Objective The main purpose of this study was to discuss the current situation of our nursing education from the perspective of educate,and to provide enlightenment for the higher nursing education reform.Methods The current situation of the development of nursing education questionnaire was adopted to conduct the survey.Results Nursing education in our country faced with the problems such as imperfection of the education concept,lack of humanistic curriculum,less practice classes,theory was divorced from practice,single evaluation tools of teaching.Conclusions Our country should carry on the reform of education mode,build international nursing personnel training system,improve the training quality and competition of nursing personnel.

Henoch-Sch?nlein purpura(HSP)is an IgA-associated leukocytoclastic small-vessel vasculitis, commonly occurred in children.Recent studies have shown that its pathogenesis is closely related to the disturbance of humoral immune response mediated by B cells.CD4 + T cells have the function of help B cells.Each subgroup of CD4 + T cells has unique functions of promoting or regulating immune inflammatory response.There are abnormal changes in the proportion of CD4 + T cells subsets in HSP patients, including the imbalance of Th1/Th2, increasing numbers of Th17 and Tfh cells, together with decreasing Treg cell numbers.The changes are closely related to the occurrence, development and the clinical phenotype of HSP.It is suggested that the detection of CD4 + T cells plays critical roles in guiding the evaluation of HSP, and is expected to provide a new idea for the clinical diagnosis and individualized treatment of HSP.

Objective To investigate the effects of keratinocyte growth factor on peritoneal adhesion formation in rats. Methods Thirty Sprague-Dawley( SD) female rats were randomly assigned to 3 groups, KGF group( n = 10), positive control group (n = 10) , and negative control group (n = 10). Seven days after surgery, rats were killed and the adhesion degree was evaluated by Leach scale. Immunohistochemical technique was used to identify the expression of tPA and PAI-1. Stained with HE,the histomorphology changes of the adhesion tissue were observed by light microscope. Picrosirius-polarization method was used to observe the expression of type Ⅰ or Ⅲ collagens in two groups. Results In the KGF group,lower collagen fibers were noted and the gross adhesion scores was significantly lower than that in positive control group (4. 8 ± 1. 0 vs 7. 6 ± 1. 0; t = 5.422; P ＜ 0. 01). The expression level of type Ⅰ collagens was significantly lower in the KGF group than in positive control group (69 ±11 versus 55 ±9;t = 3. 214 ;P ＜0. 01) ,but there was no significant difference in the expression of type Ⅲ collagens among the two groups (48 ± 7 versus 50 ± 10; t = 0. 481; P ＞ 0. 05). The immunohistochemistry showed that the expression of tPA significantly increased in the KGF group than in positive control group and negative control group(88 ±4.0 versus 112 ±4.0, 101 ±2.0;F = 109. l,P＜0. 01) , However, no statistically significant difference for the expression of PAI-1 was noted among the three groups ( F = 1. 391, P ＞ 0. 05). Conclusions Keratinocyte growth factor promotes mesothelium repair, increases mesothelial fibrinolytic activity, inhibits the deposition of collagen and reduces the intensity of postoperative adhesions.

Objective To evaluate the effect of surgical treatment for primary hepatocellular carcinoma(HCC) with bile duct thrombi(BDT).Methods Eleven cases were diagnosed as HCC with BDT by B ultrasound,CT,MRCP or ERCP.Hepatectomy and choledochotomy were performed,resecting the primary tumor and cleaning the BDT completely,followed with TACE.Results No patients died during operation.The survival time of 9 patients who received hepatectomy and BDT clearance ranged from 3 to 38(average 18.5) months,and that of the other two patients received TACE and BDT clearance survived 6 and 11 months respectively.Conclusion Accurate diagnosis and radical hepatectomy with complete BDT clearance are effective treatment for HCC with BDT.

Objective:To understand the drug purchase behaviors and prescription flows of outpatients and their influencing factors. Methods: After selecting and investigating tertiary hospitals, secondary hospitals, community health service centers ( one per each level) in Beijing, Zhengzhou, Guangzhou, this paper uses structured question-naire method to analyze 3,155 valid questionnaires. A logistic regression analysis is performed to understand the fac-tors influencing the drug purchase behaviors. Results:The factors influencing the drug purchase behaviors of outpa-tients mainly include the region where the patient is, level of the hospital, type of health insurance that the patient has, frequency of drug purchase, etc. Conclusions: This paper suggests hospital administrators to take measures to improve prescription flows, such as reforming the health care insurance to make payment system more suitable for pharmacies standardizing supply channels in order to make varieties consistent between hospitals and pharmacies, strengthening education and publicity to raise the outpatients’ awareness for drug purchase outside of hospitals, etc.

Background and purpose: Cervical cancer is one of the most common malignant tumors and poses a great threat to women's fitness. Monitoring its present status and variations over the past 3 decades could provide scientific basis for prevention and control strategies of cervical cancer in China. Methods: This study collected the mortality rates of cervical cancer data in Chinese women from 1987 to 2014, described the features and trends of age-standardized rates and truncated rates, and estimated the variations via joinpoint regression models. Results:The mortality rates of cervical cancer for rural women were roughly higher than those for urban women. It showed downward trends for both urban and rural women, and the average rate of decrease for rural women (AAPC=3.94％, P<0.01) was higher than that for urban women (AAPC=1.79％, P<0.01). The gap between urban and rural areas was narrowing, with urban rates exceeding rural rates after 2010. The mortality rates of cervical cancer increased with time for urban women aged from 30 to 54, decreased with time for the elderly urban women and all the rural women. Conclusion: The overall mortality rates of cervical cancer took a desirable turn in China over the past 3 decades, while the status for the middle-aged urban women was getting worse as well as the elderly in both urban and rural areas during the past 10 years.

OBJECTIVE:To optimize extraction technology of polysaccharides from Stemona tuberosa so as to increase the ex-traction rate and efficiency. METHODS:Anthrone-sulfuric acid method was used for detection. With water and alkaline water (NaOH solution)as the solvent respectively,the effects of decocting method,ultrasound method and microwave method on the ex-traction rate of crude polysaccharide were observed respectively. By carrying out single factor and orthogonal tests,with the extrac-tion rate of crude polysaccharide as the index,the effects of the amount of water,NaOH solution concentration,extraction tempera-ture and extraction time on the extraction of crude polysaccharide by alkaline water ultrasound method were observed to optimize the technology parameters,and verification test was conducted. RESULTS:The alkaline water ultrasound method is superior to oth-er extraction methods,where the optimal technology parameters were as follows as 0.3 mol/L NaOH aqueous solution 30 times as much as the amount of crud drug,ultrasonic processing for 70 min at 50 ℃. The verification tests showed that the average extrac-tion rate of crude polysaccharide was 25.76%(RSD=3.51%,n=6). CONCLUSIONS:The optimal alkaline water ultrasound method can better extract crude polysaccharide from S. tuberosa.

Objective To construct the recombinant plasmid containing human filaggrin gene,purify and identify the immunoreactivity of the recombinant protein,and establish the indirect ELISA to detect AFA for diagnosis of RA.Methods The constructed plasmids were transformed into E. Coli Rosettagami(DE3).This fusion protein was purified by NAT chromatography.ELISA coated with the fusion protein Was established to detect the AFA in serum of patients,which included 114 cases of RA,56 cases of SLE,32 cases of OA and 40 cases of normal controls. The correlation between the results of AFA and anti-CCP in RA group were compared. Results 321 bp fragment of filaggrin gene was amplified and the recombinant expression vector pET-28a( + )-filaggrin was constructed. The sequence of filaggrin gene was the same as the sequence reported in the literatures. The Rosetta-gami (DE3) strains of E. Coli with recombinant vector showed high level of filaggrin protein after induction. The SDS-PAGE showed that the plasmid expressed the filaggrin fusion protein with molecule weight of 14 000 Da. The expression protein could be purified by Ni-NAT with activity. The absorbance value of AFA in RA group was 0.473 ±0. 248 while they were 0. 160 0. 088, 0. 121±0. 070, 0.050 0. ±018 in SLE, OA and normal groups respectively. There were significant differences of absorbance values of AFA between RA and SLE, OA, control group (t = 12.004, 14. 464, 18.078, P<0. 01, respectively). The positivities of anti-filaggrin in RA, SLE and OA were 48.2%, 5.4% and 3. 1% respectively. The positivities of AFA were significantly different between RA, OA and normal control groups (x~2 = 67. 088, P < 0. 01). There was positive correlation of results between AFA and anti-CCP antibody (r = 0.42, P < 0. 05 ) . The consistency rate of results between AFA and anti-CCP was 70. 1%. Anti-CCP was negative in 10 out of 114 patients with AFA positive. AFA can be used to diagnose RA with sensitivity of 48. 2% , specificity of 96.9% , positive predictive value of 93. 2% and negative predictive values of 67. 9% . Conclusions The purified human filaggrin fusion protein is successfully purified. The indirect ELISA method based on the recombinant protein shows good sensitivity and specificity. Joint detection with AFA and anti-CCP can improve the positive rate of detection.

Objective To investigate the effects of ulinastatin (UTI) combined with magnesium isoglycyrrhizinate (MgIG) on the expression of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) in lung tis?sue of rats with pulmonary fibrosis induced by bleomycin (BLM). Methods Ninety Wistar rats were randomly divided into five groups: BLM group, methylprednisolone (MTH) group, UTI group, MgIG group and UTI combined with MgIG (UTI+MgIG) group, n=18 for each group. The rat model of pulmonary fibrosis was established by injecting bleomycin through tra?chea in five groups. Twenty-four hours after treatment with BLM,rats were treated with normal saline every day in BLM group, and rats were treated by corresponding drugs in other groups. Six rats of each group were killed at the 7th,14th and 28th day respectively. The pathological changes of alveolitis and pulmonary fibrosis were evaluated by HE staining, and ex?pression levels of TGF-β1 and CTGF in lung tissues were detected by immunohistochemistry method. Results (1) Com?pared with BLM group, the degree of alveolitis and pulmonary fibrosis was reduced in other groups. There was significant dif?ference in alveolitis at the 7th and 14th day between UTI+MgIG group and BLM group. And there was significant difference in pulmonary fibrosis at the 14th and 28th day between UTI+MgIG group and BLM group (P<0.05). (2) Compared with BLM group, the expression levels of TGF-β1 and CTGF were decreased in other groups. In UTI+MgIG group, the expres?sion levels of TGF-β1 were significantly lower at the 7th and 14th day compared with those in UTI group and MgIG group, and which were significantly lower at the 28th day than those in MTH group, UTI group and MgIG group (P<0.05). The ex?pression levels of CTGF were significantly lower at the 7th day in UTI + MgIG group than those in UTI group and MgIG group, and which were significantly lower at the 14th and 28th day than those in MTH group, UTI group and MgIG group (P<0.05). Conclusion The combination of UTI and MgIG can alleviate alveolitis and fibrosis in BLM-induced pulmonary fibrosis rats, which might related with the down-regulation of TGF-β1 and CTGF expressions.

Objective To evaluate the efficacy of routine extraluminal use of an Arndt endobronchial blocker (AEB) for one-lung ventilation (OLV) in infants.Methods Thirty American Society of Anesthesiologists physical status Ⅰ or Ⅱ infants,aged 6-36 months,weighing 5-18 kg,undergoing elective thoracoscopic surgery,were enrolled in the study.The loop of AEB was fastened to the front of the endotracheal tube (ETT),and the blocker was placed externally to the ETT.After induction of general anesthesia,the AEB's placement was facilitated through the use of a fibreoptic bronchoscope.Mean arterial pressure,heart rate,end-tidal pressure of carbon dioxide,oxygen saturation and airway pressure were recorded before AEB placement (T1),during AEB placement (T2),at the beginning of OLV (T3),at the beginning of two lung ventilation (T4) and at extubation (T5).The AEB placement time and successful placement and lung collapse time were recorded.The satisfaction with lung collapse,AEB shifting,hoarseness and development of intraoperative adverse cardiovascular events and hypoxemia and hypoventilation during OLV were recorded.Results Compared with the baseline at T1,no significant change was found in heart rate or mean arterial pressure at the other time points (P＞ 0.05),airway pressure was significantly increased at T2,3,and end-tidal pressure of carbon dioxide was increased at T4 (P＜0.05).The AEB placement time was (5.6± 1.2) min,the success rate of AEB placement 93％,the rate of satisfaction with lung collapse 83％,and the incidence of AEB shifting (only found in the pediatric patients in whom AEBs were placed on the right side) 13％.No intraoperative adverse cardiovascular events,hypoxemia or hypoventilation was observed in the pediatric patients in whom AEBs were successfully placed.Conclusion Routine extraluminal use of an AEB can provide a fast,safe and effective method for OLV in infants.