How to cultivate and evaluate the nursing students′clinical competency is an important part of the process of higher nursing education .Objective structured clinical examination is regarded as an effective assessment method to evaluate the clinical com -petency of medical students .However , it is still at the initial stage in the nursing education in China .This article presents an overview on the design of nursing objective structured clinical examination , the present application of objective structured clinical examination in cultivating and evaluating the nursing clinical competency and the effectiveness of objective structured clinical examination .

Objective To compare the characteristics of food and nutrition intake in type 2 diabetes mellitus (T2DM) patients with or without carotid atherosclerosis and analyze the relationship between diets/C-reactive protein (CRP) and carotid intima-media thickness (C-IMT). Methods Sixty patients with T2DM were enrolled and divided into two groups based on C-IMT: group A (C-IMT ＜ 1 mm, n=30) and group B (C-IMT≥1 mm, n=30). All subjects were investigated with questionnaires including 3-day food recall They all took somatometric measurement. Blood and urine samples were collected in all subjects to examine the levels of high sensitive-CRP,C-peptide, blood glucose, glycosylated hemoglobin, blood lipid, renal function, urine microalbumin, and other indicators. Results The intakes of vegetables, fruits, and aquatic products were significantly higher in group A than in group B ( P ＜ 0. 05 ). The intake of vitamin C in group A was significantly higher than that in group B ( P ＜0. 05 ). The levels of CRP in group B was significant higher than that in group A (P = 0. 000). Positive correlation was found between CRP level and C-IMT in T2DM patients ( r = 0. 36, P = 0. 004). Furthermore, CRP was negatively correlated with the intakes of vegetables and fruits ( r = - 0. 334, P = 0. 01 ), aquatic products ( r = -0. 315, P = 0. 016), and vitamin C ( r = - 0. 2786, P = 0. 038 ), respectively. The intake of fruits was negatively correlated with C-IMT (r, = -0. 33, P = 0. 01 ). Conclusions T2DM patients without carotid atherosclerosis intake more vegetables, fruits, aquatic products and vitamin C than those with atherosclerosis. Vegetables, fruits,sea foods and vitamin C may be the protective factors against atherosclerosis in T2DM patients. CRP is associated with the development of atherosclerosis in T2DM patients.

Objective: To explore the diagnostic values of Wells score and YEARS algorithm in the patients with pulmonary embolism and to compare the areas under receiver operating characteristic (ROC) curves (AUC) of Wells score and YEARS algorithm, and to find the more suitable score method for pulmonary embolism in clinic. Methods: A total of 139 patients who were suspected with pulmonary embolism were collected, among them 48 patients were clinically as confirmed pulmonary embolism. The disease history, clinical manifestation and results of auxilliary examinations of the patients were collected. All the patients were assessed by Wells score and YEARS algorithm, respectively; the computed tomographic pulmonary angiography (CTPA) was considered as golden standard. The sensitivities, specificities, misdiagnosis rates and omission diagnostic rates, and the accuracies of Wells score and YEARS algorithm of the patients in two groups were analyzed with SPSS 22.0 software; the conformities of results of Wells socre, YEARS algorithm, and CTPA were analyzed. Then ROC curves of Wells score and YEARS algorithm in diagnosis of pulmonary embolism were made, and the AUC was calculated and compared. Results: Compared with YEARS algorithm, the specificity and accuracy of Wells score in diagnosis of pulmonary embolism were markedly increased (P<0.05), the misdiagnosis rate was decreased (P= 0.037), however the sensitivity and the misdiagnosis rate had no significant differences ( PX). 05). The Kappa value of Wells score and CTPA was 0. 45, the conformity was moderate; the Kappa value of YEARS algorithm and CTPA was 0.22, the conformity was passable; the Kappa value of Wells score and YEARS algorithm was 0. 11, the conformity was bad. The AUC of Wells score and YEARS algorithm were 0. 753 + 0. 044 ( P<0. 01) and 0. 585 + 0. 049 ( P=0. 101). Conclusion: The Wells score is superior to the YEARS algorithm in the diagnosis of pulmonary embolism.

etary oil with MCT can improve insulin resistance.

Objectives:To observe the influence of PN treatment on the postoperative patients of advanced ovarian cancer. Methods:The patients were divided into two groups.Thirty cases of patients(PN group) were treated with PN after the operation for the ovarian cancer.Thirty five cases of patients(control group) were treated regularly without PN.The biochemical indicators,complications and mortality rate were compared between the two groups. Results:The biochemical indicators in PN group were better than those in control group.The incidence of complications and mortality rate in PN group were significantly lower than those in control group. Conclusions:PN can improve the general status of postoperative patients with advanced ovarian cancer and decrease the complication incidence and motality rate.

AIM: To study the role of scavenger receptor A(SR A) in the uptake of oxidized low density lipoprotein(OxLDL) in mouse peritoneal macrophages(MPM). METHODS: Comparing the difference of the uptake of OxLDL in SR A-deficient and wild-type MPM. RESULTS: The results showed that the binding of OxLDL wasn't apparently reduced in SR A-deficient MPM. The association of OxLDL was reduced by 35.8% and degradation of OxLDL was reduced by 42% in SR A-deficient MPM compared with those in wild-type MPM. CONCLUSION: Studies showed that SR A didn't play an important role in the uptake of OxLDL in MPM. Approximately 70% of the uptake of OxLDL in macrophages is attributable to non-SR A receptor.

Objective:To detect the neutrophil extracellular traps (NETs) formation in the peripheral blood of the patients with recurrent respiratory tract infection,and to evaluate the effect of sulbactam sodium/cefoperazone sodium on the formation of NETs.Methods:A total of 36 patients with recurrent respiratory tract infection (case group) and 30 healthy volunteers (healthy control group) were selected.The NETs formation of subjects in two groups was detected by confocal microscope and scanning electron microscope (SEM).According to the appearance of neutrophils,the formation of NETs was classified as grade Ⅰ,Ⅱ and Ⅲ,the number of NETs formation cells of subjects in two groups was calculated.The formation of NETs of the patients in case group were detected before and after treated with sulbactam sodium/cefoperazone sodium.Results:The number of NETs formation cells of grade Ⅰ and Ⅱ of the patients in case group was more than that in healthy control group (P<0.05);while the number of NETs formation cells of grade Ⅲ of the patients in case group was less than that in healthy control group (P<0.05).The number of NETs formation cells of grade Ⅰ and Ⅱ of the patients in case group were significantly decreased (P<0.05),while the number of NETs formation cells of grade Ⅲ was significantly increased (P<0.05) after treated with sulbactam sodium/cefoperazone sodium.Conclusion:A lot of NETs with high antibacterial function can be formed in the patients with recurrent lower respiratory tract infection,and sulbactam sodium/cefoperazone sodium can inhibit the formation of NETs.

Objective To compare the risk factor of chilldren with autism and ordinary children during perinatal period. Methods One hundred and fourty children with autism and 82 ordinary children were reviewed by self-written general circumstance questionnaire and risk factor questionnaire. Results Viral influenza during pregnancy (x2 =15.29) ,bom suffocate( x2 =6. 04) , premature delivery (x2 =6. 48) , dystocia (x2 =2. 83) and artificial feeding ( x2 = 6. 02 ) were risk factors for children autism (P < 0. 05 ). Conclusion Childeren autism is associated with risk factors in rinatal period. Early dectecion and early prevention and treatment may improve the outcome.

Objective To evaluate the relationship between the anxiety condition and educational background of the autistic children's parents. Methods Questionnaires for the self-evaluation of anxiety were collected from the parents of 140 children with autism. Results The autistic children's mothers had significantly higher score of anxiety than the fathers (42. 73 ±8. 25) (t =6. 783,P ＜0. 05). The autistic boy's parents had significantly higher anxiety pressure than autistic girl's parents ( 51.38 ± 11.24 vs. 43.23 ± 6. 12) ( t = 4. 894,P ＜0. 05). The anxiety intensity of the autistic children's parents was negatively correlated with the parents'educational background ( F = 10. 788, P ＜ 0. 05 ). Conclusion The autistic children' s parents had certain anxiety,which is correlated with the their educational background and genders of the autistic children. It is necessary to interfere the negative mood to facilitate the treatment of the autistic children.

BACKGROUND: Serious scalding leads to dysfunction of each aspect in immune system, and activated macrophage can secret many bioactive transmitters. The relationship between macrophage dysfunction and signal conduction after scalding is unclear at present.OBJECTIVE: To observe the alternation of tumor necrosis factor- alpha(TNF-α) at different time points after scalding and the activity of nuclear factor κB(NF-κB) and alternation of protein kinase C (PKC) after the application of specific modulator H-7 to explore whether PKC participates in the modulation of TNF-α in macrophage on signal conduction level for the clarification of some mechanisms of macrophage dysfunction.DESIGN: A randomized controlled experimental study by employing experimental animals as subjectsSETTING: An institute of burn research of a military medical university MATERIALS: The study was conducted in the Laboratory (state) of the Institute of Burn Research, Third Military Medical University of Chinese PLA between January and December 1999. Experimental animals were 32 healthy clean inbreeding Kunming white mice.METHODS: 15% Ⅲ scalding was created in mice for the establishment of routine scalding model. Mice were randomly divided into 6 groups according to different time points before or after scalding, I.e. 0(normal control group), 2, 6, 12, 24, or 48 hours group. Celiac macrophages were collected for the detection of TNF-α content by radioimmunoassay, NF-κB activity by electrophoretic mobility shift analysis (EMSA), and membrane or plasma PKC activity by isotope analysis.MAIN OUTCOME MEASURES: ① TNF-α content; ② NF-κB activity; ③Membrane or plasma PKC activity RESULTS: After scalding, macrophage excessively secreted TNF-α and reached its peak of (1 085.65 ± 122.99) ng/L at 12 hours, which was significantly higher than that of control group( t = 14.92, P ＜ 0.01 ).Compared with control group, membrane PKC activity increased after scalding, which significantly heightened to(231.80 ± 31.66) nmol/min · g at 2hours( t = 7. 930, P ＜ 0.01 ), slightly decreased to close to normal level of (174.29±16.80) nmol/min· gat 6hours(t=2.531, P ＜0.05), and rapidly elevated at 12 hours [512. 10 ±33.42) nmol/min · g] and 24 hours [ (454.70 ± 21.06) nmol/min · g] to reach its peak of(530.49 ± 28.54)nmol/min. G at 48 hours( t = 29.42, 28.03, 30. 19, P ＜ 0. 01 ). Correlation analysis of the alternation between TNF-α and membrane PKC indicated a significant positive correlation( r = 0. 796 4, P ＜ 0. 05) . As indicated by EMSA image, NF-κB activity significantly elevated after scalding. Twelve hours after scalding was set as modulation point, NF-κB activity was significantly inhibited by the application of H-7.CONCLUSION: The secretion of TNF-α and the activities of PKC and NF-κB are significantly activated in celiac macrophage after scalding, and PKC-NF-κB signal pathway participates in the modulation of TNF-α expression, which provide experimental data for the modulation of immune function and rehabilitative intervention during scalding.serious scalding.