The authors have applied the Omaha system in six different researches conducted in Hong Kong and mainland China in the last ten years. These researches have been conducted using different client groups,specialty nurses,and in the hospital,clinic and community settings. The Omaha system was found to be instrumental in serving as a conceptual framework for study,designing the intervention protocol,identifying clients' health problems,defining nursing interventions and evaluating research outcomes. The Omaha system is a valuable tool for research and practice and is worth exploring further for its application in mainland China,particularly in the areas of community nursing and transitional care.

A novel method for assaying the enzymatic activity of ribosome-inactivating proteins(RIPs) has been developed.The principle of the method is based on that RIP can remove some adenine bases from double-stranded supercoiled DNA molecules,subsequently,the deadenylated DNA was cleaved into nicked and linear form.After treatment with acidic aniline,the deadenylated DNA was degraded into many small fragments,and run out of the gel.The enzymatic activities of two RIPs(trichosanthin and cinnamomin) were tested using this method,the limit of sensitivity is about 50 ng(trichosanthin) and 5 ng(reduced cinnamomin) .It should be emphasized that the merit of this method is to avoid the preparation of ribosome.

Objective To investigate the effects of clearing liver and purging the heart decoction( CLPHD) combined with methimazole on hormone levels in hyperthyroid rats. Methods Rats were administered with levothyroxine (600 μg·kg-1 ) for 3 weeks to establish the hyperthyroid model,and the serum contents of T3,FT3,T4,FT4,TSH and TRAb in hyperthyroid rats treated with CLPHD combined with methimazole were detected. Results Methimazole, CLPHD, and the combination therapy significantly reduced food intake,water intake and body temperature of the hyperthyroid rats. All treatments reduced levels of FT3, T4 and FT4 in hyperthyroid rats. Compared with the CLPHD mono-therapy, the combination therapy significantly lowered serum T4 in hyperthyroid rats,but not the TRAb level. Conclusion CLPHD combined with methimazole can obviously improve the function of thyroid gland in hyperthyroid rats.

Objective To develop an evidence-based community extended care model for patients with asthma.Methods Mixed research methods were applied to integrate best evidences:80 literatures were included in systemic review; 394 medical records were analyzed; 112 nurses admitted a test and a questionnaire to assess their competence on asthma care; clinical observation to both hospital and community centers were conducted; 6 multidisciplinary experts were consulted; and 100 patients admitted a questionnaire on patient needs and 17 of them were further interviewed.Results The nursing care model with the feature of hospital and community health service center collaborating to provide extended care for patients with asthma was established.Conclusions The development of a nursing care model for practice should be based on the current best evidence generating from the best research evidence,professional judgment on clinical practice requirement and patients' needs.

Objective To observe the ultrasonographic features of primary female genital system lymphoma and its histopathological characteristics.Methods Sonographic appearances and histopathological characteristics of 14 patients who were pathologically comfirmed as primary female genital system lymphoma were reviewed.Results Fourteen patients underwent ultrasonography and 15 lesions were found,6 cases of which were found in the ovary and cervix separately,3 cases in the uterine body.Among the lesions detected,10 of which respectively represents extremely low echo and homogeneous internal echo,all lymphomas had posterior enhancement.The margins were most frequently circumcribed (13/15),5numbers primary lymphomas of the ovary were mostly elliptical in shape,while 5 numbers of cervix tumors showed the shape of lobular,all of the tumors in the uterine body showed diffuse symmetrical enlargement without disruption of the endometria.Color Doppler imaging showed hypervascularity in most tumors(13/15).The pathological examination showed that all tumors were non-Hodgkin lymphoma diffuse B-cell type.Conclusions Primary female genital system lymphoma has some ultrasonic features,including extremely low echo,homogeneous echo and posterior enhancement.Final diagnosis depends on the histopathology.

ObjectiveTo investigate the risk factors of metabolic syndrome ( MS ) in obese subjects.Methods A seven-year follow-up study was conducted in 413 simple obese subjects and 196 subjects with normal body weight who were recruited from community residents during physical examination in 2000.There was a 7 years follow-up.Anthropometrics,blood pressure,lipid profile,fasting blood glucose,and 2 h blood glucose after glucose loading were measured.Endothelium-dependent dilatation (EDD) test was also performed.Results Among 553 of 609 subjects who were followed up in 2007,there were 381 simple obese subjects ( simple obese group) and 172 normal weight subjects( normal weight group).Seven-year cumulative incidence of MS was 35.17％ in simple obese group and 8.14％ in normal weight group.In simple obese group,subjects with MS showed greater or higher levels of waist circumference( WC ),waist-hip ratio ( WHR ),triglyceride ( TG ),fasting plasma glucose ( FPG ),fasting insulin (FINS),and homeostasis model assessment for insulin resistance index (HOMA-IR) (all P＜0.05 ),and also decreased EDD( P＜0.05 ) as compared with those without MS.WC,WHR,and FINS were higher( all P＜0.05 ) and EDD was lower( P＜0.05 ) in subjects with MS of normal weight group than those without MS.Logistic analysis showed that the male gender,WC,WHR,FPG,HOMA-IR,and EDD were major risk factors of MS.Conclusion Central obesity,insulin resistance,and endothelial dysfunction are important independent risk factors for development of MS.

ObjectiveTo investigate the value of strain ratio (SR) in the diagnosis of Hashimoto's thyroiditis.Methods 116 patients who had been diagnosed clinically as Hashimoto' s thyroiditis were enrolled in the study.Those patients were classified into four groups:the hyperthyroidism group,the euthyroidism group,the subclinical hypothyroidism group,and the clinical hypothyroidism group.50volunteers with normal thyroid functions were enrolled as a control group.SR of the thyroid and sternocleidomastoid muscle of same side was calculated.The correlation coefficient between the elasiticity SR and the serum thyroid stimulating hormone (TSH) was evaluated and their differences in the diagnosis of Hashimoto's thyroiditis were compared.ResultsThe Spearman's correlation coefficient between the SR and the serum TSH was 0.605,which was significant (P =0.000).The SR increased in an ascending order among the group with hyperthyroidism,the control group,the group with euthyroidism,the group with subclinical hypothyroidism,and the group with clinical hypothyroidism.ConclusionsElastography SR is valuable way for evaluating the progression of Hashimoto's thyroiditis.

Objective To study the changes of left ventricular(LV) function before and after rAAV2-GFP targeted to myocardium by the ultrasound mediated microbubbles. Methods Twenty rats were divided into 2 groups. Ten rats underwent ultrasound mediated microbubbles destruction without rAAV2-GFP as control. Another ten rats underwent ultrasound mediated microbubbles destruction containing rAAV2-GFP as experimental group. The mean value of LV rotation of rats was obtained in apical and base plane using speckle tracking imaging(STI) software. LV torsion(LVtor) was defined as apical rotation relative to the base. LV function including circumferential strain,circumferential strain rate of systolic and early diastolic and late diastolic, torsion, time to peak, ejection fraction, fractional shortening, end-diastolic volume, end-systolic volume of LV,heart rate and so on were also measured before and after 14 days. Other rats were killed after 14 days and hearts were harvested. GFP protein expression which showed rAAV2 transfer was observed under fluorescence microscope in frozen section. Results There was no significant difference of LV function of rats before and after rAAV2-GFP myocardium transfection by the ultrasound mediated microhubbles. Conclusions LV myocardial function has no significant difference before and after delivering rAAV2 to the heart in vivo by ultrasound-mediated microbubbles destruction.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

Objective To investigate the sonographic diagnostic value of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. Methods Ultrasonography of 22 cases with differentiated thyroid carcinoma and anaplastic thyroid carcinoma were observed with color doppler sonography.The shape,size,echo,boundary,microcalcifieation foci and blood stream distribution were studied,and contrasted with pathological diagnosis after operation.Lymphnode in cervical part and sulcus esophagus were examined.The characters of thyropathy according to the above sonographie features were judged. Results 16uhrasonography or before operation and biopsy,in which 9 were left,7 were right.6 cases were in both leaves.Ultrasound showed that 2 cases were poody differentiated thyroid carcinoma, 1 case was parathyroid carcinoma. 1 case was Hashimoto's thyroditis, and remainders were thyroid carcinoma. Conclusion Ultrasonography could enhance the detection rates and diagnose accordance rates of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma.