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Objective: To investigate the molecular mechanism and distribution characteristics of RhD negative phenotypes in Han population of blood donors in Wuhu city., Methods: A total of 210 RhD - samples from August 2021 to August 2022 were screened by serological test and collected from Wuhu Central Blood Station for the voluntary blood donor population. Exons 1 and 10 of the RHD gene were amplificated by PCR to determine whether the samples had the RHD gene. Exons 1-10 of the RHD gene were amplificated by PCR and zygosity analysis were performed in 82 samples containing D gene, and Sanger sequencing was performed on 55 samples containing all RHD exons to determine the genotype., Results: Among 210 RhD - specimens, 128 cases (60.38%) had RHD gene deletion. 27 cases had partial exons of RHD , including 2 cases with RHD*DVI.3/RHD*01N.01 , 24 cases with RHD*01N.04/RHD*01N.01 , and 1 case with RHD-CE(2-10)/RHD*01N.01 . 55 cases had retained all of 10 exons, including 4 cases with RHD*01/RHD*01N.01 , 6 cases with RHD*15/RHD*01N.01 , 1 case with RHD*01W.72/RHD*01N.01 , 1 case with RHD*15/RHD*01EL.01 , 39 cases with RHD*01EL.01/RHD*01N.01 , and the remaining 4 cases were determined to have no RHD gene deletion by zygosity analysis and sequencing showed the presence of 1227G>A mutation loci., Conclusion: There is polymorphism in the molecular mechanism of RhD - D gene in Wuhu blood donor population, among which RHD*01EL.01 and RHD*15 are the main variants in this region. The results of this study provide a theoretical basis for RhD blood group identification and clinical blood transfusion in this region.

The concept of mesenteric anatomy has been evolving in cognition. With the continuous development of endoscopic techniques, the submicroscopic structures of many mesenteries have been gradually understood, ultimately confirming the ubiquitous presence of mesenteries in the digestive organs. Based on various domestic and foreign mesenteric anatomical theories and combined with years of clinical practice, we have summarized and proposed a new concept and theory-vascular-guided complete mesenteric resection for gastric cancer. The theoretical basis is that, from the perspective of the embryonic development of the digestive tract, the rotation of the digestive tract and its associated mesentery is always centered on blood vessels. Therefore, the supply vessels and digestive tracts and their associated mesentery are naturally connected. The mesentery is a complex structure that encompasses blood vessels, nerves, and lymphatic tissues. The blood vessels serve as the boundary of the mesentery, ensuring that the lymphatic network that drains the tumor is maximally resected. This article focuses on the complete mesenteric resection margins in gastric cancer surgery, that is, the lateral boundary of the mesentery as the vascular-supplied guided resection boundary and its mesentery, and the base boundary as the mesenteric bed. Using precise vascular guidance to define the extent of mesenteric resection will help accurately define the mesenteric margin during radical resection for different stages of gastric cancer.

Background: Critically ill neonates receive care in the neonatal intensive care unit (NICU). Unfortunately, some neonates pass away in the NICU. Providing comprehensive neonatal palliative care and hospice services is crucial in supporting parents through the loss of their offspring. In our NICU, we identified that only 74.5% of nurses are able to properly recognize the need for palliative care and only 55% are able to implement the necessary procedures., Purpose: A project was designed and implemented to enhance the ability of nursing staff to recognize the need for and properly implement palliative care to improve the quality of this care in the NICU., Resolutions: We organized an on-the-job education and training program within our NICU with the goals of heightening awareness among nursing staff. In addition, a specialist palliative care operation flow chart, process preparation checklist, and palliative-care-related tools were created to facilitate the care process., Results: After program implementation, among nursing staff in our NICU, the palliative care recognition accuracy rate rose to 100% (from 74.5%) and the implementation rate rose to 94.8% (from 55%). The quality of provided neonatal palliative care and hospice services was significantly improved., Conclusions: The developed program was shown to significantly improve nursing staff recognition and implementation of neonatal palliative care in our NICU. This experience provides a reference for improving palliative care quality and for helping families effectively manage end-of-life challenges.

In order to explore the pollution characteristics， ecological risks， and pollution sources of heavy metals in farmland soils around typical factories in Hunan Province， the content characteristics of eight heavy metals in farmland soils around fluoride factories， leather factories， and plating plants were analyzed. The geo-accumulation index and potential ecological risk index were used to evaluate the pollution and environmental risk of heavy metals. The correlation analysis， hierarchical cluster analysis， and principal component analysis were used to analyze the sources of heavy metals. The Monte-Carlo model was used to evaluate the probability risk of regional ecological risk. The results showed that the main pollution elements in the soil were Cd and Zn， and their mean values were 4.46 and 2.73 times the background values， respectively. Zn was at a mild pollution level in the soil of the three typical factories， and Cd was at a moderate pollution level in the whole fluoride factory. The pollution sources of heavy metals in the typical factories were mainly natural sources， industrial activity sources （industrial waste discharge， mineral mining， and smelting activities）， traffic sources， etc. The results of potential ecological risk assessment showed that the ecological risk of the fluoride factory was at a high risk level， and the ecological risk of the leather factory and plating plants was at a high risk level. Cd was the main contributing element. The results of Monte-Carlo probabilistic ecological risk assessment reduced the uncertainty of deterministic assessment， which could provide scientific basis for accurate risk management and control in the regions.

Background: Outpatient clinics in medical centers are the most common location where people seek medical treatment. Because they must provide patients with treatment information in a timely manner, good communication skills are a key competency for outpatient nurses. However, the tools available for communication behavior assessment are general and rarely tailored for outpatient settings., Purpose: The purpose was to develop a communication behavior inventory for outpatient nurses and to examine its reliability and validity., Methods: During phase one, the authors conducted a literature search and synthesis, using the findings to develop the Outpatient Nurses Communication Behavior Inventory. During phase two, two expert validation rounds were conducted to confirm content validity. During phase three, 220 licensed outpatient nurses were recruited from a medical center in northern Taiwan to complete the instrument (December 2018 - January 2019.) The construct validity and internal consistency of the inventory were evaluated., Results: The literature search and synthesis identified six domains of communication, including connect, introduce, communicate, ask, respond, and exit. A total of 25 items were generated. Following the two expert panel validation rounds, the six domains remained but the inventory items were reduced to 21. Both item-content validity index and scale-level content validity index were 1.0. In phase three, the results of the confirmatory factor analysis retained six factors with a total of 16 items. Model three showed that the inventory demonstrated goodness of fit (Χ ² = 155.75, p < .001, RMSEA = .06, GFI = .92, AGFI = .87, NNFI = .97, NFI = .95, Model AIC = 253.75). Internal consistency was demonstrated with a Cronbach's α of .89., Conclusions / Implications for Practice: The Outpatient Nurses Communication Behavior Inventory exhibits good reliability and validity and may be used to assess outpatient nurses' communication behaviors and as a basis for education. The six CICARE (connect, introduce, communicate, ask, respond and exit) domains may be utilized to remind outpatient nurses to demonstrate effective communication consistently, promote outpatient nurses' communication with patients, and improve quality of care.

Background & Problems: Early detection tests are highly effective in helping adult women prevent the onset of cervical cancer. However, the cervical Pap smear screening rate in a health management center was only 54.3% in 2020., Purpose: This project was developed to improve the Pap smear screening rate for cervical cancer in a health management center., Resolution: The strategies developed included revising the health examination lists, developing an online appointment booking system, designing a patient decision aid, creating a standardized simulation moulage for education, and rechecking patient's National Health Insurance cards., Results: After implementation of these strategies, the Pap smear screening rate for cervical cancer rose from 54.3% to 81.2%. The screening rate at the health management center in 2022 reached 96.6%., Conclusions: Shared decision-making can elucidate the comprehensive options available to clients and support them in considering their options and achieving informed choices regarding Pap smear preferences.

Objective: To explore the clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery. Methods: A retrospective observational study was conducted. From January 2019 to June 2021, 12 patients with wounds after lower leg limb-sparing surgery who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital, including 6 males and 6 females, aged 17 to 74 years, with original wound area ranging from 17 cm×9 cm to 40 cm×15 cm. Five patients had infection in wounds. The wounds were all repaired by free anterolateral thigh perforator flap from contralateral thigh, with area of 18 cm×10 cm to 37 cm×9 cm. The artery of flap was anastomosed with the descending genicular artery, and the wounds in donor areas were sutured directly. Seven patients were transplanted with split-thickness skin grafts from the contralateral thigh to cover the remaining wounds that can not be covered by flap and the wounds in donor areas were covered with gauze. During the operation, the types of perforating branch carried by flap and the types of arteries and veins in recipient areas were recorded. The survival and occurrence of vascular crisis of flap, the survival of skin graft, the wound healing in donor and recipient areas, and the length of hospital stay after flap transplant surgery were recorded. During follow-up, the color and texture of flap, reinfection in lower leg, and fracture healing were recorded. At the last follow-up, the limb salvage function of patients was evaluated according to the functional evaluation criteria of Chen Zhongwei's amputated limb replantation. Results: The types of perforating branches carried by flaps were as follows: 6 cases of only carrying the descending branch of the lateral circumflex femoral artery, 3 cases of only carrying the oblique branch of the lateral circumflex femoral artery, and 3 cases of carrying the descending branch of the lateral circumflex femoral artery and oblique branch of the lateral circumflex femoral artery after internal pressurization anastomosis. The types of arteries in the recipient area of flap were as follows: one case of main trunk of the descending genicular artery, 8 cases of the saphenous branch of the descending genicular artery, and 3 cases of the articular branch of the descending genicular artery. The types of veins in the recipient area of flap were as follows: 8 cases of one accompanying vein of the descending genicular artery and one branch of the great saphenous vein, and 4 cases of two branches of the great saphenous vein. All the flaps survived without vascular crisis, and all the skin grafts also survived. The wounds in the donor and recipient areas were all healed. The length of hospital stay of patient after flap transplant surgery ranged from 13 to 79 days. During the follow-up of 6 to 23 months, the color and texture of flap were both good, with no infection in lower leg wound. Internal or external fixation were removed after fracture healing in 5 patients, and bone graft internal fixation was performed in 7 patients whose fractures were not healed after surgery and all the incisions healed without infection. At the last follow-up, the limb salvage effect of patients was evaluated as followings: excellent in 7 patients, good in 4 patients, and fair in one patient. Conclusions: Free anterolateral thigh flap pedicled with descending genicular artery can effectively repair the wounds after lower leg limb-sparing surgery and control infection with short length of hospital stay, while not increasing the risk of secondary injury of distal limb vessels. Thus, it can obtain satisfactory limb salvage effect which is worthy of clinical promotion.

Background & Problems: The extracorporeal membrane oxygenation (ECMO) system can provide cardiopulmonary support to and reduce the mortality rate in severely ill newborns. According to our investigation, completion rate of the care process among staff nurses was only 63.5% in our ward. We assumed that the reasons for the above problems included: lack of care awareness, unfamiliarity with the ECMO operation process, inadequate instruments preparation, improper ECMO pipeline fixation, lack of designated space in the unit for placing ECMO supplies, lack of specialty care guidelines, lack of a regular inspection system, and lack of regular on-the-job education., Purpose: Improve awareness related to assisting ECMO placement among nurses in the neonatal intensive care unit and the completeness of care., Resolutions: 1. Create a care process guidebook describing the procedures for ECMO system placement in newborns to help nurse accomplish proper placement. 2. Establish the ECMO system consumables checklist and install an ECMO system-specialized toolbox to reduce the preparation time and smooth the process. 3. Regularly organize comprehensive nurse training and develop performance indicators to enhance ECMO system placement awareness and skills., Results: The cognitive accuracy rate for the assisted placement of ECMO among nurses in the neonatal intensive care unit increased from 51.9% before improvement to 89.9% afterward. Also, the complete care rate of ECMO placement increased from 63.5% before improvement to 100% afterward., Conclusions: This project effectively improved the accuracy rate of nurses involved in assisting with ECMO placement, made the ECMO system placement process easier to implement, improved the care process completion rate, and improved newborn care quality.

This study was conducted to evaluate the efficacy and safety of Simotang Oral Liquid in the treatment of functional dyspepsia in adults. &quot;Simotang Oral Liquid&quot; &quot;Simotang&quot; &quot;Si Mo Tang&quot; &quot;Si Mo Tang Oral Liquid&quot; were used for retrieval of the relevant papers from CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library, Springer Link, and Web of Science from database inception to June 2021. Randomized controlled trial(RCT) of Simotang Oral Liquid in the treatment of functional dyspepsia in adults was screened out for Meta-analysis which was conducted in RevMan 5.3. A total of 16 RCTs were included. Meta-analysis showed that compared with the control group, Simotang Oral Liquid increased the total response rate and lowered the traditional Chinese medicine syndrome scores, serum cholecystokinin(CCK), serum nitric oxide(NO), and incidence of adverse reactions. However, the serum substance P(SP) had no statistical difference between the two groups. Simotang Oral Liquid is effective and safe in the treatment of functional dyspepsia in adults. However, this study has evidence and limitations, so the conclusions need to be further verified by large sample and multicenter clinical studies.

The concept of radical surgery has experienced from vascular anatomy guidance, lymph node dissection guidance to en-bloc resection guidance. At present, the mesentery guided surgery has developed to a new level of understanding. There are many classical theories on the understanding of the mesentery, from "the mesentery is a wrapped composite structure" to "the mesentery is an organ" and then to "the generalized mesentery theory", but they do not clearly put forward the boundary mark of the mesentery. On the basis of various membrane anatomy theories at home and abroad, we summarized and defined three boundaries of mesenteric excision in radical resection of colorectal cancer. The lateral boundary of the mesentery is the intestinal resection boundary and its mesentery oriented by supplyvessel, the bottom boundary is the mesentery bed, and the central boundary is the degree of lymph node radical resection. Through the detailed description of the mesentery excision, it is helpful to accurately define the mesenteric margin in different stages of radical resection of tumors.

Objective: To analyze the spatiotemporal distribution of life expectancy (LE) and health-adjusted life expectancy (HALE) in Guangzhou from 2010 to 2019, and quantize the comprehensive impact of different causes and sequelae on health. Methods: The LE, HALE, and cause-excluded health adjusted life expectancy (CEHALE) were estimated using cause-of-death surveillance datasets from Guangzhou Municipal Center for Disease Control and Prevention from 2010 to 2019 and open data from the Global Burden of Disease Study. Joinpoint log-linear regression model was used to analyze the temporal trend and described spatial distribution. Results: In 2019, the LE in residents in Guangzhou was 82.9 years (80.1 years in men and 85.9 years in women), and the HALE was 75.6 years (74.0 years in men and 77.3 years in women). Compared with the urban fringe, the central urban area had higher LE and HALE, and the differences between LE and HALE were small. The LE and HALE in Guangzhou showed an increasing trend from 2010 to 2019. The LE increased by 2.8 years (AAPC=0.4, 95% CI : 0.3-0.4), with the increase of 2.8 years in men and 2.9 years in women. The HALE increased by 2.4 years (AAPC=0.3, 95% CI : 0.3-0.4), with the increase of 2.5 years in men and 2.2 years in women. The median healthy life lost due to communicable, maternal, neonatal, and nutritional diseases was 6.2 years (AAPC=-4.2, 95% CI : -5.3--3.1), while the median healthy life lost due to non-communicable diseases was 14.7 years (AAPC=1.6, 95% CI : 0.9-2.3), the median healthy life expectancy reduced by injury was 6.3 years (AAPC=-3.5, 95% CI : -4.5--2.6). Musculoskeletal disorders, skin and subcutaneous diseases, cardiovascular diseases, nutritional deficiencies, diabetes and kidney diseases were the top five diseases causing healthy life expectancy loss. Conclusion: The LE and HALE in residents in Guangzhou increased steadily from 2010 to 2019, but the quality of life in the urban fringe was lower than that of the central urban area. Non-communicable diseases were the leading causes of healthy life expectancy loss. Health policies and prevention measures should be developed according to area specific characteristics, and social medical resources should be rationally allocated to key diseases to reduce their disease burden.

Background ≥ Problems: Nutrition is very important for premature infants. Our recent research showed that the accuracy of recognition related to tube feeding was 74.8%, and the completeness of tube feeding was 74.3%. After analyzing this situation, the reasons found to be significantly associated with the low rates of tube-feeding recognition accuracy and completion included: inconsistent treatment of gastric residual by nurses in the neonatal intensive care unit (NICU), lack of sufficient assessment tools in the NICU, out-of-date specialist care guidelines, and lack of a regular inspection system., Purpose: Our aim was to improve tube-feeding-related recognition accuracy and completion to reduce the incidence of feeding intolerance., Resolutions: The intervention included developing a guideline manual for feeding procedures and making a gastric residual color card as a clinical-care reference. Holding on-the-job training and monitoring the quality of nursing care can reduce the incidence of feeding intolerance in preterm., Results: The accuracy of tube-feeding recognition increased from 74.8% to 93.7%. The completion of tube feeding increased from 74.3% to 95.5%. The incidence of feeding intolerance in premature infants decreased from 71.8% to 39.0%., Conclusions: The results and process of this project provides a reference for improving the clinical care model for preterm infants in the NICU and for improving the enteral nutrition of preterm infants. The implementation of this project may improve the quality of nursing care and enable preterm infants to receive safer and more-complete care.

This study aims to explore the effect of icariin(ICA) on mitochondrial dynamics in a rat model of chronic renal failure(CRF) and to investigate the molecular mechanism of ICA against renal interstitial fibrosis(RIF). CRF was induced in male Sprague-Dawley(SD) rats with 5/6(ablation and infarction, A/I) surgery(right kidney ablation and 2/3 infarction of the left kidney). Four weeks after surgery, the model rats were randomized into the following groups: 5/6(A/I) group, 5/6(A/I)+low-dose ICA group, and 5/6(A/I)+high-dose ICA group. Another 12 rats that received sham operation were randomly classified into 2 groups: sham group and sham+ICAH group. Eight weeks after treatment, the expression of collagen-Ⅰ(Col-Ⅰ), collagen-Ⅲ(Col-Ⅲ), mitochondrial dynamics-related proteins(p-Drp1 S616, p-Drp1 S637, Mfn1, Mfn2), and mitochondrial function-related proteins(TFAM, ATP6) in the remnant kidney tissues was detected by Western blot. The expression of α-smooth muscle actin(α-SMA) was examined by immunohistochemical(IHC) staining. The NRK-52 E cells, a rat proximal renal tubular epithelial cell line, were cultured in vitro and treated with ICA of different concentration. Cell viability was detected by CCK-8 assay. In NRK-52 E cells stimulated with 20 ng·mL~(-1) TGF-β1 for 24 h, the effect of ICA on fibronectin(Fn), connective tissue growth factor(CTGF), p-Drp1 S616, p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6 was detected by Western blot, and the ATP content and the mitochondrial morphology were determined. The 20 ng·mL~(-1) TGF-β1-stimulated NRK-52 E cells were treated with or without 5 μmol·L~(-1) ICA+10 μmol·L~(-1) mitochondrial fusion promoter M1(MFP-M1) for 24 h and the expression of fibrosis markers Fn and CTGF was detected by Western blot. Western blot result showed that the levels of Col-Ⅰ, Col-Ⅲ, and p-Drp1 S616 were increased and the levels of p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6 were decreased in 5/6(A/I) group compared with those in the sham group. The levels of Col-Ⅰ, Col-Ⅲ, and p-Drp1 S616 were significantly lower and the levels of p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6 were significantly higher in ICA groups than that in 5/6(A/I) group. IHC staining demonstrated that for the expression of α-SMA in the renal interstitium was higher in the 5/6(A/I) group than in the sham group and that the expression in the ICA groups was significantly lower than that in the 5/6(A/I) group. Furthermore, the improvement in the fibrosis, mitochondrial dynamics, and mitochondrial function were particularly prominent in rats receiving the high dose of ICA. The in vitro experiment revealed that ICA dose-dependently inhibited the increase of Fn, CTGF, and p-Drp1 S616, increased p-Drp1 S637, Mfn1, Mfn2, TFAM, and ATP6, elevated ATP content, and improved mitochondrial morphology of NRK-52 E cells stimulated by TGF-β1. ICA combined with MFP-M1 further down-regulated the expression of Fn and CTGF in NRK-52 E cells stimulated by TGF-β1 compared with ICA alone. In conclusion, ICA attenuated RIF of CRF by improving mitochondrial dynamics.

Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P >0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P <0.001), smaller maximum tumor diameter ( t =3.969, P <0.001), less number of metastatic lymph nodes ( t =1.343, P <0.001), lower ratio of vessel invasion (χ(2)=11.897, P =0.001) and nerve invasion (χ(2)=12.338, P <0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P =0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P =0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P <0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P <0.05); patients over 45 years of age ( P <0.05) and with normal body mass ( P <0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly ( P <0.05); patients with signet ring cell carcinoma benefited little ( P >0.05); tumors in the gastric body and gastric antrum benefited more significantly ( P <0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.

Based on the pollutant data provided by the environmental monitoring stations and the routine observation data of 11 national meteorological stations in Jiangxi Province from 2016 to 2019, the characteristics of ozone pollution and the relationships with meteorological factors were investigated in this study. The results showed that ozone pollution has become increasingly severe in Jiangxi Province in recent years. The annual mean concentration of ozone in Jiangxi Province (the maximum daily 8 h average) was 80.1 μg·m -3 in 2016 and reached up to 98.2 μg·m -3 in 2019, with an average annual growth rate of 6 μg·m -3 . The number of over-standard days of ozone was 475 d, accounting for 72.6% of 2019 in Jiangxi Province. The average concentrations observed in summer were higher than those observed in the other seasons during 2016 to 2018, but in 2019, higher ozone concentrations were observed in autumn owing to the lower precipitation, more sufficient sunshine, and the resulting higher air temperature. Overall, the ozone concentrations were found to be positively correlated with air temperature and sunshine but negatively correlated with relative humidity in Jiangxi Province. A high ozone concentration usually appeared with an air temperature higher than 30℃, relative humidity of 20%-40%, and wind speed of 2-3 m·s -1 . The spatial distribution of the ozone concentrations exhibited distinct characteristics with higher values observed in southern Jiangxi relative to those in the northern areas and lower values in northeastern Jiangxi compared with those in other regions. More serious ozone pollution was found in Ganzhou among the 11 cities in Jiangxi Province, with the highest annual concentration of 104.2 μg·m -3 observed in 2019. The results of the model analyses, including the HYSPLIT backward trajectory model and potential source contribution function model, indicated that there was a significant difference in the potential source contribution of ozone pollution in Ganzhou on seasonal scales, specifically in central Guangdong and the northwest of Jiangxi Province in spring, the northwest parts of Jiangxi Province in summer, and the north of Guangdong and central Anhui Province in autumn.

Background & Problems: Medical management protocols prioritize the safety of patients during emergency resuscitation situations. According to a medical center in Taiwan statistics gathered in 2017, the unnecessary activation of resuscitation teams by new nurses because of their improper assessment of patient conditions was a significant cause of anxiety in patient relatives and source of complaints directed at the medical center. In June 2018, 18.7% of the emergency resuscitation calls in the emergency department (ED) were false alarms or absent treatment incidents. After investigation, lack of clearly stated resuscitation team member responsibilities and insufficient practical training for new nurses were primary factors associated with the high rate of false alarm/absent treatment incidents in the ED., Purpose: To decrease the rate of absent treatment by nurses during resuscitation from 18.7% to 0% in the ED., Resolution: The assignments of emergency team members were revised, a new "Emergency app" was introduced, the assignment schedule of the emergency resuscitation team was distributed, SIM realistic education training was held, stronger team work was promoted, and a standard assignment review schedule was established and regularly monitored., Results: After the introduction of the resolution measures, the false alarm / absent treatment incidents in the ED caused by ED nurses dropped from 18.7% to 0%., Conclusions: Resuscitation workflow is closely related to patient safety, and teamwork among colleagues critical to successful resuscitation. The project revised resuscitation teamwork assignments and organized resuscitation education training, including simulation courses, to enhance the understanding of team members. The strategy outlined in this paper may be used to raise awareness using posters and resuscitation record checklists to track and manage the team`s progress. This project was designed to enhance teamwork to decrease the rate of absent treatment and to provide safe and quality resuscitation care in order to improve resource management by the team to increase productivity.

Objective: To investigate the safety and short-term efficacy of apatinib combined with oxaliplatin and S-1 in the conversion treatment for gastric cancer with different types of peritoneal metastasis. Methods: A prospective study "one arm exploratory clinical study of conversion therapy of apatinib with S-1 and oxaliplatin in the treatment of advanced gastric cancer" (clinical registration ChiCTR-ONC-17010430) from medical record database was retrospectively analyzed. Patients aged 18-70 years with gastric cancer peritoneal metastasis confirmed by histology and laparoscopic exploration, and had not receive radiotherapy, chemotherapy, targeted therapy or immunotherapy before were enrolled. Before operation, the patients received 6 cycles of S-1 (80-120 mg/d, d1-d14) and oxaliplatin (130 mg/m(2), d1), and 5 cycles of apatinib (500 mg/d, d1-d21) conversion regimen. Three weeks after chemotherapy, whether the operation was performed or not depending on re-evaluation and patient preference. The main outcome were adverse reactions, and the secondary outcome were objective remission rate (ORR), disease control rate (DCR), and overall survival (OS) rate. The follow-up period was up to May 2020. Results: A total of 27 patients with gastric cancer peritoneal metastasis were enrolled in this study. There were 13 males and 14 females, with a median age of 58 (30-68) years old. There were 9 cases of P1a, 5 cases of P1b, and 13 cases of P1c. There were 14 cases with 1-5 scores of PCI (peritoneal cancer index), and 13 cases with 6 scores or above. The incidence of adverse reactions was 100%. The most common adverse reactions were hematological events including leucopenia (70.4%, 19/27) and granulocytopenia (74.1%, 20/27). Non-hematological adverse events included fatigue (51.9%, 14/27) and oral mucositis (37.0%, 10/27). One patient was withdrawn due to grade 4 thrombocytopenia. Among 26 patients with feasible efficacy evaluation, 18 (69.2%) achieved partial remission, 3 (11.5%) achieved stable disease, and 5 (19.2%) disease progression. The objective remission rate was 69.2% (18/26) and the disease control rate was 80.8% (21/26). Fourteen patients underwent surgery, including 6 patients undergoing R0 resection with the R0 resection rate of 42.9% (6/14). The postoperative pathological response rate was 64.3% (9/14). The follow-up time was 12-40 months, and the follow-up rate was 100%. The 1-year OS rate was 65.2% and the survival time was (14.0±1.7) months. The 1-year OS rates of P1a/P1b group and P1c group were 81.8% and 42.0% respectively, whose difference was statistically significant ( P =0.041). The 1-year OS rates of PCI 1-5 group and PCI ≥6 group were 67.3% and 38.5% respectively, whose difference was statistically significant ( P =0.022). Conclusion: In the conversion treatment of gastric cancer peritoneal metastasis, the safety of apatinib combined with oxaliplatin and S-1 is acceptable, and this regimen shows a good short-term survival efficacy in patients with P1a/P1b and PCI of 1-5.

Background & Problems: Dermatitis associated with incontinence was the cause of 55% of the total of 386 skin lesion cases in our unit between July and December 2016 and 40.3% of the skin lesion cases in our unit during March and April 2017, indicating the importance of this issue. Our survey showed that the nurses in our unit scored an average of 78.9% on knowledge related to the prevention of incontinence-associated dermatitis and only 58.2% on knowledge related to incontinence-associated dermatitis care. The main reasons for the high incidence of incontinence-associated dermatitis included: incorrect implementation of care, no discussion with the medical team, no incontinence care standards, no continue education, lack of related equipment for preventing incontinence-associated dermatitis, unit patient characteristics, and drugs used., Purpose: To reduce the incidence of incontinence-associated dermatitis from 40.3% to 32.0%., Resolution: A care-bundle in treating incontinence-associated dermatitis was implemented by designing an assessment flow chart for evaluating incontinence-associated dermatitis, by setting standard guidelines for incontinence-associated dermatitis care, by distributing reminder cards, special toolboxes, and by changing how the little diapers were wrapped. In-service education lessons, inter-professional collaborative practice, and regular internal audit were also executed., Results: After project implementation, the knowledge score of nurses increased from 78.9% to 95.7%; the correctness of care score, as retested in November 2017, increased from 58.2% to 91.5%; and the incidence of incontinence-associated dermatitis dropped to 18.5%. These improvements achieved the goals of this project. Furthermore, the sustained effect of the project measures was confirmed, with the incidence of incontinence-associated dermatitis determined as 17.9% at three months after completion of the project., Conclusions: Formulating care procedures and cooperating with medical team personnel to provide creative care measures were shown to effectively decrease the incidence of incontinence-associated dermatitis and improve overall quality of care. The findings of this project support the revision by hospitals of regulations and procedures related to adult incontinence-associated dermatitis to provide caregivers with basis-of-care standards and uniform care procedures and standards in support of effective patient skin care regimens.

In a preliminary experiment, 91 pepper varieties were screened, and one variety each with high Cd accumulation (X55), medium Cd accumulation (Daguo 99), and low Cd accumulation (Luojiao 318) were selected to study the effect of different cadmium levels (0, 5, and 10 mg·kg -1 Cd) on cadmium migration and enrichment ability, and its subcellular distribution and chemical form. The results showed that under the stress of Cd, shoot dry weight of pepper plants was in the order X55>17>27. At the same level of Cd, the Cd transfer coefficient of fruit was 17>27 and X55. Cadmium concentrations in each subcellular component of the pepper fruits were 27 > 17 > X55. Cadmium concentration in subcellular component of the roots, stems, leaves, and fruits of the pepper plants was in order of cell wall (F1) > organelle (F2) > cell soluble component (F3). Cadmium was limited in cell wall and plays an important role in detoxification mechanism and resistance of Cd in pepper plants. The morphological content of various Cd forms in the pepper fruits of the three varieties increased with the increase of Cd treatment level, in the order Cd NaCl > Cd HAC > Cd R > Cd HCl > Cd W > Cd E . Cd NaCl and Cd HAC account for a large proportion of Cd in pepper fruits, which may be an important defense mechanism for reducing the biological toxicity of Cd.

To compare the polysaccharides( LBLP),total flavonoids( LBLTF) and total phenols( LBLTP) of Lycium barbarum leaves from 14 production areas from Ningxia,Qinghai and Gansu at different harvesting time. Our results showed that there were significant difference of LBLP,LBLTF and LBLTP among different production areas. The LBLP collected from Xiangride township production area,Dulan,Qinghai was as high as 15. 02%. The LBLTF collected from Dagele township production area,Geermu,Qinghai was as high as28. 63%. The LBLTP collected from Keluke township production area,Delingha,Qinghai was as high as 16. 7%. There were also significant difference of these 3 components between different harvest periods. The average LBLP in May( 10. 20%) was significantly higher than that in June( 8. 49%). However,the average LBLTF( 17. 71%) and LBLTP( 12. 77%) in June was significantly higher than that in May( 14. 15%,11. 19%). The LBLTF and LBLTP have a positive correlation with the altitude of production areas,but there was no significant association between LBLP and altitude. The LBLP,LBLTF and LBLTP in different production areas and harvesting time was significant difference,the results provide some references for furthermore development and utilization of L. barbarum leaves.

Traditional Chinese medicine is widely used in the treatment of fractures, osteoporosis, other bone related diseases for thousands of years. There are many animal experiments and clinical trials demonstrating that the traditional Chinese medicine such as epimedium, Drynaria and other traditional Chinese medicine can stimulate bone regeneration and inhibit bone resorption, accelerating the fracture healing. In recent years many cell experiments have shown that these herbal ingredients up-regulated the expression of intracellular osteogenic transcription factors and osteogenic related genes, and then induced osteoblastic differentiation and stimulated the proliferation of osteoblasts, bone nodule formation and matrix mineralization. Meanwhile these herbal ingredients up-regulated the expression of intracellular osteoclastic transcription factors and osteoclast related genes, inhibited osteoclast differentiation and bone resorption of osteoclasts. In addition, intracellular signaling pathways regulated these herbal ingredients by might be involved in the above effects. We can have a conclusion that the genes expression regulated by transcription factors in pre-osteoblast and pre-osteoclast and these signaling pathways are the major molecular mechanisms and research hotspots of traditional Chinese medicine in promoting fracture healing. Based on these molecular mechanisms to review, this review provides not only the foundation for the study of traditional Chinese medicine in promoting fracture healing, but also the basis for clinical treatment of fracture., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© 2017 by the China Journal of Orthopaedics and Traumatology Press.)

Innovation and rapid technological development in Smart Medicine or Smart Healthcare impact profoundly on many aspects of healthcare. It is believed that Health Information Technology (HIT) has the potential to improve integration between care providers, reduce administrative costs and burdens, reduce medical errors, and improve care quality and patient outcomes. However, issues such as interoperability, compatibility, and integration are critical to effectively integrating hardware and software in order to fully realize the benefits of HIT. High-end medical devices and equipment, including medical carts / mobile computer carts and wireless physiological and biomedical monitoring devices, should also be integrated into the hospital information system. Furthermore, the Data, Information, Knowledge, and Wisdom Hierarchy (DIKW) has been gaining popularity in the development of Nursing Information Systems (NIS) since 2013. To create a DIKW-based information system, data must first be defined and analyzed and then transformed into meaningful information. Eventually, this information is transformed into an intelligent system. For example, if evidence-based nursing research results / findings are integrated into the NIS to guide clinical practice, patient outcomes, patient safety, and healthcare quality will be greatly enhanced.

In this study, we developed a model for photosynthetic production in double cropping rice by integrating the advantages in current crop models (including the models of canopy structure, canopy light distribution, canopy photosynthesis and dry matter production). The canopy light distribution and dry matter accumulation were preliminarily validated with independent field experiment datasets. The distribution of direct radiation both on a level surface and on the leaf surface within canopy, the canopy daily photosynthate and its characteristics with varying leaf area index for three typical plant types (erect both upper and lower, upper erect and lower flat, and flat both upper and lower) were quantitatively analyzed by the model. The results indicated that there was a good agreement between the simulated and observed values. The root mean square error (RMSE), relative root mean square error (RRMSE) and correlation coefficient (r) of prediction of canopy light distribution in double cropping rice were 12.01 J ·m -2 ·s -1 , 8.2% and 0.9929, respectively. Meanwhile, the RMSE, RRMSE and r of prediction of dry matter accumulation were 0.83 t·hm -2 , 14.6% and 0.9772, respectively. It was indicated that the model had a performance. The upper erect and lower flat plant type had highest canopy daily photosynthate due to higher incident sun light received on the leaf surface, leaf photosynthetic efficiency and leaf area index.

Current treatments for hepatitis C include pegylated interferon-α (Peg-IFNα) and ribavirin (RBV) combination therapy and direct antiviral agents (DAAs). Antiviral treatment can be initiated after 4 to 6 months of clinical observations for patients with acute infections, but should be started as early as possible for those with chronic infections. However, for patients who are ineligible for Peg-IFN and RBV combination therapy and have no unrestricted access to DAAs, it is advised that they wait for the approval of DAAs in China if their medical condition is under control. Though, antiviral therapy should be started immediately if the disease progresses. It has been reported that there are numerous clinical benefits of antiviral treatment for hepatitis C. However, the long-term impact of DAAs treatment including efficacy and safety is limited and remains to be explored.

Objective: To investigate whether Lactobacillus rhamnosus GG conditioned medium(LGG-CM)has preventive effect against E. coli K1-induced neuropathogenicity in vitro by inhibiting nuclear factor-κB (NF-κB) signaling pathway., Methods: An in vitro blood-brain barrier (BBB) model was constructed using human brain microvascular endothelial cells (HBMECs). The effect of LGG-CM on E. coli-actived NF-κB signaling pathway was assayed using Western blotting. Invasion assay and polymorphonuclear leukocyte (PMN) transmigration assay were performed to explore whether LGG-CM could inhibit E. coli invasion and PMN transmigration across the BBB in vitro. The expressions of ZO-1 and CD44 were detected using Western blotting and immunofluorescence. The changes of trans-epithelial electric resistance (TEER) and bacterial translocation were determined to evaluate the BBB permeability., Results: Pre-treament with LGG-CM inhibited E. coli-activated NF-κB signaling pathway in HBMECs and decreased the invasion of E. coli K1 and transmigration of PMN. Western blotting showed that LGG-CM could alleviate E. coli-induced up-regulation of CD44 and down-regulation of ZO-1 expressions in HBMECs. In addition, pre-treatment with LGG-CM alleviated E. coli K1-induced reduction of TEER and suppressed bacterial translocation across the BBB in vitro., Conclusion: LGG-CM can block E. coli-induced activation of NF-κB signaling pathway and thereby prevents E. coli K1-induced neuropathogenicity by decreasing E. coli K1 invasion rates and PMN transmigration.

Objective: To observe the effect of parathyroid hormone (PTH)(1-34) on the expression of matrix Gla protein (MGP) and Wnt/β-catenin signaling pathway and elucidate the possible molecular mechanism of PTH (1-34) in the prevention and treatment of osteoporosis., Methods: MG63 cells treated with PTH (1-34) at 10(-9), 10(-8), and 10(-7) mol/L, alone or in combination with Wnt/β-catenin signaling pathway inhibitors DKK-1 (200 ng/ml) were examined for mRNA and protein expressions related with Wnt/β-catenin signaling with real-time PCR and Western blotting. The cell differentiation after the treatment was assessed with alkaline phosphatase (ALP) staining and cell viability assay., Results: PTH (1-34) significantly increased the expression of MGP in a dose-dependent manner in MG63 cells (P<0.05 or P<0.01). PTH treatment obviously enhanced ALP activity in the cells, and this effect was suppressed by DKK-1. Combined treatment with DKK-1 partially blocked PTH-induced enhancement of ALP activity (P<0.05). PTH promoted the expression of MGP and enhanced LRP5, β-catenin, and Runx2 expressions in Wnt/β-catenin signaling pathway at both protein and mRNA levels (P<0.05 or P<0.01). DKK-1 partially blocked the effect of PTH (1-34) on Wnt/β-catenin signaling pathway (P<0.05) without affecting MGP expression., Conclusion: PTH (1-34) significantly increases the expressions of MGP and proteins in the Wnt/β-catenin signaling pathway. Wnt/β-catenin signaling pathway and MGP mediate the regulation of osteogenosis by PTH.

To clear from botanical view the original materials under the traditional Chinese medicine names of "Jinchai", "Jinchai Shihu" within the genus Dendrobium of the family Orchidaceae. Combined of different methods including study of historical records from the local chronicles and historical accounts of past event in Hubei, Sichuan, Chongqing, Henan and Shaanxi provinces, interviewing face to face with the old traditional Chinese workers and folk doctors in 20 downtowns and countrysides, such as, Laohekou, Lichuan, Fangxian, Xixia, Neixiang, and Ankang, and collecting a few plants of "Jinchai" for taxonomic identification. The traditional Chinese medicine names of "Jinchai", "Jinchai Shihu" were widely used by the local people from the eastern Chongqing, western Hubei, northeasten Sichuan, southeastern Shaanxi, western Henan. Those two names were frequently found in the local Chronicles and historical accounts of past event, even in the local daily life such as folk songs and stories. The botanical identification results showed that a endemic species of D. flexicaule is the original materials of the traditional Chinese medicine names "Jinchai" and "Jinchai Shihu", and this species are also called "Longtoujin", "Renzijin", "Huanzijin" and "Longtoufengweijin" by the local people. The dried artifactitious specimens of D. flexicaule are traditionally named as "Jinerhuan". The botanic resource plants of the traditional Chinese medicine names of "Jinchai", "Jinchai Shihu" are the endemic species of D. flexicaule that is distributed mainly in central areas of China including eastern Chongqing, western Hubei, northeasten Sichuan, southeastern Shaanxi, and western Henan, rather than D. nobile as referring in both Chinese and English version of Flora of China, and in official recorded serious versions of The Chinese Pharmacopoeia since 1977. In order to avoid confusion in the traditional Chinese medicine dendrobiums industry, the Chinese name of D. nobile is suggested as "Biancao Shihu", which characterized one stem feature of this species, and the traditional Chinese medicine names "Jinchai" or "JinchaiShihu" is suggested to refer to the species D. flexicaule., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Direct observation of urban atmospheric CO2 concentration is vital for the research in the contribution of anthropogenic activity to the atmospheric abundance since cities are important CO2 sources. The observations of the atmospheric CO2 concentration at multiple sites/heights can help us learn more about the temporal and spatial patterns and influencing mechanisms. In this study, the CO2 concentration was observed at 5 sites (east, west, south, north and middle) in the main city area of Nanjing from July 18 to 25, 2014, and the vertical profile of atmospheric CO2 concentration was measured in the middle site at 3 heights (30 m, 65 m and 110 m). The results indicated that: (1) An obvious vertical CO2 gradient was found, with higher CO2 concentration [molar fraction of 427. 3 x 10(-6) (±18. 2 x 10(-6))] in the lower layer due to the strong influences of anthropogenic emissions, and lower CO2 concentration in the upper layers [411. 8 x 10(-6) (±15. 0 x 10(-6)) and 410. 9 x 10(-6) (±14. 6 x 10(-6)) at 65 and 110 m respectively] for the well-mixed condition. The CO2 concentration was higher and the vertical gradient was larger when the atmosphere was stable. (2) The spatial distribution pattern of CO2 concentration was dominated by wind and atmospheric stability. During the observation, the CO2 concentration in the southwest was higher than that in the northeast region with the CO2 concentration difference of 7. 8 x 10(-6), because the northwest wind was prevalent. And the CO2 concentration difference reduced with increasing wind speed since stronger wind diluted CO2 more efficiently. The more stable the atmosphere was, the higher the CO2 concentration was. (3) An obvious diurnal variation of CO2 concentration was shown in the 5 sites. A peak value occurred during the morning rush hours, the valley value occurred around 17:00 (Local time) and another high value occurred around 19:00 because of evening rush hour sometimes.

The MnO(x)-CeO2/m-ZrO2 catalyst was prepared by impregnation with nano monoclinic-phase zirconium (m-ZrO2) as the supporter. The influence of active component and reaction temperature on the denitration performance of the catalyst was investigated, while the surface properties of the catalyst and the denitration mechanism were discussed. The denitration efficiency was improved as the active component increased and the reaction temperature rose. The denitration efficiency of 2.5% MnO(x)-CeO2/m-ZrO2 catalyst at 110 degrees C was 55.5% while that of 15% MnO(x)-CeO2/m-ZrO2 catalyst was 93.5%. The results of XRD, SEM, BET and H2-TPR showed that the surface structure of the loaded catalyst was beneficial for denitration and oxidation-reduction. NH3-TPD test demonstrated that NH3 was adsorbed at the Lewis acid sites and Brönsted acid sites on the surface of catalysts. Intermediate products NH2NO and NH4NO were generated from a series of reactions between NO and NH3 and finally transformed into N2 and H2O. Most of the denitration process happened at Lewis acid sites.

Objective: To study the clinical efficiency, electroencephalogram (EEG) changes and cognitive improvements of ketogenic diet (KD) in children with refractory epilepsy., Methods: Twenty pediatric patients (7-61 months in age) with refractory epilepsy were recruited between August 2012 and August 2013. KD therapy was performed on all participants for at least 3 months based on a fasting initiation protocol with the lipid-to-nonlipid ratio being gradually increased to 4 : 1. Seizure frequency, type and degree were recorded before and during KD therapy. A 24 hours video-electroencephalogram (V-EEG) examination and Gesell Developmental Scale assessment were performed prior to KD therapy, and 3, 6, 9 months after KD therapy., Results: Six patients became seizure free after KD therapy, with a complete control rate of 30%. Seizure frequency reduction occurred in 13 (65%) patients, EEG improvement in 8 (40%) patients, and improvement in Gesell Developmental Scales (gross motor and adaptability in particular) in 6 (30%) patients. The KD therapy-related side effects were mild., Conclusions: KD therapy is safety and effective in reducing seizure frequency and improving EEG and cognitive function in children with refractory epilepsy.

Objective: To observe the specificity relationship between acupuncture at "Hegu" (LI 4) and the facial muscular movement in rhesus monkeys under the physiological state by using neuromuscular electrical measurement technique., Methods: Eighteen rhesus monkeys were randomized into a Hegu group, a Houxi group and a Waiguan group, 6 monkeys in each one. Under the physiological state, EMG was detected on the frontal muscle, zygomatic muscle and orbicular muscle before and after acupuncture at different acupoints. The impacts of acupuncture on the facial EMG were studied and compared among different acupoints., Results: With acupuncture at "Hegu" (LI 4), the latency was reduced (P < 0.01) and the peak value and area were increased (P < 0.05, P < 0.01) in the frontal EMG; the area and the peak value were increased (P < 0.01, P < 0.05) and latency was reduced (P < 0.05) in the zygomatic EMG; the frequency was increased (P < 0.01) and the latency was reduced (P < 0.05) in the orbicular EMG. Before and after acupuncture at "Hegu" (LI 4), the change rates of EMG frequency, peak value, area and latency on the frontal, zygomatic and orbicular muscles were higher than those at "Houxi" (SI 3) and "Waiguan" (TE 5) (P < 0.05, P < 0.01) separately., Conclusion: The relative specificity presents between Hegu (LI 4) and facial muscular movement.

By using dilution plate, fumigation extraction, and phospholipid fatty acid (PLFA) methods, this paper studied the quantities of soil microbial populations and the characteristics of soil microbial community structure in a Chinese fir (Cunninghamia lanceolata) plantation converted from an evergreen broadleaved forest. The results showed that, during the vegetation change from evergreen broadleaved forest to Chinese fir plantation, the microbial biomass carbon and the quantities of culturable bacteria and actinomyces were decreased. The total PLFAs, bacterial PLFAs, and fungi PLFAs in the woodland soil from Chinese fir plantation were decreased by 49.4%, 52.4%, 46.6%, simultaneously. And G+ and G- bacterial PLFAs in Chinese fir plantation were lower than in evergreen broadleaved forest. As compared with those in rhizosphere soil from Chinese fir plantation, the microbial biomass carbon and the quantities of culturable bacteria and actinomyces in bulk soil were decreased. The total PLFAs, bacterial PLFAs, and G+ and G- bacterial PLFAs in the rhizosphere soil were increased, while the ratio of fungal to bacterial PLFAs was lowered. The principal component analysis of the soil microbial community structure indicated that the first principal component (PC1) and the second principal component (PC2) together accounted for 78.2% of total variation of soil microbial community structure. This study showed there were some differences in the soil microbial community structure between evergreen broadleaved forest and Chinese fir plantation.

Objective: The primary aim of this prospective study was to use serial (18)F-FDG PET-CT imaging to evaluate the trend of the tumor's maximum standardized uptake value (SUVmax) during radiotherapy (RT) for patients with nasopharyngeal carcinoma (NPC), and to explore the possibility of early evaluation of the tumor bio-metabolic response during radiotherapy., Methods: Sixty patients with biopsy-proven primary NPC were prospectively enrolled into the study. All patients underwent four (18)F-FDG PET-CT scans: one initial scan before RT/cisplatin based concurrent chemoradiotherapy, at the point of 50 Gy during RT, the end of RT, and one month after RT, respectively. Tumor (18)F-FDG uptake was analyzed according to the World Health Organization pathological type., Results: There was a significant difference (P < 0.001) of the mean of SUVmax of the primary site among pretreatment (11.20 ± 5.37) and posttreatment at the dose of 50 Gy (3.50 ± 1.59), at the end of RT (3.05 ± 1.56) and one month after RT (2.52 ± 1.46). There was also a significant difference (P < 0.001) of the mean of SUVmax of neck node site. However, there was a significant difference of the SUVmax between histological WHO type IIb and type IIa in the primary site (P = 0.046) [(67 ± 19)% reduction at dose 50 Gy for type IIb vs. (55 ± 24)% for type IIa] but not in the lymph nodes., Conclusions: Early PET scan during or right after RT instead of conventional 3 months interval after RT is indicated to evaluate the tumor response and to develop individualized adaptive radiotherapy in NPC. Our next study will attempt to demonstrate the results based on long-term follow-up data.

Substrate availability affects microbial growth, whereas extraneous nitrogen forms can significantly affect microbial metabolic processes. As for soil amino sugars, the stable residues in microbial cell wall, their synthesis, decomposition and turnover are closely related to the availability of extraneous carbon and nitrogen. Using isotope tracing technique to study soil amino sugars can further understand the substrate utilization profiles by soil microorganisms. In this study, two incubation tests were conducted, with glucose plus 15N-labelled NH4+ or NO3- as the substrates, respectively. The 15N enrichment in each kind of soil amino sugars was identified by gas chromatography/ mass spectrometry (GC/MS) to trace the dynamics of soil 15N-labelled and native amino sugars. During the incubation, the content of soil 15N-labelled amino sugars increased significantly, and the transformation rate from NH4+ to amino sugars was significantly higher than that from NO3-, suggesting the preferred utilization of NH4+ than NO3- by soil microorganisms. Significant changes in the amounts of soil unlabelled amino sugars were observed. The amount of unlabelled glucosamine increased with NH4+ addition, but decreased gradually with NO3- addition. The content of unlabelled muramic acid decreased gradually, especially with NO3- addition. Either the increase or the decrease of galactosamine did not exceed 20% to the original value. These compound-specific changes showed that the heterogeneous microbial residues played different roles on the turnover and stabilization of nitrogen in soil matrix. Fungal cell wall residues were easily accumulated in soil matrix, which benefited the stabilization of soil organic matter, while bacterial cell wall residues were easily degraded, playing an important role in the turnover of soil organic matter.

Background & Problems: Detailed descriptions of nursing shift tasks are necessary to achieve comprehensive nursing care. The 22 cases of postoperative recovery ward error reported by our unit included chest tube obstructions, lost dentures and other nursing issues. To improve patient health and nurse shift quality, our unit established an ad hoc group to collect data helpful to overcoming problems attributable to nurse shift changes. We aimed to better nursing care by facilitating individualized patient care and avoiding accidents detrimental to patient safety., Purpose: This project was designed to raise the rate of 100% completion of nursing shift-change tasks to 91% of postoperative recovery room nurses., Resolution: Newly revised operating standards regarding the recovery period after anesthesia established guidelines for a regular audit mechanism and in-service education programs for recovery room shift tasks., Result: Full completion of shift tasks in the postoperative recovery room improved from 73.5% to 98.6% of nurses., Conclusion: Comprehensive completion of postoperative nursing shift-change tasks increases communication between team members, provides continuous care for patients, and enhances overall nursing care quality.

Objective: To analyze the effects to iron status who were given preventive iron supplements for two months from when they were breast-fed to four-month-old., Methods: A total of 123 infants in four-month-old age who were breast-fed were randomly divided into iron supplementation group (63 cases) and control group (60 cases), iron supplementation group was supplied with low-dose iron (1 mg×kg⁻¹×d⁻¹) for two months with no intervention for control group. Blood samples were collected to test C reactive protein and iron status indicators in six-month-old age group infants, and the growth indices were measured and compared on the gender difference of iron status at and 6 months., Results: After 2 months of low-dose iron supplementation, the hemoglobin of iron supplementation group (26 cases) increased about 5.5 g/L while the control group (34 cases) increases about 0.0 g/L (median), 95% confidence intervals were -7.0 - 13.0 g/L and -9.0 - 15.0 g/L, respectively. The hemoglobin increase of iron supplementation group was higher than the control group, the difference was statistically significant (u = -2.326, P < 0.05). The other iron nutritional status and the growth did not show any significant difference between iron supplementation group and control group (P > 0.05). At age 6 month, the MCV of the boys were (75.89 ± 3.34) fl, while the girls were (77.20 ± 3.17) fl. The boys had lower values of MCV than the girls, and the gender difference was statistically significant (t = 4.73, P < 0.05). The other iron nutritional status did not show any significant gender difference (P > 0.05)., Conclusion: Low-dose iron supplementation of breast-fed infants at 4-month-old can increase the hemoglobin level when they were 6-month-old, and had no measurable side effect on growth.

Objective: To explore whether delayed umbilical cord clamp timing of newborn can improve iron stores of infant period and growth and development., Methods: Mother-infant pairs were randomly assigned to early clamping (94 cases, < 15 s after delivery) and delayed clamping (64 cases, 1 min after delivery) by draw lots, and followed up until 4 months postpartum. Infant hematological status, iron status, the level of growth and development of infants after 4 months were measured respectively. Transcutaneous bilirubin at the third day after delivery was also measured., Results: At 4 month age, the median of serum ferritin and mean of corpuscular volume value in delayed group were 87.30 µg/L and (79.62 ± 4.13) fl, significantly higher than the values in early group (64.3 µg/L, (78.21 ± 4.38) fl), respectively (Z = -2.36, t = 2.23, both P values < 0.05). The hematocrit value was (33.59 ± 2.48)%, higher than that in early group (32.76 ± 2.69)% (t = 1.95, P = 0.05). There was no statistically significant difference at other iron nutrition indicators and infants' weight and body length at 4 month (P > 0.05). Under the different cut-off values (hemoglobin (Hb) < 105 g/L and Hb < 110 g/L, respectively), the prevalence of anemia in delay and early clamping group were 6.25% (4/64), 21.86% (14/64), and 12.77% (12/94), 34.04% (32/94), respectively (both P values > 0.05)., Conclusion: Delayed umbilical cord clamp timing until 1 min can improve iron stores of breastfed infants at 4 month; there is no significant adverse effects to growth.

Objective: To compare the number of harvested perisplenic hilar lymph nodes by laparoscopy-assisted total gastrectomy (LATG) and conventional open total gastrectomy (OTG) for advanced upper and middle gastric cancer., Methods: Three hundred twelve patients with advanced gastric cancer treated in a single institution between Sept 2008 and Jan 2011 were included in this study. They were divided into two groups: the LATG group and OTG (D2) group. All the surgical operations were performed by one surgeon or under his supervision. The lymph node clearance outcomes of the patients treated by those two surgical procedures were analyzed., Results: The harvested lymph node numbers of the two groups were (29.57 ± 9.62) and (29.38 ± 11.22) respectively, statistically with no significant difference (P = 0.875). The numbers of lymph node dissected around the splenic area in the LATG group and OTG group (Section 10, 11 group) were (2.01 ± 1.34) and (1.33 ± 1.11), respectively, indicating a significant difference (P = 0.000). The numbers of lymph nodes dissected around the celiac region (Section 7, 8, 9, 11p and 12a(2) group) were (7.90 ± 3.41) and (7.22 ± 2.65), respectively, with a non-significant difference (P = 0.050). There were also no significant differences while comparing with the numbers of lymph nodes dissected in the cardiac area (group 1, 2), pyloric region (5, 6 group) and the greater and lesser omentum area (group 3 and 4) between the two groups (P = 0.605, P = 0.248, P = 0.262)., Conclusion: Short-term results of this study indicate that laparoscopy-assisted total gastrectomy (D2) is better than conventional open surgery in perisplenic hilar lymph node dissection.

Objective: To study the clinical features of non-epileptic seizures associated with cerebral palsy (CP) in children., Methods: A total of 1 198 children with CP (age: 9 months to 6 years) were enrolled. The children with paroxysmal events were monitored by 24 hrs video-EEG (VEEG) to make sure the seizures were epileptic or non-epileptic. The symptoms, age, CP types and EEG features were observed in children with non-epileptic CP., Results: Five hundred and seventy-eight children (48.24%) presented paroxysmal events. The seizures were epileptic in 231 children (19.28%) and non-epileptic in 322 cases (26.88%). In the 322 cases of non-epileptic CP, the paroxysmal events were of various kinds, including non-epileptic seizure tonic, seizure shake head, shrug shoulder or head hypsokinesis, cry or scream, panic attacks, sleep myoclonic and stereotyped movement. One hundred and fifty-eight (49.1%) out of the 322 children demonstrated nonspecific EEG abnormalities. One hundred and eleven children (34.5%) were misdiagnosed as epilepsy in primary hospitals. The CP children less than one year old showed higher frequency of non-epileptic seizures than the age groups over 1 year and 3 to 6 years. The frequency of non-epileptic seizures was the highest in children with spastic CP (168 cases, 52.2%), followed by dyskinetic CP (69 cases, 21.4%) and mixed type CP (65 cases, 20.2%)., Conclusions: The paroxysmal events in children with CP partially are non-epileptic seizures and it is important to differentiate non-epileptic from epileptic seizures. The frequencies of non-epileptic seizures may be associated with a child's age and CP type.

Up to present, no study has been published with respect to the cross-comparison between ASTER and Landsat-7 ETM+ imagery. Therefore, the present paper has implemented the complementary study on the images between these two sensors. The study firstly conducted the sensors characteristics comparison, including orbit characteristic, sensor scanning mode and imagery spectral characteristic. Further comparison was implemented to get the relation equations between corresponding VNIR and SWIR bands of these two sensors based on the apparent reflectance of the three pairs of synchronization images and large common ground regions. The validation has been done to verify the effectiveness of the proposed corresponding bands relation equations and matching coefficients. The result shows that the provided relation equations have high accuracy.

Objective: To investigate the inhibitory effect of TBN on rabbit platelet aggregation in vitro and in vivo, and compare with tetramethylpyrazine (TMP)., Methods: To seek out the maximum of platelet aggregation (expressed in percentage) within 5 minutes which was induced by ADP, PAF and AA according to the Born turbidimetric method with a Platelet-Aggregometer., Results: TBN significantly inhibited platelet aggregation induced by ADP, PAF and AA both in vitro and in vivo. TBN was more active than TMP., Conclusion: TBN has significant activity inhibiting platelet aggregation induced by ADP, PAF and AA in vitro and in vivo.

Objective: To study three-dimensional finite element analysis for external midface distraction after different osteotomy in patients with cleft lip and palate (CLP)., Methods: Three-dimensional FEM models of Le Fort I, II and III osteotomy in CLP patients were established. External midface distraction were simulated. An anteriorly and inferiorly directed 900 g force was applied to bilateral maxillary arch in directions 30 degrees to the occlusal plane. Biomechanical changes for the maxillary complex were investigated by means of finite element analysis., Results: Maxillary complex was advanced after different osteotomy. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. Clockwise rotation occurred in Le Fort I osteotomy complex. Counterclockwise rotation occurred in Le Fort II and III osteotomy complex., Conclusions: Three-dimensional finite element research on external midface distraction could provide reference for the preoperative design.

Due to its geographic position and the effect of changes in both global and island-specific environments, Taiwan is an area highly prone to natural disasters. While responsibility for national disaster prevention and rescue are distributed amongst various authorities, healthcare agencies hold sole responsibility for the treatment of injuries sustained during disaster events. Disaster casualties require differing levels of medical assistance. In order to respond systematically to disaster events, the government should require that all healthcare facilities operate a hospital emergency incident command system (HEICS). Past experience shows the important role that nurses play in the disaster relief process. The 911 disaster in the United States both helped reorient the direction of nursing education and emphasized teaching practical strategies, standard operating procedures, and frequently asked questions for nurses. Recognizing the limited research done worldwide on disaster nursing, the World Society of Disaster Nursing (WSDN) was established in 2008 in Kobe, Japan. The main purposes of the WSDN is to promote international academic exchange, establish an Internet information exchange platform, and organize international disaster nursing related activities. The WSDN has suggested that future research may focus in on critical issues that include post-disaster health status follow-up, exploration of the healthcare needs and other issues of disaster survivors, care skills development, and the potential for development of cooperative support networks between medical institutions.

Objective: To compare the medial-to-lateral approach with the lateral-to-medial approach in laparoscopic right hemi-colectomy for right colon cancer., Methods: A prospective randomized controlled trial was performed in the Fujian provincial tumor hospital between January 2007 and July 2009. Forty-eight cases with right colon cancer were randomly divided into two groups:medial-to-lateral laparoscopic right hemi-colectomy group(group M) and lateral-to-medial laparoscopic right hemi-colectomy group(group L). Primary outcome(operative time) and secondary outcomes (estimated blood loss, intra-operative complication, post-operative complication, number of lymph node retrieval, hospital stay) were compared between two groups., Results: Operative time was(122.5+/-25.8) min in group M and (162.9+/-30.9) min in Group L (P=0.01). Estimated blood loss was(55.8+/-36.2) ml in group M and (104.6+/-58.2) ml in group L(P=0.01). There were no significant differences between the two groups in intra-operative complications(4.2% vs 8.3%, P=1.00), post-operative complications (8.3% vs 16.7%, P=0.66), number of lymph node retrieval (17.4+/-3.2 vs 17.8+/-3.4, P=0.67), and hospital stay[(7.8+/-2.2) d vs (8.0+/-3.6) d, P=0.81]., Conclusion: The medial-to-lateral approach reduces operative time and blood loss in laparoscopic right hemi-colectomy as compared with the lateral-to-medial approach.

Objective: To assess bone mineral content (BMC) of 15 - 17 year-old dancers and high school females and analyze the relationship between physical activity status and BMC., Methods: Sixty dancers and 77 healthy controls aged 15 - 17 years old were enrolled in our study. BMC in the total body and forearm were measured by dual-energy X-ray absorptiometry (DEXA) while body weight and height were also measured. Physical activity information was collected by "one-year physical activity questionnaire"., Results: The physical activity level (PAL) and the average daily energy expenditure (EE) of dancers were all higher than controls (PAL: 2.17 +/- 0.34 vs 1.63 +/- 0.34, t = 7.283; EE: (6876.43 +/- 1036.72) kJ vs (5388.43 +/- 920.83) kJ, t = 7.214, both P values < 0.01). The dancers showed lower BMC/height at total body and arms compared with the controls (the total body BMC/height was (13.896 +/- 1.308) vs (14.494 +/- 1.272) g/cm, F = -2.563); and the BMC/height of left and right arm were (0.779 +/- 0.088) vs (0.829 +/- 0.101) g/cm (F = -2.892) and (0.766 +/- 0.093) vs (0.829 +/- 0.097) g/cm (F = -3.650) respectively, all these P values were < 0.01.Yet after adjusting age and BMI, the dancers showed higher BMC/height at total body and legs, the corresponding values were (14.550 +/- 0.146) vs (13.947 +/- 0.131) g/cm (F = 7.868), (2.681 +/- 0.033) vs (2.389 +/- 0.030) g/cm (F = 36.520), (2.821 +/- 0.031) vs (2.450 +/- 0.028) g/cm (F = 65.279), all these P values were < 0.01. While no differences were found with controls at non-weight bearing sites (arms). Daily period (h) of training was significantly related to BMC/height of legs, total body (r value were 0.618, 0.448 and 0.554 respectively, all the P values < 0.01), while the history of training was also correlated with BMC/height of two legs (r value were 0.38 and 0.304 respectively, both P values < 0.05)., Conclusion: The adolescent dancers showed higher BMC after adjusting age and BMI, which was attributed to the long-term high level weight-bearing physical activity.

Objective: To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP)., Methods: 3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied., Results: The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy., Conclusion: 3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.

Integrated weighted clustering method was applied to plan the monitoring points for agricultural products security. Definite amounts of key monitoring sampling points were mined out from enormous monitoring objects to make the fewer monitoring sampling points cover the product categories, yields, and regions as more as possible. Among the 10172 agricultural products security enterprises all over the China, 2.46% of them were selected. The tested categories, yields, and regions of agricultural safety products covered 32.71%, 44.29%, and 75% of the total, and their coverage increased by 2.80%, 10.85%, 5.56%, respectively, compared with that by using conventional monitoring and management methods, which suggested that it could be more effective to apply integrated weighted clustering method in setting the monitoring points for agricultural products security.