In the implementation of community health service,the working efficiency of the community nurses becomes increasingly important to the overall service standards of the service centers as the local residents have begun to take it into consideration when evaluating the service quality.By illustrating the roles of nurses in all the six major functions played by the community health service,this paper intends to arouse the attention from the concerning authorities to the training of the nurses so that the nurses can be developed in an all-round way and provide better services for the community.

Objective To determine the effect of resurfacing completely degloved thumbs by free perforator flaps in a spiral fashion.Methods A retrospective case series study was made on 22 patients with completely degloving injury of the thumb treated by different free perforator flaps in a spiral fashion from June 2009 to December 2014,including 19 male and 3 female patients at the age of 18-46 years (mean,27.8 years).A total of 13 patients were reconstructed using the medial arm perforator flaps ranging in size from 8.0 cm × 3.0 cm-14.5 cm × 3.5 cm,and 9 patients were reconstructed using the peroneal artery perforator flaps ranging in size from 6.0 cm × 3.5 cm-21.0 cm × 10.0 cm.Follow-up was made to evaluate the sensation,appearance and function of the thumbs and the recovery of flap donor sites.Results All flaps survived completely,with no occurrence of postoperative vascular crisis and infection.Only one medial arm flap and one soleus perforator flap distal flap showed blood flow disorder in the distal sections and were healed uneventfully after conservative therapy.Function and cosmetic recovery of the reconstructed thumbs were good.Follow-up ranged from 9 to 22 months (mean,14.5 months).Twopoint discrimination test of the flaps was recovered to 6-13 mm.No linear scar contracture was left.Flap donor site wound healed primarily.All patients were satisfied with the overall results.Conclusion The free perforator flap in a spiral fashion can avoid linear scar contracture,maximally decrease donor site morbidity and achieve satisfactory functional recovery and good aesthetic restoration,indicating a good candidate for reconstruction of thumb degloving injury.

OBJECTIVE:To establish a RP-HPLC method for simultaneous determination of caffine,acetaminophen and isopropylphenazone in human plasma after oral dose of saridon.METHODS:Hypersil Hypurity TM Advance was used as chromatographic column and the mobile phase was a mixture of0.01mol/L phosphoric acid-methanol-tetrahydrofuran(86∶12∶2).The detection wavelength was273nm.RESULTS:The calibration curves were linear in the ranges of0.39～100.0?g/ml for caffine,1.96～500.0?g/ml for acetaminophen,and1.17～300.0?g/ml for isopropylphenazone,respectively.The accuracy of all was higher than95.0%.The inter-day and intra-day RSD was less than10.0%.CONCLUSION:The present method is sensitive,accurate,convenient,and highly specific,which can meet the requirement in plasma determination of three components in Saridon tablet.

Objective To explore the pathogenesis of invasive pituitary adenomas,and to improve the effect of clinical treatment.Methods 15 pairs of invasive pituitary adenoma tissues and noninvasive pituitary adenoma tissues were selected from 114 specimens collected and the Id1 gene expression and Id1 protein expression in invasive pituitary adenoma tissues and noninvasive pituitary adenoma tissues were tested by quantitative RT-PCR,Western blot and immunohistochemical methods;Then small interfering RNA (siRNA) was used to interfer Id1 gene expression in NQ-04 cells.Results The Id1 gene expression in invasive pituitary adenoma tissues was significantly higher than that in noninvasive pituitary adenoma tissues(n =15,t =2.725,P =0.013) ;The migration of pituitary adenoma cells interfered was significantly reduced.Conclusion The invasive pituitary adenoma tissues has high level of Id1 gene expression,which may be correlated with its invasion.And Id1 is expected to become a biological marker of diagnosis and determination in the prognosis of pituitary adenoma.

Objective To provide evidence for clinical practice by analyzing the factors associated with bloodstream infection in ICU patients through retrospective case-control study. Methods Using self-made data collection form, 133 cases of blood sample record from HIS system during May 2013 to December 2015 at Peking Union Medical College Hospital ICU ward were collected. In this study, 54 patients with positive blood culture results were allocated to the case group while 79 patients with negative results were in the control group. Baseline characteristics, which included sex, age and chronic diseases, were almost the same between both groups. Binary Logistic regression analysis was used to identify factors related to blood infection. Results During May 2013 to December 2015, there were 54 blood infectious cases, among which 19 cases with positive gram bacteria accounted for 35.2%(19/54), 57.4%(31/54) of gram-negative bacilli and 7.4%(4/54) of fungal infection. Logistic regression analysis revealed that blood filtration treatment (OR=7.691), pulmonary infection (OR=7.682), ICU (OR=1.115), Acute Physiology and Chronic Health Evaluation (APACHEⅡ) scores(OR=1.096), procalcitonin (OR=1.065) were risk factors of bloodstream infection for ICU patients, while albumin (OR=0.763) was a protective factor. Conclusions Blood filtration treatment, pulmonary infection, hospital length of stay, APACHEⅡand procalcitonin are factors associated with bloodstream infection in ICU patients. Clinical procedures in ICU should mainly focus on improvement of prevention awareness, strict aseptic technology, professional quality of nursing staff. Besides, guarantee of patients′nutrition, effective treatment of primary diseases, and shortened hospital length of stay are also important to reduce the infection and improve quality of life of these patients.

Objective Medication for pituitary adenomas is mainly targeted on the prolactin-secreting and growth-hormone types and shows poor therapeutic effects on other adenomas .Therefore, new drugs urgently need to be developed for this purpose .This study was to investigate the effects of glivec and everolimus on mouse pituitary AtT-20 cells and their molecular mechanisms in vitro. Methods Mouse pituitary AtT-20 cells were incubated with glivec or everolimus or combination of both and their inhibitory effect on the proliferation of the cells was measured by CCK-8 assay.The mRNA levels of AKT and ERK were determined by q-PCR and the ex-pressions of the phosphorylated AKT (p-AKT) and ERK (p-ERK) were detected by Western blot. Results Used alone, both glivec and everolimus inhibited the proliferation of the AtT-20 cells in a time-and dose-dependent manner , but their combination produced a mutually antagonistic effect, with combination index values of 1.13 ±0.06, 1.12 ±0.03, and 1.07 ±0.03 respectively.The two a-gents , either used alone or in combination , induced no significantly inhibitory effects on the mRNA and protein expressions of AKT and ERK ( P >0.05 ).Both glivec and everolimus up-regulated the expressions of p-AKT and p-ERK, and their combination manifested an even stronger effect (P>0.05). Conclusion Both glivec and everolimus inhibit the proliferation of AtT-20 cells when administered alone, but their combination produces an antagonistic effect .Their action mechanism might be that when targeting some signaling path-ways to inhibit cell proliferation , glivec, as well as everolimus , in-duces a feedback activation of AKT and ERK .

Dermatitis, Occupational ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Trichloroethylene ; adverse effects ; Young Adult

Background and purpose:Nowadays, about therapy of laryngeal carcinoma, people are paying more and more widely attention to ifnding out how to improve quality of patients’ life besides radical surgery. For glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, we performed modiifed frontolateral partial laryngectomy or modiifed cricohyoidoepiglottopexy, and contrastive analyzed the therapeutic efifcacy of the two ways. Methods:Sixty cases patients of glottic laryngeal carcinoma who treated in Hunan Provincial Tumor Hospital during 2005 to 2010, which invaded the anterior commissure or bilateral vocal cord, were randomly attributed to two groups as A and B;30 patients of group A were underwent modiifed frontolateral partial laryngectomy and repaired with bilateral sternohyoid muscle lfap, 30 patients of group B were treated by modiifed cricohyoidoepiglottopexy. Follow-up time of each patient was 5 years postoperation and clinical data were retrospectively analyzed. Results:The 5-year survival rate was 86.7%in group A as well as 83.3%in group B, and there was no statistical difference between two groups (P=0.718). Pronunciation function:22 cases in group A and 21 cases in group B whose pronunciation function can be competent in the noisy environment, and can pronounce“a”and“i”vowel;8 cases in group A and 9 cases in group B can pronounce only a“ha”,“hi”sound, that couldn’t communicate with others in a noisy environment. There was no statistical difference in pronunciation function between the two groups (P=0.774). Incidence of deglutition disorder 4 weeks postoperation:group A was 0 (0/30), group B was 16.7%(5/30), and the difference between the two groups was statistically signiifcant (P=0.026);average time of extubation postoperation:group A was (10±2.3) d, group B was (20±4.6)d, and the difference between the two groups was statistically signiifcant (P=0.0000);recurrence rate of dyspnea after extubation:group A was 16.7%(5/30), group B was 0 (0/30), and there was statistically signiifcant difference between the two groups (P=0.026). Conclusion: For the glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, there was no statistical difference in 5-years survival rate and function of pronunciation between modified frontolateral partial laryngenctomy and modified cricohyoidoepiglottopexy postoperation. The former had less postoperative deglution disorder, earlier extubation time, and to some extent, alleviated the suffering of the patients, but part of these patients needed secondary surgery due to dyspnea which resulted by radioactive tissue adhesion after extubation. The latter had more serious deglution disorder postoperation, longer recovery time, and relatively longer time to extubating, showed no again dyspnea after extubation, and had more extensive adaptation disease. In a word, each way of operation has its advantage respectively.

BACKGROUND:Matrix attachment region(MAR)are DNA elements that bound to the nuclear matrices after chromatin digested with restriction endonuclease.Plenty of studies have shown that MAR considered as initiaI point of DNA replication or transcription of regulatory gene.Thereby,construction of MAR expression vector can elevate the overall level of transgene expression,enhance stability of exogenous gene.as welI as increase frequency of stable transfectant cells.OBJECTIVE:To construction pLXSN-CAT recombinant retrovirus vector that containing chloramphenicol acetyltransferase(CAT)via cloning MAR sequence of human.and to explore the influence of MAR on the gene expression.METHODS:An open experiment was performed at the Department of Biochemistry and Molecular Biology.Xinxiang Medical College from September 2007 to December 2007 The PLXSN-CAT vector of CAT was constructed by the laboratory.TaqDNA polymerase,T_4 DNA ligase,DNA Marker,restriction enzyme BamH I,agarose gel DNA purification kit,as well as plasmid purification kit were purchased fromTakara Biotechn0Iogy(Dalian)Co.,Ltd.The sequence of csp-B MAR was amplified by polymerase chain reaction(PCR)method applied to human DNA.The fragment was inserted into retrovirus vector PLXSN-CAT plasmid.The recombinant plasmid was verified by double digestion and DNA sequencing.RESULTS AND CONCLUSION:The length of specific fragment applied by PCR was 931 bp,and the recombinant plasmid PLXSN-CAT-MAR presented two bands:5.9 kb and 931 bp using respective restriction enzymes BamH I The sequence of MAR was confirmed by blasting to Genbank(serial numobr:M6271 6).It suggested that MAR had been cloned into PLXSN-CATR vector correctly.The recombinant retrovirus vector PLXSN-MAR was successfully constructed.

OBJECTIVE: To investigate the usefulness of anterolateral thigh flap for reconstruction of the defect after maxillectomy. METHOD: Seventy-two cases with defect after maxillectomy were constructed with anterolateral thigh flap in our department during 10 years. All cases were undertaken total maxillectomy. RESULT: All flaps except one were transferred successfully. Patients were satisfied with their appearances. No serious complications had happened. CONCLUSION Anterolateral thigh flap could be an donor flap for the reconstruction of the defect after maxillectomy.
Face ; surgery ; Free Tissue Flaps ; Humans ; Maxilla ; surgery ; Reconstructive Surgical Procedures ; Thigh