Aim To investigate the effects of Ginkgo biloba extract(EGB)on tumor necrosis factor-alpha(TNF-?)in TNBS-induced colitis in rats and its mechanisms.Methods Colitis in rats was induced by colonic administration with 2,4,6-trinitrobenzene sulfonic acid(TNBS).Wistar rats were randomly divided into four groups,10 in each:normal group,model group,5-aminosalicylic acid(5-ASA group)and Ginkgo biloba extract group(EGB group).The levels of nitric oxide(NO),and glutathion peroxide(GSH-Px)were measured by biochemical methods.The expressions of TNF-? and nuclear factor kappaBp65(NF-?Bp65)in the colon tissues of colitis rats were detected by means of immunohistochemistry.The expressions of induce nitric oxide synthase(iNOS)in the colon tissues of colitis rats were detected by reverse transcription polymerase chain reaction(RT-PCR).The effects of EGB on colonic inflammation and macroscopic and histological damage were evaluated as well.Results Compared with the model group,treatment with EGB for 4 weeks significantly reduced colon macroscopic and histological damage,elevated the activities of GSH-Px and reduced the contents of NO,inhibited the protein expressions of TNF-? andNF-?Bp65,and decreased the mRNA levels of iNOS in the colon tissues of experimental colitis.Conclusions The probable mechanisms of EGB was that it ameliorated inflammatory injury in TNBS-induced colitis in rats by its reduction of TNF-?,NF-?Bp65 and iNOS levels.Then EGB could curb the inflammatory cascade effects of inflammatory mediators to protect ulcerative colitis.

Objective To apply six sigma management method to optimizing flow,enhancing treatment quality,prolonging service life and decreasing purchase cost of the non-coated surgical instrument.Methods The treatment flow of the noncoated surgical instrument was optimized through five steps of six sigma method including defining,measuring,analyzing,improving and controlling.The treatment results before and after flow optimization were compared,analyzed and evaluated.Results The rates for corrosion and rejection were both decreased significantly after flow optimization,while the quality was increased obviously (P＜0.05).Conclusion Six sigma management method involved in the treatment of the non-coated surgical instrument saves purchase cost,enhances the efficiency of disinfection supply room and facilitates effective supervision and monitoring.

Objective To master iodine intake ways of children in Yancheng (coastal) and Zhenjiang (inland) cities,analyze their urinary iodine difference and provide solid evidence for adjustment of salt iodine and adequate iodine intake level of local residents.Methods Totally 50％ counties were randomly selected in Yancheng and Zhenjiang cities and 5 towns were sampled in each county in 2014,local water iodine,domestic salt iodine,local eating habits and urine iodine of children 8-10 years old were investigated,and the influences of different iodine intake ways on urine iodine level were analyzed.Results The median of water iodine was 4.76 μg/Lin Zhenjiang (n =40) and 50.80 μg/L in Yancheng (n =50),the difference was statisticelly significant in two cities (Z =6.93,P ＜ 0.05).Totally 2 400 salt samples were tested,the mean of salt iodine was (24.20 ± 5.07) mg/kg in Yancheng (n =1 500) and (22.87 ± 2.77) mg/kg in Zhenjiang (n =900),the difference was statisticelly significant in two cityies (t =7.23,P ＜ 0.05).The salt intake level in Zhenjiang (10.69-± 9.00) g/d appeared to be higher than that in Yancheng (8.40 ± 3.57) g/d,but the difference was not statistically significant (t =1.62,P ＞ 0.05).Totally 1 200urine samples were tested,the urine iodine level of Zhenjiang got higher results (265.83 μg/L,n =450) than that of Yancheng (182.15 μg/L,n =750,Z =12.18,P ＜ 0.05).The ratio of water iodine intake/salt iodine intake was about 1 ∶ 4 in Yancheng and 1 ∶ 50 in Zhenjiang,while residents in Zhenjiang got 21％ of daily iodine through extra ways.Eating habits like eating out did not have significant impact on urine iodine.Conclusions Based on the water iodine level,Yancheng is considered to be a appropriate iodine level area while Zhenjiang is a lack region.However,Zhenjiang has a higher urine iodine level than Yancheng,which is more than adequate to the recommendation.Salt iodine is a main iodine source in both cities.In iodine appropriate and deficiency areas,eating habits and food choices may play a more important role than geochemical factors in iodine intakes among residents.

Objective To evaluate the value of combining PCT, BNP, D-Dimer and PCIS score in predicting the prognosis of pediatric severe pneumonia in the early stage. Methods 80 cases of children with severe pneumonia were selected, 49 cases were boys , 31 cases were girls, with a median age of 7.5 months (1 month to 156 months). According to the final outcome, the cases are divided into treatment group and poor prognosis group. The score of PCIS, PCT, BNP and D-dimer within 24 hours after admission were recorded. According to the indicators, ROC curve was drawn independently and integrated with the four indicators,and the corresponding areas under ROC curve (AUC) were calculated to compare the accuracy of the assessment. Results The AUC of PCIS, PCT, BNP and D-dimer were between 0.7 and 0.9. The ROC curve integrated the four indicators showed the AUC were 0.932, which improved sensitivity and specificity. Conclusions The integration of PCIS, PCT, BNP and D-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.

Objective To analyze the expression characteristics of excision repair cross-complementing 1 (ERCC1), topoisomeraseⅡ (TOPOⅡ), ribonucleotide reductase M1 (RRM1), β3-tubulin and thymidylate synthase (TS) in lung cancer and their associations with the pathological types. Methods The immunohistochemical EnVision method was used to determine the expression of ERCC1, TOPOⅡ, RRM1,β3-tubulin and TS in 548 patients who were diagnosed as lung cancer from January 2011 to December 2014. Variance analysis was performed to analyze their expression characteristics among different pathological types and correlation. Results The expression positive rates of ERCC1, TOPOⅡ, RRM1, β3-tubulin and TS were 61.86 % (339/548), 91.06 % (499/548), 62.59 % (343/548), 73.18 % (401/548) and 70.44 % (386/548), respectively. The expression of ERCC1 was weak positive mostly (P<0.05), meanwhile the expression of TOPOⅡ was medium-strong positive mostly (P<0.05). In ERCC1 group, the positive rate of squamous cell carcinoma was higher than that of adenocarcinoma [57.39 % (167/291) vs. 42.61 % (124/291), P=0.000]. In weak positive of TOPOⅡ group, the proportion of adenocarcinoma was higher than that of squamous cell carcinoma [23.58 % (100/137) vs. 8.73 % (37/137), P=0.000]. In medium-strong positive of TOPOⅡ group, the proportion of squamous cell carcinoma was higher than that of adenocarcinoma [47.41 % (201/287/) vs. 20.28%(86/287), P=0.000]. The expressions of ERCC1, TOPOⅡ, RRM1,β3-tubulin and TS were irrelevant (r=0.4, P=0.397). Conclusions The expressions of ERCC1 and TOPOⅡ are higher in squamous cell carcinoma than those in adenocarcinoma. The expression of ERCC1 is weak positive mostly, meanwhile the expression of TOPOⅡis medium-strong positive mostly. There is no correlation between them.

Objective To describe the level of self-perceived burden (SPB) and analyze its influencing factors among the patients with advanced lung cancer, in order to provide a theoretical basis for individualized nursing care. Methods A total of 102 hospitalized patients with lung cancer from 3 hospitals in Shandong province were investigated by the Self-Perceived Burden Scale for Cancer Patient (SPBS-CP). Results The total score of the SPBS-CP was (60.31±17.06) points, which indicated at a moderate level. Those patients rated the highest score on the sub-scale of economic/family burden (22.04±6.72) points, the lowest score on the sub scale of care burden (10.28±3.62) points. Single factor analysis and regression results showed that different work conditions, different stages were related with SPB. Conclusions Patients with moderate and advanced lung cancer had a moderate or higher level of SPB. Staff nurses should focus on the psychological status of the patients and take positive interventions to release the negative emotional experiences.

Objective To estimate the clinical value of thinprep cytologic test (TCT) in screening cervical lesion. Methods 4234 TCT samples were interpreted according to the Besthesda System (TBS), 272positive cases (ASC-US or above) were taken colposcopic examination and biopsy. Results The coincidence of the results between TCT and biopsy in low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), squamous cell carcinoma (SCC), adenocarcinoma (AC) were 85.71%(12/14), 100 % (20/20), 75 % (3/4) and 100 % (2/2), respectively. The positive rates of over ASC-H by TCT and of over CIN Ⅰ by biopsy were 23.16 % (63/272) and 24.26 % (66/272), respectively. There is no difference between two positive rates (x2 = 0.868, P = 0.581). Conclusion TCT and histopathological diagnosis had a high coincidence, a combination of both can greatly enhance HSIL and cervical cancer and reduce the incidence of missed diagnosis. TCT would be a rapid and convenient method for screening cervical cancer.

Objective To study the direct immunofluorescence method for rapidly detecting influenza A virus antigen and its clinical application .Methods The inpatients with clinically diagnosed acute respiratory tract infection were selected .Two hundred samples were collected and divided into two groups :the winter and spring epidemic seasons children group and the summer and au‐tumn non‐epidemic seasons children group ,100 cases in each group .The US D3 Ultra influenza A virus antigen detection reagent was used .The fluorescence labeled monoclonal antibody was adopted to detect influenza A virus antigen in the patients with cold . Results During the winter and spring seasons of influenza prevalence ,8 cases of 100 detected cases were positive with the positive rate of 8% ;during the summer and autumn seasons of non‐influenza prevalence ,2 cases of 100 cases were positive with positive rate of 2% ,the difference in the positive rate between the two groups had statistical significance(P<0 .05) .Conclusion Applying the direct immunofluorescence method for rapidly detecting influenza A virus antigen is an economical ,efficient ,rapid and specific detec‐tion method ,and can guide clinical rapid diagnosis and rational medication .

In line with the worldwide trend in population aging, China has stepped into an aging society since 2000. The outstanding features of aging, including a large proportion of the older population, rapid growth, dramatic expansion of the oldest-old, and uneven aging distribution, have put China in a unique position. Besides, older population is expanding in parallel with the escalating burden of disease, high prevalence of disability, and low social involvement. However, China is not prepared to solve these problems in terms of the economy, awareness, geriatric care system, geriatric team, social security, or age-friendly environment. From the perspective of public health, we summarized the major challenges and proposed the following policy recommendations: (1) strengthening the top-level design and building a "government-leading, multi-sectoral-cooperating, and society-participating" pattern; (2) enhancing health services by implementing the "comprehensive health" strategy; (3) developing home and community care, coordinately enhance institutional care, promote integration of medical and care systems, and establish a multidimensional tailored care system; (4) optimizing geriatric the supporting system, included the construction of geriatric team and the long-term care insurance system; and (5) establishing a physical and socially age-friendly environment.

Objective To investigate influencing factors of disability after craniocerbral injury caused by road traffic accident.Methods We collected 486 cases with craniocerebral injury caused by traffic accident,and conducted analysis.Factors related to disability were found by univariate analysis,and multivariate logistic regression analysis was conducted to filter the most important factors.Results Degrees of brain injury,drunk driving,age and types of accident were the major influencing factors.Drunk driving and age were positively related with disability grade while the degree of brain injury and type of accident were negatively related.Concuusiorn It is helpful to reduce disability and the burden on society by taking intervening measures on the related factors of disability after brain injury in road traffic accident.