A cross-sectional study on the prevalence and associated risk factors for workplace violence against Chinese nurses.

OBJECTIVES: The purpose of the present study was to explore the characteristics of workplace violence that Chinese nurses at tertiary and county-level hospitals encountered in the 12 months from December 2014 to January 2016, to identify and analyse risk factors for workplace violence, and to establish the basis for future preventive strategies. DESIGN: A cross-sectional study. SETTING: A total of 44 tertiary hospitals and 90 county-level hospitals in 16 provinces (municipalities or autonomous regions) in China. METHODS: We used stratified random sampling to collect data from December 2014 to January 2016. We distributed 21 360 questionnaires, and 15 970 participants provided valid data (effective response rate=74.77%). We conducted binary logistic regression analyses on the risk factors for workplace violence among the nurses in our sample and analysed the reasons for aggression. RESULTS: The prevalence of workplace violence was 65.8%; of this, 64.9% was verbal violence, and physical violence and sexual harassment accounted for 11.8% and 3.9%, respectively. Frequent workplace violence occurred primarily in emergency and paediatric departments. Respondents reported that patients' relatives were the main perpetrators in tertiary and county-level hospitals. Logistic regression analysis showed that respondents' age, department, years of experience and direct contact with patients were common risk factors at different levels of hospitals. CONCLUSIONS: Workplace violence is frequent in China's tertiary and county-level hospitals; its occurrence is especially frequent in the emergency and paediatric departments. It is necessary to cope with workplace violence by developing effective control strategies at individual, hospital and national levels.

Clinicopathological significance of E-cadherin, VEGF, and MMPs in gastric cancer.

E-cadherin, vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMPs) are important molecules involved in tumor metastasis. In this study, we examined the expressions of E-cadherin, VEGF, MMP-1, MMP-2, and microvessel density (MVD), as well as microlymphatic vessel density (MLVD) in 200 cases of gastric cancer tissues, and determined the relationship between these parameters and the clinicopathological features and patient survival. Protein expressions, MVD, and MLVD were detected by immunohistochemistry. The correlation between the expression levels of these molecules and the clinicopathological features was analyzed. Patient survival was estimated by Kaplan and Meier analysis. Compared to normal gastric mucosa, expression of E-cadherin was reduced in 78% of gastric cancer tissues and 44.6% of adjacent non-cancerous gastric tissues. VEGF was positive in 81.5% of gastric cancer tissues, 35.7% of adjacent non-cancerous gastric tissues, and 10% of normal gastric mucosa. MMP-1 was positive in 80.5% of gastric cancer tissues, 69.6% of adjacent non-cancerous gastric tissues, and 20% of normal gastric mucosa. Reduced expression of E-cadherin was closely correlated with poor tumor differentiation and a deeper tumor invasion. Increased expressions of VEGF and MMP-1 were closely linked with poor differentiation and Lauren classification. Increased expression of MMP-2 was closely correlated with more lymph node metastasis, a deeper invasion, and a larger tumor size. More MVD was observed in VEGF-positive tissues than in VEGF negative tissues. Therefore, abnormal expressions of E-cadherin, VEGF, MMP-1, and MMP-2 are widely present in gastric cancer tissues. Abnormal expressions of E-cadherin, VEGF, and MMP-2 may represent the early molecular changes in the development of gastric cancer. Positive expression of E-cadherin and negative expression of VEGF and MMP-2 are correlated with a better patient survival.

[Relationship between Ets-1 expression and angiogenesis, clinicopathological features and survival of patients with gastric carcinoma].

OBJECTIVE: To investigate the expression of Ets-1 in gastric carcinoma, para-cancerous tissue and metastatic lymph nodes, and to determine the relationship between Ets-1 expression and clinicopathological features, angiogenesis and survival of patients with gastric carcinoma. METHODS: Gastric carcinoma tissue microarray was used to determine Ets-1 protein expression by SP immunohistochemical staining in 189 advanced gastric cancer, 54 papacancerous tissues, 41 metastatic lymph nodes and 32 control tissues. RESULTS: The positive rates for Ets-1 expression of the carcinoma, paracancerous and control tissues were 71.4%, 29.6% and 18.8%, respectively, with a significant difference among the three groups (P < 0.01). In the cancer tissues, the positive rate of Ets-1 protein expression was significantly associated with depth of invasion and lymph node metastasis (P < 0.01), but not associated with degree of differentiation, Lauren's histological type, sex, age, and size of tumor (P > 0.05). The positive rates for Ets-1 expression of the 41 gastric cancer and 41 metastatic lymph nodes were significantly different (P < 0.05). In metastatic lymph nodes, the positive rate for Ets-1 expression was higher. The MVD in Ets-1 positive tumors was higher than that in the Ets-1 negative tumors, with a significant difference (P < 0.05). Kaplan-Meier survival analysis showed that the survival time of Ets-1-negative patients was longer than that of Ets-1-positive patients (P < 0.05). Cox regression analysis showed that Ets-1 expression was not an independent prognostic factor of gastric carcinoma. CONCLUSION: A higher expression of Ets-1 is involved in carcinogenesis, development, invasion, and metastasis of gastric cancer. Ets-1 plays an important role in angiogenesis in gastric cancer. Ets-1 is a useful marker for predicting the outcome for patients with gastric carcinoma, though it is not an independent prognostic indicator.

[Expression of cyclooxygenase-2 and urokinase plasminogen activator in gastric carcinoma and the clinical significance thereof].

OBJECTIVE: To investigate expression of cyclooxygenase-2 (COX-2) and urokinase plasminogen activator (uPA) in gastric carcinoma and the clinical significance thereof. METHODS: Strepavidin-peroxidase method was used to detect the expression of COX-2 and uPA in 192 specimens of gastric carcinoma, 56 specimens of paracancer tissues obtained during operation. Immunohistochemical double staining was used to detect the microvessel density (MVD) and microlymphatic density (MLD). Thirty specimens of normal gastric mucosa obtained during gastroscopy were used as controls. RESULTS: The positive rates of COX-2 in the gastric carcinoma and paracancer tissues were 67.7% and 62.5% respectively, both significantly higher than that of the control group (40.0%, both P < 0.05). The positive expression of COX-2 in gastric carcinoma was significantly related with the depth of invasion and MVD (both P < 0.05). The positive rates of uPA in the gastric carcinoma, paracancer tissue were 78.1% and 44.6% respectively, both significantly higher than that of the control tissues (6.7%, both P < 0.01) and there was a significant difference in the positive rates of uPA between the first 2 groups too (P < 0.01). The positive expression of uPA in gastric carcinoma was significantly related with lymph node metastasis, depth of invasion, Lauren typing, differentiation, MVD, and MLD (P < 0.05, P < 0.01). COX-2 expression was positively linked with uPA expression (r = 0.167, P = 0.021). The survival time of the uPA positive group was (38 +/- 4) months, significantly shorter than that of the negative group [(54 +/- 6) months, P < 0.05]. The survival time of the group positive in both COX-2 and uPA was (27 +/- 3) months, significantly shorter than that of the single positive or double negative groups [both (58 +/- 4) months, both P < 0.01). CONCLUSION: COX-2 and uPA are highly expressed in gastric carcinoma. COX-2 expression is positively linked with uPA expression. COX-2 and uPA in the gastric carcinoma participate in the development of gastric cancer in the early process. uPA is significantly related with the survival time.