Objective To investigate the effect of a fast-track based clinical nursing pathway of hepatic carcinoma on patient satisfaction and job satisfaction of nurses. Methods A total of 91 primary hepatic carcinoma (PHC) patients undergoing elective hepatectomy were enrolled and were divided into two groups by admission time, namely the control group (48 cases) and the experimental group (43 cases). The patients in the control group received traditional perioperative nursing care of hepatectomy, while the cases in the experimental group participated in fast-track nursing pathway. Patient satisfaction and nurse job satisfaction were measured before and after implementation. Results Final analysis included 45 patients in the control group and 40 patients in the experimental group. In the experimental group, the total score of patient satisfaction and the scores of all dimensions (including services and techniques, concern and care, services and techniques and overall satisfaction) were (132.75 ± 13.71), (48.30 ± 6.53), (42.60 ± 4.62), (35.98 ± 3.85), (5.88 ± 0.94), while they were (122.89 ± 16.62), (44.53 ± 7.74), (39.49 ± 5.67), (33.53±4.40), (5.33±1.13) in the control group. And the scores of the experimental group were significantly higher than that of the control group (t=-2.961, t=-2.409, t=-2.753, t=-2.709, t=-2.389, P<0.05). Furthermore,after implementing the fast-track clinical nursing pathway,the total score of nurse job satisfaction and the scores of six factors were (143.23 ± 9.40), (28.45 ± 2.72), (24.82 ± 2.28), (23.05 ± 1.33), (13.91 ± 1.95), (15.05 ± 1.43), (16.64 ± 1.65) while they were (127.36 ± 13.14), (25.68 ± 4.16), (19.64 ± 2.75), (20.23 ± 2.35), (13.23 ± 2.22), (13.68 ± 2.01), (14.50 ± 1.95) before the implementation. The former was significantly better than the latter (t =-12.462,-7.743,-12.670,-6.560,-2.417,-1.483,-6.587,P<0.05). However, no differences were observed in the other two dimensions of wages and benefits andwork-family balance(t =-1.945,-1.312,P>0.05) since the scores after implementation were (13.86 ± 2.12), (7.45 ± 1.57), while that of (13.18 ± 2.30)、(7.23 ± 1.41) were obtained before performance. Conclusions Application of fast- track nursing pathway in perioperative patients with PHC can contribute to promoting the level of patient satisfaction and job satisfaction of nurses and improving nursing quality. It is suggested that this nursing pathway will have more potential value for PHC patients.

Objective To explore role of 64-slices spiral CT in differetiation of acute chest pains.Methods Thirty six patients with acute chest pains were performed 64-slices spiral CT chest angiography.Two-dimensional and three-dimensional reconstruction was performed in all patients by means of multiplanar reconstruction(MPR)(coronal,sgittal oblique),curved planar reformation(CPR), maximum intensity projection(MIP),and volume rendering(VR).All images were blindly reading by two experienced radiologist.DSA were performed at the same time in 16 cases.Results The coronary artery branches,pulmonary artery and aortic artery in all patients were showed clearly,The acute myocardial infarction were showed in 10 cases,The pulmonary artery embolism in 14 cases,The aortic dissection in 6 cases respectively,The Coronary embolism in One case ,pneumothorax In One case The constrictive pericarditis in 1 case respectively.Normal findings in 4 cases.Conclusion 64-slices spiral CT is a useful and noninvasive examination in acute chest pain.

OBJECTIVETo evaluate the effect of elevated basal follicle-stimulating hormone (FSH) on both the quantity and quality of oocytes and embryos and the clinical outcomes of pregnancy in women under 35 years of age.

METHODSA retrospective analysis was conducted for inspecting 294 in vitro fertilization-embryo transfer (IVF-ET) cycles in women under 35 years of age. According to the basal FSH levels, the women were divided into groups A, B, and C with basal FSH of 10-14.99, 15-19.99 and ≥20 IU/L, respectively, to compare the average number of oocytes retrieved, morphologies of the oocytes and embryos, and clinical outcomes of pregnancy.

RESULTSGroup A showed greater average numbers of oocytes collected, total embryos and good-quality embryos with a lower gonadotrophin dose required to achieve follicular maturity than groups B and C. The 3 groups showed no significant differences in the percentage of metaphase II oocytes, optimal embryos-blastomere number, normal fertilization rate, cleavage rate, good-quality embryo rate, implantation rate, pregnancy rates, live birth rate or miscarriage rate, but the pregnancy rates and live birth rate tended to decrease in women with basal FSH ≥15 U/L.

CONCLUSIONIn women below 35 years of age, an elevated serum FSH (especially one ≥15 U/L) indicates diminished ovarian reserve and reduced numbers of oocyte and embryo but not poor oocyte or embryos quality, and good clinical pregnancy rate can still be expected.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Follicle Stimulating Hormone ; blood ; Humans ; Infertility, Female ; blood ; therapy ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Young Adult

OBJECTIVETo study the value of basal antral follicle count (AFC) and age in predicting ovarian response and clinical outcome of in vitro fertilization-embryo transfer (IVF-ET).

METHODSA total of 1319 oocyte retrieval cycles in women with an AFC&le;10 and complete IVF/ICSI cycles were analyzed retrospectively. According to the AFC, the patients were divided into groups A, B, and C with AFC&le;4, of 5-7, and of 8-10, respectively, and each was further divided into <38 years old group and ≥38 years old group. The oocytes retrieved, ovarian response, implantation rate, cancellations, pregnancy, pregnancy loss, and live births were evaluated.

RESULTSAs the AFC increased, the total gonadotrophin (Gn) dose increased and the follicles aspirated and oocytes retrieved decreased significantly (P<0.001). Patients below 38 years of age had a lower total Gn dose and more follicles aspirated and oocytes retrieved than older patients. An AFC>7 and age≥38 years was associated with significantly lower total Gn dose, greater number of follicles aspirated and oocytes retrieved, and lower pregnancy rate than an AFC&le;7 and age<38 years (P<0.05). Bivariate correlation and linear regression analysis identified AFC as the best single predictor of ovarian response in IVF. The pregnancy rate differed significantly between the 3 groups, and older patients (≥38 years) had higher early miscarriage rate.

CONCLUSIONAntral follicle count&le;7 or age≥38 years old with AFC&le;10 is the suitable threshold of diminished ovarian reserve in controlled ovarian stimulation for infertile women. Combination of AFC and age is the best predictor of ovarian response in IVF. Age has a better predictive value of pregnancy rate than AFC. AFC influences mainly the oocytes quantity, while age also affects oocyte quality.

Adult ; Age Factors ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Ovarian Follicle ; anatomy & histology ; cytology ; physiology ; Ovulation Induction ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies

OBJECTIVETo discuss the value of multi-slice CT dynamic enhancement scan in the diagnosis and treatment of colonic lymphomas.

METHODS16 patients with colonic lymphomas underwent multi-slice CT dynamic enhancement scans, images of axial and reconstructive images of VR, MPR and CTVE were analyzed, patients were respectively diagnosed.

RESULTSAppearances of primary colorectal lymphomas were categorized into focal and diffuse lesions. Focal and diffuse lesions were 6 and 10 patients, respectively. The accuracy rate of diagnosis was 87.5%.

CONCLUSIONMSCT dynamic scan has distinctive superiority in diagnosis and treatment of colonic lymphomas.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Barium Sulfate ; Child ; Colon ; diagnostic imaging ; drug effects ; surgery ; Colonic Neoplasms ; diagnosis ; drug therapy ; surgery ; Colonoscopy ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Enema ; Female ; Humans ; Lymphoma, B-Cell ; diagnosis ; drug therapy ; surgery ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Radiographic Image Enhancement ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods ; Vincristine ; therapeutic use

Objective To study the mechanism and protection of ulinastatin on organ functions in patients with severe disease.Methods Sixty patients in the intensive care unit(ICU)from October 2005 to July 2007 were randomly divided into a control group and an ulinastatin treatment group(each 30 cases).The patients in the control group received the conventional therapy,and the cases in the other treatment group accepted ulinastatin and conventional therapy.According to the disease situations,ulinastatin was administered 200-400 kU once,2-4 times a day,sequentially for 5-7 days.On the day of admission and 3, 5,and 7 days after admission in ICU respectively,blood samples were obtained for measuring alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),blood urea nitrogen(BUN), activated partial thromboplastin time(APTT),fibrinogen(FIB)and oxygenation index(PaO_2/FiO_2); whether breathing machine or hematodialysis was used and the end results were recorded.Results The rate of usage of breathing machine(23.3%),the incidences of hepatosis(3.3%)and renal dysfunction(10.0%) and fatality(3.3%)in ulinastatin treatment group were obviously lower than those of the control group (63.3%,23.3%,46.7%,10.0%,P0.05).Only one patient received bematodialysis in control group.Conclusion Ulinastatin can protect liver,renal and lung functions markedly and lower the incidence of multiple organ dysfunction syndrome and mortality in patients with severe disease.

Objective This paper discussed the implementation effect of medical research integrity and related code of conduct in a general hospital in xinjiang,to provide theoretical basis for the construction of medical research integrity.Methods According to the gap analysis theory,a questionnaire was designed for satisfaction with the implementation effect of medical research integrity and related code of conduct in the hospital.101 researchers in the hospital were surveyed to understand their evaluation on various aspects of the hospital's scientific research integrity construction policies and the space for improvement.Results The gap analysis showed that the hospital has a large gap in the construction of "institutional construction of scientific research integrity management " and "methods and regulations for dealing with academic misconduct",which were urgently need to be improved in the scientific research integrity construction.Conclusions The hospital should further improve the system of scientific research integrity construction,combine the characteristics of medical development and the corresponding national policy development,strengthen the innovation of scientific research management,create a healthy and positive environment for scientific research activities,and promote the comprehensive construction and long-term development of scientific research integrity construction.

OBJECTIVETo isolate and purify a new phospholipase A2 (PLA2) homologue from Agkistrodon blomhoffii siniticus and investigate its effects on the gene expression profile of Hep3B cells.

METHODSThe PLA2 homologue was isolated and purified by reverse-phase high-performance liquid chromatography (HPLC) and its purity was determined also by HPLC. The relative molecular mass of the homologue was measured by electrospray ionization mass spectrum. The gene expression profile of Hep3B cells was detected with gene chip after exposure of the cells to 139 microg/ml PLA2 homologue for 12 h.

RESULTSThe purity of the PLA2 homologue was 97.2%, whose relative molecular mass was 13,900. After exposure of Hep3B cells to 139 microg/ml PLA2 homologue for 12 h, 19 genes were down-regulated and 20 up-regulated in the cells. The genes showing altered expressions in response to the exposure were mainly involved in cell cycle control and DNA damage repair, cell apoptosis and senescence, production of signal transduction molecules and transcription factors, cell adhesion, angiogenesis, and tumor invasion and metastasis.

CONCLUSIONSThe PLA2 homologue induces alterations in the expression of a wide variety of genes involved in the growth and metastasis of tumor cells. The results of this study provide clues for further study of the possible mechanism for the action of PLA2 homologue on Hep3B cells.

Agkistrodon ; Animals ; Carcinoma, Hepatocellular ; genetics ; Chromatography, High Pressure Liquid ; DNA Damage ; drug effects ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; drug effects ; Hyaluronan Receptors ; biosynthesis ; genetics ; Isoenzymes ; Liver Neoplasms ; genetics ; Phospholipases A ; isolation & purification ; pharmacology ; Phospholipases A2 ; Proto-Oncogene Proteins c-bcr ; biosynthesis ; genetics ; Snake Venoms ; enzymology ; Tumor Cells, Cultured

BACKGROUND: Previous studies have found that polygonatum sibiricum polysaccharide (PSP) exhibits anti-osteoporosis effect, but its therapeutic effect in ovariectomized osteoporotic rats and the molecular mechanisms are poorly understood. OBJECTIVE: To investigate the effect of administration of PSP on the bone microstructure, bone mineral density as well as osteoblast- and osteoclast-related gene expression in rats. METHODS: Twenty-five infertile female Sprague-Dawley rats aged 3 months were randomly allotted into five groups (n=5 per group): sham operation (same volume normal saline), model, zoledronate (0.2 mg/kg?d), high-dose PSP (800 mg/kg?d) and medium-dose PSP (400 mg/kg?d) groups. All rats were subjected to ovariectomy except sham operation group. The administration was intragastrically given every 2 days beginning at 7 days after modeling and lasted 12 weeks. Then, the rats were sacrificed, and the uterus was weighed. The bilateral tibias were removed, one side for histomorphometric analysis by micro-CT, and the other one for RNA detection by qualified PCR. RESULTS AND CONCLUSION: Compared with the sham operation group, the rat body mass in the model group was significantly increased and the weight of uterus was significantly decreased (P < 0.05). Compared with the model group, zoledronate and high-dose PSP could significantly alleviate the excessive increase in body mass (P < 0.05). The bone mineral density in the model group was decreased by 63% compared with the sham operation group (P < 0.01), Compared with the model group, after 12-week high-dose PSP and zoledronate administration, the bone mineral density was increased by 44% and 38%, respectively (P < 0.01); the trabecular bone volume fraction and trabecular number rose significantly(P<0.05),while the trabecular separation decreased significantly(P<0.05).In vivo,PSP could significantly promote the expression levels of osteoblast-related genes (alkaline phosphatase, RUNX2, Col1a1 and osteocalcin), and significantly inhibit the expression levels of osteoblast-related genes (ACP5 and CTSK) (P < 0.05). These results imply that high-dose PSP can reduce bone loss and decrease of bone mineral density, improve the destruction of bone microstructure, as well as promote osteoblast-related genes but inhibit osteoclast-related gene mRNA expression in the ovariectomized rats.

OBJECTIVETo evaluate the reliability of the birth defects surveillance system in four counties with high prevalence of birth defects (Pingding, Xiyang, Taigu and Zezhou counties) in Shanxi province, China.

METHODSOne township was selected from each county as study site. The health workers chosen from township or village level were trained to visit families on the outcomes of each pregnancy who gave birth during year 2003 in the study site. The number of births and cases collected in the study were compared with that from the surveillance system. The number of births reported by surveillance system in four counties was also compared with the data from the local government. The criteria of evaluation were: 1) number of the missing report of births should < or = 5%, 2) the number of missing report on major external birth defects cases should < or = 10%. Researchers from the Peking University were responsible for examining the quality of surveillance in some terminal units of surveillance system.

RESULTSThe numbers of births reported in the study and from the surveillance system for four-township were 1043 and 997, respectively. 46 births were missing and the rate of misreporting for births was 4.4%. The numbers of birth defects cases reported in the study and from the surveillance system were 30 and 29, respectively. 1 case of birth defect as missed, and rate of misreporting for birth defects cases was 3.3%. The total number of births reported from surveillance was similar to that in the study in four counties, with a difference of 1.2%. Birth registry data was rather readable and special health workers responsible for surveillance work were present in all the terminal units of the surveillance system.

CONCLUSIONThe misreporting of births and cases existed in the birth defects surveillance system of the four counties in Shanxi province, but were lower than the allowable criteria. The surveillance units had better registration, reporting and administration of births and birth defect cases. Hence, the quality of the data from the surveillance system in these four counties was reliable.

Birth Certificates ; China ; epidemiology ; Congenital Abnormalities ; epidemiology ; Female ; Humans ; Infant, Newborn ; Population Surveillance ; Pregnancy ; Pregnancy Outcome ; Registries ; Reproducibility of Results