The problems in nursing postgraduate training in China are summarized,which include the ambiguity of subject orientation,absence of unified standard on training objective,imperfection of tutor team,uncertainty of research direction,lack of scientific research funds,etc.The countermeasures are then proposed,and the direction of nursing postgraduate education reform in China is discussed.

Objective To investigate the relationship between the expression of estrogen receptor (ER),progesterone receptor(PR)and epidermal growth factor receptor(EGFR)in uterine leiomyoma and the recurrence after myomectomy.Methods Eighty cases underwent myomectomy were enrolled in this study.ER,PR and EGFR expression in uterine leiomyoma tissue and normal myometrium tissue were examined by immunohistochemical technique.All the patients were followed up regularly after myomectomy.Results The positive expression rate of ER,PR and EGFR in uterine leiomyoma tissue were significantly higher than those in normal myometrium tissue[88.8％(71/80)vs.48.8％(39/80),92.5％(74/80)vs.30.0％ (24/80),86.2％(69/80)vs.57.5％(46/80),P ＜ 0.05].The recurrence rates in ER,PR and EGFR positive expression patients were significantly higher than those in negative expression patients[42.3％(30/71)vs.22.2％(2/9),41.9％(31/74)vs.16.7％(1/6),42.0％(29/69)vs.27.3％(3/11),P ＜ 0.05].The recurrence times in ER,PR and EGFR positive expression patients were significantly shorter than those in negative expression patients(P ＜0.05).The expression of EGFR had positive correlation with ER and PR(r =0.837,0.702,P ＜ 0.05).Conclusions The recurrence of uterine leiomyoma may have correlation with high expression of ER,PR and EGFR in uterine leiomyoma.

Objective To investigate the clinical efficacy of Xi-Cleft point acupuncture plus surrounding electro- acupuncture in treating occipital neuralgia.Methods Forty-eight patients with occipital neuralgia were randomly allocated to treatment and control groups, 24 cases each. The treatment group received Xi-Cleft point acupuncture plus surrounding electroacupuncture and the control group, surrounding electroacupuncture alone. The VAS score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups (P<0.05). There was a statistically significant post-treatment difference in the VAS score between the treatment and control groups (P<0.05). The total efficacy rate was 95.8% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Xi-Cleft point acupuncture plus surrounding electroacupuncture is an effective way to treat occipital neuralgia.

Objective To investigate the influence of Trisialoganglioside-GTlb combined with Edaravone Injection on clinical effect and serum related indicators in patients with acute cerebral infarction.Methods A total of 126 cases of patients with acute cerebral infarction in our hospital from October 2010 to May 2016 were selected and divided into observation group and control group,63 cases in each group.Patients in the control group were treated with regular treatment and Edaravone Injection,and patients in the observation group were treated with regular treatment,Edaravone Injection and Trisialoganglioside-GTlb.The clinical effect,NIHSS scores,Barthel index scores,serum level of neuron specific enolase (NSE),S100β protein,superoxyde dismutase (SOD),advanced oxidation protein products (AOPP) and malondiadehyde (MDA) were compared.Results The total effective rate of the observation group (90.48％) was significantly higher than that of the control group (76.19％),the difference between the two groups was statistically significant (P ＜ 0.05).After two weeks of treatment,two groups of NIHSS and Barthel index scores were significantly lower than before treatment,the difference was statistically significant (P ＜ 0.05);and the NIHSS and Barthel index scores of observation group were significantly lower than that of control group,the difference was statistically significant (P ＜ 0.05).NIHSS scores,Barthel index scores of the observation group were significantly better than that of the control group (P ＜ 0.05);The serum level of NSE,S100,AOPP,MDA of two groups after treatment were significantly lower than that before treatment,the difference was statistically significant (P ＜ 0.05);and the above indexes of the observation group was significantly lower than the control group,the difference was statistically significant (P ＜ 0.05);SOD levels of two groups were significantly increased than before treatment,the difference was statistically significant (P ＜ 0.05);and the SOD levels of observation group was significantly higher than that of control group,the difference was statistically significant (P ＜ 0.05).Conclusion Trisialoganglioside-GT1b can synergy improve the clinical effect of Edaravone Injection in patients with acute cerebral infarction,and be good to recovery the neurologic function and ability of daily living,and these may be related to the change of the serum level of NSE,S100β protein,SOD,AOPP and MDA.

Objective To explore the effects of microstructure grinded on the labial face of porcelain fused to metal crown (PFM) in esthetic prosthesis for anterior teeth. Methods 193 patients with single maxillary incisor tooth defects were repaired with 2 crowns for each one. After the crowns being blent colour and molded, the crown A was not grinded particularly on the labial face and the crown B was done according to the records of the microstructure.The patients were allowed to choose the most satisfied one when 2 crowns were cemented temporarily. Results 36 patients chose the crown A and 157 chose B.The difference was significant ( P0.05). Conclusion The crown has great vitality and accordes with the esthetic standards of the patients by way of being grinded microstructure on the labial face.

Objective To investigate the effect of calpeptin on diaphragmatic injury and atrophy under controlled mechanical ventilation in rats.Methods A total of 24 SPF Sprague-Dawley (SD) rats were randomly divided into anesthetized control group (CON group),24-hour controlled mechanical ventilation group (CMV group),and 24-hour CMV + treatment with calpeptin group (CMVC group),with 8 rats in each group.Animals in the CON group received an intraperitoneal injection of pentobarbital sodium without CMV and continuous infusion of pentobarbital sodium.A small-animal ventilator was used for 24 hours in rats of CMV group.Rats of CMVC were treated with a specific calpain inhibitor calpeptin (4 mg/kg).The drug was injected subcutaneously 2 hours before and 8,15 and 23 hours after mechanical ventilation.Changes in diaphragm ultrastructure,light microscopic picture,and myosin heavy chain (MHC) expression were observed.Results ① Alignment of myofilaments and normal Z-band,and the shape of mitochondria were maintained in CON group as revealed by electron microscope.The signs of misalignment of myofibrils,disruption of Z-band and vacuolar mitochondria were found in CMV group,and they were obviously improved in CMVC group.The density of muscle injury (× 10-2/μm2) in CMV group was significantly higher than that in control group (36.8 ± 13.7 vs.6.4 ± 6.3,t=6.373,P=0.001),and that in CMVC group was significantly lowered (17.6 ± 9.1 vs.36.8 ± 13.7,t=3.694,P=0.002).② In CON group,the diaphragm fibers appeared regular in cross section without pathologic change under light microscopy.Fuzzy muscle striations,irregular muscle fibers,centralized nuclei and swelling of capillary endothelial cells were observed in CMV group,while pathological changes in the CMVC group were milder significantly.③ In CMV group,the density of MHCslow and MHCfast was lower compared with that of CON group,and the gray value was lowered by 61.1％ (t=8.138,P=0.001) and 77.1％ (t=8.844,P=0.001),respectively,especially in MHCfast.However,the gray values of MHCslow and MHCfast were increased by 1.51 folds (t=4.601,P=0.010),and 1.33 folds (t=2.859,P=0.011),respectively,after treatment with calpeptin,and the elevation was more significantly in MHCslow.Conclusions Diaphragmatic injury and atrophy were found after CMV for 24 hour.Calpeptin could reverse the detrimental effects of CMV,and it suggested that calpain plays an important role in modulating the ventilator-induced dysfunction of the diaphragm.

Objective To explore the effect of the straight line and the auxiliary incision of lip skin on repairing unilateral incomplete cleft lip.Methods 120 cases of unilateral incomplete cleft lip repaired with the straight line method and reconstruction of the orbicularis oris muscle with the auxiliary incision of lip skin.Results 2 cases of cleft relapse by tumble.The wound of 115 children were healed one stage.3 children were healed two stage.All children didn't present vermilion deficiency.The upper lip presented natural labial groove between affected and unaffected side.Both sides of nostrils were symmetry and scars were not ovbious.Conclusion This new method was simple and effective in repairing unilateral incomplete cleft lip.

Objective To evaluate the influence of aging on left ventricular systolic and diastolic function by quantitative tissue velocity image(QTVI) and B-type natriuretic peptide (BNP). Methods Sixty healthy participants aged from 36 to 82 years old were divided into age <60 years group (32 cases) and age≥60 years old group (28 cases). Compared traditional echocardiography,QTVI and BNP between the two groups, and analysised the correlation between age and the abovementioned measurements. Results Compared age ≥60 years group with age <60 years group, the ratio of early to late mitral annulus flow velocity(E/A) (0. 92 ±0. 18 vs. 1. 28 ± 0. 18), mean of systolic mitral annulus velocity (Sm) ([6. 04 ± 0.77] cm/s vs.[6. 89 ± 1. 03] cm/s) ,mean of early diastolic mitral annulus velocity (Em) ([5. 67 ±0.99]cm/s vs. [7.29 ± 1. 11]cm/s),the ratio of Em to Am(Em/Am) (0. 79 ± 0. 13 vs. 1.18 ± 0. 33) were significantly decreased (t =5. 396,2.478,4.075,3. 535, respectively, Ps < 0. 05), whereas mean of late diastolic mitral annulus velocity (Am) ([7. 67 ±0. 80]cm/s vs. [6. 80 ± 1. 16] cm/s),the ratio of E to Em(E/Em) (14. 83 ±4.43 vs. 10. 68 ±2. 85), BNP ([51. 25 ± 12. 21] ng/L vs. [14. 15 ± 6. 68] ng/L) were significantly increased (t =-2. 268,-2.995 and-3. 523, Ps < 0.05) . Age was negatively correlated with Sm, Em, Em/Am, E/A (r =-0.411,-0. 631,-0.622,-0. 614,Ps<0.05),and age was positively correlated with Am,E/Em and BNP (r = 0.481,0.614 and 0. 684,Ps <0. 05). Conclusion Left ventricular systolic and diastolic function decreased with aging. QTVI and BNP could evaluate left ventricular function sensitively and easily.

Objective To evaluate the effect of ecoimmunonutrition on systemic inflammatory response in swine with acute necrotizing pancreatitis (ANP). Methods Swine model of ANP was induced by retrograde injection of 5% sodium taurocholate and trypsin into the pancreatic duct. 24h after the ANP models were established, eighteen swine were randomly divided into total parenteral nutrition (PN) group (n = 6), enteral nutrition (EN) group (n = 6), and ecoimmunonutrition (E1N) group (n = 6). Each of the three nutrition formulas was given to each group respectively for eight days. The level of plasma endotoxin and serum concentrations of TNF-α, IL-1β, IL-6 and IL-10 were measured before, 24 h after the induction of ANP and 1,2, 4, 8 d after nutrition support. Results 24 hours after the ANP models were established, the serum level of plasma endotoxin, TNF-α, IL-1β, IL-6 and IL-10, NF-κB activities in EIN group were ( 1.85 ± 0.18) EU/L,(461.59 ± 128.25 ) pg/ml, ( 185.49 ± 58.81 ) pg/ml, ( 354.26 ± 34.63 ) pg/ml, ( 110.32 s 25. 18 ) pg/ml,(51.06 ± 2.27 )%, respectively, which all were significantly higher than those before the ANP models were established, but there were no difference among three groups. Eight days after nutrition support, those levels in EIN group were (1.48 ±0.16 )EU/L, (30.11 ±9.12)pg/ml, (20.17 ±7.04)pg/ml, (36.42 ±7.24) pg/ml and ( 89.46 ± 13.54 ) pg/ml, (9.06 ± 0. 17 ) %, respectively, which all were significantly lower than those of TPN and EEN group ( P ＜ 0. 05 ). The ration of IL-10/IL-6 was 2.51 ± 0.42 in EIN group, and 2.28 ± 0. 19 before the ANP models were established. Conclusions EIN could attenuate endotoxemia, decrease NF-κB activities and serum concentrations of cytokines and maintained the balance of pro- and anti-inflammation.

Objective To evaluate the effect of ecoimmunonutrition on maintenance of the mucosal barrier function in pigs with severe acute pancreatitis(SAP).Methods Twenty pigs were injected with5% sodium taurocholate and trypsin into the pancreatic duct to establish SAP models.Twenty four hours later,18 suvival pigs were randomly given parenteral nutrition(PN group,n=6),elemental enteral nutrition(EEN group,n=6),or ecoimmunonutrition(EIN group,n=6)for 8 days.The serum amylase,endotoxin and intestinal permeability were determined on different times.All pigs were sacrificed 8days later,and their venous blood,mesenteric lymph nodes(MLN),liver,lung,spleen and pancreas specimens were cultured quantitatively and qualitatively with standard techniques.The morphology of small bowel was observed and pathological changes of the pancreas was analyzed.Results Serum amylase of all groups were obviously elevated,but there was no significant difference among them(P＞0.05).The plasma endotoxin and intestinal permeability were lower in EIN group[(1.50±0.18)EU/L and(42.8±20.0)×10-3 respeetively]compared to EEN group[(1.98 4±0.20)EU/L and(67.4±23.0)×10-3 respectively]and PN group[(3.96±0.40)EU/L and(197.2±47.4)×10-3.respectively](all P value＜0.05).The incidence and the magnitude of bacterial translocation in EIN group were lower than those in PN and EEN groups.However,the ileum mucosa thickness,villus height,crypt depth and the rate of the normal intestinal villi in EIN group were(398.27±52.93)μm,(269.72±41.66)μm,(681.98±58.33)μm and 79%,respectively,but in PN group were(218.32±35.81)μm,(145.76±23.34)μm,(376.20±48.23)μm and13%,respectively and in EEN group were(305.70±42.72)μm,(192.52±38.17)μm,(507.31±68.23)μm and 47%,respectively.Conclusions EIN can maintain the integrity of intestinal mucosal barrier and decreasing intestinal bacterial and endotoxin translocation in SAP pigs.