实施行管、医疗、护理联合总值班的实践与成效

Objective: To explore the effect of combined duty mode on discovery and control of medical nursing hidden trouble. Method: In order to make sure that patients are in the first place, we should take the mode of combined duty of administrative management, medical treatment and nursing. Results：The incidence of nursing errors and defects reduced, and patients’ satisfaction improved. the differences were statistically significant (P＜0.01 or P＜0.05).Results: Combined duty can the reduce medical nursing defects, improve the efficiency of quality health care services and the management efficiency.目的  探讨实施联合总值班模式对发现及控制医疗护理隐患的有效性。方法  以优化值班模式为前提，以病人为中心，采取行管、医疗、护理联合总值班的方法。结果  通过实施联合值班，护理差错及缺陷发生率降低，患者的满意度提高，实施前后比较差异均具有统计学意义（P＜0.01或P＜0.05）。结论  实施联合总值班，可以最大程度地预防医疗护理缺陷的发生，提高医疗护理服务及管理效率

4,5,6,7-Tetra­chloro-N-(2-fluoro­phen­yl)phthalimide

In the title compound, C14H4Cl4FNO2, the benzene ring and the phthalimide plane are nearly planar, the maximum deviations being 0.005 (2) and 0.010 (2) Å, respectively, but the mol­ecule as a whole is not planar: the dihedral angle between the two planar ring systems is 68.06 (10)°. A short Cl⋯O contact of 2.914 (2) Å exists in the crystal structure

Future potential evapotranspiration changes and contribution analysis in Zhejiang Province, East China

PublishedJournal ArticleThis is the final version of the article. Available from Wiley via the DOI in this record.Potential evapotranspiration is an important component of hydrological modeling. In this study, the objective is to project potential evapotranspiration in the future period 2011-2040 and understand their changes in Zhejiang Province, East China. The sensitivity of potential evapotranspiration to five climatic variables (solar radiation, daily minimum and maximum air temperature, relative humidity, and wind speed) is analyzed based on observation data from 1955-2008 using a global sensitivity analysis method, Sobol's method. The changes in potential evapotranspiration during the future period are generated using one regional climate model, Providing Regional Climates for Impacts Studies, with two global climate models, ECHAM5 and Hadley Centre Coupled Model version 3, and their causes are analyzed based on sensitivity analysis results. Global sensitivity analysis results reveal substantial spatial-temporal variations in the sensitivity of potential evapotranspiration to climatic variables and unignorable interactions among climatic variables. Rather similar spatial change patterns of annual mean potential evapotranspiration (PET) are generated for both general circulation models; however, seasonal or monthly changes are very different due to different spatial-temporal changes in climatic variables. Different contributory sources to potential evapotranspiration changes are identified at different months and stations; the PET changes in 2011-2040 are mainly due to three climatic variables including solar radiation, relative humidity, and daily minimum temperature. © 2014. American Geophysical Union. All Rights Reserved

An Empirical Comparative Study on the Two Methods of Eliciting Singers’ Emotions in Singing: Self-Imagination and VR Training

Emotional singing can affect vocal performance and the audience’s engagement. Chinese universities use traditional training techniques for teaching theoretical and applied knowledge. Self-imagination is the predominant training method for emotional singing. Recently, virtual reality (VR) technologies have been applied in several fields for training purposes. In this empirical comparative study, a VR training task was implemented to elicit emotions from singers and further assist them with improving their emotional singing performance. The VR training method was compared against the traditional self-imagination method. By conducting a two-stage experiment, the two methods were compared in terms of emotions’ elicitation and emotional singing performance. In the first stage, electroencephalographic (EEG) data were collected from the subjects. In the second stage, self-rating reports and third-party teachers’ evaluations were collected. The EEG data were analyzed by adopting the max-relevance and min-redundancy algorithm for feature selection and the support vector machine (SVM) for emotion recognition. Based on the results of EEG emotion classification and subjective scale, VR can better elicit the positive, neutral, and negative emotional states from the singers than not using this technology (i.e., self-imagination). Furthermore, due to the improvement of emotional activation, VR brings the improvement of singing performance. The VR hence appears to be an effective approach that may improve and complement the available vocal music teaching methods

Mechanism of Selective VEGF-A Binding by Neuropilin-1 Reveals a Basis for Specific Ligand Inhibition

Neuropilin (Nrp) receptors function as essential cell surface receptors for the Vascular Endothelial Growth Factor (VEGF) family of proangiogenic cytokines and the semaphorin 3 (Sema3) family of axon guidance molecules. There are two Nrp homologues, Nrp1 and Nrp2, which bind to both overlapping and distinct members of the VEGF and Sema3 family of molecules. Nrp1 specifically binds the VEGF-A164/5 isoform, which is essential for developmental angiogenesis. We demonstrate that VEGF-A specific binding is governed by Nrp1 residues in the b1 coagulation factor domain surrounding the invariant Nrp C-terminal arginine binding pocket. Further, we show that Sema3F does not display the Nrp-specific binding to the b1 domain seen with VEGF-A. Engineered soluble Nrp receptor fragments that selectively sequester ligands from the active signaling complex are an attractive modality for selectively blocking the angiogenic and chemorepulsive functions of Nrp ligands. Utilizing the information on Nrp ligand binding specificity, we demonstrate Nrp constructs that specifically sequester Sema3 in the presence of VEGF-A. This establishes that unique mechanisms are used by Nrp receptors to mediate specific ligand binding and that these differences can be exploited to engineer soluble Nrp receptors with specificity for Sema3

Effects of levothyroxine therapy on bone mineral density and bone turnover markers in premenopausal women with thyroid cancer after thyroidectomy

Introduction: We investigated the impact of long-term levothyroxine (LT4) treatment on bone mineral density (BMD) and bone turnover markers (BTMs) in premenopausal women with differentiated thyroid cancer (DTC) after thyroidectomy. Material and methods: Sixty-five premenopausal women who received LT4 therapy at least one year (range, 1.5–9.0 years) after thyroidectomy for DTC and 50 premenopausal women without thyroid diseases were enrolled in this study. We measured the Z-scores of lumbar and hip BMD, serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), intact parathyroid hormone (iPTH), N-terminal propeptide of type 1 N procollagen (P1NP), C terminal telopeptide of type 1 collagen (CTX-1), calcium (Ca), phosphorus (P), vitamin D3, and alkaline phosphatase (ALP) in all participants. Results: In DTC subjects, serum TSH levels were lower, and serum FT4, P1NP, CTX-1, and ALP levels were higher compared with controls. The prevalence of low BMD was higher in DTC subjects than in controls. Multivariate logistic regression analysis showed that serum TSH levels were negatively associated with CTX-1 and ALP. Conclusions: We found a high prevalence of low BMD among premenopausal women who received long-term LT4 therapy for DTC after thyroidectomy. Long-term TSH suppression therapy was a significant risk factor for decreased bone strength, mainly by increasing bone turnover.

4,5,6,7-Tetra­chloro-2-(4-fluoro­phen­yl)isoindoline-1,3-dione

The title compound, C14H4Cl4FNO2, has crystallographic twofold symmetry with the N and F atoms and two C atoms of the benzene ring located on a twofold rotation axis. The isoindole­dione ring system is almost planar [maximum atomic deviation = 0.036 (3) Å], and is twisted with respect to the florobenzene ring, making a dihedral angle of 58.56 (16)°. Weak inter­molecular C—H⋯Cl hydrogen bonding is present in the crystal structure

RGD-conjugated gold nanorods induce radiosensitization in melanoma cancer cells by downregulating αvβ3 expression

Background: Melanoma is known to be radioresistant and traditional treatments have been intractable. Therefore, novel approaches are required to improve the therapeutic efficacy of melanoma treatment. In our study, gold nanorods conjugated with Arg-Gly-Asp peptides (RGD-GNRs) were used as a sensitizer to enhance the response of melanoma cells to 6 mV radiation. Methods and materials: A375 melanoma cells were treated by gold nanorods or RGD-GNRs with or without irradiation. The antiproliferative impact of the treatments was measured by MTT assay. Radiosensitizing effects were determined by colony formation assay. Apoptosis and cell cycle data were measured by flow cytometry. Integrin alpha(v)beta(3) expression was also investigated by flow cytometry. Results: Addition of RGD-GNRs enhanced the radiosensitivity of A375 cells with a dose-modifying factor of 1.35, and enhanced radiation-induced apoptosis. DNA flow cytometric analysis indicated that RGD-GNRs plus irradiation induced significant G2/M phase arrest in A375 cells. Both spontaneous and radiation-induced expressions of integrin alpha(v)beta(3) were downregulated by RGD-GNRs. Conclusion: Our study indicated that RGD-GNRs could sensitize melanoma A375 cells to irradiation. It was hypothesized that this was mainly through downregulation of radiation-induced alpha(v)beta(3), in addition to induction of a higher proportion of cells within the G2/M phase. The combination of RGD-GNRs and radiation needs further investigation.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000302718200001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Nanoscience & NanotechnologyPharmacology & PharmacySCI(E)22ARTICLE915-924