The JCI-based PDCA cycle makes continued quality improvement its comerstone.Its use in ICU human resource management consists of assurance of HR quantity,assurance of HR quality,and scientific use of human resources.Its application in ICU nursing care consists of creating excellent environment and providing high quality nursing items,with emphasis on quality nursing service in detail.Conversion of working mode,rationalized HR deployment,high quality nursing care,all contribute to raising the quality and social reputation of the hospital and the department,to standardized management,enhanced teamwork,better nursing care quality,and to higher satisfaction of the patients in the end.

Thirteen compounds were isolated from the ethyl acetate fraction of Crepis crocea by column chromatographies on silica gel, Sephadex LH-20 and semi-preparative HPLC. The structures were elucidated on the basis of spectral analysis as tectorone I (1), 8β- (2-methyl- 2-hydroxy-3-oxobutanoyloxy) -glucozaluzanin C (2), tectoroside (3), luteolin-7-O-glucoside (4), cosmosiin (5), esculetin (6), 3,4-dihydroxybenzaldehyde (7), trans-4-hydroxycinnamic acid (8), Caffeic acid (9), methyl p-hydroxyphenyllactate (10), ethylp- hydroxyphenyllactate (11), cis-3,4-dihydroxy-β-ionion (12). All the compounds, except for compounds 4 and 9, were isolated from this plant for the first time, and tectorone I (1) is a new natural product.
Crepis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Mass Spectrometry ; Molecular Structure

Animals ; Disease Models, Animal ; Hypoglycemia ; chemically induced ; metabolism ; Hypothalamus ; drug effects ; metabolism ; Insulin ; pharmacology ; Intracellular Signaling Peptides and Proteins ; metabolism ; Male ; Neuropeptides ; metabolism ; Orexins ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the effect of military performance stress on the changes of concentrations in salivary chromogranin A ( CgA) ,β-endorphin (β-EP) and salivary IgA ( sIgA) of submariners.Methods Twenty-nine submarine soldiers were selected, and their saliva samples were collected separately at the end of a long dive trip and nine months after relaxation ashore.In addition,the saliva samples of twenty-eight graduate students were collected as the normal control.The method of ELISA was used to detect the level of salivary CgA,β-EP and sIgA.Results After long-term dive training, the submariners showed significantly decreased CgA,β-EP and sIgA.Conclusion After a long term dive trip, chronic military performance stress is associated with the decline of salivary CgA,β-EP and sIgA, indicating that the function of sympathet-ic adrenal medulla is suppressed.The biological significance of these changes needs to be assessed in the future.

In this study, ITS2 barcode was used to identify Bupleurum chinense and B. longiradiatum. The ITS2 regions of 48 samples were amplified and sequenced. The sequences obtained above were aligned and the K2P distances were calculated. We used three methods, BLAST1, nearest distance and phylogenetic tree (NJ-tree), to test the identification ability. The results showed that the maximum intraspecific genetic distance of B. chinense was 0.013, and the minimum interspecific genetic distance between B. chinense and B. longiradiatum was 0.049. The NJ-tree can easily identify B. chinense and B. longiradiatum. Therefore, the ITS2 barcode is suitable to identify B. chinense and B. longiradiatum.
Bupleurum ; classification ; genetics ; DNA Barcoding, Taxonomic ; methods ; DNA, Plant ; genetics ; DNA, Ribosomal Spacer ; genetics ; Drugs, Chinese Herbal ; chemistry ; classification ; Molecular Sequence Data ; Phylogeny ; Quality Control

OBJECTIVETo introduce the clinical manifestations and laboratory tests of adult onset of primary hemophagocytic syndrome (HPS), and to investigate the essentials of diagnosis and the genotype characteristics in adult onset patient.

METHODSThe definite diagnosis of HPS was made according to HLH-2004. Exons of PRF1, STX11, UNC13D, SH2D1A and RAB27A genes coding region were amplified using polymerase chain reaction.

RESULTSA 48-year-old man was admitted to our hospital because of recurrent fever, pancytopenia and lymph node enlargement. His laboratory test revealed bone marrow hemophagocytosis, elevated ferritin level (2000 µg/L), reduced level of NK cell activity (20.13%) and elevated soluble CD25 level (12277 U/ml). Based on the HLH-2004 diagnostic criteria, the patient was diagnosed as HPS. The patient had viral infection, and no other primary disease was identified that would cause HPS. The patient responded poorly to anti-viral therapy. DNA sequencing was used to confirm that perforin gene mutations might be one of the causes of the patient suffered from primary HPS.

CONCLUSIONSAlthough primary HPS usually affects infants and young children, it also occurred in teens and adults. It is essential to perform genetic screenings to patient whose illnesses recur with unknown causes. In addition, detection of molecular genetic alterations can be used to distinguish primary HPS from acquired HPS.

Objective To investigate the significance of salivary cortisol , dehydroepiandrosterone sulfate (DHEA-S) and cortisol/DHEA-S ratio changes for evaluation of military performance stress .Methods Forty submarine soldiers were selected, whose saliva samples were collected separately at the end of long-term dive training and after nine months of relaxation break.In addition, the saliva samples of thirty-four graduate students were collected the moment they finished a three-hour final examination and one week later .The method of ELISA was used to detect the levels of salivary cortisol and DHEA-S and to count their ratio .Results After long-term dive training , the submarine soldiers showed significantly decreased DHEA-S and an increased cortisol/DHEA-S ratio, but the cortisol level did not change very much .In contrast, the final examination stress did not change the level of cortisol , DHEA-S or the cortisol/DHEA-S ratio among these students.Conclusion This is the first study to show that long-term, chronic military performance stress is associated with the salivary DHEA-S and cortisol/DHEA-S ratio changes .The increase in the cortisol/DHEA-S ratio may be used as an important and useful biomarker to evaluate chronic stress .In addition , it is relatively simple and sensitive to detect stress biomarkers by using saliva samples .

Objective To discuss the histology change,apoptosis state and Bcl-2,Bax expression after the bone cement leakage into the intervertebral disc in vertebroplasty.Methods Eight majority canis familiaris were studied.Three lumbar intervertebral discs(L2 to L5)in each dog were randomly classified into three groups(control group,PMMA group,and CPC group),the canine discs were stabbed by 18-gauge needle,and 0.1 ml cement was injected into them.Control discs were only stabbed and injected with nothing.Histology of all discs was studied 24 weeks after the operation.Terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL)and immunohistochemisty were used to detect apoptosis and Bcl-2,Bax expression in the discs.The data were statistically analyzed by SPSS 12.0.Results Intervertebral disc degeneration was not found in control groups.In bone cement groups,however,ruptured or serpentine patterned fibers,decreased cellularity of the nucleus pulposus and condensed matrix of the nucleus pulposus were found in histologic results.The Bax protein decreased in the order of control group, CPC group,and PMMA group.However,the Bcl-2 protein increased in the order of control group,CPC group,and PMMA group.The histology grade was significantly different among the three groups under ANOVA analysis(P

ObjectiveTo investigate the occurrence of new cretinism cases and the prevalence of endemic goiter in iodine deficiency disorders(IDD) high-risk areas of Fujian province,so as to put forward target prevention and control measures for these areas.Methods Twelve counties from Xiuyu,Xiangan,Pingtan,and Dongshan were chosen into the survey by simple random sampling,searching for new cretinism cases were carried out in children under 10 years old.Two schools were chosen in every county and the thyroid volume of forty children aged 8 - 10 were determined by B-ultrasonography methods and their urinary iodine(UI) was determined by As3--Ce4+catalytic spectrophotometry in each school.Twenty women of child-bearing age aged 18 - 40 were chosen for collecting edible salt and urine samples,and the salt iodine content was determined using self-quantitative kit and their UI was also determined by As3--Ce4+ catalytic spectrophotometry.Results In the 4 high-risk counties,no cretinism cases were found.The goiter rate of children aged 8 - 10 was 3.6％(37/1027),and that in Dongshan county was 5.4％(13/240),which was higher than the national standards for eliminating IDD( ＜ 5％).The median urinary iodine(MUI) of children aged 8 - 10 was 175.3 μg/L,and the MUI of women aged 18 -40 was 152.7 μg/L.The coverage rate of iodized salt was 82.7％(382/462).ConclusionsNew case or suspected new case of cretinism is not discovered in the high-risk areas of IDD of Fujian province,and median urinary iodine level of people is in the adequate range.

Objective To understand the prevalence,drug resistance and clinical features of children with acute lower respiratory tract infection(ALRI) caused by escherichia coli.Methods From Oct. 2005 to Oct. 2006,659 patients with ALRI who were admitted to hospital were chosen and their nasopharyngeal secretions were obtained and cultured.K-B disc diffusion for antibiotic susceptibility were performed for these clinical isolates.Results Among 659 patients,118 cases were isolated escherichia coli,the rate was 17.99% which had 90 boys and 28 girls.Eighty-seven of 118 E.coli strains were with extended-spectrum ?-lactamase(ESBLs),the rate was 73.73%.All of strains were sensitive to imipenem.For ESBLs-producing strains,the ratio of resistance tocefotaxime,ceftriaxone,cefuroxime,ampicillin,piperacillin were 78.81%,73.73%,73.73%,76.27%,78.81%,respectively.Conclusions The positive rate of ESBLs producing E coli in Kunming area is high and drug resistance is severe gradually.Imipenem can be the first selection for treatment on these infections.