Objective To summarize the successful experience of radiodiagnosis specialist nursing model in our hospital.Methods Retrospectively analyze the course of establishment and development of radiodiagnosis specialist nursing model in our hospital.Many aspects including setting of the nursing unit,post,quota and salary,development of post responsibilities,systems,standards and procedures,establishment of quality control and performance evaluation system,standardization of the conventional specialist technology,study and application of the new specialist technology were expounded.Results Radiodiagnosis specialist nursing model had been established and improved after five years' exploration.Quality index of care,service and safety showed a steady upward trend.Specialist new technologies had prominent features.Teaching and research achieved initial success.Conclusions Establishment of radiodiagnosis specialist nursing model makes radiology nursing connotation more comprehensive.More importantly,it is of significance in guiding the development of radiodiagnosis specialist nursing.

Objective To investigate the effects of sericin pretreatment on the expression of extracellular matrix(ECM) associated protein in diabetic nephropathy(DN) rats' kidney.Methods Sixty six male SD rats were randomly divided into 3 groups(n=12):normal control group,DN model group and sericine pretreatment group.DN rats model in model group and sericine pretreatment group were established by intraperitoneally injection of streptozotocin(STZ).Blood glucose≥16.7 mmol/L was taken as the standard of successful modelization.The rats in sericine pretreatment group were lavaged with sericine(2.4 g·kg~(-1)·d~(-1)) for 35 days before injecting STZ.The enzymic method was used to measure the blood glucose.Type Ⅳ collagen(cⅣ)and laminin(LN)content in the serum were detected by ELBA.The expression of transforming growth factor-β_1,(TGF-β_1)and tissue inhibitors of maprix metalloproteinase-1(TMP-1) protein in the kidney was observed by immunohistochemical staining.The expression of Smad 3 protein in the kidney was detected by Western blot.Results Compared with normal control rats,the blood glucose,cⅣ and LN content in the serum,TGF-β_1,TIMP-1 and Smad 3 expression in the kidney of the model group rats increased obviously(P<0.01).The blood glucose,cⅣ and LN content in the serum,TGF-β_1,TMP-1 and Smad3 expression in the kidney of rats in sericine pretreatment group were significantly lower than those of the rats in model group(P<0.01).Conclusion Sericin pretreatment can inhibit the activation of TGF-β/Smad 3 signal pathway in the kidney of DN rats,and prevent the decrease of MMPs activity induced by up-regulation of TIMP-1.So sericin can prevent accumulation of ECM and glomerulosclerosis during DN,and has satisfactory apotropaic effects on the development of DN.

Objective To develop subjective well-being simplify scale (SWBSS),and examine its reliability and validity.Methods A self-report SWBSS containing 13 items was developed on college student and research literature.2374 college students completed SWBSS,Index of Well-Being(IWB),World Health of Organization Quality of Life Brief Scale (WHOQOL-BREF),Beck Depression Rating Scale (BDI) and Self-rating Anxiety Scale(SAS).Results ①Exploratory factor analysis results showed that SWBSS had 1 factor,and accounted for 41.768％ of variance.②Confirmatory factor analysis results indicated that x2/df =2.208,RMR =0.016,RMSEA =0.032 ; GFI =0.986,AGFI =0.974,NFI =0.978,RFI =0.966,IFI =0.988,TLI =0.981,CFI =0.988 ; PGFI =0.552,PNFI =0.639,PCFI =0.646 ; construct reliability =0.901.③The Cronbach'α coefficient,split-half reliability,stability coefficient of SWBSS was 0.876,0.817 and 0.740 (P ＜ 0.01).The SWBSS scores was significantly correlated with the scores of IWB,WHOQOL-BREF,BDI and SAS (r =0.706 ～ 0.892,r =-0.650 ～-0.580,P＜0.01).Conclusion The stability,internal consistency,and validity of the SWBSS are good and meet with psychometric standard.

Objective:To study the effects of PRF and recombinant hPDGF-AB,TGF-β1 and VEGF on the proliferation and adhe-sion of rat adipose tissue-derived stem cells(ADSCs)in vitro.Methods:ADSCs were cultured with PRF membrane and various do-ses of PDGF-AB,TGF-β1 and VEGF,cell adhesion was examined by adhesion assay after 2 culture,cell proliferation was examined by CCK-8 kit after 1 -7 d culture.Results:Cell adhesion assay showed that the adhesive numbers of rat ADSCs in PRF group were significantly higher than those in the negative group(P <0.05).The adhesive numbers of the ADSCs treated by PDGF-AB showed no significantly difference among different concentration groups(P >0.05).The adhesive numbers of the ADSCs treated by VEGF or TGF-β1 at different concentrations showed significant difference(P <0.05).CCK-8 kit assay showed that at different time points, the A values of ADSCs in PRF group were significantly higher than those of the negative control group(P <0.05).The A values of ADSCs in VEGF or PDGF-AB groups at different concentrations showed significant difference(P <0.05).The A values of rat AD-SCs in TGF-β1 group at different concentrations were lower than those in the negative control group(P <0.05).Conclusion:PRF as a combination of growth factors may stimulate the proliferation and adhesion of rat ADSCs in vitro.PDGF-AB and VEGF may stim-ulate the proliferation of rat ADSCs.TGF-β1 and VEGF may stimulate the adhesion of rat ADSCs in a dose-response manner to some degree.

Objective To study the effects of traditional Chinese medicine (TCM) five-tone therapy on nursing care of patients with irritable bowel syndrome (IBS).Methods By convenience sampling,a study was conducted among 100 patients with IBS.The patients were randomly divided into the control group and the intervention group,each group consisted of 50 patients.Patients in two groups were both treated with conventional drug and routine nursing care,but patients in the intervention group were intervened by TCM five-tone therapy for 3 months.Clinical efficiency of patients in two groups were assessed by Symptoms Check List-90 (SCL-90),Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD)before treatment and after 12-week treatment.Results The clinical efficiency in the control group and intervention group were 60％ (30/50) and 84％ (42/50) after intervention (P＜0.05).The scores of HAMA and HAMD after TCM five-tone therapy intervened were (5.24±1.15)points and (5.21±1.63) points,which were lower than the control group (8.32±1.42)points and (7.64±1.96) points (P＜0.05).The intervention group was scored lower than the control group in SCL-90 (P＜0.05).Conclusions TCM five-tone therapy may be more effective in decreasing the depression and anxiety of patients with IBS and alleviating their abdominal symptoms.

Objective To know about the current status of the work engagement of the clinical nurses and its influencing factors,to explore the influencing factors of work engagement of clinical nurses so as to provide basis for improving the level of the work engagement of the clinical nurses.Methods The work engagement scale,hardiness scale,role pressure scale,perceived organizational support scale and questionnaire of family care index were used to investigate a total of 630 clinical nurses.The results were analyzed.Results The average score of work engagement,hardiness,role pressure and perceived organizational support were showed respectively as following:(3.28±0.51),(2.60±0.53),(3.00±0.50),(3.43± 1.04) scores.Clinical nurses number of the total point between 7 and 10 of family support accounted for 70.9％(447/630).Hardiness,perceived organizational support,family support and work engagement were in obvious positive correlation,whereas role pressure was in obvious negative correlation with work engagement.Hierarchical regression analysis showed after the variable of demographic was controlled,the hardiness and perceived organizational support respectively had significant positive predictive function on work engagement as respective independent variables.Role pressure had obvious negative predicative function on work engagement.Conclusions Hospital managers should create a good working environment for clinical nurses,measures should be taken from individual and organizational aspects so as to improve the hardiness and perceived organizational support,reduce role pressure and the work positivity of the clinical nurses,so that the nurse more positively devoted to their work.It has important practical significance to improving the quality of their services and stabilizing nursing troop.

Objective To explore the effects of traditional Chinese medicine (TCM) five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention on patients with irritable bowel syndrome (IBS). Methods By convenience sampling, a study was conducted among 68 patients with IBS. The patients were divided into the control group and the intervention group by random digital table method, and each group consisted of 34 patients. Patients in two groups were both treated with conventional drug and routine nursing care, but patients in the intervention group were provided TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention for 3 months. Patients in two groups were assessed by Chinese Medicine Constitution Questionnaire (CMCQ), Symptom Check List-90 (SCL-90), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) before treatment and after 12-week treatment. Results After TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention, the number of IBS patients with pathological constitution types decreased in two groups, the number of patients with gentleness constitution increased to 8 and 25 separately in the control group and intervention group (P<0.05). After intervention, the scores of SAS and SDS in the intervention group were (40.73±8.27)points and (41.16±8.75)points respectively, which were lower than(48.36±7.53)points and(50.03±9.23)points of the control group, and the difference was statistically significant (P< 0.05). The intervention group scored lower than the control group in SCL-90, and the scores had significant differences between two groups (P<0.05). Conclusions TCM five-tone therapy in combination with constitutional types of Chinese medicine based dietary intervention may be more effective in adjusting pathological constitution to gentleness constitution of patients with IBS, alleviating their depression and anxiety and improving their physiological symptoms.

Objective To outline the research fronts of ten major sub-specialties in internal medicine.Methods Based on their impact factor scores and the proportion of the journals of 10 subspecialties (endocrinology & metabolism,cardiac & cardiovascular systems,hematology,infectious diseases,nephrology,gastroenterology & hepatology,respiratory system,rheumatology,critical care medicine,clinical neurology) in Journal Citation Report (JCR),and careful consulation of expert clinicians,we identified 50 journals.Their bibliographic records (including references) published in 2011 were downloaded,and the frequency of the references (citations) in each sub-specialty was counted and the highly cited records were extracted.We performed a clustering analysis according to the co-cited times among any pairs of the highly cited records.To tag each cluster of highly cited records,we browsed the titles and abstracts of all highly cited records in the same cluster,and concluded the main topics of each cluster.Finally,we extracted the current published papers devoted to particular cluster by some clustering analysis indicators.The clusters of highly cited records were considered as the intelligence base,and the main topics in current papers which citing these highly cited papers were considered as research fronts.Results Totally 50 journals on 10 sub-specialties in internal medicine were identified.A total of 202 highly cited papers,38 clusters (knowledge bases),and 152 corresponding current citing papers presenting the research fronts were selected.Conclusions We confirm and present research fronts in 10 major sub-specialties of internal medicine.This study provides a synchronic structure of contemporary research activities in internal medicine sub-specialties.

Objective To compare the application and clinical significance of the liquid based cytology examination and the DNA quantitative analysis in female cervical lesions.Methods The cervical cell samples were collected from 879 women participating in the comparison by the cervical brush and performed the the liquid-based thin layer section preparation for conducting Papanicolaou staining and DNA staining respectively.The liquid based cytology examination was performed on the Papanicolaou staining section and the fully automatic scanning diagnosis was performed on the DNA staining section.Results The cases of above atypical squa-mous cells of undetermined significance(ASCUS)detected by the liquid based cytology examination and the partial cases of hetero-ploid cell detected by the fully automated DNA ploidy analysis system were recommended to further perform colposcopy and cervi-cal biopsy.28 women were performed the pathological biopsy.With the cytological examination result as the standard,the detection rate of above ASCUS cervical lesions detected by the cellular DNA quantitative analysis was calculated.Conclusion The combined application of the cellular DNA quantitative analysis method and the liquid based cytology examination can obviously increase the positive detection rate of cervical cancer and precancerous lesion,which has important significance for the prevention and treatment of female cervical cancer in our country.

Objective To develop a nurse-driven analgesia and sedation management plan and determine whether the protocol leads positive results.Methods This was a before and after protocol implementation study in 2 pediatric intensive care units of 2 tertiary care hospitals.A total of 77 medical pediatric patients requiring mechanical ventilation with pediatric intensive care unit (PICU) length of stay for at least 24 h were included.Prior to implementation of the protocol,analgesia and sedation was managed by the attending physician's order.Afterwards,post implementation,nurses managed analgesia and sedation following the protocol,including maximum human care,complying the same sedation objective,ordination of the speed according to Comfort Scale and Withdrawal Assessment Tool.Results Before the implementation of protocol,the amount of murphy equivalent was (18.51 ± 13.34) mg/kg,the amount and time of Midazolam were (26.29 ± 13.58) mg/kg and (137.31 ± 104.78) h respectively,mechanical ventilation time was (174.00±90.17)h and time of PICU stay was (12.28 ± 8.86) d;after the implementation of protocol the indexes were (11.46 ± 15.97) mg/kg,(12.01 ± 10.06) mg/kg,(99.44 ±47.29) h,(111.15 ± 58.82) h,(10.88 ± 7.68) d,and there were significant differences (t=0.743-2.595,P＜0.05).The incidence of withdrawal after the implementation of protocol (19.44％,7/36) was significantly lower than that before the implementation of protocol (4.88％,2/41),and there was significant difference (x2=3.940,P＜ 0.05).The coincidence of sedation assessment of after the implementation of protocol was 93.33％ (126/135),that of before the implementation of protocol was 83.67％ (82/98),and there was significant difference (x2=5.532,P＜0.05).Conclusions The plan takes "early analgesia,minimizing sedation,maximizing human concern" as the guiding ideology,and strives to achieve the goal of sedation individualization,clarification of medical and nursing responsibilities,continuity of medical communication,standardization of drug selection and regulation,routinization of withdrawal procedures,routinization of evaluation records,and the management of analgesia and sedation is included in the department.In the key projects of nursing quality management,we should institutionalize the implementation process management.The implementation of the program improves the comfort level of children,thus reducing the stress state of children,reducing the incidence of withdrawal symptoms and unplanned extubation,and ultimately reducing drug consumption and mechanical ventilation time.