ObjectiveTo investigate the effect of tacrolimus (FK506) on macrophage accumulation,proliferation and activation in the kidney of early diabetic rats and to explore its possible mechanism of renal protection.Methods Rats were randomly divided into control,model and tacrolimus groups.Diabetic model rats were induced with intraperitoneal injection of streptozotocin.Tacrolimus(0.5 or 1.0 mg·kg-1 ·d-1) was orally administered once a day for 4 weeks.Kidney weight index(KWI),24-h urinary albumin excretion rate(UAER) and creatinine clearance rate(Ccr) were measured.Kidney pathology was observed by light microscopy.ED-1,PCNAandiNOSpositivemacrophagesweredetectedbysingleanddoublestainingof immunohistochemistry.Results KWI increased in model group and was significantly reduced by tacrolimus treatment with 1.0 mg·kg-1 ·d-1 (P＜0.05).UAER elevated in model group and was markedly attenuated by tacrolimus treatment with 0.5 and 1.0 mg·kg-1 ·d-1 (P＜0.05).Elevated glomerular volume of model rats was significantly decreased by tacrolimus treatment with 0.5 and 1.0 mg·kg-1·d-1 (P＜0.05),and increased indices of tubulointerstitial injury were only ameliorated by 1.0 mg·kg-1·d-1 tacrolimus(P＜0.01).Marked accumulation of ED-1+ cells in diabetic kidney was found,which was not inhibited by tacrolimus treatment with 0.5 and 1.0 mg·kg-1·d-1.ED-1PCNA+ cells and ED-1+ iNOS+ cells were significantly elevated in kidneys of model group,while they were significantly inhibited by tacrohmus treatment with 0.5 and 1.0 mg·kg-1·d-1 (P＜0.01).Conclusion Tacrolimus can ameliorate early renal injury of diabetic rats and its mechanism may be partly associated with the suppression of increased macrophages activation.

Objective To investigate the core competency of nurses in the operating rooms from 8 first-class grade A general hospitals in Guangzhou.Method A total of 408 nurses in the operating rooms from 8 first-class grade A general hospitals in Guangzhou were involved in the survey by completing the questionnaire of Competency Inventory for Registered Nurses.Results The total score of core competency was(161.49±3.70).The average score of different items was(2.78±0.44).The first three items scored the highest including legal/ethical practice(2.93±0.61),professional development(2.85±0.61)and leadership(2.80±0.58).The item scored the least was critical thinking(2.66 ±0.64).Conclusions The core competence of nurses in the operating rooms from 8 first-class grade A general hospitals in Guangzhou falls at the intermediate level,their strengths including legal/ethical practice, professional development and leadership.They are poor and weak at critical thinking and scientific research.

Objective To observe the clinical effect of tongluozhitong capsule combined with carbamazepine on the treatment of trigeminal neuralgia.Methods94 patients with trigeminal neuralgia from January 2012 to May 2014 in Dongyang people's hospital were randomized double-blindly divided into the control group and the observation group, 47 cases in each group.The control group received carbamazepine treatment, and the observation group received tongluozhitong capsule combined with carbamazepine.VAS score, the effect and adverse reaction were recorded and analyzed before treatment, atwo weeks and four weeks after.Recurrence was followed-up a half and one year after treatment.Results①VAS scores in the observation group 2 weeks and 4 weeks after treatment were (3.78±0.44), (2.01±0.23) points separately, which were lower than those in the control group (5.96±0.53), (4.02±0.38) points separately, and the differences were statistically significant (P<0.05).②The total effective rate in the observation group 4 weeks after treatment was 95.74%, which significantly higher than that in the control group 78.72%, and the difference was statistically significant (P<0.05).③ The adverse reactions in the observation group 4 weeks after treatment was 21.28%, 27.66% in the control group, the difference was not significant;④ The recurrence rate in the observation group six months and one year after treatment were 6.38% and 10.64%, which significantly lower than those in the control group 23.40% and 29.79%, and the differences were statistically significant (P<0.05).ConclusionIt can effectively relieve pain, reduce the recurrence rate, and will not increase the adverse reactions which tongluozhitong capsule combined with carbamazepine were used on the treatment of trigeminal neuralgia.It is a safe and effective treatment program.

Objective To explore the self-management behaviors of the patients with lumbar disc herniation. Methods Chronic disease self-management behavior measuring scale was used to investigate the self-management behaviors of 96 lumbar disc herniation patients. Results The score on self-management behaviors of the LDH patients was 20.42±7.52. 65.63%~84.38%of the patients took the wrong position at sitting, moving articles, and fetching articles from a low and high spot. 59.38%of them did not wear the waist supporter. 73.96%~95.83%of them did not follow the doctors' advice to sleep on hard bed, carry weights and keep the back warm. Conclusions The self-management behavior among LDH patients is dissatisfying. The nurses should provide patients with education on self-management behaviors, instructing them to take effective functional exercises, focusing on importance of cognitive symptom management in relieving pain and reducing negative emotion. Meanwhile, the nurses should advice patients to take right self-management behavior in daily life in order to promote the recovery of the function by patients' healthy behavior and life style.