Objective To conduct surveys on nursing managers'pre-post training needs in the country.Methods Self-made questionnaires on nursing managers'pre-post training and the managerial skills of nursing managers in the next five years were used to conduct surveys on 1 004 nursing managers in 77 domestic hospitals.Results Among those surveyed,45.8% of the heads of nursing departments and 54.2% of the head nurses had no pre-post training while 94.5% of those surveyed deemed it extremely necessary for nursing managers to receive pre-post training.Conclusion It is essential for nursing managers to get pre-post training,which ought to be conducted at various levels,with different focal points, and according to their needs.Such training should be gradually conducted in a standardized and systematic way.

Objective To study the mechanisms of Re Bi granule on treating RA.Methods Make SD maleness rats Adjuvant-Induced Arthritis(AA)which was derived by Freund's complete adjuvant(CFA)as investigation object.Make Wang Bi granule as positive control medicine,and divide it into six groups(blank group,model group,control group,Infusion of Re Bi granule high dose group and midst dose group and low dose group).Observe Re Bi granule's influence and mechanism to synovial cell apoptosis and T cell subsets.Results Re Bi granule could distinctly heighten synovial cell apoptosis ratio of AA rats,heighten CD8+cell's number and reduce CD4+cell's number,lower CD4+/CD8+ ratio,adjust T cells for two-way.Conclusion Re Bi granule not only is an effective treatment way for rheumatoid arthritis,but also can improve the abnormal immune status.

New registry classifications of chemical drugs redefined the concepts of new drugs and generic drugs. New drugs emphasize the international innovation including innovate new drugs and modified new drugs. Modified new drugs are improvement of drugs already on the market to achieve superior efficacy. With the advantages of high success rate,high return,low risk and long life cycle,modified new drugs have become the mainstream of new drugs research and development in the world. Modified new drugs R&D in China should be based on clinical demand and focused on the differentiation research in order to obtain new preparations with signif-icant clinical advantages to better serve the clinical practise. This paper states the concept and characteristics of modified new drugs in China,makes case analysis and shares the development history of blockbuster modified new drugs in the world,clarifies the opportuni-ties and challenges and provides ideas for the future development of modified new drugs in China.

Objective Among the factors affecting embryo implantation, oxidative stress is one that receives much medical attention. The purpose of the study was to explore the effect of H2 O2 on the endometrial stromal cells ( ESCs) in the decidual mouse model of oxidative stress of ESCs. Methods Primary ESCs cultured by enzymatic digestion with a mesh filter were divided into a control, an experimental, and a model group. Decidualization was induced in the mice of the experimental and model groups by inter-vention with 10 nM E2 and 1μmol/L P4 for 72 h in vitro. Then, the animals of the model group were treated with different concentra-tions of H2 O2 for 4 hours. The primary ESCs were identified by immunohistochemistry, the expression of dPRP mRNA determined byRT-PCR, the proliferation of the decidual ESCs treated with H2 O2 analyzed by CCK-8, and the level of ROS detected by flow cytometry. Results Primary mouse ESCs were successfully isolated, cultured, and identified, which were shaped like spindles and polygons, radial-ly aligned under the microscope. Immunofluorescence analysis showed positive expression of vimentin and negative expression of cytokeratin. The purity of the primary mouse ESCs was ( 96. 3 ± 0. 49 )%. Theexpression of dPRP mRNA was significantly higher in the ESCs treated with E2 and P4 than in the control (0.0002±0.0000 vs 1.0010±0.0011, P<0.01). H2O2 at ≥150μmol/L suppressed the proliferation of the decidual ESCs by 6.9% (P<0.05), and in a concen-tration-dependent manner, reaching the maximum inhibition rate of 70.6% at the concentration of 300μmol/L. The level of intracellular ROS was markedly increased in the ESCs treated with H2O2 at 50μmol/L (27.77±4.20) and 100μmol/L (43.57±6.58), with statisti-cally significant difference from that in the control group (17.47±0.61) (P=0.001). Conclusion H2O2 at 100μmol/L can signifi-cantly elevate the intracellar ROS level without affecting the proliferation of decidual primary ESCs, and therefore can be used for estab-lishing the model of oxidative stress of ESCs in decidual mice.

Objective To investigate the myocardium protective effect of immunoinflammatory response induced by preinfarction angina. Methods Eighty-eight patients of acute myocardial infarction were divided into preinfarction angina group (48 subjects) and sudden onset group (40 subjects). The incidence of severe arrhythmia,heart failure,cardiac shock and in-hospital mortality were assessed in the two groups. The myocardial infarction size,ventricular function,coronary angiography were compared between the two groups. Some immunoinflammatory markers levels were detected. Results In preinfarction angina group,the incidences of severe arrhythmia,heart failure,and in-hospital mortality were lower (P

Objective To analyze the epidemiological characteristics, clinical manifestations, diagnosis and treatment effect of brucella in=nfection, and to provide practical foundation and valuable experience for clinical treatment and prevention of brucellosis.Methods One hundred and nineteen patients with brucella infection hospitalized at the First Hospital of Lanzhou University from January 1st 2011 to July 30th 2011 were enrolled.Clinical data including gender, age, contact history with bovine and clinical manifestations such as fever, sweating and joint and muscle pain were extracted.Diagnosis and treatment effect of these patients were all recorded.The epidemiological characteristics and clinical manifestations were analyzed.Results The majority of patients were middle-aged male, and the number of male cases were 2.5 times of female cases.The brucella infections were observed all seasons in Lanzhou, while most cases were observed between May and July.A total of 78 cases had clear animal contact history.Among them, 53 cases (44.54%) had contact history with bovine.Main clinical manifestations included fever (n=84, 70.59%), muscle and joint pain (n=93, 78.15%), sweating (n=52, 43.70%), fatigue (n=29, 24.37%), and the most common clinical symptoms was joint and muscle pain.Blood routine test showed neutropenia (n=25, 21.01%), increase in blood sedimentation (n=34, 28.57%) and blood coagulation dysfunction (n=30, 25.21%).Liver function examination showed increase in ALT (n=37, 31.09%) and AST (n=43, 36.13%).Other examination showed that splenomegaly (n=28, 23.52%) was the most common finding, and liver diffuse lesions (n=22, 18.49%) ranked second.The most common drugs were doxycycline (n=79, 66.39%), rifampin (n=60, 50.42%) and cephalosporins (n=50, 42.02%).Among them, 45 cases (37.82%) were treated with combination therapy of rifampin and doxycycline, and 31 cases were treated with combination therapy of doxycycline and rifapentine or cephalosporins.Totally 112 cases (94.12%) recovered.Conclusions The majority of patients with brucellosis are male.The clinical manifestations of brucellosis are varied.Clinicians should pay attention to identify and prevent misdiagnosis.The timely and effective treatment should be provided according to patients' conditions.The relevant departments should also strengthen supervision and education of brucellosis.

Objective To observe the changes of serum ferritin and 25-(OH) vitamin D3 in patients with diabetic cranial neuropathy.Methods There were 50 patients without diabetic Cranial neuropathy,46 patients with diabetic cranial neuropathy,and 40 cases of normal control group.The changes of serum ferritin and 25-hydroxy vitamin D3 were observed in each group.The correlation between two indexes and the correlation with diabetic cranial neuropathy were analzyzed.Results The serum ferritin levels in diabetic group and diabetic neuropathy group were significantly higher than those in normal control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(687.54 ± 65.38)ng/ml] was significantly higher than that of patients without diabetic cranial neuropathy [(497.28 ± 46.39) ng/ml,P ＜0.01].The serum 25-(OH) vitamin D3 levels in the diabetic group and diabetic neuropathy group were lower than those in the control group (P ＜ 0.01),and its level in patients with diabetic cranial neuropathy [(26.45 ± 8.93)nmol/l] was significantly less than that of patients without diabetic cranial neuropathy [(37.19-± 9.74)nmol/L,P ＜ 0.01].Serum ferritin levels were positively correlated with 25-(OH) vitamin D3 (r =-0.59,P ＜ 0.01).Multivariate unconditional Logistic regression analysis showed that diabetic neuropathy was negatively correlated with 25-(OH) vitamin D3 (P ＜ 0.05).Conclusions The increases of serum ferritin and 25-(OH) vitamin D3 are closely related to the occurrence and development of diabetic cranial neuropathy,which provides the theoretical basis for clinical intervention therapy.

Objective To explore the efficacy and tolerability of sorafenib in combination with interferon-α-2b for Chinese patients with metastatic renal cell carcinoma. Methods Seventeen pa-tients with unreseetable metastatic renal cell carcinoma were enrolled and received sorafenib in combi-nation with interferon-α-2b. Sorafenib was continuously given at the dose of 400 mg twice per day, in-terferon-α-2b 300 MIU subscutaneously once per day for 5 d each week, until disease progression or intolerable toxieities occurred. Tumor responses were evaluated every two months by response evalua-tion criteria in solid tumor. Results The median treatment duration was 120(51-442)d. All 17 pa-tients were evaluable for efficacy and safety. Five patients achieved partial responses (PR), 1 uncon-firmed PR,9 stable diseases. Two patients had progressed diseases. The overall response rate was 29%(5/17)with the disease control rate of 88%(15/17). Due to short-time follow up, the median progression free and overall survival time were not yet available. The common side effects included: fever 82%(14/17), diarrhea 82%(14/17), hand-foot syndrome 71%(12/17), asthenia 65%(11/17), rash 53%(9/17), alopecia 41% (7/17), mucosities 41% (7/17), hypertension 29% (5/17), anorexia 24% (4/17), hoarseness 24% (4/17), myalgia 24 % (4/17), nausea/vomiting 12 % (2/17) and headach/ dizzle 12%(2/17). Eleven (65%) out of 17 patients developed neutropenia, 5(29%) thrombocytope-nia and 5 (29%)anemia. Four(24%) out of 17 patients had abnormally elevated ALT/AST. Conclu-sion Sorafenib in combination with interferon-α-2b for metastatic renal cell carcinoma improves re-sponse rate with manageable toxicity.

Objective:To evaluate the vital signs changes,influence factors in different grades of hy-pertension patients during the treatment of acute pulpitis,in order to obtain the risk prevention measures. Methods:In this study,90 different grades of hypertension patients with acute pulpitis were recruited from February 201 4 to February 201 5 in the Department of Oral Emergency,Peking University School and Hospital of Stomatology.The information about the patients’general health,oral treatment,life signs of change information was collected.Patients were divided into high risk group,middle risk group, and low risk group (30 patients for each group).Results:(1 )Compared with the preoperative,systolic blood pressure (90%),diastolic blood pressure (80%),heart rate increase (1 00%)were increased in the high risk group.The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group (P<0.01 ).At the same time,the systolic blood pressure of 1 /4 (26.7%)patients in high risk group increased more than 20 mmHg (1 mmHg=0.1 33 kPa),and the diastolic blood pressure of 2/5 patients in high risk group increased more than 1 0 mmHg,the difference was statistically significant compared with the other two groups (P<0.05).(2)Compared with the pre-operative,the average increase of the maximum peak were increased [systolic blood pressure (1 8.0 ± 1 .5)mmHg,diastolic blood pressure (8.0 ±1 .7)mmHg],the mean of heart rate changes [(7.0 ± 0.3)beats per minute]was also increased in the high risk group,while these two indicators were de-creased in the low risk group and the middle risk group.The electrocardiogram (ECG)was changed in 6 cases during the treatment in the high risk group.No significantly changed were observed in the low risk group and the middle risk group.(3 ) Compared the risk assessment in preoperative with that in postoperative,in the middle risk group,23 cases were evaluated as medium risk in final evaluation,6 as low risk,and 1 as high risk (risk assessment increased);in the high risk group,20 cases were evaluated as high risk,7 as very high risk,and 3 as medium risk (risk assessment decreased).Conclusion:Oral treatment is very safe for patients with hypertension,but the risk factor,target organ damage,and com-plications will also increase the risk of cardiovascular events in elderly patients during the acute pulpitis treatment.Dentist should take some measures to avoid the risks.

Objective To explore the value of Color Doppler Flow Imaging in diagnosis of superfi-cial substantial tumors.Methods Retrospective analysis of 742 cases of superficial substantial masses ( all confirmed by operation and pathology) of Patients'ultrasonography , and summarized its features of benign and malignant, and made a comparison.Results Of the 742 patients, ultrasound detection rate of 100%, including 12 cases of malignant lesions, ultrasound diagnosis of 12 malignant cases, the accuracy rate of 100%;730 cases of benign lesions, ultrasound diagnosis of 711 cases of benign, qualitative accuracy rate 97.4%.Conclusions Color Doppler Flow Imaging has an important value in the diagnosis of benign and malignant of superficial substantial tumors.