Objective To improve th current teaching situation,increase clinical teaching quality in order to ensure the nursing students to adapt to new nursing model and social development.Methods The main problems existing in clinical nursing teaching of our country was analyzed,furthermore countermeasures were put forward.Results At present clinical nursing teaching of our country lacked perfect management system,teacher resources were weak,teaching time was not reasonably arranged,training of comprehensive quality for nursing students was lack.Conclusions Through analysis of current situation of clinical nursing teaching,we propose the corresponding ponder,guarantee the clinical nursing teaching quality and do fully preparatory work for training of nursing reserve forces with high quality.

Objective To analyze the relationship between the serum CysC,lipoprotein(a) [Lp(a)] and the urinary microalbumin/creatinine ratio in elderly type 2 dibetic (T2CM) patients.Methods A total of 102 elderly patients with T2CM who were treated in our hospital from December 2014 to December 2015 were selected.The patients were divided into diabetic nephropathy(DN) group(mALB≥20 μg/min,48 cases)and non-diabetic nephropathy(NDN) group (mALB<20 μg/min,54 cases) according the levels of urinary mALB,while 30 cases of healthy controls were selected from physical examination center.The biochemical indexes,CysC,Lp(a) and UACR were detected among all cases.The correlation between indexes and UACR was analyzed by Pearson correlation analysis,risk factors for UACR among DN patients were analyzed by Logistic regression analysis.Results There were significant differences in levels of low density lipoprotein cholesterol(LDL-C),Lp(a),urea,creatinine,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),Cysc,and UACR among these groups (P<0.05).No correlation between CysC、Lp(a) and UACR was found in normal-control group and non-diabetic nephropathy group.In diabetic nephropathy group,there was a positive correlation between CysC,Lp(a) and UACR(r=0.658,P<0.01;r=0.525,P<0.05).The Logistic regression analysis showed that diabetes duration,CysC,Lp(a) were independent risk factors for UACR(P<0.05).Conclusion In patients with diabetic nephropathy,CysC,Lp(a) are positively correlated with UACR,and CysC is a sensitive index that reflect early renal damage in T2DM patients.Lp(a) level is one of the independent risk factors for UACR,which can reveal the kidney damage in DN patients.

Objective To evaluate the efficacy of modifiedXiaochengqi decoction in treatment of gastroparesis syndrome (GS).Methods A total of 81 patients with GS from 2010 July to 2013 July in HuiZhou Municipal Central Hospital were selected and randomly recruited into a control group and a treatment group. The control group was treated with domperidone, 15-30 min before the meal, while the treatment group was additionally treated with modifiedXiaochengqi decoction on the basis of the control group. Both groups were treated for 4 weeks. The clinical curative effect, and the symptoms in both groups were observed. The serum motilin and gastrin concentration were measured by radio-immunity, the preprandial and postprandial electrogastrography was performed.Results The total effective rate in the treatment group was significantly higher than that in the control group (72.5%vs. 31.7%;χ2=11.911,P=0.000). The serum levels of motilin (treatment group: 532.8±16.7 ng/Lvs. 355.2±14.3 ng/L,t=51.089,P=0.000; control group: 505.1 ± 21.3 ng/Lvs. 372.9 ± 18.4 ng/L,t=30.074,P=0.000) and gastrin (treatment group: 69.8 ± 15.3 ng/Lvs. 54.3 ± 13.8 ng/L, t=4.758,P=0.000; control group: 62.6 ± 14.2 ng/Lvs. 53.4 ± 12.3 ng/L,t=3.136,P=0.002) were significantly reduced, and their decrease in the treatment group were greater than those in the control group (t values were 6.503, 2.196, allP<0.05). After the treatment, the dominant power (preprandial period: 84.5 ± 14.8μVvs. 72.3 ± 15.0μV, t=3.684,P<0.01; postprandial period: 100.5 ± 17.3μVvs.89.3 ± 15.9μV,t=5.713,P=0.000) and dominant frequency (preprandial period: 4.3 ± 0.4 cpmvs. 3.9 ± 0.2 cpm,t=3.035,P=0.000; postprandial period: 4.7 ± 0.5 cpmvs. 4.4 ± 0.5 cpm,t=2.700,P=0.000) were significantly higher, while the percentage of bradygastria (preprandial period: 50.6% ± 16.6%vs. 60.1% ± 16.3%,t=2.599,P=0.000;postprandial period: 36.6% ± 14.8%vs. 57.4% ± 15.3%,t=6.217, P=0.000) was significantly lower in the treatment group compared with the control group at preprandial and postprandial periods.ConclusionXiaochengqi decoction can obviously promote the gastric motility, and reduce the serum levels of motilin and gastrin in patients with GS.

Objective To observe the therapeutic efficacy and safety of acupuncture and epidural anesthesia during full-term labor. Method A total of 199 eligible subjects experiencing natural labor were randomized into four groups. The acupuncture group was intervened by acupuncture at acupoints; the epidural group was given epidural anesthesia;the combined analgesia group was given acupuncture at acupoints plus epidural anesthesia; the control group was not given any interventions for analgesia. The Visual Analogue Scale (VAS) was adopted to record and compare labor pain (cervix dilation 3 cm at 0 min, 30 min, and 60 min, and at full cervix dilation); meanwhile, the active period of the first stage of labor, cervix dilation speed, the second stage of labor, Caesarean section (C-section) rate, instrumental delivery rate, Apgar score, and post-labor bleeding amount (2 h) were also recorded. The contents of blood β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) were monitored during the first stage of labor. Result Compared with the control group, the VAS scores dropped in the other three groups, and the decreases were similar in the epidural group and combined analgesia group, while the decrease in the acupuncture group was the least significant. Regarding the labor-related indexes, the cervix dilation speed was higher in the acupuncture group than in the control group(P<0.05), while there was no significant difference between the acupuncture group and control group in comparing the duration of the second labor stage(P>0.05). There were no significant between-group differencesin comparing the post-labor bleeding amount and Apgar score of the new-born babies(P>0.05), but compared with the epidural group, there was no use of assisted delivery. The content of blood β-EP during the first stage of labor increased in the acupuncture group and combined analgesic group(P<0.05), but there were no significant changes in the epidural group and control group(P>0.05). Conclusion Acupuncture analgesia can reduce labor pain and shorten labor duration without affecting the second stage of labor and security-related indexes.

Objective To explore the definition,classification and imaging characteristics of abdominal enterogenous cysts in in-fant.Methods 18 patients with abdominal enterogenous cyst in infant,confirmed by surgical pathology,with complete imaging data (including ultrasonography,CT and enhanced CT),have been enrolled in the study.The imaging findings and pathological character-istics have been analyzed,and the classification of diagnosis has been conducted.Results According to the positions and imaging fea-tures of the pathological changes,abdominal enterogenous cysts could be further classified as:gastrointestinal wall type,mesenteric type and retroperitoneal type.In this study,gastrointestinal wall type in 1 1 patients (outside intestinal wall in 2,inside intestinal wall in 8,and outside gastric wall in 1);mesenteric type in 4 and retroperitoneal type in 3 were identified.Conclusion Classification of diagnosis can be conducted according to the enterogenous cyst’s special imaging findings,which provides a reference for the surgical operation.

Objective To observe the effects of exogenous adrenomedullin(ADM)on expressions of IL-4 and IFN-γ following mechanical renal trauma in the rats. Methods A total of 104 healthy adult plain grade Wistar rats were,randomly divided into four groups,ie,normal control group(eight rats),simple trauma group(32 rats),prevention group(32 rats,injected with ADM before trauma)and treatment group(32 rats,injected with ADM after trauma).The experimental model of rat with mechanical renal trauma was prepared by striking the ridge of the left rib area with free dropping forrous hammer in all groups except for the control group.Ten minutes before and after mechanical renal trauma,ADM ly.All rats were sacrificed by draining out all the blood in their hearts at 1,6,12 and 24 hours after mechanical renal trauma.Then,the renal tissues were removed and fixed with 10% formalin for observing the positive expressions of IL-4 and IFN-γ by means of SABC staining. Results Compared with the simple trauma group,the positive expression of IL-4 in the prevention group Wag observed at 1 hour,gradually increased at 6 and 12 hours and reached the peak at 24 hours after mechanical renal trauma,with statistical difference(P<0.05).The positive expression of IL-4 in the treatment group WaS increased at one hour and reached the peak at 6 hours after mechanical renal trauma,with statistical difference(P<0.05).Compared with the simple trauma group,the IFN-γ expression in the prevention group was,increased at 6 and 24 hours but decreased at 12 hour,while that in the treatment group was decreased significantly at 1,12 and 24 hours.Compared with the normal control group,the IFN-γ expression in the treatment group was significantly decreased at 1 and 12 hours.The IFN-γ expression in the treatment group was lower than that in the prevention group at every time points,with statistical difference(P<0.05). Conclusions Preventive and therapeutic administration of exogenous ADM can enhance the expression of IL-4.IL-4 and IFN-γ play an antagonistic role in repair ofthe renal injury.The primary role of exogenous ADM is the dynamic regulation of IFN-γ expression.

Objective To investigate the relationship between the efficacy of autologous epidermal grafting and the levels of epidermal cytokines in vitiligo. Methods A total of 57 patients with stable vitiligo receiving autologous epidermal grafting were included in this study. Before grafting, 17 patients were irradiated with narrow-band UVB on vitiliginous sites. Suction blister fluid was collected from the recipient site (vitiligous lesions) and donor site (normal skin) in these patients (including the 17 patients irradiated with NB-UVB). ELISA was used to detect the levels of endothelin-1 (ET-1 ) and stem cell factors (SCF) in suction blister fluid. Clinical efficacy was evaluated through a 3-month follow-up. Resttlts Among these 57 patients, 45 successfully responded to autologous epidermal grafting. In these 45 patients, the levels of ET-1 and SCF in vitiligous lesions were 728.97±286.12 ng/L and 329.97±114.13 ng/L respectively, significantly higher than those in nomal skin (503.16±251.44 ng/L, 224.73±107.91 ng/L, t = 5.443, 5.897, respectively, both P < 0.05 ). In those who responded poorly, significant difference was also observed in the level of SCF between the normal skin and vitiligous lesions (309.00±163.89 ng/L vs 204.22±83.25 ng/L, t = 3.03, P < 0.05), but not in the level of ET-1. Increased level of ET-1 was observed in both vitiligous lesions and normal skin of patients who responded well compared to those who responded poorly, while no difference was noticed in the level of SCF between these two groups of patients. The level of ET-1 was statistically higher in vitiligous lesions in patients exposed to NB-UVB than in those without exposure (t = 1.44, P > 0.05). In those patients who responded successfully, the level of ET-1 was lower in the 15 patients exposed to NB-UVB compared to the other 30 patients without exposure (548.48±230.22 ng/L vs 794.60±278.72 ng/L, P<0.05); no significant difference in the level of SCF was noted. Conclusions ET-1 and SCF may both play important roles in the repigmentation of vitiligo, with ET-1 exerting a more important role.

Medical preparedness and response to radiation emergency are challenged by the fast development of nuclear energy and nuclear technology, the rapid use of radiological source and devices,and terrorist threats involving radiological material. Against this background, hospitals play a vital role in medical response to radiation emergency. In this article, we discussed the hospital's responsibility in medical response to radiation emergency, and raised a series of requirements to the medical bases engaged in radiation emergency, which cover the planning, personnel, facilities, equipments and drugs stockpiling, and medical management technique of such bases. Adequate preparedness in advance makes the best guard for such bases, to effectively handle nuclear and radiological emergency, minimizing casualties and health damage and protecting people's health and safety.

Objective To analyse the possible risk factors associated with the progression of vitiligo.Methods A questionnaire survey was carried out to collect the clinical data on 1088 patients with vitiligo.The relationship between possible inducements to the progression of vitiligo and lesion area was statistically analyzed in patients with the same clinical course of vitiligo. Paired t test was performed to compare the mean area index of involvement between patients with inducements and those without Results A significant difference was observed in the mean area index of involvement between patients with isomorphic response and those without (t = 6.770, P ＜ 0.01 ) as well as between patients negatively affected by psychiatric factors and those unaffected (t = 6.704, P ＜ 0.01 ), but not between patients with family history and those without (t = 1.499,P ＞ 0.05). Conclusion A rapid progression of vitiligo is more likely to be observed in patients negatively affected by psychiatric factors and patients with isomorphic response.

Objective To isolate the dedifferentiation-derived epidermal stem cells (DDESCs)to further investigate their phenotypic characteristics. Methods The sheets of human foreskin were digested overnight after removal of adipose tissues and then the epidermis was separated from the dermis.The epidermis sheets which eliminated basal stem cells by repeated adhesion to type Ⅳ collagen and flushing were transplanted onto the full-thickness skin wounds on the back of BALB/c nude mice. After five days, the sheets were collected and digested into single cells, after which the percentages of positive cells of CK10, CK19 and β1 integrin were detected by flow cytometric analysis. DDESCs were isolated by rapid adhesion to type Ⅳ collagen. The expressions of CK19, β1 integrin, Oct4 and Nanog in the cells were examined using immunofluorescence and quantitative real-time polymerase chain reaction (RTPCR). Results The percentages of positive cells of CK19 and 31 integrin were increased (P ＜0.01 )and those of CK10 in the transplanted sheets decreased ( P ＜0.01 ) five days after transplantation. Isolation of DDESCs by repeated adhesion to type Ⅳ collagen showed 4.56% adhering cells in the transplantation group within 10 minutes. The in vitro phenotypic assays showed that the expressions of CK19, β1 integrin, Oct4 and Nanog in DDESCs were similar to those of original epidermal stem cells ( P ＞0.05 ) but remarkably higher than those in the control group ( P ＜ 0.01 ). Conclusion The phenotypic characteristics of DDESCs cultured in vitro are similar to those of epidermal stem cells, indicating a new approach for wound repair and regeneration.