Objective To explore the concordance of nursing grades which are ordered by the nurses and the standards of nursing grade and the inpatients' needs. Methods 120 inpatients were rated using the three methods respectively, which were the nurses' order, the standards of musing grade and Bartbel index, and then compare the concordance of the nursing grades rated by the three. Results Then nurses' order was of well concordance with the standards of nursing grade and Barthel index,and the Kappa value was 0.862,0.611,P<0.01,respectively. Conclusions The nurses' order accords with the standards of nursing grade and the patients' needs, is helpful to develop the clinical work, and should be spreaded and exploited.

0.05).No significant histological and ultrastructural changes were observed in the skin biopsies.Conclusion The long pulsewidth Diode Laser is a safe hair removal technique with good result and without adverse effect on the function of axillary sweat gland excretion.

Objective To evaluate the long-term effects and safety of diode laser in hair removal.Methods A retrospective study was conducted.In this study,350 patients with hypertrichosis were treated by an 800-nm diode laser with a pulse duration of 30 ms for various sessions.Two groups were divided based on the treatment sessions:group A receiving 6(≥4 for axillae)or more treatments,group B less than 6(＜4 for axillae)treatments.Patients were followed up for 8 months to 3 years(mean 22.5 months)by return visit or telephone.Evaluation of efficacy and side effects were performed.Results Follow-up and evaluation were completed in 235 patients,and a total of 375 sites treated.After 2-18 treatments,a total effective rate of 80.53%(302/375)was achieved.Significant higher effective rates were observed in group B compared with group A at all sites 86.84%(33/38)vs 35.00%(7/20)on the lips,68.42%(26/38)vs 30.77%(4/13)on the face and neck,92.00%(46/50)vs 55.56%(5/9)in lower extremities,86.96%(20/23)vs 50.00%(4/5)on the trunk.93.81%(91/97)vs 55.56%(5/9)at the axillae,92.16%(47/51)vs 73.68%(14/19)in the upper extremities(all P＜0.05),Side effects were noted in only 6 cases,including hyperpigmentation,itching,and development of follicular papules,blisters and white hair.Neither hypopigmentation nor scarring was observed.Conclusions Diode laser system is effective and safe for hair removal.The effect varies with lesional sites and treatment sessions.

Objective To valuate the effect of high energy ultrapulse CO2 laser on congenital melanocytic nevi of the orbit. Methods 46 patient with congenital melanocytic nevi of eyelid, 58 le-sions were vaporized with high energy ultrapulse CO2 laser. The area of the largest one was 3.0 cm×6.0 cm, and the smallest one was 0.3 cm×0.3 cm, with average of 1.3 cm×2.0 cm. The depth of the vaporizing reached the layer of lowest skin, even the orbicularis, aponeurosis and conjunctiva of tarsus, till no melanin on the wound in view, tried the best to reserve the normal follicle of eyelash. There was no eschar and bleeding on the wound during the procedure. Followed up lasted for 1 - 56 months, with average 12.9 months. Results 44 of 46 patients were satisfactory to the effect of the laser. The most of scars resulted from the vaporizing with the laser became evenness and smooth (50/58). The edge of eyelid looked normal after the laser. The excellent result was observed in 84.5 % (49/58) lesions, good in 10.3 % (6/58), and improved in 5.2 % (3/58). The overall effect was 94.8 % (55/58). And eyelashes were getting growth. Conclusion The treatment of con-genital melanocytic nevus of eyelid with high energy ultrapulse CO2 is a good method. But to be careful in selecting the lesions that may not he too large.

Total DNA of B. amyloliquefaciens and S. aureus were isolated and cut partially with Hind Ⅲ Separately, The genes for barnase and for staphylococcal nucl ease were obtained by PCR and cloned into pGEM7Z-f(+), The sequencing show that the n ucleotide (nt) sequence of the barnase is 99.3% homologous with the previously determimed sequence and the deduced animo acid (an)sequence found to correspond precisely to the previously determined sequence; the nucleotide (nt) sequence of the staphylococcal nuclease is 99.1% homologous with the previously determined sequence and the deduced amino acid (an) sequence 99.3% homologous with the previously determinded sequence.These have built basis of making use of special expression or activation of nuclease to produce the male sterility plant by plant gene engineering and to explore new antiviral strategy.

Objective To Analyze the clinical outcomes of pediatric liver transplantation (LT) for liver-based metabolic disorders.Methods We conducted a retrospective analysis on 42 pediatric patients with liver-based metabolic disorders from June 2013 to March 2017,and analyzed the pediatric end stage liver disease model (PELD),growth and development,type of transplant,postoperative complications and prognosis of patients.Results There were 42 children with liver-based metabolic disorders (15.56%) out of all the 270 children who underwent LT.The median age was 51.0 months (range,3.4-160.9 months).Of the 42 children,19 received living donor liver transplantation (LDLT),18 cases received deceased donor liver transplantation (DDLT) and 5 cases received domino liver transplantation.1-,2-and 3-year cumulative survival rate of 42 recipients was 97.7%,93.6% and 93.6%,and that of the grafts was 95.3%,91.4% and 91.4%,respectively.As compared with the 194 children with biliary atresia who underwent LT,significant difference was found in PELD and weight Z-score between the two groups.Conclusion Liver transplantation is a valuable option for children with metabolic disorders,and it has gained a better prognosis.

Objective:To investigate the current status of clinical teaching towards postgraduates of master of nursing specialist(MNS) in China.Methods:Objective sampling was used to invest 390 MNS clinical nursing teachers in 36 hospitals across the country. The survey included the admission and evaluation criteria of teachers, the MNS postgraduates′ clinical teaching plan and implementation, and the assessment of MNS postgraduate ′s clinical practice ability, etc. Results:Among the criteria for clinical teachers for MNS postgraduates, 79.49% of departments required bachelor ′s degree or above, and 67.18% of departments requested medium-grade professional title or above; 47.44% of the departments demanded that clinical teachers had the research experience, 58.21% departments asked for the experience of articles publication. The main method of selecting clinical teaching teachers was examination (50%), while 31.28% departments had no definite criteria. The evaluation indicators of clinical teachers mainly depended on the results of students ′ clinical practice capability assessment (81.79%) and students ′ satisfaction (80%). Only 49.23% of the study objects knew the training objectives of MNS. The pivotal abilities of MNS graduate students were the ability of clinical nursing practice (91.79%) and clinical research (82.82%). The MNS postgraduate teaching plan of each department was mainly derived from the requirements of tutors and colleges (87.69%). The mode of clinical teaching was that one student was guided by a fixed clinical teacher (87.18%). Clinical practice assessment methods of MNS mainly included theoretical knowledge assessment (88.46%) and the performance of section lectures (82.56%). The assessment personnel were mainly clinical teachers (95.40%) and head nurses (83.51%). The self-assessment of clinical teachers was rated at the medium level about their performance on the postgraduate MNS students ′ clinical teaching. Conclusions:The homogenization and standardization of the construction of MNS clinical teaching base needs to be improved in China. In the field of defining the criteria of clinical teaching teachers, strengthening the construction of clinical faculty, perfecting the clinical teaching plan and evaluation system according to the cultivation objectives and specialist characteristics, and elevating the comprehensive medical education combined with clinical education and college education, further exploration is indispensable.

Objective:To review our experience in the use of "Full right-Full left" split liver transplantation in adult-to adult or adult-to adult-size child.Methods:The clinical data of liver donors to 4 recipients of full right-full left split liver transplantation performed at Beijing Friendship Hospital of Capital Medical University from January to December 2019 were reviewed. The surgical methods of split liver transplantation, cold ischemia time, operation time, intraoperative blood transfusion, and postoperative complications and prognosis were analyzed.Results:The 4 recipients of complete right hepatic-left hepatic split liver transplantation included 3 adults and 1 heavy child (45 kg). Their ages ranged from 14 to 48 years, and body weight ranged from 45 to 61 kg. The end-stage liver disease model score were 21, 12, 41, and 30 points. The ratios of graft mass to recipient's body mass ranged from 0.85% to 1.35%. The cold ischemia time was 457-650 min, and the operation time was 460-575 min. Early liver function recovered smoothly in all the 4 patients after transplantation, and no small liver syndrome occurred. Patients were followed up to 6 months after operation. One patient developed anastomotic biliary leak, which was cured by endoscopic retrograde cholangiopancreatographic treatment. Another patient developed biliary stricture presenting with repeated biliary tract infection despite percutaneous transhepatic puncture biliary drainage. A third patient died six months from lung infection.Conclusion:In properly selected patients, using full right-full left hemiliver by split liver transplantation increased organ utilization and provided patients with increased treatment opportunities.

Objective To evaluate the clinical efficacy of liver transplantation in children with Alagille syndrome (ALGS). Methods Clinical data of 12 children with ALGS were collected and retrospectively analyzed. Clinical characteristics of children with ALGS, pathological characteristics of liver tissues, characteristics of liver transplantation, postoperative complications and follow-up of children with ALGS were analyzed. Results JAG1 gene mutation and typical facial features was present in all 12 children. Jaundice was the most common initial symptom, which occurred at 7 (3, 40) d after birth. Upon liver transplantation, the Z scores of height and body weight were calculated as -2.14 (-3.11, -1.83) and -2.32 (-3.12, -1.12). Five children developed severe growth retardation and 4 children with severe malnutrition. Eight of 12 children were diagnosed with cardiovascular abnormalities. Pathological examination showed that the lobular structure of the diseased livers of 4 children was basically maintained, and 8 cases of nodular liver cirrhosis in different sizes including 1 case of single early moderately-differentiated hepatocellular carcinoma. Three children were misdiagnosed with biliary atresia and underwent Kasai portoenterostomy. Eight children underwent living donor liver transplantation, three children underwent cadaveric donor liver transplantation (two cases of split liver transplantation and one case of cadaveric total liver transplantation), and one child underwent domino liver transplantation (donor liver was derived from a patient with maple syrup urine disease). during the follow-up of 30.0(24.5, 41.7) months, the survival rates of the children and liver grafts were both 100%. During postoperative follow-up, the Z scores of height and body weight were calculated as -1.24 (-2.11, 0.60) and -0.83 (-1.65, -0.43), indicating that the growth and development of the children were significantly improved after operation. Conclusions Liver transplantation is an efficacious treatment for children with ALGS complicated with decompensated cirrhosis, severe itching and poor quality of life. For children with ALGS complicated with cardiovascular abnormalities, explicit preoperative evaluation should be delivered, and consultation with pediatric cardiologists should be performed if necessary.

Bone formation and deposition are initiated by sensory nerve infiltration in adaptive bone remodeling. Here, we focused on the role of Semaphorin 3A (Sema3A), expressed by sensory nerves, in mechanical loads-induced bone formation and nerve withdrawal using orthodontic tooth movement (OTM) model. Firstly, bone formation was activated after the 3rd day of OTM, coinciding with a decrease in sensory nerves and an increase in pain threshold. Sema3A, rather than nerve growth factor (NGF), highly expressed in both trigeminal ganglion and the axons of periodontal ligament following the 3rd day of OTM. Moreover, in vitro mechanical loads upregulated Sema3A in neurons instead of in human periodontal ligament cells (hPDLCs) within 24 hours. Furthermore, exogenous Sema3A restored the suppressed alveolar bone formation and the osteogenic differentiation of hPDLCs induced by mechanical overload. Mechanistically, Sema3A prevented overstretching of F-actin induced by mechanical overload through ROCK2 pathway, maintaining mitochondrial dynamics as mitochondrial fusion. Therefore, Sema3A exhibits dual therapeutic effects in mechanical loads-induced bone formation, both as a pain-sensitive analgesic and a positive regulator for bone formation.
Humans ; Bone Remodeling ; Cell Differentiation ; Osteogenesis ; Semaphorin-3A/pharmacology* ; Trigeminal Ganglion/metabolism*