Objective To probe into the influencing factors and countermeasurses for clinical nursing teaching in pediatric department. Methods From June 2009 to June 2010, 86 nursing interns in pediatric department were selected, and a retrospective analysis was carried out. Results In the 86 interns in nursing practice, influencing factors of clinical nursing teaching included: 65 interns thought of department factors, accounting for 75.58%; 61 interns thought of nursing students factors, accounting for 70.93%; 59 interns thought of teacher factors, accounting for 68.60%; 57 interns thought of social factors, accounting for 66.28%. Conclusions Many factors influence pediatric clinical nursing teaching, we should strictly implement the rules and regulations and to actively take measures to comprehensively improve the quality of clinical practice for nursing students.

Objective To study the influencing factors on the time of acute cerebral apoplexy patients visiting the hospital.Methods 64 patients with acute ischemic stroke were researched.The clinical data of all patients were collected.The influencing factors on treatment time were analyzed by univariate and multivariate Logistic regression analysis.Results In the 64 patients, 26 cases of the visiting time≤6 h(40.63%), 38 cases of visiting time>6 h(59.37%).The results of single factor analysis showed that the relationship between the time of treatment,pre-hospital transfer mode (x2=6.650,5.081,all P<0.05),educational level,living location,MRS score,whether or not know the stroke(x2=4.561,6.557,8.788,4.146,all P<0.05);the disturbance of consciousness and symptoms ≥3 symptoms compared with the visiting time had significant difference(x2=5.133,5.926,all P<0.05);in the multiple factors Logitic regression analysis,the degree of education(OR=2.332,95%CI:1.402~3.904),severity of illness(OR=3.956,95%CI:1.934~7.446),understanding of stroke(OR=3.621,95%CI:1.563~8.125),disturbance of consciousness(OR=4.336,95%CI:2.394~11.374),pre-hospital transport mode(OR=5.658,95%CI:2.546~12.554) were the risk factors of treatment time.Conclusion There is a close relationship with extension and various factors of acute ischemic stroke patients,in the future,not only need to improve the pre-hospital emergency care system,but also need to strengthen the public understanding of the disease.

Complaints of medical consumers are caused by a good many factors,which aim at distincting medical pur?pose further,asking for economic compensation and justice,and punishing complained individual or complained hospital.It’s a realistic proposition on howto treat,reduce and avoid complaints,and maintain a correct attitude by units which ac?cept the complaints.

Objective To explore the impact of hyperglycemia on Hypersensitive C-reaction protein (hsCRP),B-type natriuretic peptide(BNP) and ventricular remodeling in elder patients with acute myocardial infarction(AMI).Methods One hundred and twenty elder patients with AMI are divided into hyperglycemia group(blood sugar in admission ＞ 7.8 mmol/L) and non-glycemia group(blood sugar in admission ≤7.8 mmol/L).The levels of blood sugar in admission,hsCRP,BNP were detected.LVEF,LVEDD,LVESD,WMS were observed by cardiac echo in admission and two weeks after therapy.Results The blood sugar in admission,hsCRP and BNP of the patients in hyperglycemia group were (9.6 ± 0.6) mmol/L,(1 750.6 ±677.1) ng/L,(56.1 ±38.6) ng/L,higher than those in non-glycemia group (t =38.679 and P =0.000; t =11.941 and P =0.000; t =3.288 and P ＜0.01,respectively).LVEF,LVEDD,LVESD and WMS of patients in hyperglycemia group didn't show statistical significance before and after therapy.However,there were significant in hyperglycemia group (t =2.049 and P =0.043,t =2.836 and P =0.005,t =3.814 and P =0.000,t =2.086 and P =0.039,respectively).Conclusion Hyperglycemia can reduce the increase of hsCRP and BNP,which has an impact on hsCRP,BNP and ventricular remodeling in elder patients with acute myocardial infarction,but the mechanism need to further research.

Objective To observe the effect of curcumin on the expression of smad7 and TGF-β1 in rats renal tubular cells of with Ang II, and discuss the mechanism of curcumin to improve renal interstitial fibrosis.Methods Cultured rat renal tubular epithelial cells were divided into the blank group, the Ang II control group and the low, medium and high dose curcumin group. The rest of the groups were intervened by 10-8 mol/L Ang II except the blank group; the low, medium and high dose groups of curcumin were intervened by 2.5, 5.0, 10.0μmol/L curcumin. Then Western blot was used to detect the expression of TGF-β1 and smad7 protein, RT-PCR was used to detect the TGF-β1 and smad7 mRNA expression.Results Compared with the blank group, the expression of TGF-β1 protein (0.23 ± 0.03vs. 0.16 ± 0.01), and TGF-β1 mRNA (1.89 ± 0.20vs. 1.00 ± 0.00) significantly increasedin AngⅡ control group (P<0.05), and the expression of smad7 protein (0.19 ± 0.03vs. 0.24 ± 0.02), and smad7 mRNA (0.48 ± 0.05vs. 1.00 ± 0.00) significantly reduced in AngⅡcontrol group (P<0.05). Compared with the AngⅡ control group, the expression of TGF-β1 protein in low, medium and high dose curcumingroup (0.18 ± 0.02, 0.17 ± 0.02, 0.16 ± 0.03vs. 0.23 ± 0.03) and TGF-β1 mRNA (1.58 ± 0.11, 1.34 ± 0.16, 0.97 ± 0.19vs. 1.89 ± 0.20) significantly decreased (P<0.05), and the expression of smad7 protein (0.28 ± 0.04, 0.31 ± 0.03, 0.34 ± 0.04vs. 0.19 ± 0.03) and smad7 mRNA (0.68 ± 0.07, 0.80 ± 0.06, 0.98 ± 0.09vs.0.48 ± 0.05) increased significantly (P<0.05).Conclusions Curcumin can thus play its role in renal protection by counteract the AngⅡ mediated renal interstitial fibrosis. Its mechanism may be related to the reduction of TGF-β1 protein and its mRNA expression, up regulation of smad7 protein and its mRNA expression.

Objective To define basic medical service items in Shanghai community health centers.Methods Two rounds of Delphi expert consultation were carried out with 36 experts specialized in general practice,general practitioner training,internal practice,public health and health management,then the scope of medical service system was set up based on experts' opinions.Results The newly-defined system consisted of three first-grade items:outpatient medical service,hospital medical service and medical service for home beds and temporary home visits.The first-grade items contained 22 second-grade items and the second-grade items consisted of 26 detailed items,including 17 baseline items,8 optional items and 1 restrained item.In two rounds of Delphi consultation the activity coefficient of experts was all 100％,authority coefficients of experts was 0.825,and harmonious coefficient of the importance of the evaluation was 0.361 and 0.488 (all P ＜ 0.01),respectively.Conclusion The preliminarily developed system of basic medical service items in Shanghai community health service can provide a reference frame for government policy-making.

BACKGROUND: There are various methods for management of allogeneic bone, xenogeneic bone and various tissue engineered materials, but there is no ideal method for treatment of insufficient bone mass following jaw defects. OBJECTIVE: To observe the repair efficiency of bone composite and biomembrane following large mandibular defect and mandibular defect combined with tooth luxation in animal studies. DESIGN, TIME AND SETTING: The controlled observational animal study was performed at the Animal Laboratory of Zhejiang University from March to July 2006. MATERIALS: The mixed proportion of Bio-oss material and autologous bone powder was 1:1. The proportion of recombinant human bone morphogenetic protein-2 freeze-dry powder dissolved in autologous fresh blood was 0.25 mg:1 mL. Bone powder mixture was moistened by blood containing human bone morphogenetic protein to stick on the medicine spoon for moulding easily. METHODS: Ten New Zealand rabbits were selected. Consecutive bone defects (15 mm×6 mm×5 mm) were made in the inferior border of bilateral mandible body. Bone composite and Bio-gide membrane were randomly implanted into one side (bone composite + Bio-gide membrane group). Another side was directly sutured as blank control group. The remaining 30 rabbits were considered bone composite + Bio-gide membrane + implantation tooth group. A bone defect (15 mm×6 mm×8 mm) was made at the upper site of inferior border of mandible, with the combination of tooth luxation. Bone composite and Bio-gide membrane were implanted, and the luxation teeth were implanted into the original site. MAIN OUTCOME MEASURES: Implantation site, composite conjugation, loose of bone formation and implanted teeth were generally observed. New bone formation at the bone defect site was observed using radiograph and histological method. RESULTS: At 12 weeks following surgery, a bone defect, which was smaller than the original bone, was found at the mandibular defect site in the blank control group. New bones were visible in the mandibular defect site in the bone composite + Bio-gide membrane group. Radiograph demonstrated that the density of defect bone site was similar to normal bone tissue. Histological method revealed that bone implant formed board-shaped bone. No significant loose was detected in implanted teeth of 17 rabbits in the bone composite + Bio-gide membrane + implantation tooth group. Radiograph demonstrated that no transparent area was found in the root tip of 13 rabbits. Histological method showed replacement resorption in 13 rabbits. CONCLUSION: Bone composite combined with Bio-gide membrane for repairing large mandibular defect obtained good efficiency. The outcome of autologous tooth implantation is acceptable in the near future.

OBJECTIVE:To observe clinical efficacy and safety of Kangfuxin liquid in the treatment of pediatric hand,foot and mouth disease. METHODS:128 children with hand,foot and mouth disease were randomly divided into observation group and control group,with 64 cases in each group. Control group was given routine treatment as herpes and oral care,antibiotics for infec-tive children reflected by hemogram elevation,fluid infusion and non-steroidal analgesic-antipyretic agent based on disease condi-tion. Observation group was additionally given Kangfuxin liquid,3 ml for below 3 year-old,tid and 5 ml for more than 3 year-old,tid. Clinical efficacy of 2 groups were observed as well as CRP,lactic acid,Ig,the level of myocardial enzyme before and after treatment;the time of symptoms and signs disappearance and ADR were compared between 2 groups after treatment. RE-SULTS:The total effective rate of observation group(89.06%)was significantly higher than that of control group(70.31%),with statistical significance(P<0.05). There was no statistical significance in CRP,lactic acid,Ig and myocardial enzyme before treat-ment and IgM level after treatment between 2 groups,with statistical significance(P>0.05). CRP,lactic acid creatine kinase and lactate dehydrogenase level of 2 groups decreased significantly,while IgA and IgG levels increased significantly,and the observa-tion group was higher than the control group,with statistical significance(P<0.05). Antipyretic time,hand foot skin rash subsided time and oral ulcer healing time of observation group were significantly shorter than those of control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Kangfuxin liquid is effective in the treatment of hand,foot and mouth disease in children,and can effectively improve CRP,Ig,lactic acid,and myocardial enzyme level with good safety.

Objective To explore the relationship of personality and coping style between parents and male inpatients with internet addiction disorder. Methods 51 male inpatients with internet addiction disorder and their parents were investigated with Cattell 16PF and Coping Style Questionnaire to evaluate their personality and coping style. All data were analyzed by partial correlate analysis. Results Multi-factors of 16PF( warmth, reasoning, emotional stability, dominance, vigilance, sensitivity, abstractedness, privateness, openness to change, perfectionism, apprehension, tension ) of male inpatients were significantly correlated with father' s ( r = 0.72 ～ 0. 85 or - 0. 71 ～ - 0.93 ) or mother' s 16PF( r = 0.73 ～ 0.92 or - 0. 72 ～ - 0.81 ), bu+ non of those factors corrected with the same factor of parental. Male inpatients' coping style did not corrected with father' s, but their problem sloving, rationalization and self-accusation corrected with mother's seeking support, rationalization and avoidance respectively. Conclusion The personality of male inpatients with internet addiction disorder is affected by parental personality, but under the impact of internet addiction disorder, this kind of influence is weakened. In coping style, the father' s influence is far weaker than the mother' s, suggesting that there is father function flaw during the process of those inpatients growing up.

Objective To determine the prevalence of latex glove(LG)-induced type Ⅳ hypersensitivity in clinical nurses. Methods 100 clinical nurses were selected,among whom 69 nurses were set as the latex glove hypersensitivity group,and the other 31 nurses did not show hypersensitivity to latex glove (the control group).The two groupe underwent a patch testing with a modified European standard series of allergens supplied by Chemotechnique Diagnostics.The positive allergens were compared between the two groups. Results The positive rate of patch testing in patients of the latex glove hypersensitivity group was superior to that in the control group (73.9％ vs 25.8％).Cobalt chloride and potassium dichromate were the most common allergens in both groups,while only formaldehyde and para-phenylenediamine were more susceptible in the latex glove hypersensitivity group compared with that in the control group.26.1％ of the latex glove hypersensitivity group was responsive to rubber additives,but in the control group the results were negative.Conclusions The hand dermatitis of female nurses with LG allergy is mainly caused by exposure to daily necessities.The prevalence of LG-induced type Ⅳ hypenensitivity is relatively high in clinical murses.