BACKGROUND:Immunoglobulin G4-related disease (IgG4-RD) is an immune mediated fibro inflammatory condition characterized by abundant IgG4-positive (IgG4+) plasma cell infiltrated lesions and elevated serum IgG4 concentrations. Tubulointerstitial nephritis and glomerular lesions are the most common renal IgG4-RDs. However, solitary mass lesion is rarely observed in renal IgG4-RD. MATERIALS AND METHODS:We reported a 55-year-old male patient with a space-occupying lesion in the right kidney detected during a routine ultrasound medical examination. Computed tomography indicated a 20 mm × 15 mm × 18 mm mass located at the lower pole of the right kidney. Both T1-weighted imaging and T2-weighted imaging magnetic resonance imaging scans showed a hypointense mass. Diffusion-weighted imaging (b value = 800) showed slightly hyperintensity. RESULTS:The lesion was diagnosed as renal cell carcinoma clinically based on the laboratory and radiological findings and treated with laparoscopic resection. However, the postoperative histological examination results indicated the lesion IgG4-RD of the kidney. CONCLUSION:We should consider pseudotumor-like IgG4-RD as a differential diagnosis for solitary renal lesion although the incidence is low.

Objective To investigate the current situation of emergency nurses′ psychological capital and job burnout,and to analyze the relationship between them. Methods A total of 148 emergency nurses in the third-grade class-A hospital were investigated using nurse psychological capital questionnaire and nurse job burnout scale. Results The average scores of psychological capital and optimism, efficacy, resilience, hope for emergency nurses were 3.24 ± 0.53, 3.35 ± 0.85, 3.26 ± 0.57, 3.24 ± 0.58, 3.18 ± 0.69. The average scores of job burnout and emotional exhaustion, personal accomplishment, personified were 2.51 ± 0.87, 3.04 ± 1.08, 2.38 ± 1.06, 1.78 ± 1.36. The scores of different ages, titles, family support, number of children and monthly income situation were statistically different (P<0.05 or 0.01) in psychological capital and job burnout. The scores of different genders were statistically different ( P<0.01) in job burnout. Emergency nurses′ psychological capital was negatively correlated to job burnout. After controlling for the demographic variables, the overall state of emergency nurses′ psychological capital and resilience could explain 33.3%(R2=0.116-0.449) for the variances of job burnout. Conclusions Nursing managers should pay attention to the psychological situation of emergency nurses, take measures to reduce job burnout, improve nursing quality and the long-term development of themselves and hospital.

Due to t he limitations of the computer network technology and some human factors, computer network not only brought us convenience, but also security risks is existence. Therefore, we must have a thorough understanding the problem of computer network security, and study the corresponding countermeasures, so that the computer network security issues are properly resolved, maintenance of computer network security.

Objective To investigate the level of head nurses' career plateau and job satisfaction, and to analyze the relationship between them. Methods A total of 206 head nurses in the third -grade class -A hospital were investigated with head nurses' personal information questionnaire, Career Plateau Questionnaire and Nurses' Job Satisfaction Questionnaire, and the data were analyzed with SPSS19.0. Results Head nurses' career plateau level was latent plateau, the total score was (2.12 ± 0.53), the scores of head nurses of different ages, departments, working time, managing time and children ages were statistically different, F values were 4.88, 4.47, 8.63, 9.47 and 8.86. Head nurses' job satisfaction level was in middle level, the total score was (3.50 ± 0.37), the scores of head nurses of different martial status(t=2.56), further education times (F=4.52) were statistically different, P<0.05. Head nurses' career plateau was negatively correlated with job satisfaction. After controlling for the demographic variables, the overall state of head nurses' career plateau could explain 31.3% for the variances of job satisfaction respectively. Conclusions Hospital leaders and nursing department managers should pay attention to the level of head nurses' career plateau, take measures to make the level down to improve the level of job satisfaction, so as to ensure the hospital nursing quality. Key words: Nursing, supervisory; Career plateau; Job satisfaction; Relationship

PURPOSE:This study was conducted to assess the preventive effect of Actinidia valvata Dunn (AVD) extract on an animal model of gastrointestinal carcinogenesis on the basis of changes in tumor incidence, cell proliferation, and apoptosis.MATERIALS AND METHODS:Seventy-five male Wistar rats were divided into five different treatment groups with 15 rats in each group. Group I was given normal feed, whereas Groups II to IV were treated with 10% sodium chloride in the first six weeks and 100 ug/mL of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) in drinking water for 24 weeks. Group II was then given normal feed, whereas Group III was given AVD extract (0.24 g/kg/day) for 12 weeks. Group IV was given AVD extract from the first week to the 36th week, whereas Group V was treated with AVD extract alone for 36 weeks. All rats were sacrificed at the end of the 36-week experiment and assessed for the presence of gastrointestinal tumors. The occurrence of cancer was evaluated by histology. Bax, Bcl-2, Caspase-3, and cyclinD1 were determined by immunohistochemical staining and Western blotting.RESULTS:The incidences of gastric cancer were 0% in Group I, 73.3% in Group II, 33.3% in Group III, 26.7% in Group IV, and 0% in Group V. Bcl-2 and cyclinD1 expression was decreased in AVD extract treated groups, whereas Bax and Caspase-3 expression was increased. Comparison with group II revealed significant differences (p<0.01).CONCLUSIONS:AVD extract exhibits an obvious preventive effect on gastrointestinal carcinogenesis induced by MNNG in rats through the regulation of cell proliferation and apoptosis.

Objective The study was desingned to analyze the characteristic of blood group serologic produced by Bx subtypes with anti-B,and explore the therapeutic schedule by blood transfusion. Methods Samples of ABO blood group with identification of positive and negative stereotypes discrepancy were analyzed by blood type serological analysis such as absorb-radiation test,blood type material of saliva agglutination inhibition test. The patients accord with the charac-teristic of blood group serologic produced by Bx subtypes with anti-B were comparatively studied with blood transfusion treatment,and the curative effect of blood transfusion was observed. Results The results of serological test suggested that the patients with blood type Bx subtypes and anti-B did not get a blood transfusion adverse reactions and has a good effect, when they received a blood transfusion therapy with O red blood cells,type AB blood platelets and plasma. Conclusion Because B antigen expression decreased,serological characteristics of Bx subtypes with anti-B are inconsistent. The reaction with anti-AB agglutination can be enhanced or not react with the positive and negative blood type identification. The intensi-ty of H antigen expression is similar to the O cells,while producing low reactivity of anti-B. The secreting type spittle can only have H,lack of B. The infusion treatment with assorted blood instead is safe and effective when the Bx subtypes with anti-B patients is in urgent circumstances and the same type of blood cannot be found.

<正>随着放射技术和介入技术的深入开展,造影剂在临床的广泛使用,由造影剂导致的急性肾损伤——造影剂肾病(contrast induced nephropathy,CIN)的发病率也随之增高。注射造影剂后48 h内血清肌酐(SCr)绝对值大于等于5 mg/L或相对值大于等于25%,即可诊断CIN。其病死率为34%,已

在无线网络中,以传输距离的最短为主要的选取节点方式,没有考虑节点能耗能量的提前耗尽,导致网络距离发生不规则分割,影响网络的连通性。本文以传统协议为基础,提出了一种基于模糊距离的网络通讯协议优化算法。在路由节点选择过程中,该算法综合考虑路径上的下一跳节点剩余能量、节点稠密度对最短距离的影响,利用参考节点能量的模糊距离算法,对节点的有效选择进行合理的动态优化,降低节点能量消耗。实验结果表明,该优化协议能有效减少节点能量消耗,提高数据成功发送率,降低端到端平均延迟时间,提高了网络性能。

<正>近年来我们在中医护理教学中,改变传统教学方法,采用PBL(Problem-Based Learning)和CBL(Case-Based Learning)相结合的教学方法。1对象和方法1)对象。选择我校2008级护理学专业2个班学生共56例。随机将2个自然班分别设为试验组和对照组。2组学生生源无差异,其他课程教师、教材、教学大纲、教学目标、教学时数均相同。以上各指标2个班经

It has been not only a problem urgent to be solved in medical education but also an inevitable requirement of modern teaching development to improve the traditional teaching methods in order to train and strengthen medical students' self-study ability.The new teaching method combined PBL with CBL was used to study the teaching effect comparing with traditional teaching mode in Department of Traditional Chinese Medicine of Nanjing Medical University.It is found that teaching method combined PBL with CBL is better than the traditional teaching method and is helpful to cultivate the students' comprehensive quality.

目的探讨基层医院中多器官功能障碍综合征(MODS)患者血清心肌酶变化特点及临床意义。方法采用酶法测定MODS患者和健康人(对照组)的血清心肌酶水平。结果 MODS患者血清心肌酶水平与对照组比较有显著性差异(P<0.01)。结论检测MODS患者血清心肌酶水平,可作为反映病情程度和评估预后的相关指标。

In order to solve the problem that the coverage of hybrid wireless sensor network nodes is low,an improved particle swarm hybrid wireless sensor network node coverage iterative optimization algorithm was proposed.In this algorithm,firstly,the hybrid wireless sensor network node coverage model was translated into a dynamic optimization problem of seeking the coverage of the maximum node deployment location in the network system;then,an improved particle swarm optimization algorithm was used to map the particles and their weights for the coverage of the node optimization program,and the particle weights were adjusted according to particle clustering and particle of information entropy,and then,the values of the particle local optimal and global optimal were updated based on the value of the particles fitness;lastly,the particle's position and velocity iterated were calculated to output the node deployment scenarios with optimal coverage.The simulation results show that this algorithm can improve network coverage effectively,and the convergence of the algorithm is speeded up.

Experiment of Traditional Chinese Medicine(TCM) is a scientific study of TCM with modern methods and means.This paper gives some analysis about necessity and feasibility of experimental teaching combining with requirements and characteristics of TCM study in the western medical colleges and universities.

目的验证无针密闭正压接头连接血液净化管路后其流量及管路静脉压力能否达到血液净化治疗要求。方法随机抽取三种品牌的正压接头各20个,分为A、B、C三组,分别连接到透析管路上,以置换后血浆做为管路液体,设置透析机泵速为30~350 ml/min,每20 ml/min为一档,在每档泵速下,测量管路内的静脉压力值并记录,取均值绘制正压接头流量-静脉压力折线图。结果血液净化管路连接A、B、C三组正压接头后,随着泵速的递增,静脉压力均呈递增趋势;三组正压接头对应的管路静脉压力均末超过70 mmHg。结论正压接头连接到血液净化管路上,其流量及对应的管路静脉压力均能够满足血液净化治疗静脉TC为<200 mmHg的要求。

<正>我院于2009年1月至2011年2月对45例孕早期来院检查、建立孕期档案者通过系统培训孕妇,从孕16周起开始音乐胎儿教育和语言胎儿教育,并与58例随机抽选新生儿作耳声发射通过时间检测对比,现分析报告如下。资料与方法1临床资料实验组:45例。为我院2009年1月至2011

在现代护理发展过程中,护理工作一直是女性为主导的职业.但是随着社会进步和护理专业发展的需要,临床男护士逐年增多,无论是从临床护理、护理管理、护理教育的角度,还是从护理科研的角度,护理专业会因为男性的加入而更趋完善、更加合理,并且有助于护理专业社会地位的提高.

Objective To summarize the nursing strategies for the adverse reactions in cerebral glioma patients after chemotherapy.Methods From April 2007 through December 2008,the clinical data was analyzed retrospectively in 30 cerebral gliomas patients with chemotherapy using teniposide,semustine and temozolomide,so as to analyze the adverse reactions and nursing strategies during chemotherapy.Results Of the 30 patients,the symptoms of high intracranial pressure disappeared with a better control of seizures symotoms and improvement of psychiatric symptoms and disturbance of consciousness as well as hemiplegia and sensory abnormalities.A series of adverse reactions during chemotherapy were observed:nausea(n=22),vomiting(n=6),leukopenia(n=8),thrombocytopenia(n=4) and oral ulcers(n=12).Conclusion Good psychological nursing before treatment,close observation during the treatment,timely management of adverse drug reactions and effective health education at the end of treatment,can improve patient compliance,thereby enhancing the therapeutic effects.

Objective To enhance the promotion of the real-time settlement system for local social security card holders who are receiving medical treatment by way of HIS real-time settlement improvement in medical institutions.Methods The relationship between the medical insurance system reform and the hospital information system was analyzed with several measures to integrate related information between them concluded.Results The outpatient treatment process for patients holding Social Security Cards was integrated with the working efficiency improved.Conclusion Hospital information system is improved with the reform of the medical insurance system.

作为一个具有科学基础的完整性医学理论体系,功能医学在20世纪70年代被提出来,它是一门融合分子医学与现代营养学的临床医学,其理念认为人体处于动态的平衡之中,当平衡被打破时,人就会生病.功能医学所探求的不是疾病后人体发生了什么样的病理变化,而是疾病前人体发生了什么样的改变导致疾病的发生……[1].

目的探讨患者留置尿管、会阴擦洗期间的心理感受,分析相关应激源对患者的影响,为护理工作者制定针对性的护理措施,为指导护理实践提供依据。方法采用现象学研究方法探讨10例留置尿管和会阴擦洗患者的真实体验,以半结构式的深入访谈取得访谈资料,对访谈资料以缩减、分类、诠释、提炼的方法进行分析,提炼主题。结果所有患者感受留置尿管过程痛苦大,精神紧张,情绪波动明显,加重局部刺激症状,选择麻醉下留置尿管。结论医务工作者应重视患者的主观感受,根据患者尿道宽窄选用导尿管型号;尊重患者意见在麻醉下留置尿管,以减轻患者痛苦;还应重视应激反应对病情的影响,制定个性化、人性化护理措施,提升护理质量。