Aortic dissection is an acute injury of the aortic intima due to various factors from the outside or itself. The rapid blood flow enters the middle layer of the aortic elastic force from the breach and expands longitudinally along the aorta to form a true and a false two lumens. Aortic dissection is a rare, high-risk cardiovascular disease with a low incidence, but it is extremely harmful. Lesions can affect the systemic system, without treatment, the natural prognosis is poor. Surgery is the most effective treatment, especially for Stanford A and high-risk Stanford B dissection. With the increase of the incidence of aortic dissection, the diagnosis and treatment and nursing technology have developed rapidly in recent years, but the mortality rate is still high due to the complex, rapid changes and complications. This article reviews the current status of preoperative aortic dissection in order to improve the understanding of clinical nurses and provide a reference for the perioperative nursing intervention study of aortic dissection.

Objective To investigate the effect of optimizing nursing process in emergency PCI on the reduction of radiation received by interventional nurses.Methods A total of 100 cases of acute myocardial infarction patients who need emergency PCI in First Affiliated Hospital of University of South China were selected for the study,with the first 50 cases as the control group using conventional nursing process and the other 50 cases as the optimization group using the optimal nursing process in the test.Two radiation monitoring methods were used at the same time to measure,record and analyze the radiation dose to the intervention nurses in the two groups.Results The differences in radiation doses to nurses between the two groups were statistically significant in the single operation of intracoronary drug configuration,non-intracoronary drug configuration,intravenous injection,patient care,emergency material unpacking,and contrast agent replacement (Z =-5.171,-3.774,-7.208,-2.454,-4.516,-3.819,P ＜ 0.05).There was no significant difference in radiation dose to nurses between the two groups in the subcutaneous injection of drugs and vomiting care of patients (P ＞ 0.05).The difference in radiation doses to nurses between the two groups during the entire operation was statistically significant (Z =-6.105,P ＜ 0.05).Conclusions The optimized nursing process helps to reduce the radiation received by interventional nurses in emergency PCI.

Objective To confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating breast lesions on ultrasonic elastography(UE).Methods Eight hundred and forty-six consecutive female patients with 1 071 breast lesions were recruited into a multicenter retrospective study,which involved 8 centers across China.All the patients underwent the UE procedure and the strain ratios were calculated.The sensitivity,specificity,accuracy,PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared.Results The strain ratios of 559 benign lesions(2.7±1.4)and 512 malignant lesions(8.1±5.9)were significantly different (P<0.001).When the cutoff point was 3.03,strain ratio method had 81.6% sensitivity,89.7% specificity,81.7% accuracy,80.2% PPV and 84.2% NPV.The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0.865 and 0.862,respectively(P =0.622).For the lesions with elasticity score 3 and 4,the areas under the ROC curve of the two Methods were 0.71 1 and 0.629, respectively(P = 0.020).Conclusions Although the two UE Methods have similar diagnostic performance,separate calculation of the strain ratios seems compulsory,especially for the lesions with elasticity score 3 and 4.

This study was conducted to explore a proper training model of interns' clinical thinking ability under the construction of a new four-year system of medical laboratory technology courses, combined with the establishment of innovative standard whole process practice mode. Multi-teaching methods of clinical thinking, such as explanation of laboratory sheet, interactive teaching based on micro digital system, interdisciplinary multiple information system, combined PBL teaching and intern report, were applied and evaluated in the laboratory. Integrated application of these methods remarkably improved the intern's com-prehensive professional quality and their practice performance. All methods received high evaluation from both the interns and teachers.

Objective To investigated the clinical distributions and antimicrobial susceptibility of Streptococcus agalactia strains isolated from the patients .Methods The identification and susceptibility of the strains were mainly measured by automatic VITEK‐Ⅱ system ,the K‐B disc diffusion tests were used for the resistance test of erythromycin ,meropenem ,and D‐test .Results The iso‐lates were mainly from urine (63 .1% ) ,genital tract(7 .8% ) and wound secretion(6 .7% ) .They were obtained from patients in dif‐ferent situations ,including 110 patients who were older than 50 years old (61 .5% ) ,113 female patients (63 .1% ) ,12 gravidas (6 .7% ) ,3 vertical transmitted newborns(1 .7% ) ,and 82 patients with cancer ,undergoing chemo radiotherapy ,with diabetes ,tuber‐culosis or after operations(45 .8% ) .The resistant rates of the isolated Streptococcus agalactia to erythromycin and clindamycin were 42 .9% -93 .3% and 41 .9% -80 .0% respectively .The positive rate of D‐test was 4 .1% .The strains were highly resistant to tet‐racycline(>80% ) ,while the resistance to penicillin was below 10% except in 2008 .All isolates were susceptible to vancomycin and meropenem .Only one strain was resistant to Quinupristin‐dalfopristin .Conclusion Streptococcus agalactia infection in adults most‐ly cause genitourinary tract ,skin and soft tissue infections .There were more females than males with Streptococcus agalactia infec‐tion .Penicillin andβ‐lactams are still the first choice for the treatment .Erythromycin ,clindamycin and tetracycline should be used with caution under the guidance of laboratory susceptibility test results .

Cubic and conductive teaching pattern is based on standardized operation process of microbiological specimens. It uses multi-dimensional teaching methods including tests, question guid-ance, discussion, lectures, measurements and scientific researches to lead the undergraduate students to master the standardized inspection process and to train talents with good gifts and abilities in prac-tical application. The teaching pattern helps the trainees complete training in basic experiment skills, analysis and problem solving skills, scientific thinking and working methods. Then the corresponding practical quantification evaluation criteria has been established according to the standardized inspec-tion process to assess the interns' level of grasping various vocational skills and comprehensive appli-cation in the inspection process. This pattern reflects the teaching philosophy of modern laboratory medicine and can scientifically and objectively assess the talent cultivation quality and teaching quality. Since its implementation, these trainees have improved their overall vocational abilities, and made a good preparation for their practical work after school. Besides, it has enhanced the teaching level of microbiology laboratory practice and has been highly valued by interns. It is hoped that this practical experience will be a useful attempt to promote medical education development of modern laboratory medicine.

Objective To discuss training of the nurses in outpatient blood collection room with the digital training modular of blood sample collection to improve the quality of blood sample collection. Methods Nurses were trained with the digital training modular by multimedia,group discussion to impmve the quality of blood sample collection continuously. Results The unqualified blood sample rate in the same season after training were statistically different compared with that before training. Conclu-sions Training the nurses in outpatient blood collection room with the digital traimg modular of blood sample collection have actual direction value to improve the quality of blood sample collection.

BACKGROUND: Functional hydrogel Is a new biomaterial, which considered as wound dressing should be generally evaluated according to biological standard to prove the great biocompatibility prior to clinical application.OBJECTIVE: To evaluate the biocompatibility of a new kind of wound dressing, polyvinyl alcohol-gelatin esterified (PGE) hydrogel.DESIGN, TIME AND SETTING: A materials study was performed at Central Laboratory, College of Public Health, University of South China from April 2008 to June 2009.MATERIALS: Fibroblast strain of NCTC L-929 mice was provided by Medical College of Sun Yat-sen University; experimental animals were provided by Animal Faulty of Southern China University; polyvinyl alcohol and gelatin were provided by Chemical Agent Engineering Developing Center, Guangdong.METHODS: A 10-g polyvinyl alcohol was generally dissolved in 100 mL water and the mixture was added with 5 g gelatin at 70 °C. Additionally, hydrochloric acid was added and fully stirred for esterification reaction. The dispersion solution was inserted into the tooting and transformed into membrane-like products which were sectioned into 1-mm round and thin sections. Toxicity test, hemolytic test, and whole-body acute-term toxicity test, and sensitization test of PGE were performed according to national GB/T16886 standard.MAIN OUTCOME MEASURES: Biocompatibility of PGE hydrogel.RESULTS: Toxicity reaction of PGE hydrogel was grade 0-1, and hemolytic ratio was 5%. Following an injection of PGE hydrogel, mice did not have death, convulsion, paralysis, respiratory depression, diarrhea, and decreased body mass. Seventy-two hours later, erythema and edema were not observed on both sides of spine of mice.CONCLUSION: The PGE hydrogel has a good biocompatibility and can be used for wound dressing on clinic.

Objective To design and apply the digital training modular for nurses in blood sample collection in order to improve the quality of blood sample collection.Methods Based on the principle of evidence-based nursing,the records of unqualified blood samples in the clinical laboratory department were analyzed.Then,the modular of examination item list,tube choosing,volume of blood sample,patient preparation and theoretical foundation,influential factors of the quality of blood collection,and quality information were designed and applied to train nurses.Results After training,the unqualified rate of blood samples was significantly decreased from 0.56% to 0.34% (P<0.01).Conclusion The application of digital training modular of blood sample collection can improve the quality of blood collection.

AIM: To observe the effects of puerarin on blood lipid and expression of aorta laminin B_1 mRNA in streptozotocin-induced diabetic rats. METHODS: Diabetic nephropathy rats were induced by intraperitoneal injection of STZ, and the experimental rats were divided into normal control group, model group, and puerarin group. During and after the treatment for 12 weeks, the general state, blood suger(BS), triglyceride(TC), cholesterol, low density lipoprotein(LDL-C), high density lipoprotein(HDL-C), glycosylated hemoglobin(HbA1c) and glycosylated low density lipoprotein(G-LDL) were detected. Aorta alteration of tissue morphology was observed by H.E staining, and the expressions of laminin B1 mRNA were determined by in situ hybridization analysis. RESULTS: Diabetes mellitus and aorta lesion occurred in the two model groups. Puerarin could improve the general state, decrease the level of triglyceride(P