Objective To study the teaching effect in physical evaluation by application of item teaching method for high occupation nursing students. Methods 249 high occupation nursing students of grade 2008 from four class were divided into the experimental group and the control group randomly. 123students of the control group were taught by traditional method, 126 students of the experimental group were taught by item teaching method, that is, listing teaching emphasis, examining item and standard for evaluation, preparing the lesson for students, teaching theory for teacher, teaching medical examination in groups,simulated training, testing item. The practical operation results and various capabilities were compared between two groups. Results The practical operation results and various capabilities of the experimental group was better than the control group. Conclusions Constructing evaluation system of physical evaluation by application of item teaching method is a beneficial attempt for high occupation nursing students. It improves the students' general ability and is beneficial to the justice and fair of teaching evaluation. So it is worth popularizing.

Two hundred and sixty-one subjects were recruited from in-patients and subjects for phaysical Check-up,and were divided into normal control group (NC),nonalcoholic fatty liver disease group (NAFLD),type 2 diabetes mellitus group (T2DM),and T2DM accompanied by NAFLD group (DMN).According to the result of ultrasonic examination,the patients with T2DM were further divided into non-NAFLD group,light fatty liver group (NAFLD-L group),moderate fatty liver group(NAFLD-M group),and severe fatty liver(NAFLD-S group).Fasting plasma glucose,blood lipid,liver function,kidney function,and serum retinol-binding protein 4 (RBP4) levels were determined.The risk of various indicators for NAFLD was determined by correlation analysis and logistic regression analysis.The results showed that fasting glucose levels in diabetics with or without NAFLD were significantly higher than those in NC and NAFLD groups(P＜0.01).Triglyceride (TG) level in DMN group was significantly higher than those in other three groups(all P＜0.01),while high density lipoprotein-cholesterol level was lower than those in other three groups(all P＜0.01).Systolic blood pressure and diastolic blood pressure in DMN group were higher than those in NC and T2DM groups (P＜0.05 or P＜0.01).Serum RBP4 level in patients with NAFLD was significantly higher compared with the subjects without NAFLD [45.00 (38.75,51.00) mg/L vs 51.00 (43.00,62.00) mg/L,P ＜0.01],and was rising with the progress of NAFLD [NAFLD-L group 44.00 (37.00,51.00) mg/L,NAFLD-M group 52.00(46.00,63.00) mg/L,and NAFLD-S group 78.5 (72.75,83.00) mg/L,all P＜0.01].Logistic regression analysis showed that the RBP4 level was an independent factor associated with NAFLD (P =0.029).In addition,serum RBP4 level was correlated with body mass index,waist-to-hip ratio,serum gamma-glutamyl transpeptidase,total cholesterol,TG,aspartate aminotransferase,alanine aminotransferase,prealbumin,creatinine,blood urea nitrogen,and uric acid.These resuhs suggest that serum RBP4 is an independent risk factor of NAFLD.