In clinical nursing practice, ethnics dilemmas which nurses facing with are not usually a simple question of right and wrong or yes and no, but two or more mutual conflicts under some special circumstances; In order to help nurses to understand and deal with ethnics dilemmas effectively and reasonably, the authors summarize the four different ethnics dilemmas: the different ethical principles selection dilemma, the different stakeholder selection dilemma, the different interpersonal ethnics dilemmas and the conflict of the nursing professional ethics and the role morality. Typical cases of common ethnic dilemmas were summarized and analyzed in this paper.

Objective To evaluate the clinical effects,CT features and side-effects of percutaneous microwave coagulation therapy(PMCT) in the treatment of peripheral lung cancer.Methods CT-guided PMCT was applied to 16 cases of peripheral lung cancer from August 2003 to October 2004 in this hospital.Pathological or cytological findings showed 9 cases of squamous carcinoma and 7 cases of adenocarcinoma.A needle microwave antenna was applied into the tumor percutaneously under CT guidance.In each emission of microwave,the tumor was ablated with a 2 450 Hz microwave coagulation output of 65~75 W for 3~5 min.According to the size and shape of the tumor,single or multiple ablation emission was selected.Results The operation time was(15~60) min(mean,35 min).Complete remission(CR) was achieved in 1 case,partial remission(PR) in 4 cases,and no changes(NC) in 11.Follow-up observations in the 16 cases for 3~15 months(mean,9.5 months) found 2 cases of tumor metastasis and 1 case of death.Conclusions Percutaneous microwave coagulation therapy is a safe,micro-invasive,and effective treatment for the management of peripheral lung cancer.

Traditional teaching mode of biochemistry experiment couldn’t satisfy the demand of cultivating creative medical talents in new era. Offering designing experiment is the developing direction of experiment teaching reforms. But in the practice,there are various of obstacles which prevent the reforming process.

BACKGROUND: It is important to study the methods of culturing bone marrow-derived mesenchymal stem cells (MSCs) to obtain a great amount of high purity MSCs for applying ocular tissues constructed by tissue engineering technique to treat eye diseases.OBJECTTVE: To separate and culture in vitro MSCs from bone marrow of the adult rats by density gradient centrifugation combined with adherence culture, and observe the growing characteristics and the possibility of mass multiplication.DESIGN: A completely randomized grouping design/repetitive measuring experiment.SETTING: Pathological laboratory, Zhongshan Ophthalmic Center, Sun Yat-sen University.MATERIALS: Four six-week-old SD rats about 250 g, grade Ⅱ of cleaning, were provided by the Animal Center of Sun Yat-sen University [certificate number: SCSK(Yue)2004/0011], about 250 g each rat and there was no limit to the sex. The main reagents and instruments included low sugar Dulbecco modified Eagle culture medium (DMEM/F12, American Gibco Corporation), trypsin (fetal bovine serum (FBS, Hangzhou Sijiqing Bio-Engineering Material Research Institute), American Gibco Corporation), disodium edetate, lymphocyte separating medium, fibronectin, CD44, CD34, CD31 monoclonal antibodies, two-step-method kit for immunohistochemistry (Beijing Zhong shan Biotechnology Corporation).METHODS: This experiment was conducted at the Key laboratory of Ophthalmology (Sun Yat-sen University), Ministry of ethanol (750 g/L) for 10 minutes. Under aseptic condition, the medullaris cavitas was exposed, the syringe containing application m edium was directly punctured into the femoral cavity, the cells in the medullaris cavitas were washed out with the culture medium containing heparin and taken as the cell suspension. The bone marrow-derived MSCs were separated and purified by density gradient centrifugation combined with adherence culture, and the growing conditions of the wells. When the cells had generally connected with each other, they were fixed with methanol or dimethy ketone in situ for 10 minutes, and then hematoxylin eosin (HE) staining or immunohistochemical staining. Antibodies against fiinoculated to 96-well culture plate by a cell density of 4.25×107/L, with 200 μL every well; then put the culture plate into culture box. Then from the next day to the sixth day, 5 g/L MTT solution was added into two rows (20 μL every well) every day, continuously cultured for 4 hours, then the supernatant was removed, and 200 μL DMSO was added to each well, agitated for 5 minutes, then detected the absorbance (A) values at 570 nm wave length, and a growth curve was drawn.branes were clear and the cell bodies were lucent. Being cultured for 2 days, there appeared adherent cells. 3 days later,most of the adherent cells extended and appeared to be in polygon, star or long-shuttle shapes. 4 days later, the cells showed to be in division growth stage; and about 12 days later, the cell clones were connected to each other, appearing curve of subcultured MSCs was in S shape. Cells began growing fast on the 2nd day after being passaged, and they entered the growth period for 3-4 days followed by saturation period, and then cells stopped growing.CONCLUSION: It is a simple and practical method to separate MSCs from the bone marrow of adult rats by means of density gradient centrifugation and adherence. MSCs can greatly proliferate in vitro and offer seed cells for the application of tissue engineering technique to treat eye diseases.

[ ABSTRACT] AIM: To explore the role of chemokine receptor CXCR 4 in the pathogenesis of protein C system (PCS) in ulcerative colitis (UC).METHODS:In vivo, the mice were divided into control group and UC group .The mac-roscopic score, microscopic score and ulcer index were assessed .The mRNA levels and activity of myeloperoxidase ( MPO) , cyclooxygenase-2 ( COX-2 ) , stromal cell-derived factor-1α( SDF-1α) and monocyte chemotactic protein 1 (MCP-1) both in colonic tissue and plasma were determined .The expression and location of CXCR4,β-arrestin, p-JNK, endothelial cell protein C receptor (EPCR) and thrombomodulin (TM) were detected.The activity of protein C (PC) and protein S ( PS) was measured in each group .In vitro, mouse colonic microvascular endothelial cells were isolated , cultured and identified.Both CXCR4-overexpressing and CXCR4-silencing colonic mucosa microvascular endothelial cells were con-structed.The effects of SDF-1αon the protein levels of EPCR , TM,β-arrestin and p-JNK, and on the activity of PC , PS and activated protein C ( APC) were observed .RESULTS:Compared with control group , UC mice showed increased gross score, histopathological score and ulcer index (P<0.05).The mRNA levels and activity of MPO, COX-2, SDF-1αand MCP-1 in colon and plasma were increased (P<0.01).The protein levels of CXCR4,β-arrestin and p-JNK were up-regu-lated, EPCR expression was down-regulated in colon, and the activity of PC and PS in plasma was decreased (P<0.05 or P<0.01).CXCR4 overexpression further aggravated SDF-1α-induced PCS inhibition in colonic mucosa microvascular en-dothelial cells, and further up-regulated the protein levels of β-arrestin and p-JNK (P<0.05).CONCLUSION:PCS is inhibited in UC.CXCR4 is involved in the regulation of PCS inhibition by mediating chemokines and acting on colonic mu -cosa microvascular endothelial cells through β-arrestin-JNK pathway .

Objective To construct the gall-stone patients' nursing workload measurement project by Delphi method,so as to measure single disease workload scientifically and reasonably.Methods The gall-stone patients' nursing workload measurement project were designed on the basis of consulting literature and experts discussion,then two rounds of consultations were made with experts by using the Delphi method.Results The valid recovery rate of questionnaires of two rounds consultations were all 100％ (22/22).The expert authority coefficient was 0.886 1.Nursing workload measurement project,directly related to the gall bladder calculi 54 nursing projects,including technical 46,unskilled 7;indirectly related to the gall bladder calculi 36 nursing projects,including technical 17,unskilled 19.Conclusions The measurement project of gall-stone patient determined by Delphi method has high reliability,which is significant to the scientific measuring of nursing single disease workload.

Objective In order to measure the nursing unit workload scientifically,we used the Delphi method to investigate the influencing factors of nursing unit workload.Methods After consulting literature and discussing with experts,alternative indicators were designed,then two rounds of consultations were made with experts by using the Delphi method.Results The questionnaires revealed that the valid recovery rate,after two rounds of consultations,were 95％ and 100％ respectively,which reflected the positivity of the experts which participated in this study.The expert authority coefficient was 0.896,which indicated the high reliability of the consulting.The coordination indexes of expert opinions were 0.467 and 0.239 respectively,which showed the expert advices had good coordination and the results had high reliability.Conclusions The influencing factors of nursing unit workload determined by Delphi method have high reliability,which is significant for the scientific measuring of the nursing unit workload.

Objective To establish an animal model to study endometriosis. Methods Six female Bama miniature pigs that were sexually mature were chosen and their endometrial tissues were acquired surgically. The endometrial tissues were implanted to abdominal cavity and subcutaneous tissues. Results The ectopic endometria in the implant location formed mass or cyst that was verified pathologically to be similar to normal endometrial tissues. Conclusion The establishment of ectopic endometriosis in Bama miniature pigs is successful, which provides an ideal model for further therapeutic study of endometriosis.

Objective To investigate the effects of nordihydroguaiaretic acid(NDGA)on the endometriosis established in Bama miniature pigs.Methods Six Bama pigs that had been successfully established into animal model of endometriosis subcutaneously received 3% NDGA at dose of 20 mg/kg(n=4)or PBS solution(n=2)for 20 d.The grafts in abdominal cavity and subcutaneous tissues were observed and the serum concentrations of hormone,were measured by chemiluminoimmunoassay before and after the period of NDGA or PBS injection.The expressions of FⅧAg and VEGF in the endometriotic tissues were observed.Results The endometriotic masses were reduced to some degree after the time period of NDGA injection,even partially disappeared,while those treated with PBS showed no obvious changes.Histoimmunochemical analysis showed NDGA decreased the number of endometrial glands,the proliferation rate of the glandular epithelial cells,the endometrial stroma cells and the vessels,and inhibited the microvascular density and VEGF in the endometriotic tissues(P

OBJECTIVETo summarize the clinical characteristics of an infant with chronic myelogenous leukemia (CML) and the effects of imatinib on the case.

METHODThe clinical features of an infant with CML, who was treated with imatinib in the Norman Bethune International Peace Hospital at June 2009, were retrospectively analyzed and the reports in literature were reviewed. The 1-year-old boy suffered from recurrent low-degree fever and pallor. He had a moderate anemia, distended abdomen and marked splenomegaly. Bone marrow aspiration revealed CML in chronic phase)CP). The t (9; 22))q34; q11) could be detected and BCR-ABL (p210) was positive. The boy was diagnosed as CML-CP and treated with imatinib 100 mg per day. There were 10 related papers and more than 100 child CML patients were reported as retrieved from CNKI)from its establishment to August 2014) and Wanfang Database)from its establishment to August 2014) when "Child", " Chronic" and "Leukemia" were used as keywords. And there were 30 related papers including 400 cases from PubMed Database (from its establishment to August 2014) and one detailed report of an infant with CML was retrieved when "childhood" and "chronic myeloid leukemia" "imatinib" were used as keywords. The clinical effects of imatinib in infant CML cases were analyzed and summarized based on the literature.

RESULTThe boy obtained a complete hematologic response (CHR) at the 6th week of diagnosis, a complete cytogenetic response (CCyR) at the 3rd month and a complete molecular response)CMR) at the 12th month without side effect. This boy grows very well and after a 62-month follow-up, his disease was stable. According to the domestic literature, 5 children CML cases aged 6 -12 years were treated with imatinib without side effects and got complete hematologic response (CHR) after 2-month-therapy. The dose, metabolic characteristics and clinical observation of imatinib can be found in foreign literature and imatinib showed good response with good tolerance in children with CML. Imatinib is regarded as the first line drug for children CML. But it may affect the development of the children.

CONCLUSIONThe children with CML-CP had a good response to imatinib, but more experience in the treatment of children with CML with iniatinib is needed.

Anemia ; Antineoplastic Agents ; therapeutic use ; Fusion Proteins, bcr-abl ; Humans ; Imatinib Mesylate ; therapeutic use ; Infant ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Male ; Remission Induction ; Retrospective Studies