Objective To compare the effect of enteral nutrition by jejunum colostomy nutrition infusion pump of patients after Whipple surgery as well as reduce adverse reactions in patients.Methods Sixty-five cases with the implementation of Whipple and jejunum of colostomy were selected as our subjects,who were hospitalized in the Affiliated hospital of Hebei United University from Feb.2009 to Nov.2013.All patients were divided into observation group (33 cases) and control group (32 cases) according to the methods of nutrient input.Patients in observation group were given nutrition infusion pump pumping (15 to 50 ml/h) ;and patients in control group were adopted disposable infusion connection infusion with the speed of 30 drops/min with the thermostat heating temperature and the water pipe.The blood glucose,serum albumin,blood electrolyte concentration of postoperative,and the adverse reactions during input nutrient solution including vomiting,abdominal distention,diarrhea and other adverse circumstance were recorded.Results At 1st,3rd,5th day,there was no statistically significant difference in terms of the levels of glucose,blood albumin,blood C1,Na +,K + between two groups(blood glucose:F inner grouP =3.01,P ＞ 0.05 ; F between group =2.90,P ＞ 0.05 ; F cross group =2.87,P ＞ 0.05 ; serum albumin:F inner group =2.94,P ＞ 0.05 ; F between group =2.89,P ＞ 0.05 ; F cross group =2.76,P ＞ 0.05 ; blood Cl:F inner group =1.78,P ＞ 0.05 ; F between group =1.96,P ＞ 0.05 ; F cross group =1.88,P ＞ 0.05 ; blood Na +:F inner group =1.06,P ＞ 0.05 ; F between group =1.35,P ＞ 0.05 ; F cross group =1.27,P ＞ 0.05 ; blood K +:F inner group =3.12,P ＞ 0.05 ; F between group =3.04,P ＞ 0.05 ; F cross group =2.93,P ＞ 0.05).There were significant differences regarding of the rate of vomiting,abdominal distention,diarrhea and other adverse conditions compared with the infusion enteral nutrition has good clinical effect,postoperative blood (x2 =4.029,4.381,4.905 respectively; P ＜ 0.05).Conclusion The methods of colostomy enteral nutrition with infusion pump after Whipple surgery is proved to be with the better clinical effect in reducing postoperative vomiting,abdominal distention,diarrhea and other adverse conditions compared with the infusion enteral nutrition,and there are no significant difference in the terms of the levels of glucose,blood albumin,blood Cl,Na +,K +.

Objective To investigate the clinical significance of setting nasojejunal nutrition tube in Whipple operation,which can promote patient recovery and prevent complications.Methods Fourty-one patients were undergone Whipple operation and they were randomly divided into eternal nutrition (EN) and parenteral nutrition group (PN).Patients in EN group were set nasojejunal nutrition tube during Whipple operation in order to supply eternal nutrition at earlier period,while in PN group were supplied parenteral nutrition in earlier period.The operative procedure time,the complication in post-operation,the cost of hospitalization and the periods of hospitalization of two groups were recorded.The scores of nutritional status were measured.Results The operative time in EN group and PN group were (200.71 ±51.33)min and (160.48 ± 47.62) min,and no significant difference was found between two groups (t =-1.524,P ＞ 0.05).The hospitalization expenses in EN group was (38835.65 ± 537.69)yuan,lower than that in PN group ((47833.18 ±659.24) yuan,t =2.073,P ＜ 0.05).The hospital periods of EN group and PN group were 10 (3) d and 18(3) d,and the difference was significant (Z =-5.374,P ＜0.001).There were 2 cases who occurred complications after operation in EN group,including 1 cases with incision infection,and 1 cases of pancreatic fistula.Nine cases occurred complications in PN group,including 3 cases with incision infection,2 cases with pancreatic fistula,2 cases with pulmonary infection,2 cases with gastric paralysis,and all were cured by conservative treatment.There was statistically significant difference in the incidence of postoperative complications (P =0.027).All cases with complication were recovery after corresponding treatment.At 7th day after operation,hemoglobin in EN group and PN group were (113.09 ± 12.35) g/L and (107.04 ± 11.81) g/L,and the difference was significant (t =2.035,P ＜ 0.05).The levels of retinol binding protein,serumalbumin,serum prealbumin,serum transferrin in EN group were (42.62 ± 5.64) mg/L,(40.24 ± 6.79) g/L,(321.43±31.28) mg/L,(32.86±4.67) mg/L,(32.86 ±4.67) mg/L,significant different from those in PN group ((15.50 ± 4.26) mg/L,(31.52 ± 5.92) g/L; (197.86 ± 37.71) mg/L,(23.59 ± 4.32) mg/L; t=2.398,2.606,2.119,2.569; P ＜0.01 or P ＜ 0.05).Conclusion Nutritional status and prognosis are improved obviously by setting nasojejunal nutrition tube in Whipple operation.And the cost of hospitalization,the periods of hospitalization are decrease.

Objective To analyze the literature related to post competency evaluation index system that based on competency theory and know the deficiencies in the construction of index structure,in order to strengthen its normative and scientification and provide reference for the construction of index structure.Methods By retrieving the database of China national knowledge infrastructure (CNKI),Chinese biomedical literature service system (CBM),Wanfang and VIP database,we included the literature about the post competency evaluation index construction in the core journals from January 2007 to March 2016.Literature acquired by retrieval were imported Note Express 3.1 software,then the title,the first author,year of publication,evaluation object,system framework,system building method,the level of evaluation index and the weights of index were analyzed.Results There were 314 articles,and the overall number of literature was increasing in the past nine years.The evaluation objects were divided into the junior nurses,clinical nurses,the nursing managers,nursing teachers,nursing students,community nurses and new nurses,and the number of articles were:33,157,41,28,29,6 and 20.The main methods were multifarious,there were 20 articles adopted Delphi and analytic hierarchy process (AHP).The contents of index mainly consisted of 3 level such as clinical nursing,nursing management and nursing education.The contents of first-level index were mainly focus on knowledge,skill,social role,self-concept,trait and motivation,while the differences of second-level index were great.Conclusions The constructing methods of nursing post competency evaluation index system in our country are diversified,but relatively loose and lack of systemic.The elements of evaluation index are not full and normative,and the main research contents were knowledge and skill dimension;the weighted empowerment approach is relatively single,and the main methods are experiential judgment and qualitative description.The rigorous scientific design and measurement analysis and qualitative and quantitative method are insufficient.

Objective:To investigate the effect of a disintegrin and metalloproteinase 17 (ADAM17) - short hairpin RNA (shRNA) transfection on the proliferation of human breast cancer MCF-7 cells.Methods:Four shRNA sequences (adam17-hsa-297, adam17-hsa-1508, adam17-hsa-1658) targeting ADAM17 were designed, Adam17-hsa-1864) and a negative control (LV10-NC) were used to screen the best inhibition rate of ADAM17 shRNA by qPCR.The experiment was divided into three groups: transfection group, meaningless sequence group and control group.RNA was extracted according to routine steps, and then reverse transcripted and amplified.The expression of ADAM17 mRNA was detected by qPCR and the proliferation of MCF-7 cells was measured by MMT method.Results:The results of MTT assay showed that the absorbance values of control group, nonsense sequence group and transfection group were 0.270±0.040, 0.250±0.035 and 0.185±0.080, respectively.There was significant difference between the two groups ( F=3.854, P=0.045). There was no significant difference between the control group and the nonsignificant sequence group ( P>0.05), and the difference between the control group and the transfection group was statistically significant ( P<0.05). There was no significant difference between the nonsignificant sequence group and the transfection group ( P>0.05); the absorbance values of the control group, the meaningless sequence group and the transfection group at 48 h were 0.500±0.057, 0.494±0.086 and 0.311±0.007, respectively, and the differences between the two groups were statistically significant( F=19.42, P<0.001). There were significant differences between transfection group and control group and no significant sequence group (all P<0.05), but there was no significant difference between control group and non significant sequence group ( P>0.05). The absorbance values of control group, nonsense sequence group and transfection group at 72 h were 0.720±0.150, 0.713±0.174 and 0.558±0.071, respectively.There was no Conclusion:BMSC transfected with ADAM17 shRNA could inhibit the proliferation of MCF-7 cells at 24 h and 48 h, while the proliferation of MCF-7 cells decreased at 72 h.