Objective To make nurses understand the essential factors of caring nursing service and satisfy the requirement of in-hospital patients. Methods To establish the plan of role-play test(RPT).The roles of patients were played by nurses. They experienced the caring requirement of patients, true feeling, the state of physiology and psychology, etc. Then we discuss and analyze the collected information to consummate measures of caring nufing service. Results The RPT deeped the nurses' understanding about essential factors of caring nursing service. The nursing quality and patients' satisfaction degree were improved compared with those of before(P＜0.05).The nursing complaints and service quality were also increased. Conclusion Application of RPT proved to be an effective way to deepen the caring nursing service.

Nerve segments were excised from the posterior limb of the adult dog and treated by repeated freezing and thawing for five times. A segment about 5 mm long was removed from the right tibial nerve proximal to the popliteal fossa of each experimental adult rabbit, and 8 mm of nerve segment from the dog prepared as above was transplanted in the gap. Both the proximal and distal ends of the tibial nerve of host rabbits were sutured to the graft nerve of the donor dog. The grafts were excised together with the sutured cut ends of the recipient tibial nerve at 3, 4, 5, 6, 7, 15, 18, and 31 weeks after transplantation. The regenerating nerve fibers were found by light microscope from the proximal end of the right tibial nerve to the graft, and from the graft to the distal part of the tibial nerve at 3, 4, 5, 6, 7, 15, 18 and 31 weeks. Under electron microscope regenerating myelinated and unmyelinated fibers were found to be separate or in fascicle in the graft and the distal segment of the tibial nerve at the above survival time after transplantation. Perineurium was seen surrounding the regenerating nerve fascicles. Neurotubules, neurofilaments and mitochondria were found in the regenerating axons. The diameter of the regenerating myelinated fibers with long survival time after transplatation was thicker than that with short survival time. Repeated freezing and thawing reduced the antigenicity of the heterogenic nerve that it was not rejected after transplantation, and induced the regenerating nerve fibers of the host grow into the graft nerve and extend distally.

The effect of concanavalin A (Con A) on nerve regeneration in heterograft was done in the present study. A segment about 5mm long was removed from the right sciatic nerve of adult rats. A 8mm of the heterograft nerve segment from the tibial nerve of the rabbit and pretreated by Con A was transplanted into the gap of the severed rat nerve. Regenerating nerve fibers were found from the proximal part of the sciatic nerve into the graft, and also from the graft into the distal part of the sciatic nerve at the 4th,8th and 12th week after transplantation. Regenerating nerve fibers existed separately or clustered into fascicles in the graft,as well as in the distal part of sciatic nerve. Some unmyeli-nated nerve fibers were scattered among the regenerating myelinated fibers. The gastrocnemius muscle was AChE-positive at 8th and 12th week after transplantation. In silver-combined AChE staining section, the regenerating nerve fibers could be seen connecting with the motor endplates. There were regenerating free nerve endings and nerve fascicles in the dermis and epidermis at 8th and 12th week after transplantation. The present study showed that the pretreatment of Con A had benefit to that the regenerating nerve fibers to pass through the heterograft and reinnervated to the targetes.ADepartment of Anatomy,Jiangxi Medical College,Nanchang 330006,China

Objective To observe the effects of Slit2 protein on the proliferation and migration of VSMCs .Methods The VSMCs was cultured in our laboratory .The experiment was divided into two parts ,part one:VSMCs were divided into normal con‐trol group and experimental groups(culture with 50 ,75 ,100 ,125 and 150 ng/mL Slit2 respectively);part two :VSMCs were divided into normal control group ,positive control group(culture with TNF‐α10 ng/mL) and experimental groups(culture with TNF‐α10 ng/mL+Slit2 50 ng/mL ,TNF‐α10 ng/mL+Slit2 75ng/mL ,TNF‐α10 ng/mL+ Slit2 100 ng/mL ,TNF‐α10 ng/mL+ Slit2 125 ng/mL and TNF‐α10 ng/mL+Slit2 150 ng/mL respectively) .To detect proliferation and migration of VSMCs by CCK‐8 and tran‐swell experiment .Results The difference of OD value and numbers of VSMCs has no statistical significance in the presence of Slit 2 (P=0 .516 ,P=0 .52) .The numbers of VSMCs has statistical significance between control and positive control groups (P=0 .00) . The numbers of VSMCs in experimental groups were fewer than positive control group (P<0 .05) ,whereas the difference of OD value still has no statistical significance between experimental and positive groups (P= 0 .173) .Conclusion Recombinant Slit2 could inhibits migration in VSMCs induced by TNF‐α,whereas it has no effect on proliferation of VSMCs .

Objective To establish and apply the systemic caring and nursing model,the five-heart nursing service model. Methods The five-heart nursing service content was designed,the five-heart nursing service organization was perfected,the five-heart nursing service manual books were compiled and the satisfaction questionnaires for five-heart nursing service were designed.Three tryout departments were selected and the nursing staff was trained by human theory and five-heart nursing service amenity and flow according to the five-heart nursing service requirement. Results The patients satisfaction degree, medical entanglemant complaint and praise after the application of five-heart nursing service were greatly improved compared with those of before its application (P ＜ 0.05). Conclusion The application of five-heart nursing service supplied systemic caring and nursing for patients and it proved effective to improve patients satisfaction degree.

Objective:To study the patterns of tocilizumab (TCZ) use, its efficacy and safety in patients with rheumatoid arthritis (RA) in routine clinical practice.Methods:A total of 407 patients with RA were enrolled from 23 centers and treated with TCZ within 8 weeks prior to the enrollment visit, and were followed for 6-month. The patterns of TCZ treatment at 6 months, the effectiveness and safety outcomes were recorded. Statistical analysis was performed using SAS version 9.4.Results:A total of 396 patients were included for analysis, in which 330 (83.3%) patients received TCZ combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and 16.7%(66/396) received TCZ monotherapy. At baseline, TCZ was initiated in 56.6%(224/396) and 9.6%(38/396) of patients after failure of DMARDs and other biological agents (bDMARDs) respectively. During the 6-month follow-up period, the mean frequency of TCZ administration was (3.7±1.6), the mean TCZ dosage was (7.4±1.2) mg/kg, and the mean interval between doses was (40±13) days. 120(25.8%) patients were on TCZ treatment at the end of the study. Improvements in disease activity, systemic symptoms and patient report outcomes were observed at the end of the study. 22.7%(90/396) patients experienced at least one treatment related adverse event, and 8 patients experienced at least one serious adverse event.Conclusion:This study demonstrates that TCZ treatment is effective in patients with RA when being treated for 6 months with an acceptable safety profile. The duration of TCZ treatment needs to be extended.