

BACKGROUND: Electromagnetic pulse (EMP) radiation can affect the learning and memory function of experimental rats and induce injury of hippocampal issues and change of ultrastructure of rats.OBJECTIVE: To observe the effects of EMP on injury of hippocampal neurons cultured in vitro and [Ca2+]i, and analyze deeply possible mechanism of cerebral injury induced by EMP.DESIGN: Randomized controlled animal experiment.SETTING: Department of Pathology, Chengde Medical College.MATERIALS: Several Wistar neonate rats, of either sex (half and half),were selected. Source of EMP radiation was high intensity EMP dummy source.METHODS: The experiment was performed from March to December 2004 at the Academy of Military Medical Science and Chengde Medical College, respectively. Several Wistar neonate rats were decapitated to take out the brains under narcotization. Hippocampal tissues were isolated. The cell suspension was adjusted to 5×108 L-1 for inoculation. Grouping: ①Cultured cells were assigned into control group and radiation group. Cells were collected immediately after radiation to perform observation of morphology and determination of free calcium ion concentration. ②Other cultured cells were divided into control group, 0-hour radiation group and 12-hour radiation group. Cell apoptosis rate and necrosis rate were determined. (Dosage of cultured cells: one culture flask of each group was checked in each item for 3 times). EMP radiation was in 6×104 V/m, with pulse rise time of 20 ns,pulse width of 30 μs, frequency of 2.5 pulses/min, totally for 2 minutes.EMP radiation was performed in primary cultured hippocampal neurons,and then morphological change of neurons was observed under inverted phase contrast microscope before and after radiation. Cell apoptosis and necrosis were measured with FACS method; Free [Ca2+]i concentration in neurons was measured with Fluo-3-AM fluorescent probe loading and laser confocal microscopy scanning.MAIN OUTCOME MEASURES: Morphological change of neuron, cell apoptosis rate and necrosis rate and free [Ca2+]i concentration.RESULTS: ①Immediately after EMP radiation, the onset of colliquation appeared in nerval cells gradually, and neurite was recovery and degeneration. ②Apoptosis rate after 12-hour EMP radiation recovered as compared with that at hour 0 after radiation, but significantly increased as compared with the control group [(59.27±1.27)%, (72.17±6.21)%, (17.45±5.63)%,P＜0.05]. ③Necrosis rate at hour 0 and hour 12 after radiation increased as compared with the control group, but there was no statistical significant difference [(13.71±2.31)%, ( 11.96±1.04)%, (8.45±0.67)% ,P ＞ 0.05].④[Ca2+]i fluorescence intensity at hour 0 after EMP radiation was higher obviously than that in the control group (107.34±26.14,54.93±16.08,P ＜ 0.05).CONCLUSION: EMP induces morphological injury, necrosis and increase of apoptosis rate in hippocampal neurons, and Ca2+ fluorescence intensity increases markedly in neurons.

BACKGROUNDTo analyze clinicopathological correlation of detection of lung cancer micrometastasis in regional lymph nodes (LNs) by reverse transcriptase-polymerase chain reaction (RT-PCR).

METHODSRegional LNs (n=261) were obtained from 40 patients with lung cancer who underwent lobectomy. Each LN was bisected. Half of each LN was subjected to histological examination (HE) and the other half was subjected to RT-PCR amplification of CK19 mRNA.

RESULTSIn 18 of 40 patients, the metastasis in regional LNs was found by both HE and RT-PCR. Of 22 N0 diseases diagnosed by HE, 6 (27%) were found to express CK19 mRNA in regional LNs. According to the results of regional LNs metastasis in 40 patients by CK19 RT-PCR, the presence of the CK19 product in LNs was related to tumor size (Chi-square=5.76, P < 0.025), the presence of tumor vascular invasion (Chi-square=3.88, P < 0.05), cell differentiation of the tumor (Chi-square=7.08, P < 0.01) and P-TNM stages (Chi-square=7.42, P < 0.01). In the histologically node-negative patients, lymph node micrometastasis was significantly related to tumor size (P=0.038, exact test) and P-TNM stage (P=0.01, exact test). However, the results of routine histological examination did not show the above clinicopathological correlation (P > 0.05).

CONCLUSIONSThe RT-PCR method is superior to routine histological examination in detecting metastasis in LNs. The micrometastasis in LNs can be detected accurately by RT-PCR. It is helpful for screening the patients in whom the early subclinical metastasis exists and disclosing the intrinsic rule of malignancy metastasis.

Objective To study the effects of pravastatin sodium on the release and activity of neutrophil elastase ( NE) in human neutrophile granulocyte induced by lipopolysaccharide( LPS) . Methods Human neutrophile gran-ulocyte were isolated by Ficoll density gradient centrifugation, neutrophils and intracellular azurophilic granules were identified by myeloperoxidase( MPO) staining, LPS stimulated degranulation of neutrophils. The MPO activity in the supernatant was measured by colorimetric assay to determine the appropriate stimulus time and concentration, and neutrophil was treated with pravastatin sodium after LPS stimulation. ELISA mothed was used to detect the cell culture supernatant of NE content and NE activity was detected by colorimetric method. Results The content and activity of NE in the supernatant were significantly increased after LPS stimulation. The NE in the supernatant of the cells treated with pravastatin was significantly lower( P＜0.05) . Conclusion Pravastatin sodium can reduce neutrophil degranulation induced by LPS stimulation and decrease the release and activity of NE.

Objective: To investigate the reproductive health status of female workers in petrochemical industry, and to provide a reference for improving reproductive health status and developing preventive and control measures for female workers in petrochemical industry. Methods: A face-to-face questionnaire survey was performed from January to October, 2016. The Questionnaire on Women's Reproductive Health was used to investigate the reproductive health of female workers in petrochemical industry. The multivariate logistic regression model was used to identify the influencing factors for reproductive health of female workers in petrochemical industry. Results: Among the 7485 female workers, 1 268 (40.9%) had abnormal menstrual period, 1 437 (46.4%) had abnormal menstrual volume, 177 (28.5%) had hyperplasia of mammary glands, and 1 807 (24.6%) had gynecological inflammation. The reproductive system diseases in female workers in petrochemical industry were associated with the factors including age, marital status, education level, unhealthy living habits, abortion, overtime work, work shift, workload, video operation, occupational exposure, positive events, and negative events, and among these factors, negative events (odds ratio[OR]= 1.856) , unhealthy living habits (OR=1.542) , and positive events (OR=1.516) had greater impact on reproductive system diseases. Conclusion Many chemical substances in the occupational environment of petrochemical industry can cause damage to the reproductive system, which not only affects the health of the female workers, but also poses potential threats to the health of their offspring. Occupational exposure, unhealthy living habits, overtime work, and work shift have great influence on reproductive system diseases in female workers.

Objective To study the postpartum pelvic floor rehabilitation on the improvement of pelvic floor electrical physiological indexes and the prevention of female pelvic floor dysfunction in China. Methods A multicenter prospective randomized controlled study was carried out. From October 2011, postpartum women in five provinces were randomly assigned into treatment group and control group. The women in treatment group received electrical stimulation and biofeedback treatment. The women in control group performed pelvic floor muscle exercise at home. When 6 months and 12 months after delivery, comparing two groups of patients with pelvic floor electrical physiological indexes and pelvic organ prolapse quantitation measurements (POP-Q), to evaluate the effect of postpartum pelvic floor rehabilitation on the prevention of pelvic floor dysfunction. Pelvic floor impact questionnaire short form (PFIQ-7) and pelvic organ prolapse/incontinence sexual questionnaire-12 (PISQ-12) were used to evaluate the influence on quality of life and sexual life. Results Until June 2013, 324 women were participated, 124 in control group, 200 in treatment group. According to the baseline results, there was statistical significance in the results of pelvic floor electrical physiological indexes between the treatment and control groups in postpartum 6 months and 12 months; the proportion above level Ⅲ of type Ⅰ and type Ⅱ muscle fibers strength in the treatment group, it was from 41.5% (83/200) and 40.5% (81/200) to 76.3% (145/190) and 79.5% (151/190) in postpartum 6 weeks and postpartum 6 months, increased to 80.6%(58/72) and 80.6%(58/72) in postpartum 12 months, improved significantly comparing with the control group (P<0.01). According to Point Aa, treatment group and control group in the postpartum 6 weeks was (-2.2 ± 0.7) versus (-2.4 ± 0.6) cm, in postpartum 12 months (-2.5 ± 1.1) versus (-2.7 ± 0.6) cm, the improvement in treatment group was statistically significant (P<0.01). And the other points were not significantly different (P>0.05). There was no significant difference in the questionnaires in quality of life and quality of sexual life (P>0.05). Conclusion Neuromuscular electrical stimulation and biofeedback therapy in the early postpartum period could obviously improve pelvic floor electrical physiological indexes, and is beneficial to prevent the pelvic floor dysfunction.

To investigate the role of CD4+, CD25+, and CD127low regulatory T cells (Tregs) in multiple myeloma (MM). Methods:Levels of CD4+T cells and Tregs, as well as expression of CTLA-4 and apoptosis-related proteins, such as CD95, bcl-2, and Caspase3 of Tregs in peripheral blood of 30 patients with newly diagnosed cases, 27 patients under of complete remission (CR) from multiple myeloma patients, and 25 healthy adults were analyzed by flow cytometry. Results:The percentage of CD4+T cells in the untreated group was significantly lower than that of the control group (P<0.05). The percentage of Tregs in CD4+T cells in the untreated group was significantly higher than that of the CR group and control group (P<0.05), which in ISSⅢpatients of the untreated group was significantly higher than that in I/II(P<0.05). No significant difference of CD95 expression in Tregs was observed among the three groups. The expression of CTLA-4 in Tregs from the untreated group was significantly higher than that of the CR group (P<0.05) and control group (P<0.01), and so was in CR group than this in controls (P<0.05). The expression of bcl-2 in Tregs in the untreated group was significantly higher than that of the CR group (P<0.05) and control group (P<0.01), and so was in CR group than this in controls(P<0.05). The expression of Caspase3 in Tregs from the untreated group and CR group were all significantly lower than that of the control group (P<0.05). The percentage of Tregs in CD4+T cells in the untreated group was positively correlated with the proportion of bone marrow plasma cells (P<0.05). The percentage of Tregs in CD4+T cells from 15 MM patients who received bortezamib and dexamethasone (VD) chemotherapy was negatively correlated to the ratio of plasma cell reduction after the first VD chemotherapy (r=0.735, P<0.01). Conclusion:The level of Tregs in the peripheral blood of MM patients was positively correlated with tumor burden and progression of disease, but was negatively correlated with curative effect. The increased level of Tregs was associated with their strengthened anti-apoptosis function.

Objective To explore a multi-dimensional nursing post performance management system based on hospital development as the objective and workload account as the foundation. Methods A total of 1 321 nursing staff in the nursing post of Changzhou Second People's Hospital Affiliated to Nanjing Medical University was selected as the study object, to observe the effect of the nursing performance appraisal team formally established in our hospital since November 2015 on nursing performane, the nursing department, the management office, etc departments jointly developed the nursing performance allocation principle, program and allocation method, the hospital resource planning (HRP) system, hospital information system (HIS) and self-made questionnaire were used to collect data, and the changes of various indexes before implementation of performance reform (from December 2014 to November 2015) and after implementation of performance reform (from December 2015 to November 2016) were compared and analyzed; the indexes were as follows: average monthly business income, average monthly nursing income, annual clinical non-receivable consumables expenditure, nursing human resources flexible allocation rate, nurses' degree of satisfaction with performance (remuneration and paying score, performance assessment system score) and qualified rate of nursing care quality. Results After the implementation of performance reform, average monthly business income, the average monthly nursing income, nursing human resources flexible allocation rate, compensation, paying scores and performance appraisal system scores were significantly higher than those before the implementation of performance reform [average monthly business income (ten thousand yuan): 13 653.24±1 309.49 vs. 11 869.26±991.16, average monthly nursing income (ten thousand yuan): 264.2 (252.1, 269.7) vs. 88.5 (80.8, 95.2), the ratio of nursing human resources flexible allocation rate: (1.74±0.52)% vs. (0.43±0.23)%, compensation and payment score: 4.76 (4.62, 4.85) vs. 3.47 (3.12, 3.60), performance appraisal system score: 4.88 (4.78, 4.95) vs. 2.80 (2.70, 3.14)], the difference was statistically significant (all P < 0.05), the annual clinical non-receivable consumables expenditure was decreased significantly compared with those before implementation performance reform (million yuan: 1.88±0.21 vs. 2.62±0.14, P < 0.05), and the qualified rate of nursing quality after performance appraisal were significantly improved compared with those before performance appraisal [nursing grading: (97.83±1.90)% vs. (91.11±1.61)%, ward management: (96.64±2.90)% vs. (90.06±2.40)%, nursing writing: (97.30±2.51)% vs. (91.33±1.96)%, nursing safety: (97.40±2.67)% vs. (90.13±1.96)%, first aid items: (97.44±2.64)% vs. (92.27±2.56)%, perioperative period: (96.86±2.50)% vs. (90.83±3.06)%, blood transfusion quality: (97.51±2.21)% vs. (92.13±2.37)%, disinfection and isolation: (97.43±2.70) % vs. (88.50±2.57)%, basic operation: (93.48±2.22)% vs. (87.51±2.03)%, practical ability: (93.38±1.97)% vs. (85.85±2.58)%, all P < 0.05]. Conclusion The establishment and application of the new performance management system mobilizes the enthusiasm of the department to actively control costs and decrease the expenditure of non-chargeable consumables, the nursing management staff can more flexibly arrange human resources and exert the management potential of middle-level cadres, and the nurses' degree of satisfaction and the nursing quality are significantly higher than those before nursing performance reform.