Objective To investigate and analyse the status and influential factors of nurses' palliative care knowledge in Shanghai city.Methods Using cluster sampling method,a questionnaire survey using Palliative Care Quiz for Nursing (PCQN) was conducted on 973 nurses in 9 hospitals of Shanghai city.Results 939 nurses completed the survey whose scores were 8.88±2.51.The status quo of palliative care knowledge of Shanghai nurses were not very desirable.The scores of palliative care philosophy and principles and psychological,social and spiritual support were 0.376±0.009 and 0.310±0.008.The scores of knowledge of the pain and symptomcontrol was 0.496±0.005,which was better than the other two aspects.There were differences between dimension 1 and dimension 2,3 (t=-1 1.78,5.465,P＜0.01),and also between dimension 2 and 3 (t=19.673,P＜0.01).Conclusions Lacking of education and training,insufficient recognition of related institutions and the limit of traditional ideas caused the defect in the knowledge structure of palliative nursing.

Immunoglobulin preparations;SARS-CoV-2;Inactivated vaccine;Neutralization test;Neutralizing antibody Objective To evaluate the neutralizing antibody level of the population to SARS-CoV-2 and its variants before and after vaccination.Methods A total of 37 samples of immunoglobulin preparations were collected. According to the time of plasma collection, taking the time of SARS-CoV-2 vaccine intensive inoculation(September 2021) and the time of epidemic prevention policy change(December 2022) as nodes, the immunoglobulin preparations produced in different time periods were divided into three groups: 19 samples of plasma collected from February 2019 to October 2021 in group 1, 8 samples of plasma collected from March 2022 to December 7, 2022 in group 2, and 10 samples of plasma collected from January 2023 to February 2023 in group 3. The neutralizing antibody levels of the wild strain, Delta strain, Omicron BA.5,BQ.1 and XBB variant strains were measured by micro neutralizing antibody assay, and the geometric mean titers(GMTs) of the antibodies were calculated.Results The SARS-CoV-2 wild strain neutralizing antibody was detected in only 5 of the 19immunoglobulin preparations prepared by plasma collected before 2021, with the titer of not more than 1 ∶ 20, and no neutralizing antibody against the other four variants was detected. From March to December 2022, the neutralizing antibody titers of eight immunoglobulin preparations against the five SARS-CoV-2 strains increased significantly, of which the wild strain(1∶2 560) and Delta strain(1∶1 810) had the highest titers, followed by the Omicron strains(GMT_(BA.5)=1∶830;GMT_(XBB)=1∶104; GMT_(BQ.1)=1∶22). Among the 10 immunoglobulin preparations prepared by plasma collected in 2023, the neutralizing antibody titers of the five strains showed little change. The GMTs of the five strains of antibodies were∶wild strain(1∶2 079), Delta strain(1∶1 114), Omicron BA.5(1∶970), Omicron BQ.1(1∶69), and Omicron XBB(1∶121). There was no significant difference in the GMTs of the five strains between the two groups of immunoglobulin preparations(t=1. 249, 1. 495, 0. 370 2, 1. 160 and 0. 502 8, respectively, each P > 0. 05).Conclusion The neutralizing antibody level of SARS-CoV-2 has significantly increased in immunoglobulin products after the implementation of enhanced inoculation of SARS-CoV-2 vaccine in China, while compared with Omicron and its branch strains, inactivated SARS-CoV-2 vaccine has better protection effect on SARS-CoV-2 wild strain and Delta strain

Objective To investigate the effect of early rehabilitation treatment in the patients with small cerebral hemorrhage and its possible mechanisms .Methods 133 patients with cerebral hemorrhage were randomly divided into the routine treatment , non-early rehabilitation and early rehabilitation groups and given the routine drug treatment .The early rehabilitation group and the non-early rehabilitation group were additionally given the rehabilitative training after 2 d and 14 d respectively .The scores of Fugl-Meyer reassessment and the Barthel index were assessed before training and after 4-week training ,and the serum levels of circulat-ing endotheial progenitor cells(EPCs) and vascular endotheial cell growth factors(VEGF) were detected .Results Compared with the routine treatment group and the non-early rehabilitation group ,the scores of Fugl-Meyer reassessment and the Barthel index af-ter treatment in the early rehabilitation group were significantly increased (P< 0 .01) .The serum levels of circulating EPCs and VEGF in the early rehabilitation group were also significantly increased compared with the routine treatment group control (P<0 .01) .Conclusion Early rehabilitation treatment can obviously improve the limb movement function and the daily living ability in the patients with small cerebral hemorrhage ,its mechanisms may be involved with the increase of circulating EPCs and VEGF .

Objective: To examine and analyze the expression of two isoforms of livin (livin α/livin β), a novel inhibitor of apoptosis protein (IAP) family member, in tumor cell lines and malignant tumor tissues and analyze the relationship between livin expression and clinical pathological features of different tumors. Methods: Livin mBNA expression was detected by reverse transcription polymerase chain reaction (BT-PCR) in 12 malignant tumor cell lines, 50 different malignant tumor tissues, and 20 cases of normal tissues. Results: Livin mBNA was highly expressed in seven cell lines (Hela, SPEA-1, SBE-2, PC14, MKN45, LOVO, and HHCC) and poor expressed in A549 cells, It had negative expression in other four kinds of cell lines ( HL-7702, Hep-2, 7721 and K562). Livin mRNA was positively expressed in 32 of 50 malignant tumor cases (64.0%). The expression of livin mRNA was at low level in paracancerous tumors tissues (2%). Livin expression had no significant association with differentiation degree, lymph node metastasis and TNM staging of tumor patients. Conclusion: Livin expression in tumor cell lines and malignant tumor tissues provides stronger evidence for further investigating the relationship between livin and tumor initiation and development. It may serve as a new target for malignant tumor diagnosis and therapy.

Objective To compare the effect of etomidate and propofol on cardiac and renal function in perioperative elderly patients. Methods 120 perioperative elderly patients were selected and divided into two groups.60 cases in etomidate group (T group) were anesthesia induced by etomidate, and 60 cases in propofol group ( B group) were anesthesia induced by propofol.Hemodynamics, renal function and perioperative indexes were compared after operation.Results Compared with before induction, SBP, DBP and HR were lower after induction(P<0.05), and compared with T group at the same time, SBP, DBP and HR of B group were lower( P<0.05).Compared with before induction, SI, CI and EV were lower after induction (P<0.05), and compared with T group at the same time, SI, CI and EV of the B group were lower(P<0.05).Compared with B group, Cr, BUN and β2-MG of T group were lower ( P<0.05 ) .Conclusion The effects of etomidate on inhibition of cardiovascular system and damage of renal function is slighter, which has important significance for elderly cancer patients.

OBJECTIVE To investigate the drug-resistance status of clinically isolated Staphylococcus aureus(SAU) and provide scientific evidence for clinically reasonable use of antibiotics.METHODS Retrospective review was adopted to analyze the specimen source and the clinical distribution of 311 SAU strains.BioMerieux VITEK 32 was used to identify SAU.Antibiotic susceptibility testing was performed by K-B method.RESULTS Isolating rate of meticillin-resistant S.aureus(MRSA) was 48.9%.SAU were resistant to the diverse antibiotics in different degree except for 100% sensitivity to glycopeptide antibiotics.The drug-resistance to antibiotcs in MRSA were all higher than those in meticillin-sensitive S.aureus(MSSA).CONCLUSIONS Monitoring and controlling of antibiotics resistance are effective measures of prevention from nosocomial infections.

Objective To analyze the influencing factors of perioperative coagulation dysfunction in neonates with gastrointestinal surgery.Methods Coagulation indexs, including plasma prothrombin time (PT), partial activated thromboplastin time (APTT), thrombin time (TT) and plasma fibrinogen (Fib), were collected retrospectively from June 2002 to April 2016 in gastrointestinal neonatal surgery, as well as perioperative clinical data and the perioperative coagulation dysfunction associated risk factors were analyzed.Results There were 158 cases with abnormal coagulation indexs within 4 hours after operation, including 61 cases of mild abnormalities and 97 cases of obvious abnormalities.Multivariate logistic regression analysis showed that preoperative pneumonia (OR=2.880, 95%CI 1.417-5.852), perioperative low calcium (OR=2.381, 95%CI 1.167-4.857) and invasive puncture catheter (OR=2.490, 95%CI 1.299-4.773) were independent risk factors for neonatal coagulation index abnormality within 4 hours after surgery (P<0.05).Conclusion In the perioperative management, pneumonia should be actively treated, correcting hypocalcemia and choosing concentrations of less than 6.25 U/ml of heparin solution or normal saline careing arteriovenous catheter reduces the occurrence of neonatal postoperative coagulation dysfunction.

Objective In order to explore the relationship between the “Wits" appraisal and the ANB angle, and to see how accurately one can predict the “Wits”. Methods Given the ANB, lateral cephalometric radiographs were taken on 50 boys and 50 girls between the ages of 11～13. Results Each subject had no treatment either a Class Ⅰ or Class Ⅱ malocclusion, a good growth pattern. Group Ⅰ , 13 subjects of 100 had ANB≤1.5°, and negative “Wits” appraisal; group Ⅱ , 61 subjects had 5.8°＞ANB＞1.5°, and “Wits” appraisal either positive or negative; group Ⅲ , 26 subjects had ANB angle≥5.8°, and positive “Wits” appraisal. Statistically analysis showed that there was no sig nificant difference in sex (P＞0.05); there was significant correlation between the ANB and “Wits” values in the group Ⅱ and group Ⅲ (P ＜0. 05); there was statistical significance in regression analysis in the group Ⅰ and group Ⅱ (P ＜0. 05). We could predict the “Wits” with 21％ accuracy in group Ⅱ. Conclusion The results indicate that these figures are statistically significant but clinically irrelevant.

OBJECTIVE:To observe clinical efficacy and safety of triptorelin acetate in the treatment of endometriosis after lap-aroscopy. METHODS:196 cases of endometriosis were randomly divided into experimental group and control group with 98 cases in each group according to admission sequence. Both groups received laparoscopic surgery. After surgery,experimental group was given triptorelin acetate by intramuscular injection,3.75 mg/time,every 4 weeks;control group was given gestrinone orally,2.5 mg/time,twice a week,for 5 months. The ovulation,menstrual recovery and the occurrence of ADR were observed in 2 groups. The endometriosis relapse of 2 groups were followed up for 1 year and observed. RESULTS:After treatment,the ovulation recov-ery time and menstrual recovery time of experimental group were all shorter than those of control group,with statistical signifi-cance(P<0.05). The incidence of ADR in experimental group(17.34%)was significantly lower than in control group(35.71%), with statistical significance(P<0.05). During follow-up period,the relapse rate of experimental group(7.14%)was significantly lower than that of control group(18.37%),with statistical significance(P<0.05). CONCLUSIONS:After laparoscopic surgery, triptorelin acetate can significantly improve therapeutic efficacy of endometriosis,reduce the occurrence of ADR.