Objective In order to evaluate nursing students' clinical nursing knowledge and ability objectively, we tested a clinical nursing examination system which is based on the computer technology. Methods The proposed project used the whole group of sampling methods. Data were collected via class unit. All the 620 subjects recruited from seven classes of grade 2007 (280 students )and eight classes of grade 2008 (340 students). Results Students of grade two without clinical practice had lower scores when answering clinical nursing case problems compared with grade one students who went through clinical practice. Conclusions The computer simulated clinical nursing testing system has better validity and reliability in evaluating students' clinical nursing ability.

AIM:To observe the expression of angiogenesis factors in the myocardial tissue of streptozotocin-induced diabetic rats .METHODS:The diabetic rat model was induced by intraperitoneal injection of streptozotocin .After 12 weeks, the cardiac function was measured by MPA cardiac function analysis system .The myocardial collagen volume fraction ( CVF) was assessed by Masson staining .The capillary vessels was quantified as the ratio of capillary to myocyte (C/M) using CD31 immunostaining.The expression levels of vascular endothelial growth factor (VEGF), angiopoietin ( Ang)-1, endostatin and Ang-2 were observed by Western blotting .RESULTS:Compared with normal control group , the left ventricular end-diastolic pressure (LVEDP) was evidently increased (P<0.01), but left ventricular pressure rise maximum rate (+dp/dtmax), left ventricular pressure decrease maximum rate (-dp/dtmax) and the ratio of capillary/myo-cyte (C/M) were significantly decreased (P<0.05).The CVF and the expression level of endostatin were significantly increased, whereas the expression levels of VEGF and Ang-1 evidently decreased (both P<0.05) in diabetic rats.Howev-er, no marked difference in the expression of Ang-2 between the 2 groups was observed (P>0.05).CONCLUSION:Im-balances between the angiogenic factors (VEGF and Ang-1) and anti-angiogenic factors (endostatin) may play an impor-tant role in the pathogenesis of diabetic cardiomyopathy .

Object To study the effect of plant growth regulator on medicinal constituents of Dendrobrium nobile Lindl Methods The root of D nobile was treated by immersing in solutions of plant growth regulator 6 BA and GA 3 Results and Conclusion Both plant growth regulator at certain concentration, resulted in an increase of total soluble sugar content, but without effect on the content of dendrobine GA 3 can significantly elevate the content of total alkaloid in D nobile

Objective To evaluate the Thompson procedure in the treatment of chronic mallet finger with tendon defect.Methods From July 2014 to October 2016,9 cases of chronic mallet finger with tendon defect were treated by Thompson procedure at Department of Hand Surgery,Wuhan Puai Hospital.They were 4 males and 5 females,aged from 25 to 56 years (average,36 years).Their disorder was on the left side in 3 cases and on the right side in 6 ones,involving 2 index fingers,3 middle fingers,3 ring fingers and one little finger.The ranges of motion (ROM) for distal and proximal interphalangeal joints were measured after operation.Operative complications were observed and recorded.Dargan functional assessment was used to evaluate the outcomes at the final follow-up.Results All the 9 patients were followed up for 5 to 36 months (average,16.5months).The wounds healed primarily without such complications as infection,skin breakage,abnormal fingertip sensation or nail deformity.All cases of mallet finger malformation were corrected.About 10 weeks after operation,one case presented with mild mallet finger malformation which was completely corrected after active fixation for 8 weeks.The Dargan assessment at the final follow-up showed 8 excellent and one good cases.Conclusion Thompson procedure can lead to satisfactory outcomes and limited complications in the treatment of chronic mallet finger with tendon defect.

Objective To discuss the influence of Tanshinone ⅡA on the tight junction protein of intestinal mucosal epithelial cells in rat severe septic models. Methods Seventy-five Sprague-Dawley (SD) rats were randomly divided into sham operation group, model group and Tanshinone ⅡA injection high (20 mg/kg), medium (10 mg/kg) and low (5 mg/kg) dose groups, each group 15 rats. Sepsis rat models were established by cecal ligation and puncture (CLP) method, in sham operation group, only switched abdominal surgery was performed without CLP. In Tanshinone ⅡA injection groups, different doses of Tanshinone ⅡA were injected intraperitoneally after modeling for 10 minutes and 6 hours; in sham operation and model groups, equal volume of normal saline was injected intraperitoneally at the same times as above. After operation, 3 L/kg of normal saline was injected into the caudal vein in all rats for fluid resuscitation.Twelve hours after operation, the rats were killed, the abdominal lymph nodes, liver, spleen and kidney tissues were taken for bacterial culture and calculating the rate of bacterial translocation; under microscope, the histopathological changes of ileum mucosal tissues were examined and Chiu scoring was carried out; TdT-mediated dUTP nick end labeling (TUNEL) was applied to detect the ileum mucosal epithelial cell apoptosis and calculating the index (AI);fluorescence immunoassay and Western Blot methods were used to measure the contents and protein expression levels of tight junction protein, junctional adhesion molecule-1 (JAM), Claudin-1, Zonula occludens-1 (ZO-1), Occludin, c-Fos and Tryptase. Results ① In bacterial cultures of abdominal lymph node, liver, spleen and kidney, the positive rate of mesenteric lymph node was the highest, followed by liver and spleen, mainly Escherichia coli, Proteus mirabilis, etc. The highest positive rate of bacterial culture was in model group (38.8%), followed by low dose of Tanshinone ⅡA injection group (35.0%), and the lowest was 16.6% in high dose Tanshinone ⅡA injection group, the differences being statistically significant in comparisons between any pair of groups (all P < 0.05). ② Pathological examination showed that the pathological changes of ileum mucosa were obvious and the Chiu score (4.17±0.98 vs. 0) and AI (11.70±2.87 vs. 2.17±0.80) in model group were significantly higher than those in sham group (all P < 0.05); with the increase of dosage of Tanshinone ⅡA injection, the pathological changes of rat ileum mucosa were improved gradually, the Chiu score and AI were decreased gradually, and the degrees of decrease in high dose Tanshinone ⅡA group were more significant than those in model group (Chiu score: 1.12±0.79 vs. 4.17±0.98, AI: 3.65±1.98 vs. 11.70±2.87, both P < 0.05).③ Immunofluorescence staining showed that the positive staining of protein JAM, ZO-1 and c-Fos were all green in color, Claudin-1, Occludin and Tryptase were all red in color, the localizations of all of them were in the cytoplasm, the protein expression of JAM, Claudin-1, ZO-1, Occludin from strong to weak in turn were Sham group, high, medium, low dose Tanshinone ⅡA group and model group, the expression of c-Fos, Tryptase from strong to weak in turn were model group, low, medium, high dose Tanshinone ⅡA group and Sham group. ④ Western Blot showed that the expressions of ileum tissue JAM, Claudin-1, ZO-1 and Occludin in model group were all significantly lower than those of the sham group, while the expressions of c-Fos, Tryptase were obviously higher than those of the sham group, with the increase of dosage of Tanshinone ⅡA, the expressions of JAM, Claudin-1, ZO-1 and Occludin were increased gradually and the protein expressions of c-Fos and Tryptase were gradually decreased, and the changes in high dosage group of Tanshinone ⅡA were more significant than those in low and moderate groups [JAM (gray value): 25.39±1.82 vs. 12.41±1.34, 19.45±1.66, Claudin-1 (gray value): 28.44±1.56 vs.17.26±1.46, 21.23±1.34, ZO-1 (gray value): 28.84±1.59 vs. 16.45±1.21, 24.22±1.46, Occludin (gray value): 25.49±1.63 vs. 13.34±1.45, 19.45±1.37, c-Fos (gray value):15.76±1.36 vs. 27.84±1.36, 21.22±1.73, Tryptase (gray value): 14.44±1.41 vs. 28.14±1.38, 22.32±1.57], all the above comparisons of different dosage groups were statistically significant (all P < 0.05). Conclusion Tanshinone ⅡA injection may improve intestinal wall structure and reduce bacterial translocation by improving the intestinal mucosal tight junction protein in sepsis model rats, and this effect is positively correlated to Tanshinone ⅡA dosage.

Objective:To evaluate the therapeutic effect of electroacupuncture on acute gastrointestinal injury (AGI) in patients with severe traumatic brain injury (sTBI).Methods:A prospective randomized controlled trial was conducted. 126 consecutively hospitalized patients with AGI after sTBI admitted to intensive care unit (ICU) of the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2018 to December 2019 were enrolled. The patients were divided into observation group and control group by random number table. All the patients of two groups were given conventional treatment of western medicine for consecutive 7 days, including the treatments of primary diseases, indwelling nasogastric tube to extract gastric contents every 6 hours to determine gastric residual volume (GRV). When vital signs were basically stable, enteral nutrition (EN) was implemented and EN feeding amount and speed were adjusted according to GRV. On the basis of conventional western medicine treatment, the observation group was treated with electroacupuncture at Zusanli, Tianshu, Shangjuxu, Xiajuxu and Zhongwan, once in the morning and once in the evening, 30 minutes each time. The gastrointestinal function parameters including intra-abdominal pressure (IAP), serum diamine oxidase (DAO) and gastrointestinal failure (GIF) scores were observed before treatment and at day 3 and day 7 of treatment. The incidence of ICU hospital-acquired pneumonia (HAP-ICU), duration of mechanical ventilation (MV), length of ICU stay, 28-day mortality and adverse reactions of electroacupuncture were also observed in the two groups. Kaplan-Meier method was used for 28-day survival analysis.Results:During the 7-day treatment and observation, 26 cases of 126 patients withdrew from the study, and 100 cases were actually enrolled, 50 cases in the observation group and 50 cases in the control group. IAP and DAO at day 3 of treatment in both groups were significantly lower than those before treatment [control group: IAP (cmH 2O, 1 cmH 2O = 0.098 kPa) was 13.75±2.76 vs. 18.11±3.97, DAO (U/L) was 129.88±24.81 vs. 158.01±22.64; observation group: IAP (cmH 2O) was 13.56±2.19 vs. 18.50±3.54, DAO (U/L) was 129.11±29.32 vs. 159.36±28.65; all P < 0.01]. The gastrointestinal function parameters of the two groups improved gradually with the extension of treatment time, and the IAP, DAO and GIF scores at day 7 of treatment in the observation group were significantly lower than those in the control group [IAP (cmH 2O): 11.28±3.61 vs. 12.68±3.23, DAO (U/L): 49.69±17.56 vs. 57.27±20.15, GIF score: 2.02±0.74 vs. 2.40±0.70, all P < 0.05). The duration of MV and the length of ICU stay in the observation group were significantly shorter than those in the control group [duration of MV (days): 15.72±4.60 vs. 18.08±4.54, length of ICU stay (days): 16.76±4.68 vs. 19.26±5.42, both P < 0.05], and the incidence of ICU-HAP and 28-day mortality were significantly lowered (12.0% vs. 30.0%, 22.0% vs. 32.0%, both P < 0.05). Survival analysis showed that the 28-day cumulative survival rate in the observation group was significantly higher than that in the control group (86.4% vs. 76.1%; Log-Rank test: χ 2 = 37.954, P < 0.001). The patients in the observation group had no significant adverse reaction of electroacupuncture treatment. Conclusion:Electroacupuncture at corresponding acupoints can effectively improve gastrointestinal function in patients with AGI after sTBI, which is beneficial to shortening the length of ICU stay, promoting the recovery of the patients, and reducing the 28-day mortality.

Objective To investigate the protective effects of basic fibroblast fibroblast growth factor(bFGF) on local skin tissue injury caused by adriamycin(doxorubicin hydrochloride) extravasation in rabbit model. Methods The rabbit mod-els of driamycin extravasation were established by injecting in 54 adult male New Zealand white rabbits. Totally, 54 rabbits were divided into three groups:bFGF group, magnesium group and control group. The three groups were respec-tively given bFGF, magnesium sulfate, and the non-intervention topilally at three segments 30 min, 24 h, 72 h after the successful establishment of the models. The degrees of local skin tissue damage after the intervention was evaluated by naked eye and light microscope at 6 time points(3 d, 5 d, 8 d, 11 d, 14 d, 22 d) were recorded and compared. Analysis of variance and LSD-t test were used for statistics. Results (1)Visual observation results:The lesion scores in the bFGF group were significantly lower than that in the magnesium group 30 min after driamycin extravasation (P<0.05). The lesion scores between the three groups were not statistically significant 24 h after driamycin extravasation (P>0.05). The lesion scores in the bFGF group were significantly lower than that in the magnesium group and the control group 72 h after driamycin extravasation(P<0.05). (2) Pathological observations results: The pathological lesion scores in the bFGF group were lower than that in the control group 30 min after driamycin extravasation (P=0.049). The pathological le-sion scores in the bFGF group were significantly lower than that in the magnesium sulfate group and the control group 24 h and 72 h after driamycin extravasation (P<0.05). The pathological lesion scores between 24 h and 72 h after driamycin extravasation were significant differences in the bFGF group and magnesium group (P<0.05). Conclusion The bFGF has protective effects on the skin injury caused by adriamycin extravasation, and its therapeutic effect is better than magnesium sulfate.

Objective To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA) on malignant lesions in gastrointestinal adjacent tissue, and further to analyze the risk factors influencing positive rate of EUS-FNA. Methods The clinical data of 171 patients undergoing EUS-FNA from January 2009 to May 2016 were collected. The lesion location, size and characteristics, the number of needle passes, puncture suction negative pressure, size of puncture needle, and years of operator experience in EUS were retrospectively analyzed. Results The overall sensitivity, specificity, and accuracy of EUS-FNA in the diagnosis of malignant lesions were 78. 3％ ( 83/106) , 100. 0％ ( 65/65) , and 86. 5％( 148/171) , respectively. The univariable logistic regression analysis demonstrated that the risk factors of EUS-FNA were lesion location, lesion characteristics, and lesion size. In multivariate analysis, larger lesion size ( OR=1. 029, 95％CI: 1. 011-1. 047, P=0. 001) and lesion characteristics of solid ( OR=5. 098, 95％CI:1. 324-19. 633, P=0. 018) were independent factors affecting the positive rate of EUS-FNA. Among 171 cases performed by EUS-FNA, the incidence of postoperative complications was 1. 75％ ( 3/171 ) included 2 cases of fever and 1 case of acute pancreatitis, which were improved after conservative treatment. Conclusion EUS-FNA is a safe and effective method of cytological and histological diagnosis with high accuracy and sensitivity, importantly in distinguish malignancy from benign lesion in gastrointestinal adjacenttissue. Positive rate of diagnosis on malignant lesions by EUS-FNA is positively correlated with lesion size, and EUS-FNA positive rate of solid malignant lesions is significantly higher than that of cystic lesions.

As a powerful tool to advance drug discovery, molecular imaging may provide new insights into the process of drug effect and therapy at cellular and molecular levels. When compared with other detection methods, fluorescence-based strategies are highly attractive and can be used to illuminate pathways of drugs' transport, with multi-color capacity, high specificity and good sensitivity. The conjugates of fluorescent molecules and therapeutic agents create exciting avenues for real-time monitoring of drug delivery and distribution, both in vitro and in vivo. In this short review, we discuss recent developments of small molecule-based fluorophore-drug conjugates, including non-cleavable and cleavable ones, that are capable of visualizing drug delivery.

OBJECTIVE: To assess the reliability and validity of Adversity Quotient Scale in evaluating the adversity quotient among nurses. METHODS: A total of 409 nurses were selected as study subjects from three first-class hospitals in Fujian Province by cluster sampling method. The adversity quotient was investigated by Adversity Quotient Scale and its reliability and validity were tested. RESULTS: The Cronbach′s alpha coefficient, Spearman-Brown coefficient, Guttman Split-Harf coefficient and retest reliability of Adversity Quotient Scale were 0.931, 0.826, 0.823 and 0.940, respectively. The content validity ratio of Adversity Quotient Scale was 0.980. The scores of control, attribution, extension and tolerance factors were positively correlated with the total score of Adversity Quotient Scale(correlation coefficients were 0.813, 0.844, 0.874 and 0.822, respectively, P<0.05). Before model modification, the initial model fitting index of confirmatory factor analysis was χ~2/df=3.72, root mean square residual approximate(RMSEA)=0.09, the overall fitting of the model was not high. After model modification, the combined reliability of control, attribution, extension and tolerance factors were 0.780, 0.796, 0.831 and 0.871, respectively. The fitting index of the modified model was χ~2/df=3.08, RMSEA=0.07, showing a good fitting of the model. CONCLUSION: Adversity Quotient Scale has a good reliability and validity in the assessment of nurses, which can be a reliable and effective adversity quotient assessment tool.