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    Inside front cover
    Monographic report (Nursing practice and management)
    Qualitative study on experience of clinical nurses towards organizational innovation climate
    QIAN Yan, ZHANG Ya-qing, WANG Hao-cen, et al
    2014, 34 (9):  1264. 
    doi: 10.3969/j.issn.1674-8115.2014.09.001

    Abstract ( 1146 )   PDF (374KB) ( 1164 )  

    Objective To thoroughly explore the perception and experience of clinical nurses towards the organizational innovation climate. Methods The purposive sampling method was adopted and 10 clinical nurses in Shanghai were selected. The study was guided by the phenomenological method of qualitative study and the semistructured deepening interview was used. The data were analyzed by the analytical program Colaizzi and qualitative analytical software QSR Nvivo 9.0. Results Three themes were concluded by repeatedly reading, analysis, summarization, and comparision, i.e. the perception of innovation incentive, innovation resources, and innovation management. Conclusion Nursing supervisors should strengthen the innovation incentives, provide innovation resources, improve innovation management, and promote innovation development of nursing field.

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    Effects of Tai-ji exercise motor imagery on walk function of patients with hemiplegia after stroke
    ZHANG Hui-ying, QING Yang-yang, ZHANG Ya-qing, et al
    2014, 34 (9):  1268. 
    doi: 10.3969/j.issn.1674-8115.2014.09.002

    Abstract ( 1248 )   PDF (357KB) ( 1060 )  

    Objective To observe the effects of Tai-ji exercise motor imagery on the walk function of patients with hemiplegia after stroke. Methods A total of 40 hospitalized patients with hemiplegia after stroke who met the inclusion criteria were selected and divided into the group A (n=20) and group B (n=20) by the cross control design method. The experiment was divided into phaseⅠ (week 1 to 3), phaseⅡ (week 4 to 5), and phase Ⅲ (week 6 to 8). For group A, patients were treated with routine rehabilitation training combined with Tai-Ji exercise motor imagery therapy at the phase Ⅰ and routine training at the phase Ⅲ. For group B, patients were treated with routine rehabilitation training at the phase Ⅰ and routine training combined with Tai-Ji exercise motor imagery therapy at the phase Ⅲ. Phase Ⅱ was the washout period and patients of two groups were not treated with routine rehabilitation training or motor imagery therapy during phase Ⅱ. The walk function of patients was evaluated by the lower extremity part of Fugl-Meyer motor assessment (FMA), functional ambulation category (FAC), and Tinetti Gait Assessment (TGA) before the experiment and 3, 5, and 8 weeks after the intervention. Results Scores of three items of the group A and B increased significantly after the intervention. The differences of scores of 3, 5, and 8 weeks after the intervention were statistically significant (P<0.05). The differences of scores of three items of the group A and B before the intervention were not statistically significant (P>0.05). Scores of three items of the group A 3 weeks after the intervention were higher than those of the group B and the differences were statistically significant (P<0.05 or P<0.01). The differences of scores 5 weeks between the two groups after the intervention were not statistically significant (P>0.05). Scores of three items of the group B 8 weeks after the intervention were higher than those of the group A and the differences were statistically significant (P<0.05 or P<0.01). Conclusion With the increase of intervention time, Tai-ji exercise motor imagery therapy is more helpful for the recovery of walk function of patients with hemiplegia after stroke on the basis of routine rehabilitation training and improves the effect of rehabilitation training.

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    Study on improving social support of breast cancer patients at rehabilitative stage by group intervention
    WEI Jia-ling, LU Yan, LU Liu-mei, et al
    2014, 34 (9):  1272. 
    doi: 10.3969/j.issn.1674-8115.2014.09.003

    Abstract ( 849 )   PDF (287KB) ( 1053 )  

    Objective To explore the effects of group intervention on improving the social support of breast cancer patients at rehabilitative stage. Methods Four weeks of group intervention was performed for 57 breast cancer patients at rehabilitative stage, including information support, peer support, example guidance, etc. The variations of social support level of patients were assessed by the Social Support Rating Scale (SSRS) before, after, and 3 months after the intervention. Results The total score of social support and scores of the availability of objective support and usingsupport before, after, and 3 months after the intervention increased with time (P<0.001). But the difference of scores of subjective support before and after the intervention was not statistically significant (P>0.05). Conclusion The group intervention can improve the social support of breast cancer patients at rehabilitative stage. Medical staff should pay more attention to breast cancer patients at rehabilitative stage.

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    Study on establishment of core competence curriculum for nurse anesthetists
    WU Jun-yan, HU Jia-le, RUAN Hong
    2014, 34 (9):  1276. 
    doi: 10.3969/j.issn.1674-8115.2014.09.004

    Abstract ( 929 )   PDF (381KB) ( 944 )  
    Objective To establish the core competence curriculum for Chinese nurse anesthetists based on the competence model and to train nurse anesthetists to meet the needs of clinical anesthesia nursing. Methods The draft of core competence curriculum for Chinese nurse anesthetists was prepared by literature review, theoretical analysis, and expert interview. The curriculum was determined by the Delphi method. Results Two rounds of Delphi consultation were conducted and 15 experts were involved. All questionnaires of two rounds of expert consultation were valid (100%). The creditability value was 0.77 and the P value of coordination coefficient test was less than 0.05. Fifty-nine recommendations were raised by the experts and 51 were accepted. Then the core competence curriculum for Chinese nurse anesthetists was determined, which included 8 courses, i.e. anesthesia pharmacology, airway management, liquid management and blood transfusion, physiology and nursing of pain, anesthesia theory and nursing, anesthesia assessment, anesthesia monitoring and nursing, and anesthesia and monitoring equipment. Each course contained three dimensions, i.e. knowledge, skill, and attitude. Conclusion The core competence of nurse anesthetists is presented in three dimensions, i.e. knowledge, skill and attitude for the first time. Attention to the attitude is essential to cultivate nursing talents. It is scientific to establish curriculum based on relevant documents and policies at home and abroad. The core competence curriculum for Chinese nurse anesthetists can provide reference for establishing degree courses of nursing.
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    Evaluation of reliability and validity of Chinese version of Professional Quality of Life Scale for nurses
    WU Jue-min, ZHANG Ya-qing, YANG Yan, et al
    2014, 34 (9):  1281. 
    doi: 10.3969/j.issn.1674-8115.2014.09.005

    Abstract ( 2188 )   PDF (345KB) ( 1450 )  
    Objective To explore the applicability of Chinese version of Professional Quality of Life Scale (ProQOL) for measuring the compassion fatigue of Chinese clinical nurses. Methods The Chinese version of ProQOL for nurses was prepared through the translation, back translation, cross-cultural adaptation, and preliminary test of the English version of ProQOL. Then 374 clinical nurses were surveyed by the questionnaire for evaluating the construct validity, internal consistency, and splithalf coefficient of the Chinese version of ProQOL. Results The Chinese version of ProQOL for nurses consisted of 28 items. Cronbach's alpha values of three subscales, i.e. compassion satisfaction, burnout, and secondary traumatic stress, were 0.875, 0.722, and 0.786 and split-half coefficients were 0.856, 0.636, and 0.765. The exploratory factor analysis extracted one common factor from each sub-scale, which accounted for 47.35%, 31.81%, and 38.20% of the variance, respectively. Conclusion The Chinese version of ProQOL for nurses exhibits satisfactory reliability and validity and is suitable for the evaluation of compassion satisfaction and compassion fatigue of Chinese clinical nurses.
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    Current clinical training situation of Chinese anesthesia nurses surveyed by methodological triangulation
    SHI Zhen, HU Jia-le, RUAN Hong, et al
    2014, 34 (9):  1286. 
    doi: 10.3969/j.issn.1674-8115.2014.09.006

    Abstract ( 950 )   PDF (355KB) ( 1032 )  
    Objective To provide evidences for constructing the anesthesia nursing training system suitable for China by surveying the current clinical training situation of Chinese anesthesia nurses by the methodological triangulation. Methods The convenience sampling is adopted and 45 of 55 anesthesia nurses of 30 hospitals were selected. The current clinical training situation of anesthesia nurses in China was surveyed by the methodological triangulation, which combined the quantitative method (questionnaire) and qualitative method (semi-structured interview). Results The anesthesia nursing was practiced in 29 of 30 hospitals and needed development in different degrees and should be supported by training. Current anesthesia nursing training programs failed to meet the clinical needs of anesthesia nurses. Conclusion Based on clear training topics and contents, the construction of standardized and unified training programs which focuses on the clinical practice will help Chinese anesthesia nurses to identify the role of themselves and develop the specialty of nursing.
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    Establishment of model of core competence curriculum for specialty nurses
    RUAN Hong, WU Jun-yan, HU Jia-le
    2014, 34 (9):  1290. 
    doi: 10.3969/j.issn.1674-8115.2014.09.007

    Abstract ( 796 )   PDF (363KB) ( 1008 )  
    Objective To establish the model of core competence curriculum for specialty nurses and to provide a guidance for setting the structure and content of training curriculum for specialty nurses based on the model of core competence curriculum for anesthesia specialty nurses. Methods Based on the Bloom's theory of teaching objective classification and quality iceberg theory, items of core competence of the anesthesia specialty nurses were qualitatively studied by the content analysis. The three dimensional model of core competence curriculum for anesthesia specialty nurses was established according to the training purposes for anesthesia specialty nurses. Results The core competence curriculum included eight courses and each course consisted of multiple modules. Each module formed a cube of attitude, knowledge, and skill and multiple module cubes formed a course cube. Based on course cubes, the model of core competence curriculum, i.e. the core competence curriculum cube, was formed. Teaching could be independently conducted based on each course cube. Conclusion The model of core competence curriculum established by this study benefits the training for not only professional and practical talents, but also the caring attitude of professional competence of nursing talents. The model provides a teaching tool for competence teaching with independent modules. Trainees can gradually adapt to clinical posts and meet the needs of training for post competence by modular learning.
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    Application of solution-focused therapy for caregivers of children with vitreous tamponade
    ZHOU Ling-ling, GAO Yun-xiang, GE Xiao-hua
    2014, 34 (9):  1295. 
    doi: 10.3969/j.issn.1674-8115.2014.09.008

    Abstract ( 999 )   PDF (342KB) ( 1034 )  
    Objective To investigate the effects of solution-focused therapy on the care burden of caregivers of children with vitreous tamponade and care support of nurses. Methods Caregivers of 120 children with vitreous tamponade were randomly divided into the control group and intervention group. The control group adopted routine nursing methods and the intervention group adopted the solution-focused therapy. Caregivers of two groups were investigated and assessed by the Caregiver Burden Inventory (CBI) and Nurse Parent Support Tool (NPST) on the admission day and the day before discharge. Results The total score of CBI and scores of five burden dimensions of the intervention group the day before discharge were lower than those of the control group, but the average score of NPST and scores of four support dimensions were higher than those of the control group. The differences were statistically significant (P<0.01). Conclusion As a psychological intervention therapy, solution-focused therapy can effectively relieve the care burden of caregivers of children with vitreous tamponade and improve the awareness of caregivers towards the care support of nurses.
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    Analysis of indwelling effect of different puncture sites of peripherally inserted central catheter for premature infants
    CHEN Fang, FAN Qiao-ling, LI Ai-qiu, et al
    2014, 34 (9):  1300. 
    doi: 10.3969/j.issn.1674-8115.2014.09.009

    Abstract ( 1045 )   PDF (282KB) ( 921 )  
    Objective To investigate the best puncture site of peripherally inserted central catheter (PICC) for premature infants. Methods A total of 162 preterm infants who underwent PICC were divided into three groups according to their puncture sites, i.e. the elbow vein puncture group (n=66), axillary vein puncture group (n=39), and knee medial saphenous vein puncture group (n=57). The one-step success puncture rate, unplanned cupping rate, and catheter indwelling time before unplanned cupping of three groups were compared and main reason of unplanned cupping was analyzed. Results The one-step success puncture rates of elbow vein, axillary vein, and knee medial saphenous vein puncture groups were 92.42%, 94.87%, and 91.23%, respectively. The unplanned cupping rates of three groups were 18.18%, 10.26%, and 17.54%. The catheter indwelling time before unplanned cupping of three groups was (22.25±21.10)d, (28.5±15.42)d, and (22.2±4.06)d. The differences of three groups were not statistically significant (P>0.05). The main reason for unplanned cupping was tube plugging. Conclusion For PICC at different sites of premature infants, the one-step success puncture rate, unplanned cupping rate, and catheter indwelling time before unplanned cupping are similar. When the vein at commonly used puncture site is unable to perform PICC, the axillary vein and great saphenous vein can also be used for vein puncture and inserting PICC through the axillary vein shows certain advantages. The study provides more suitable sites for premature infants to establish central venous access through peripheral vein.
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    Review and expectations of studies on burden of caregivers of old people with chronic diseases
    YANG Bei-bei, ZHANG Ying
    2014, 34 (9):  1304. 
    doi: 10.3969/j.issn.1674-8115.2014.09.010

    Abstract ( 1069 )   PDF (368KB) ( 1392 )  

    With the increasingly aging of Chinese population, longterm care for old people with chronic diseases becomes prominent. This paper reviews characteristics and burden of caregivers and ways to ease the burden from the perspective of the caregiver of old people with chronic diseases. The purpose is to establish a primarily analytic framework to motivate the study and family nursing for caring old people with chronic diseases, promote physical and mental health of old patients and their caregivers, improve the quality of life, and provide evidence for the “integral strategies” of family nursing.

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    Original article (Basic research)
    Apoptosis of imatinib-sensitive and imatinib-resistant chronic myelocytic leukemia cells induced by isobavachalcone
    SONG Li-li, WANG Wei-wei, SUN Yun, et al
    2014, 34 (9):  1309. 
    doi: 10.3969/j.issn.1674-8115.2014.09.011

    Abstract ( 1091 )   PDF (456KB) ( 1135 )  

    Objective To explore the effects of isobavachalcone (IBC) on imatinib-sensitive and imatinib-resistant chronic myelocytic leukemia cells. Methods Imatinib-sensitive chronic myelocytic leukemia cells K562s and imatinib-resistant chronic myelocytic leukemia cells K562r were cultured in vitro. K562s and K562r cells were treated by IBC of different concentrations (0, 5, 10, 20, and 40 μmol/L) for different period of time (0, 24, 48, and 72 h). The effects of IBC on the viability of K562s and K562r cells were detected by the trypan blue exclusion assay. The variations of cell apoptosis and mitochondrial membrane potential were detected by the Annexin V/PI staining and Rh123/PI staining, respectively. The expressions of proteins relevant to apoptosis were detected by the Western blotting. Results The results of trypan blue exclusion assay showed that IBC had an inhibitory effect on the proliferation of K562s and K562r cells and the effect was time and dose dependent. The results of flow cytometry indicated that the apoptosis and decrease of mitochondrial membrane potential of K562s and K562r cells treated by IBC were significantly time and dose dependent. The results of Western blotting showed that IBC induced activation of caspase-3 and cleavage of PARP-1 in K562s and K562r cells. Conclusion IBC can induce the apoptosis of K562s and K562r cells and the decrease of mitochondrial transmembrane potential may involve in this process.

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    Effects of silencing TGFβ1 on growth and proliferation of hepatic stellate cell line T6
    ZHANG Rong-hua, YAN Guo-he, WANG Guo-jian, et al
    2014, 34 (9):  1315. 
    doi: 10.3969/j.issn.1674-8115.2014.09.012

    Abstract ( 900 )   PDF (482KB) ( 1037 )  

    Objective To observe the effects of silencing transforming growth factor β1 (TGFβ1) on the growth and proliferation of hepatic stellate cell line T6 (HSC-T6). Methods The TGFβ1 shRNA lentiviral vector particles with high infectivity were transfected into HSC-T6 cells. The controls were HSC-T6 cells that were not infected or infected by empty virus. The expression of green fluorescent protein (GFP) of the HSC-T6 cells was observed under the inverted fluorescence microscope. The effects of TGFβ1 shRNA lentivirus on the growth and proliferation of HSC-T6 cells were detected by the CCK-8. The expressions of the gene and encoding protein of TGFβ1 and proliferating cell nuclear antigen (PCNA) of HSC-T6 cells were detected by the RT-PCR and Western blotting, respectively. The quantitative analysis was then conducted. Results HSC-T6 cells transfected by TGFβ1 shRNA lentivirus significantly expressed GFP. The results of CCK-8 showed that the growth and proliferation of HSC-T6 cells transfected by TGFβ1 shRNA lentivirus were slower than those of controls and the differences were statistically significant after being cultured for 48 h (P<0.01). The results of RT-PCR and Western blotting revealed that the TGFβ1 shRNA lentivirus effectively silenced the TGFβ1 and down-regulated the expressions of gene and encoding protein of PCNA of HSC-T6 cells. The differences of transfected cells and controls were statistically significant (P<0.01). Conclusion Silencing TGFβ1 can effectively inhibit the growth and proliferation of HSC-T6 cells and down-regulate the expression of PCNA.

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    A typeⅡ toxin-antitoxin system encoded by BLJ_864 and BLJ_865 in chromosome of Bifidobacterium longum
    WEI Yan-xia, YE Lu, LIU Dian-bin, et al
    2014, 34 (9):  1319. 
    doi: 10.3969/j.issn.1674-8115.2014.09.013

    Abstract ( 943 )   PDF (496KB) ( 979 )  

    Objective To identify whether the BLJ_864 and BLJ_865 in the chromosome of Bifidobacterium longum JDM301 (B.longum JDM301) constitute a type II toxinantitoxin system (TA system) of mazEF family. Methods The co-transcription of BLJ_864 and BLJ_865 in B.longum JDM301 and E.coli was analyzed by the RT-PCR. The co-expression of BLJ_864 and BLJ_865 encoded antitoxin protein and toxin protein in the intact operon that carried BLJ_864 and BLJ_865 was proved by transforming the plasmid, which carried the operon, into the E.coli strain. The inhibition effect of BLJ_864 encoded toxin protein on the growth of E.coli cells and the corresponding effect of BLJ_865 encoded antitoxin protein on removing the inhibition effect were identified by the expression of BLJ_864 encoded toxin protein or co-expression of the toxin protein and BLJ_865 encoded antitoxin protein in E.coli. Results BLJ_864 and BLJ_865 constituted a dual operon and could co-transcript in the natural strain of B.longum JDM301. BLJ_864 encoded toxin protein and BLJ_865 encoded antitoxin protein could co-express in the heterologous host of E.coli when induced by isopropyl-β-D-thiogalactopyranoside (IPTG). The expression of BLJ_864 encoded toxin protein inhibited the growth of E.coli, while the co-expression of BLJ_864 encoded toxin protein and BLJ_865 encoded antitoxin protein could antagonize the inhibition effect of toxin protein. Conclusion BLJ_864 and BLJ_865 in the chromosome of B.longum JDM301 encode a functional type II TA system of mazEF family.

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    Regulation of epithelial-mesenchymal transition by MACC1 via the HGF/c-Met signaling pathway and its effects on ability of migration and invasion of gastric carcinoma cells
    ZHU Qian-qian, SHAN Hai-xia, ZHU Zheng-qiu
    2014, 34 (9):  1325. 
    doi: 10.3969/j.issn.1674-8115.2014.09.014

    Abstract ( 882 )   PDF (861KB) ( 1067 )  

    Objective To investigate the regulatory effect of metastasis-associated gene in colon cancer-1 (MACC1) on the epithelial-mesenchymal transition (EMT) by regulating the HGF/c-Met signaling pathway and the effects of MACC1 on the migration and invasion of gastric carcinoma cells. Methods Short hairpin RNA (shRNA) plasmid vector that targeted MACC1 and c-Met (MACC1-shRNA and c-Met-shRNA) and negative control plasmid (shNC) were constructed and transfected into the human gastric carcinoma MKN28 cell line by the lipofectamine technique. The variations of expressions of proteins and mRNA of markers (E-cadherin and N-cadherin) related to MACC1, c-Met, and EMT before and after the transfection were detected by the Western blotting and Real-Time PCR. The variations of the ability of migration and invasion of MKN28 cells were detected by the wound-healing and Transwell invasion tests. Results Compared to the blank control group, the expressions of proteins and mRNA of MACC1 and c-Met of the MACC1-shRNA group were significantly down-regulated (P<0.01); the expressions of protein and mRNA of E-cadherin were significantly up-regulated (P<0.01); and the expressions of protein and mRNA of N-cadherin were significantly down-regulated (P<0.01). The expressions of protein and mRNA of MACC1 of the c-Met-shRNA group did not change significantly (P>0.05) and the variations of expressions of EMT related markers were consistent with those of the MACC1-shRNA group. The results of wound-healing and Transwell invasion tests showed that compared to the blank control group, the ability of migration and invasion of MKN28 cells of the MACC1-shRNA group and c-Met-shRNA group was significantly inhibited (P<0.01). Conclusion MACC1 may regulate the EMT process by regulating the HGF/c-Met signaling pathway and enhance the ability of migration and invasion of gastric carcinoma cells.

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    Failure of Curcumin in inhibiting epileptiform discharge of hippocampal slices of rat induced by Mg2+-free artificial cerebrospinal fluid
    CHANG Yan-yan, GONG Xin-wei, GONG Hai-qing, et al
    2014, 34 (9):  1332. 
    doi: 10.3969/j.issn.1674-8115.2014.09.015

    Abstract ( 868 )   PDF (785KB) ( 1029 )  

    Objective To investigate whether curcumin has direct inhibitory effect on the epileptiform discharge by comparing the effects of curcumin and antiepileptic drug of valproate. Methods The epileptiform discharge of hippocampal slices of the rat induced by Mg2+-free artificial cerebrospinal fluid (ACSF) was recorded by the multi-electrode array (MEA). After epileptiform discharge was successfully induced, curcumin of 100 μmol/L or valproate of 3 mmol/L was applied and their effects on the epileptiform discharge were observed. Results After Mg2+-free ACSF was continuous perfused for 15 min, the epileptiform discharge of all regions of hippocampal slices was recorded by the MEA. Curcumin of 100 μmol/L did not significantly affect the frequency, duration, and propagation speed of epileptiform discharge (P>0.05). Valproate of 3 mmol/L significantly decreased the frequency of epileptiform discharge (P<0.05) and the propagation speed at retrograde direction (P<0.05). Conclusion Curcumin of 100 μmol/L fails to inhibit the epileptiform discharge of hippocampal slices of the rat induced by Mg2+-free ACSF.

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    Effects of sodium citrate on proliferation and apoptosis of ovarian cancer cells
    LIU Yan, WANG Lian-lian
    2014, 34 (9):  1338. 
    doi: 10.3969/j.issn.1674-8115.2014.09.016

    Abstract ( 1743 )   PDF (420KB) ( 962 )  

    Objective To investigate the effects of sodium citrate of different concentrations on the proliferation and apoptosis of ovarian carcinoma cells. Methods Ovarian cancer cell line SKOV3 was divided into the blank control group and sodium citrate groups, which were treated by citrate sodium of 0, 3, 5, 7, 10, and 15 mmol/L for 12, 24, and 48 h. The cell proliferation was detected by the MTT and the inhibition rate of cell proliferation and formation rate of cell clone were calculated. The expressions of apoptosis related proteins PARP and Procasease-3 and autophagy related proteins LC3 and p62 were detected by the Western blotting. Results Compared to the blank control group, the cell viability and formation rate of cell clone of the sodium citrate groups significantly decreased and were concentration and time dependent (P<0.05). The results of Western blotting showed that compared to the blank control group, the expressions of PARP and Procasease-3 in SKOV3 of the sodium citrate group treated by sodium citrate of 5 and 10 mmol/L increased; the expression of LC3 up-regulated, and the expression of p62 downregulated. Conclusion Sodium citrate can efficiently inhibit the proliferation of ovarian cancer cell line SKOV3 and induce the apoptosis via the mitochondrial pathway. The effect increases with the time and concentration of sodium citrate. Besides, sodium citrate can also induce the autophagy of SKOV3 cells.

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    Effects of metformin on proliferation and inflammatory response of vascular smooth muscle cells induced by TNF-α
    ZHANG Duo-duo, LI Pai, ZHANG Wei, et al
    2014, 34 (9):  1343. 
    doi: 10.3969/j.issn.1674-8115.2014.09.017

    Abstract ( 1247 )   PDF (1083KB) ( 986 )  

    Objective To investigate the effects of metformin on the proliferation and inflammatory response of vascular smooth muscle cells (VSMCs) induced by tumor necrosis factor-α (TNF-α) and their possible mechanisms. Methods VSMCs were treated by TNF-α and metformin of different concentrations for 24 h. Concentrations that were most suitable for treatment were selected by the MTT, and VSMCs were divided into the control group, TNF-α group, TNF-α+metformin group, and metformin group. The cell cycle was detected by the flow cytometry. Expressions of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) were detected by the RT-PCR and Western blotting. Expressions of AMPK and p-AMPK were detected by the Western blotting. Results The absorbance value of the group treated by TNF-α of 10 ng/mL significantly increased (P<0.01). The variation of absorbance value of the group treated by metformin of 2 mmol/L was the most significant (P<0.05). The cell rate of G1 phase of the TNF-α+metformin group was significantly lower than that of the control group and higher than that of the TNF-α group. The expressions of iNOS and COX-2 decreased and the expression of p-AMPK increased. Conclusion Metformin can arrest the cell cycle and inhibit the proliferation and inflammatory response of VSMCs induced by TNF-α through activating the AMPK signaling pathway.

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    Effects of advanced glycation end products on  oxidative stress of HCT116 colorectal cancer cells
    LI Ya-kui, CHEN Han-bei, TONG Xue-mei, et al
    2014, 34 (9):  1350. 
    doi: 10.3969/j.issn.1674-8115.2014.09.018

    Abstract ( 1118 )   PDF (513KB) ( 1143 )  

    Objective To observe the effects of advanced glycation end products (AGEs) on the oxidative stress of HCT116 colorectal cancer cells. Methods HCT116 cells were cultured by the reactive oxygen species (ROS) capture agent. The ROS level of AGEs-treated HCT116 cells was detected by the flow cytometry and fluorescent microscopy. The oxidative stress status was intervened by the N-acetyl cysteine (NAC) and its effects on ROS increase and cell proliferation induced by AGEs were observed. Results ROS level increased after HCT116 cells were treated by AGEs. ROS increase and cell proliferation induced by AGEs were significantly inhibited after HCT116 cells were treated by NAC. The differences were statistically significant (P<0.05). Conclusion AGEs enhances the proliferation of HCT116 colorectal cancer cells by activating the oxidative stress response.

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    Original article (Clinical research)
    Differences of balance control ability of patients with functional and mechanical ankle instability
    FENG Xu-hua, ZHENG Jie-jiao, LI Hong-yun, et al
    2014, 34 (9):  1355. 
    doi: 10.3969/j.issn.1674-8115.2014.09.019

    Abstract ( 1082 )   PDF (400KB) ( 1020 )  

    Objective To observe the balance control ability of patients with mechanical ankle instability (MAI) and functional ankle instability (FAI). Methods Patients with MAI (the MAI group, n=12) and FAI (the FAI group, n=12) and normal controls (the control group, n=12) were selected. Single-limb postural sway tests were performed for all participants with eyes closed and opened. Three tests were performed for each leg and each test lasted for 10 s. Parameters relevant to displacements from the center of pressure (COP) were measured, including mensway Y axis (MSY), mensway X axis (MSX), circumference area (CA), path length (PL), unit time path length (UTPL), and unit area path length (UAPL). Results The difference of age, sex, height, and weight of three groups were not statistically significant (P>0.05). The MSY, CA, PL, and UTPL values of the MAI group with eyes closed were significantly higher than those of the control group (P<0.05 or P<0.01). The differences of each measurement index of the FAI group and control group were not statistically significant (P>0.05). The differences of MSY and CA of the MAI group and control group with eyes opened were statistically significant (P<0.05). The differences of each measurement index of unstable ankles and stable ankles of the MAI group and FAI group were not statistically significant (P>0.05). Conclusion Significant abnormal balance control ability exists in patients with MAI, while no significant abnormal balance control ability exists in patients with FAI.

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    Clinical study on treatment of patients with dysphagia after stroke by improved Vitalstim electroacupuncture
    JIANG Wei, TAN Bo-tao, ZHOU Yuan, et al
    2014, 34 (9):  1361. 
    doi: 10.3969/j.issn.1674-8115.2014.09.020

    Abstract ( 1151 )   PDF (350KB) ( 1052 )  

    Objective To observe the therapeutic effects of improved Vitalstim electroacupuncture on patients with dysphagia after stroke. Methods One hundred and eight patients with dysphagia after stroke were randomly divided into the electroacupuncture group (n=36), Vitalstim group (n=36), and combined group (n=36). Based on the routine rehabilitation therapy, patients of the electroacupuncture group underwent electroacupuncture therapy; patients of the Vitalstim group underwent Vitalstim therapy; and patients of the combined group underwent improved Vitalstim electroacupuncture therapy. The swallowing function and rehabilitation of patients were assessed by the water swallowing test and standard swallowing assessment (SSA). The myoelectric activity of submental muscles was detected by the surface electromyography (sEMG). Results The swallowing function of three groups improved in different degrees. The differences of overall efficiency were not statistically significant (P>0.05), but the cure rate of the combined group was higher than those of the two other groups (P<0.05). The SSA scores of the Vitalstim group and combined group were lower than those of the electroacupuncture group (P<0.05). The results of sEMG showed that the improvement of contraction ability of submental muscles of the combined group was better than that of the two other groups (P<0.05). Conclusion Rehabilitation training combined with electroacupuncture therapy, Vitalstim therapy, or improved Vitalstim electroacupuncture therapy can efficiently improve the swallowing function of patients with stroke. The rehabilitation effect of improved Vitalstim acupuncture therapy is better.

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    Expressions of Notch1 and FSCN1 in breast cancer and their clinical significances
    XU Wu-qin, WU Shi-wu, MA Li, et al
    2014, 34 (9):  1365. 
    doi: 10.3969/j.issn.1674-8115.2014.09.021

    Abstract ( 863 )   PDF (716KB) ( 1046 )  

    Objective To detect the expressions in Notch1 and FSCN1 in breast cancer and their relationship with the clinical pathological features of breast cancer. Methods The protein expressions of Notch1, FSCN1, estrogen receptor (ER), progesterone receptor (PR), CerbB-2, and ki-67 of 100 breast cancer tissue samples and 30 adjacent normal breast tissue samples were detected by the immunohistochemical method. The mRNA expressions of Notch1 and FSCN1 of 60 fresh breast cancer tissue samples and corresponding adjacent tissue samples were detected by the RT-PCR. Results For 100 breast cancer tissue samples and 30 adjacent normal breast tissue samples, the positive rates of Notch1 were 79.0% (79/100) and 33.3% (10/30) and the positive rates of FSCN1 were 68.0% (68/100) and 30.0% (9/30). The positive rates of Notch1 and FSCN1 of breast cancer tissue samples were significantly higher than those of adjacent normal breast tissue samples (P<0.05). The positive expression of Notch1 of breast cancer was not significantly relevant to age, ER, and PR (P>0.05), but was relevant to axillary lymph node metastasis, clinical TNM stage, pathological classification, CerbB-2, and ki-67 (P<0.05). The positive expression of FSCN1 of breast cancer was not relevant to age (P>0.05), but was relevant to axillary lymph node metastasis, clinical TNM stage, pathological classification, ER, PR, CerbB-2, and ki-67 (P<0.05). The protein expressions of Notch1 and FSCN1 were positively related (r=0.225, P<0.05). The results of RT-PCR showed that the expressions of Notch1 and FSCN1 of breast cancer tissue were higher than those of adjacent normal breast cancer tissue and the differences were statistically significant (P<0.05). The mRNA expressions of Notch1 and FSCN1 were positively related (r=0.446, P<0.05). Conclusion The expressions of Notch1 and FSCN1 of breast cancer are high and may promote the occurrence and development of breast cancer and play an important role in the invasion, metastasis, and prognosis of breast cancer.

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    Effects of procalcitonin, C-reaction protein, and D-dimer on prediction of prognosis of patients with severe pneumonia
    DENG Yin-can, ZHOU Hua, FU Yi-qi, et al
    2014, 34 (9):  1372. 
    doi: 10.3969/j.issn.1674-8115.2014.09.022

    Abstract ( 906 )   PDF (587KB) ( 1229 )  

    Objective To investigate the effects of procalcitonin (PCT), C-reaction protein (CRP), and D-dimer on the evaluation of prognosis of patients with severe pneumonia. Methods Clinical data of 83 patients with severe pneumonia were collected and the patients were divided into the survivor group and non-survivor group according to the prognosis. Clinical characteristics, coexisting diseases, acute physiological and chronic health evaluationⅡ (APACHEⅡ) score, mechanical ventilation, and pathogens of patients were retrospectively analyzed. The initial and maximum values of PCT, CRP, and D-dimer of two groups were compared. The increasing trend of PCT, CRP, and D-dimer and its correlation with the prognosis were analyzed. The receiver operating characteristic (ROC) curve was adopted to analyze the effects of initial and maximum values of PCT, CRP, and D-dimer on the prediction of mortality. Results The initial and maximum values of PCT, CRP, and D-dimer of the non-survivor group were higher than those of the survivor group. The differences of values were statistically significant (P<0.01) except for the initial value of D-dimer. The increase of PCT, CRP, and D-dimer was correlated to the mortality and the odds ratios (OR) (95%CI) were 3.5 (1.4-8.6), 6.9 (2.6-18.2), and 11.5 (3.1-43.2)(P<0.01), respectively. Areas under the ROC curve of maximum PCT, scores of APACHEⅡ, maximum CRP, and maximum D-dimer for the prediction of mortality were 0.87, 0.86, 0.81, and 0.79. Conclusion PCT, CRP, and D-dimer can reflect the severity of pneumonia. The increase of PCT, CRP, and D-dimer suggests poor prognosis. Maximum PCT is a satisfactory indicator for evaluating the prognosis.

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    Correlation between genetic polymorphism of RFC1 gene and therapeutic reaction of high dose methotrexate
    LI Hong, JIANG Hui, LIU Qing
    2014, 34 (9):  1376. 
    doi: 10.3969/j.issn.1674-8115.2014.09.023

    Abstract ( 954 )   PDF (350KB) ( 989 )  

    Objective To investigate the correlation of genetic polymorphism of RFC1G80A and the therapeutic reaction of high dose methotrexate (HDMTX) for treating the childhood acute lymphoblastic leukemia (ALL). Methods Sixty-eight patients (280 case-times) treated by HDMTX (dose>1 g/m2) were selected. The genetic polymorphism of RFC1 G80A was detected before MTX treatment. Plasma MTX level, liver and kidney function, and peripheral blood cell count were detected regularly. Toxic side effects of MTX and prognosis were observed and their correlation was evaluated. Results The genetic polymorphism of RFC1 G80A was correlated with toxic side effects of MTX. The risks of moderate and severe hepatotoxicity and myelosuppression of RFC1-AA genotype were 7.28 and 2.8 times higher than those of RFC1-GG genotype (P=0.000, 0.005), therefore RFC1-AA genotype was a risk indicator for predicting toxic side effects of HDMTX. The differences of elimination delay of MTX and prognosis of genotypes of RFC1 G80A were not statistically significant (P>0.05). Conclusion The genetic polymorphism of RFC1G80A is correlated with moderate and severe hepatotoxicity and myelosuppression after HDMTX treatment and can be used as a risk indicator for predicting toxic side effects of HDMTX.

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    Study on pharmacodynamics of continuous infusion of rocuronium during transplantation of living donor liver for infants
    YIN Wen, WEN Da-xiang, HANG Yan-nan
    2014, 34 (9):  1381. 
    doi: 10.3969/j.issn.1674-8115.2014.09.024

    Abstract ( 1187 )   PDF (333KB) ( 1004 )  

    Objective To explore the pharmacodynamics of continuous infusion of rocuronium during the liver transplantation for infants. Methods Fourteen patients who underwent transplantation of living donor liver were selected. Patients were 6 months to 2 years old. Their body weights were 5-10 kg. The scores of Child-Push were 7-10; the classifications of hepatic function were B or C; and their ASA were Ⅲ or Ⅳ. The responses of the adductor pollicis muscle to train-of-four (TOF) stimulation of ulnar nerve were monitored. Rocuronium of 0.6 mg/kg was given during induction. Tracheal intubation was performed when 100% blockade was attained and mechanical ventilation was instituted. When T1 recovered to 3%, rocuronium was infused at an initial infusion rate of 5 μg/kg/min. The infusion rate was adjusted to maintain T1 at 3%-10%. The administration of muscle relaxant was stopped after the suture of the peritoneum. The onset time, TOF no reaction period, the time for the recovery of T1 to 25%, recovery index, and average infusion rates of rocuronium at three stage were recorded. Results The onset time of rocuronium was (82.86±14.77) s; the TOF no reaction period was (45.80±16.88) min; the time for the recovery of T1 to 25% was (18.98±8.57) min; and the recovery time was (37.05±7.95) min. The muscle inhibition was maintained constant and the infusion rate was (2.80±0.96) μg/(kg/min) before the anhepatic phase, (1.81±0.34) μg/(kg/min) during the anhepatic phase, and (2.54±0.98)μg/(kg/min) after reperfusion. Compared to the requirement of rocuronium before the anhepatic phase, the requirement of rocuronium after the anhepatic phase decreased 35% (P<0.05) and the requirement of rocuronium during the anhepatic phase remained the same. Conclusion During the liver transplantation for infants, the average dose of rocuronium after the anhepatic phase is lower than that before the anhepatic phase and the average dose of rocuronium during the anhepatic phase is the same as that before the anhepatic phase. The pharmacodynamics characteristics of muscle relaxants during liver transplantation should be fully understood. When rocuronium is administrated to induce, tracheal intubation should be performed 1.5 min after the administration of rocuronium. The drug dosage should be appropriately reduced during the anhepatic stage to avoid prolonging the neuromuscular blockade.

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    Study on correlation of plasma cholesterol level and amyloid β level
    Lü Peng, HU Ya-nan, SHENG Hong-guang
    2014, 34 (9):  1386. 
    doi: 10.3969/j.issn.1674-8115.2014.09.025

    Abstract ( 791 )   PDF (267KB) ( 849 )  

    Objective To explore the correlation of the plasma cholesterol level and the plasma amyloid β (Aβ) level. Methods Among patients aged 50-65 years, 16 patients with borderline high cholesterol and 16 patients with high cholesterol were randomly selected as the high cholesterol group and 16 healthy subjects were randomly selected as the control group. The levels of plasma Aβ-40, Aβ-42, total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and triglyceride (TG) of two groups were detected and their correlations were analyzed. Results The levels of plasma Aβ-40, Aβ-42, LDL-C, and TG of the high cholesterol group were significantly higher than those of the control group (P<0.01). The linear correlation analysis showed that for the control group, Aβ-40 and Aβ-42 did not correlate with TC, LDL-C, HDL-C, and TG. For the high cholesterol group, Aβ-40 and Aβ-42 positively correlated with TC (P<0.01 or P<0.05), and TC positively correlated with TG and LDL-C (P<0.01 or P<0.05) and negatively correlated with HDL (P<0.05). After TG, LDL-C, and HDL-C were adjusted, partial correlation analysis was performed for TC versus Aβ-40 and Aβ-42. The results showed that Aβ-40 and Aβ-42 still positively correlated with TC (P<0.05). Conclusion For patients with high cholesterol, the levels of plasma Aβ-40 and Aβ-42 significantly increase and the plasma Aβ level is correlated with plasma TC level.

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    Original article (Public health administration)
    Analysis of health inequity of urban and rural residents in Chongqing
    ZOU Qin-pei, ZHONG Xiao-ni, LI Tao-ting, et al
    2014, 34 (9):  1390. 
    doi: 10.3969/j.issn.1674-8115.2014.09.026

    Abstract ( 807 )   PDF (347KB) ( 1099 )  

    Objective To understand the basic health condition of urban and rural residents in Chongqing and its influencing factors and to analyze the health inequity. Methods Demographic characteristics, two-week prevalence, chronic illness prevalence, and poor perceived health prevalence were calculated. Logistic regression analysis was adopted to analyze the effects of gender, age, education degree, income, medical insurance, and urban and rural area effects on the health of residents. The health inequity was evaluated according to the concentration index (CI) of controlled variables and health inequity index (HII). Results The demographic characteristics and health condition of urban and rural residents were different. Factors that influenced the health were gender, age, education degree, income, medical insurance, urban area, and rural area. The HII scores of two-week prevalence, chronic illness prevalence, and poor perceived health prevalence of rural residents were above 0.1. The HII scores of two-week prevalence and chronic illness prevalence of urban residents were above 0.1 and the HII of poor perceived health prevalence was under 0.1. Conclusion Health inequity exists between urban residents and rural residents. The influencing factors of health inequity are education degree, income, and medical insurance. The comprehensive evaluation result of HII is ideal.

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    Analysis of efficiency of health resource allocation of Chongqing in 2012
    ZOU Qin-pei, ZHONG Xiao-ni, DENG Jing, et al
    2014, 34 (9):  1396. 
    doi: 10.3969/j.issn.1674-8115.2014.09.027

    Abstract ( 856 )   PDF (333KB) ( 1011 )  

    Objective To deeply analyze the efficiency of different allocations of health resources, to propose advices for the development, and to provide evidences for regional health planning by studying the efficiency of the allocation of health resources in Chongqing from different levels. Methods Two input indexes (numbers of beds and medical technicians) and two output indexes (numbers of inpatients and total visits) of district and county medical institutions, municipal medical institutions, and town hospitals in 38 counties of Chongqing in 2012 were analyzed by the BCC model of data envelopment analysis (DEA) method for the efficiency of the allocation of health resources. Results The overall efficiency of the allocation of health resources of Chongqing was low. The numbers of relatively effective regions for DEA of medical institutions in 9 main urban areas and town hospitals were 5 and 6. The relatively effective rates for DEA of other districts and counties medical institutions, municipal medical institutions, and town hospitals were 21%, 33%, and 35%. Conclusion The allocation of health resources of Chongqing is unbalanced. The overall efficiency is low. The efficiency of the allocation of health resources in urban areas is relatively high. The efficiency of the allocation of health resources of medical institutions in suburb areas and municipal medical institutions is low. Input redundancy and insufficient utilization coexist in some areas. Regional health planning should be enhanced to realize the reasonable utilization of health resources.

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    Review
    Research status of Slitrk family for mental disorders
    WANG Yuan, XIAO Ze-ping
    2014, 34 (9):  1402. 
    doi: 10.3969/j.issn.1674-8115.2014.09.028

    Abstract ( 1133 )   PDF (290KB) ( 1082 )  

    Studies of mental disorders always emphasize the etiology. Currently the etiology and pathogenesis of most mental disorders are still not well clarified. The genetics is one of fields that attract most attention. In recent years, researchers gradually focus on the effects of Slitrk family on the pathogenesis of mental disorders. This paper reviews studies on the Slitrk family for mental disorders.

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    Research progresses of mental health of MSM and its relationship with high risk sexual behaviors
    YANG Jun, ZHU Chen-di, MA Jin, et al
    2014, 34 (9):  1406. 
    doi: 10.3969/j.issn.1674-8115.2014.09.029

    Abstract ( 1247 )   PDF (344KB) ( 1125 )  

    Men who have sex with men (MSM) are high risk population of infection of human immunodeficiency virus (HIV) because of their unique ways of high risk sexual behaviors. At the same time, MSM are also disturbed by mental health problems such as depression, anxiety, etc. These mental health problems may affect their ways of sexual intercourse, increase the risk of sexual behaviors, and affect the outcome of HIV interventions. Therefore, the exploration of mental health issues of MSM and their relationship with high risk sexual behaviors is helpful for making more effective comprehensive interventions and reducing the risk of infection of HIV.

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    Application of serum tumor markers for diagnosis and treatment of gastric cancer
    HUA Zi-chen, ZHU Zheng-lun, ZHU Zheng-gang
    2014, 34 (9):  1411. 
    doi: 10.3969/j.issn.1674-8115.2014.09.030

    Abstract ( 1074 )   PDF (445KB) ( 1059 )  

    The gastric cancer is the second most malignant tumor that threats human lives due to high incidence and poor prognosis. The prognosis of gastric cancer is closely related to staging, recurrence, and metastasis. The improvement of its prognosis relies on early diagnosis, early treatment, and reasonable postoperative monitoring. Serum tumor markers (TM) are valuable for early diagnosis and postoperative monitoring because their detection is convenient and highly repetitive. This paper introduces features of traditional serum TMs of gastric cancer, including CA125, CA199, CA724, and CEA; presents research progresses of several new TMs, such as PG, MG7, VEGF and HER2; and reviews the practical value and prospects of TM for the diagnosis and treatment of gastric cancer.

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