This article analyzes the prominent features of the advanced nursing education in America from four aspects:prospects of the nursing education,requirements for the undergradua te nursing majors,network education and postgraduate education,and proposes some suggestions of developing the advanced nursing education in China,in combination with the present situation of cultivating senior nurses in our country.

Objective:To study the cause of clinical and pathological misdiagnosis and the measures against misdiagnosis in cases with primary non-Hodgkin's lymphoma in Waldeyer's ring.Methods:The clincal data of ninty two patients with primary NHL in Waldeyer's ring admitted to our hospital in recent ten years were studied retrospectively.Results:Eighteen patients were misdiagnosed clinically and seventy two patients were misdiagnosed pathologically.18 cases were misdiagnosed both clinically and pathologically, with the average misdiagnosis rate of 2～3 times per case.The misdiagnosed diseases were chronic tonsillitis,tonsil vegetation,pharyngitis,lymphatic tissue hyperplasia,etc.All seventy-two patients were diagnosed as NHL finally.Conclusion:The patients with the primary NHL in Waldeyer's ring lack characterisic symptoms.Pathological manifestation is complicated.It is important to do biopsy exactly and diagnose early by immunohistochemical approaches.

Objective:To analyze and conclude the common causes and clinical features of hoarseness in patients at different ages.Methods:The data of 1100 cases of hoarseness in diferent ages were analyzed with laryngofiberscopy.Results:The main 5 causes of hoarseness were neoplasm(767cases,69.72%),laryngitis(188cases 17.09%),paralysis of vocal cord(75cases,6.82%),trauma(30cases,2.73%),and others(40cases,3.63%).The number of its distribution in 4 age groups was different(P

Objective:To study the differential expression proteins of laryngeal squamous cell carcinoma tissue and paired normal tumor adjacent mucosa epithelia tissue.Methods:The total proteins of laryngeal cancer tissue and paired normal tumor-adjacent mucosa epithelial tissue were separated by means of immobilized pH gradient-based two-dimensional gel electrophoresis(2-DE).Coomassie brilliant blue dyeing.The differential expression proteins were analyzed by using ImageMaster 2D analysis software. Then identified by peptide mass fingerprint(PMF)based on matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS)and database searching. Result:We obtained well-resolved,reproducible 2-DE patterns of laryngeal cancer and normal mucosa epithelia1.Differential protein spots were defined as spots in 2-DE gels.33 proteins were preliminarily identified,among which 22proteins were upregulated in laryngeal cancer tissue,while 11 were decreased significantly. PMF maps of 10 proteins which were upregulated in laryngeal cancer tissue were obtained by MALDI-TOF-MS. The typic peptide masses were searched in the Mascot database. Eight proteins were preliminanily identified.Conclusion:We established the expression maps of proteomics in laryngeal cancer and normal mucosa epithelia1.There were significant differences among proteome of laryngeal cancer and normal mucosa epithelia1.These proteins may be potential diagnostic markers and therapeutic targets for laryngeal cancer.And is valuable for studying mechanisms of laryngeal carcinogenesis.

Objective To explore the reason and influence of communication difficulties between oncology nurses and patients or families of patients,and to obtain some relevant advice about communication difficulties.Methods This study used focus group to interview 24 oncology nurses who were selected from the First Affiliated Hospital of Chongqing Medical University by homogeneous sampling method,and were randomly divided into three groups (8 in each group).The data were processed and analyzed by content analysis.Results The reasons why oncology nurses had communication difficulties with patients and their families were as follows:putting forward negative problems about their disease,ineffective communication and conflicts with patients,families.The communication difficulties showed negative effect on oncology nurses.Oncology nurses thought that the main reason of communication difficulties lied in the deficiency of institution and propounded the suggestion to resolve it.Conclusions oncology nurses were tend to have difficulty in communicating with patients and their families in the long-term work,especially in the period of crisis:early diagnosis of tumor stage,relapse,advanced cancer and some special dates (birthday,parties etc.).Therefore,oncology nurses,patients and their families need to be supported.To solve the difficulties of communication could reduce the negative emotions of patients and their family,such as anxiety,frustration,helplessness,so as to improve the quality of care and life of patients.

Based on the present situation analysis of nursing experimental teaching for undergraduate,reform was carried out through our innovating experimental teaching philosophy,integrating experimental teaching curriculum,compiling experimental teaching materials,establishing experimental teaching inspection and assessment system and consummating management mechanism of experimental teaching center,and some developing thoughts were also proposed.

Objective The research aimed to identify symptom clusters of head and neck cancer (HNC) patients.Methods The M.D.Anderson Symptom Inventory-Head & Neck (MDASI-H&N) was applied to measure symptoms of 247 HNC inpatients.Factor analysis was applied to identify symptom clusters.The Spearman correlation analysis was used to find the relationship of symptoms within symptom clusters.Results Five clusters were identified and the Cronbach's α coefficients of symptom clusters were 0.904,0.928,0.898,0.815 and 0.662 respectively.Symptoms within clusters were all significantly interrelated to each other (r=0.393-0.856,P＜0.01).Conclusions Symptoms of HNC patients tend to occur not in isolation,but in symptom clusters.Effective management can not only eliminate or alleviate the symptom burden of HNC patients,but also be cost-effective.

Objective To formulate a scientific and reasonable evaluation model of post competency ,and to provide references for selection ,training and evaluation of orthodontic assistant specialist in china .Methods Items of competency for orthodontic as‐sistant specialist were established basing on semi structured interviewing and literature research ,and then Delphi technique was used to consult 22 orthodontic experts .The collected data was analyzed by SPSS 19 .0 .Results The positive coefficient for two round specialist survey was 95 .45% after two round specialist survey ,the authority coefficient was 0 .865 ,as well as the values of significant test for coordinate coefficient opinions were P<0 .01 .The evaluation competency model for orthodontic assistant special‐ist was consisted of entry requirements and evaluation system including 4primary indicators ,15secondary indicators .Conclusion The evaluation competency model is reliable and valid ,which can provide reference for selection ,training and evaluation of ortho‐dontic assistant specialist .

Objective To study if the dose verification technique for three dimensional conformal radiation therapy ( 3 DCRT) can be applied for simplified intensity modulation radiation therapy ( sIM RT). Methods From 1988 patients treated by sIMRT in our department,12 were chosen randomly for the study. For each case,3 differert plans of 3DCRT,sIMRT,and IMRT were worked out with Pinnacle TPS,and the dose verification for each plan was carried out with Elekta Precise LA by using 2D diode-matrix of MapCHECK Model 1175. Results For slMRT,the overall average percentages of pass points for DD(DTA) 2% (2 mm) ,3% (3 mm)and 4% (4 mm) were 90.5% ,94.8% and 98.2% reapectively,which were slightly worse when comparing with those of 3DCRT with deterioration of 1.9% (t=2.19,P=0.040) ,1.0% (t= 1.52,P=0.144) and 0.2% (t=0.05,P=0.623), but slightly better comparing with those of IMRT with increment of 2.1% (t=2.17,P=0.041) ,1.5% (t=2.62,P=0.016) and 1.5% (t=3.68,P=0.001) for 2% (2 mm) ,3% (3 mm) and 4% (4 mm) ,respectively. Conclusions The sIMRT technique simplifies the complicated dose verification procedure of I MRT. When the sIMRT technique is formally used, the procedure of dose distribution verification for 3DCRT can be used directly for slMRT.

This article systematically introduced the development of Smart Healthcare mode in Hangzhou. From the aspects of connotation, pattern, characteristics and the change of medical treatment mode, the authors pointed out that the development of Smart Healthcare must follow such principles as satisfaction of the people, enhanced inter-departmental synergy, government-guided social participation, and full involvement of medical workers.