Objective To study the clinical nurses and nursing students' cognition of clinical nurse specialist (CNS) and provide the basis for promoting the development of CNS.Methods Quantitative and qualitative research were adopted in this study.One hundred and ninety clinical nurses and nursing students were investigated with a questionnaire about the cognition of CNS,and the qualitative research was conducted on 9 clinical nurses selected by purposive sampling method.Results Most participants realized the importance of CNS and 78.4％ of them wished to be an excellent CNS.The cognition was different between the two groups,especially in terms of ability,working performance and status.Conclusions We should improve the clinical nurses and nursing students' cognition of CNS,and cultivate them with the core competence of CNS.Meanwhile,improving the status and confirming the role must be done to promote the development of CNS in China.

Objective: To establish an accelerated solvent extraction(ASE)-HPLC method to determine chrysophanol and aurantio-obtusin in Cassia obtusifolia L.Methods: The optimal extraction conditions were defined by orthogonal tests using ASE.The method was carried out on an ACE Excel C18-PFP column (75 mm×2.1 mm,2.5 μm) with the mobile phase consisting of 0.1% phosphoric acid solution-acetonitrile with gradient elution.The column temperature was 40 ℃,the flow rate was 0.4 ml·min-1, and the detection wavelength was 284 nm. Results: The best process parameters of ASE were as follows:the extraction solvent was methanol, the extraction temperature was 120 ℃ and the static extraction duration was 5 minutes for three cycles.The ASE method needed only 1/9 of the time as the pharmacopoeia method,while the extraction efficiency of the ASE method was higher.The linear ranges of cassia obtusifolia L.and Chrysophanol were at 0.73~58.57 μg·ml-1(r=0.999 7) and 1.09~87.29 μg·ml-1(r=0.999 6).The average recoveries were 102.7%(RSD=0.8%) and 98.2%(RSD=1.5%).Conclusion: The method is simple, rapid and sensitive, which can be used for the rapid determination of aurantio obtusin and chrysophanol in Cassia obtusifolia L.

Objective To explore the interventional effect of two different methods in the prevention of chemotherapy phlebitis caused by 5-fluorouracil.Methods Eighty cases of patients treated with cisplatin+5-fluorouracil (PF) chemotherapy in the First Affiliated Hospital of Guangxi Medical University from May 2015 to July 2016 were selected and divided into the observation group and control group according to admission time,40 cases in each group.The observation group was smeared with 2% anisodamine along the direction of vein puncture after peripheral venous puncture success,while the control group was smeared with mucopolysaccharide polysulphate emulsion paste.The occurrence of phlebitis and degree of local pain after intervention were compared between the two groups.The blood biochemical indexes and inflammatory factors levels before and after intervention were compared too.Results After the intervention,the distribution of phlebitis level and local pain degree had statistical difference between the two groups (Z=2.57,2.53;P=0.01);the observation group was superior to the control group in the aspects of phlebitis lesion degree and local pain alleviation;WBC,MPV and PDW in the observation group had statistical difference between before and after intervention;WBC,PLT and PCT in the control group had statistical difference between before and after intervention (P<0.05);PLT count was positively correlated with PCT in the two groups (r=0.952,P<0.05);the CRP level and WBC count after intervention had no statistical difference between the two groups(P>0.05).Conclusion 2% anisodamine can effectively prevent and alleviate the occurrence of 5-FU caused chemotherapy phlebitis and local pain.At the same time,PLT can provide a basis for preventing chemotherapy phlebitis.

Objective To know the present situation and the different humanistic caring abilities among college nursing students,so as to provide reference for education training strategy of nursing humanity care.Methods A total of 396 college nursing students were investigated by using the nursing students' humanistic caring ability scale.Results The total score of nursing students' humanistic caring ability was (110.85±21.57),with a scoring rate of 61.59％.Statistically significant differences of humanistic caring ability were found among students of different education levels,different genders and different colleges.Conclusions The level of nursing students' humanistic caring ability was low,so nursing schools and clinical teaching hospitals should strengthen the training of students' humanistic caring ability according to the characteristics of different education level,and take effective training strategies to improve college nursing students' humanistic caring ability.

Objective To observe the relations ot vWF,DD concentration and venous thrombosis caused by detaining needle of different time.Sensitive indicators for early prediction of venous thrombosis would be seeked so as to provide theoretical and experimental basis for the selection of intervention time.Methods The detaining needle were placed in the vein of rabbit ears with transfusion.The changes of vWF and DD concentration for the mannitol group and the saline group were measured in different retention time,while the venous thrombosis caused by detaining needle was observed pathologically.Results The results of serological test:(1)vWF concentration:when the needle was detained for 1 day,the vWF concentration of two groups peaked.(2)DD concentration:after the needler was set,the DD concentration of both groups was higher than those before detaining needler.When the needle was detained for 1 day and 3 days,the DD concentration was significantly different from those before using detaining needle.Result of pathological observation:When the needle was detained for 1 day,the venous throm-bosis rate was 100％ for both groups with a moderate degree of thrombosis.Conclusions Detection of the concentration of vWF and DD has certain reference value for predicting detaining needle-induced venous thrombosis.In order to prevent venous thrombosis,intervention should be carried out as soon as possible after detaining needle was set.

Objective:The purpose of our experiment was to use CT to observe the opening of BBB at the early stage of severely scalded rabbits. Methods:Healthy male New Zealand white rabbits were used to establish 30% and 50% TBSA Ⅲ?scalded model. Using high resolution spiral CT (SCT), the brain parenchyma were observed when plain CT scan and contrast-enhanced CT were performed. Results:CT image changes were found in 4 cases at 6 hour after scald of 30% TBSA Ⅲ?scalded rabbits, while CT image changes were found in all cases at 6 hour after scald of 50% TBSA Ⅲ?scalded rabbits. Conclusion:The larger TBSA is Ⅲ?scalded, the earlier BBB is opening . BBB of 50% TBSA Ⅲ?scalded rabbits are wider than that of 30% TBSA Ⅲ?scalded rabbits

Objective To explore the image characteristics of the opening of the blood brain barrier (BBB) at the early stages of severely scalded rabbits. Methods Twenty-six rabbits inflicted with 50% total burn surface area (TBSA) of Ⅲ degree were randomized into 7 groups: pre-scald, post-scald at 1, 2, 3, 4, 5, and 6 h groups. The spiral CT (SCT) and MRI were used to observe the image changes during the corresponding phases. Samples from the anterior cortex, temporal lobe, posterior cortex, cerebellum, and brain stem were examined by light and transmission electron microscopy (TEM), respectively. Results The pathological features showed that neurons and oligodendrocytes swelled lightly and blood vessels were congested and dilated at 3-4 h after scald. CT image changes were found at 5 h after scald and became more remarkable at 6 h after scald. MRI image changes could not be found within 6 h after scald. Conclusion The opening of BBB is earlier than the formation of edema. Enhanced CT plays an important role in manifesting the opening of BBB at the early stages of severely scalded rabbits.

Objective To investigate a special optimization technique for computer aided measure, and provide anatomical basis for screw internal fixation in the cavitas glenoidalis through the coracoid process of scapula. Methods Thirty accurate scapula models were reconstructed from CT data sets. First, special optimization objective function was designed for single screw internal fixation configuration, and the optimal placement of screw was found automatically under constraints. Then, the placements of double screws internal fixation configuration were searched taking advantage of principal component analysis. Finally, statistical measure data were provided according to new anatomical reference landmarks for clinical use. Results For single screw internal fixation configuration, the distance from the optimal screw entry point P to the acromion process point X was (39.15±2.28) mm, to the coracoid process point Y was (28.66±2.68) mm, to the angulus superior point Z was (61.13±6.57) mm;The angle was (81.27±7.15)° between PX and PY, and (133.27±6.84)° between PX and PZ. The mean inclination of the lag screw was (104.08±4.41)° for the angle with line PX, (101.29±3.51)° with line PY, and (76.23±5.03)° with line PZ. For double screws configuration, the distance from the original single screw entry point P to the screw entry point E was (5.12±1.37)mm,to the screw entry point F was (3.88±0.94)mm. The angle between the long axis of coracoid process and line EF was (27.41±3.51)°. Conclusion The automatic optimization technique for computer aided measure is very efficient and has many advantages over the conventional manual dissection methods, and is convenient to design new anatomical reference landmark system for clinical use.

Objective To discuss the MSCT diagnosis and differential diagnosis of primary ureteral carcinoma and non-specific u-reteritis.Methods The pre-contrast and three-phase post-contrast MSCT scans were performed in a group of 12 patients with prima-ry ureteral carcinoma and 5 patients with non-specific ureteritis confirmed by pathology.The MPR,CPR,CTU images were genera-ted from raw data.The MSCT image feature of the primary ureteral carcinoma and non-specific ureteritis were observed respective-ly.Results ①1 2 cases of primary ureteral carcinoma pathologically diagnosed as transitional cell carcinoma,The manifestations of MSCT:9 cases (9/12)showed irregular thickened wall and eccentricity lumen stenosis,5 cases had soft tissue mass in lumen,3 ca-ses (3/12)showed irregular thickened wall and central lumen stenosis.The lesions lumen was significant stenosis,edges and broken ends were irregular.②The non-specific ureteritis manifestations of MSCT:1 case (1/5)showed irregular thickened wall and eccen-trical lumen stenosis;3 cases (3/5)showed irregular thickened wall and central lumen stenosis,and the edge of obstruction was rel-atively smooth.1 case (1/5)prompted hydronephrosis and hydroureter.The lesions lumen was still relatively smooth,had no sig-nificant thickening.③On non-enhanced CT,primary ureteral carcinoma attenuation was equal to the non-specific ureteritis (P>0.05).The degree of enhancement was higher than non-specific ureteritis during all enhanced phases (All P<0.05).Conclusion Main performance characteristics of primary ureteral carcinoma and non-specific ureteritis can both cause the ureteral wall thickening in different appearances and degrees.The MSCT enhanced scan with varies images processing techniques such as MPR,CPR and CTU showed some clinical application potentiality in both diseases diagnosis and discrimination.

Objective To induce fluconazole resistance in T.asahii by culture in medium containing increasing concentrations of fluconazole,and to evaluate the stability of the induced resistance.Methods Two T.asahii strains with a highest sensitivity to fluoconazole,including a clinical isolate CBS2479 (minumum inhibitory concentration (MIC) =0.25 μg/ml) and an environmental isolate CBS8904 (MIC =1.5 μg/ml),were selected from 11 T.asahii strains stored in the laboratory of the Department of Dermatology,General Hospital of Beijing Military Region.Both strains were respectively and serially subcultured in potato dextrose agar (PDA) medium containing growing concentrations of fluconazole (from 0.5 MIC to 256 μg/ml).E-test was performed to evaluate the susceptibility of T.asahii to fluconazole after each passage.To evaluate the stability of fluconazole resistance,the T.asahii isolates with induced resistance (MIC ＞ 256 μg/ml) were serially subcultured in drug-free PDA medium,and drug susceptibility assay was performed after each subculture.Results After serial culture in PDA medium containing fluconazole,high level of fluconazole resistance (MIC ＞ 256 μg/ml) developed in both of the fluconazole-susceptible T.asahii strains CBS2479 and CBS8904.The MIC value of fluconazole remained unchanged in the fluconazole-resistant strain CBS2479R,but gradually decreased to 64 μg/ml in the other resistant strain CBS8904R after 18-day culture in fluconazole-free PDA medium.Conclusions Fluconazole resistance can be induced in T.asahii strains from different origins by serial culture in medium containing growing concentrations of fluconazole,and the stability of the induced fluconazole resistance varies between strains of different origins.