Objective To investigate the level and influencing factors of subjective well-being of nurses and establish a model of the relationship of job stress, self-efficacy and subjective well-being. Methods Totally 438 nurses from 5 hospitals in Changchun city were investigated with the self-designed demographic questionnaire, General Well-Being Scale, Nurse Job Stressors Scale and Self-Efficacy Scale. Results The total score of subjective well-being was (71.36 ± 18.83) points. Single factor analysis found that age (F=1.759, P<0.01), department (F=1.712, P<0.01), professional title (F=1.364, P<0.05), years of working (F=1.420, P<0.05) and monthly income (F=1.632, P<0.01) were statistically significant. Multiple linear regression analysis showed that sex (t=-2.447, P<0.05), the first factor of job stress (t=-5.033, P<0.01), the second factor (t=-2.478, P<0.05), the third factor (t=-2.315, P<0.05), the fifth factor (t=-5.862, P<0.01) and self-efficacy (t=10.705, P<0.01) were the predictive effectton of subjective well-being. The result of path analysis shows that self-efficacy has a significant effect of adjustment on job stress and subjective well-being (direct effects=-0.62, indirect effects=-0.24, P<0.01). Conclusions The nurse subjective well-being is in the medium level. Hospitals and all related departments should take effective measures to reduce or eliminate unfavorable factors and increase the protective factors, and then improve the level of nurses′subjective well-being and nursing quality.

Objective In order to analyze the research situation,development tendency and deficiencies in the aspects of nursing competency through investigating about 10 kinds of core nursing periodicals published from the year 2009 to 2013 in China.Methods Using bibliometrics methods to analyze the researches about nursing competency in the periodical literature including Chinese Journal of Nursing,Journal of Advanced Study for Nurses,Chinese Journal of Practical Nursing,Chinese Nursing Research,Journal of Nursing Science,Journal of Nursing Administration,Nursing Journal of Chinese People's Liberation Army,Chinese Nursing Management,Shanghai Nursing,Modern Clinical Nursing published from 2009 to 2013.Results There were 215 research papers about nursing competency in periodicals in the past five years,and a quantity of papers increased stably each year.The study contents mainly involved nursing education,training,competency model and standard system based on nursing competency and so on.Conclusions The researches on nursing competency are getting started in China.The quantity is keeping increase and the related research contents become more colorful and deeply than before.

Objective To explore the influence of introducing standardized patient (SP) into problem-based learning (PBL) to the autonomous learning abilities for undergraduate nursing students based on clinical thinking training. Methods To select 2 classes randomly from full-time professional nursing undergraduate classes enrolled in 2012 from Tianjin university of traditional Chinese medicine, was divided into the experimental group and the control group by random number table method. The control group uses PBL teaching mode, and the experimental group adopts introducing SP into PBL teaching mode. Course lasts for 4 weeks, a total of 18 hours. To evaluate two groups nursing students′the percentage of asking questions by themselves and examination results in the end of the course, and evaluate nursing students′autonomous learning ability before and after the course and after three months of clinical practice respectively. Results The percentage of asking questions by themselves and examination results of the experimental group were 87.80%(36/41) and (84.24±5.12) points, (87.85±5.44) points, the control group were 68.89%(31/45) and (81.51±6.63) points, (84.40±7.96) points, the difference was statistically significant (χ2=4.46, t=2.13, 2.37, P<0.05);There was no statistical significance between two groups in the score of autonomous learning ability before the course (P>0.05), while after course and after three months of clinical practice of the experimental group were (93.71±9.56) points, (103.27±11.92) points, the control group were (85.47 ± 9.28) points , (91.36 ± 10.56) points, the difference was statistically significant (t=3.56, 4.89, P<0.01). Conclusions The teaching mode of introducing SP into PBL can train and improve the autonomous learning ability of undergraduate nursing students,and can provide reference for nursing teaching mode reform.

Objective To explore the clinical efficacy of secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy for treatment of irreducible atlantoaxial dislocation.Methods From January 2014 to May 2016,12 patients with irreducible atlantoaxial dislocation were treated with secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy in our hospital.They were 7 males and 5 females,with an average age of 37.1 years (from 25 to 54 years).The efficacy was analyzed in terms of their visual analogue scale (VAS),Japanese Orthopaedic Association (JOA) scoring,improvement rate of neurological function,American Spinal Injury Association (ASIA) grading,atlas-dens interval (ADI),space available for the cord (SAC) and cervicomedullary angle (CMA) before and one year after operation.Results The patients were followed up for more than one year.All the atlantoaxial joints obtained anatomic reduction.Their preoperative values of VAS (5.73 ± 1.36 points),JOA score (9.03 ± 2.12 points),ADI (8.34 ± 1.12 mm),SAC (9.53 ± 0.69 mm) and CMA (121.23°±4.32°) were significantly improved one year after operation (1.21 ±0.63 points,14.32±2.51 points,2.83 ± 0.36 mm,14.23 ± 1.22 mm and 153.53° ± 9.25°, respectively) (P ＜0.05).The improvement rate of neurological function increased gradually with the postoperative time,reaching 94.14％ ±5.11％ one year after operation.The postoperative ASIA grading was significantly improved too one year after operation (P ＜ 0.05).Conclusion Secondary posterior internal fixation after transoral anterior atlantoaxial release under 3D operative microscopy may lead to fine clinical efficacy one year after operation for patients with irreducible atlantoaxial dislocation.

OBJECTIVE To establish the de tection method for the adulteration of Bupleurum marginatum in Ganmao qingre granules，and to determine the adulteration limit . METHODS HPLC-MS/MS method was used to detect the content of nepasaikosaponin K in commercial and self -made samples of Ganmao qingre granules ，using electrospray ionization ，and the analysis was carried out under multiple reaction monitoring model in negative mode with m/z 943.6→635.5 as the quantitative ion pair. The calculation method was established for the adulteration proportion of B. marginatum in Ganmao qingre granules . Taking nepasaikosaponin K as the index ，the adulteration limit was determined . RESULTS The linear range of nepasaikosaponin K were 0.051-20.200 μg/mL（r＝0.999 1）. RSDs of precision ，repeatability and stability （24 h）tests were all lower than 2.50%. The average recoveries were 97.58%（RSD＝2.09%，n＝9）. The limit of detection was 0.60 μg/g，the limit of quantitation was 1.80 μg/g. The adulteration ratio of B. marginatum in Ganmao qingre granules had a good linear relationship to the peak area of nepasaikosaponin K in the range of 5%-100%（r＝0.990 9）. The contents of nepasaikosaponin K in 15 batches of Ganmao qingre granules were 2.584-56.661 μg/g. One batch of samples exceeded the proposed adulteration limit （10%），and the unqualified rate was 6.67%. CONCLUSIONS The established analytical method can be used to detect the adulteration of B. marginatum in Ganmao qinggre granules ，the proposed adulteration limit is 10%.