The basic nursing quality is an important dial of the general administration level and the basic personnel quality of a hospital.Many causes have led to the down trend of the basic nursing quali- ty.After a specific analysis of the causes of such a trend,important measures and solutions have been put forth,The first is to strengthen the moral education of the profession and upgrade the quality of the nursing staff.The second is to adopt the "group responsibility" administration and gradually carry out a systimatic integrated nursing so that a transformation of nursing models is put to practice,The third is to broaden the outlet of human resources so that personnel are rationally employed and the rate of job— taking raised.The last one is to heighten the initiative of the nursing staff through the rational opera- tion of the "incentive"mechanism in accordance with the law of values.

Objective To evaluate the value of transvaginal two-dimensional ultrasound(2D-TVS)and transvaginal three-dimensional ultrasound (3D-TVS) in the diagnosis of intrauterine lesions with abnormal uterine bleeding.Methods Intrauterine lesions for 171 patients underwent 2D-TVS followed by 3D-TVS in the same session.Within 10 days of the sonographic session,each patient underwent pathologic histology examination after hysteroscopy examination or surgery therapy,which was considered the reference standard.For each of the two imaging methods,sensitivity,specificity,and accuracy were calculated.Results The results of 2D-TVS and 3D-TVS had good agreement with pathological results in endometrial hyperplasia,endometrial polyps,uterus submucous myoma and endometrial cancer.For 2D-TVS,sensitivity was 84.5％,71.4％,86.8％,66.7％,and specificity was 86.7％,90.7％,97.0％,98.7％,respectively; For 3D-TVS,sensitivity was 91.4％,87.3％,92.1％,83.3％,and specificity was 93.8％,96.3 ％,97.7 ％,98.7 ％,respectively.The diagnose accordance rate of the 3D-TVS for intrauterine lesions was statistically higher than that of the 2D-TVS (89.5％ vs 78.9％,P ＜0.05).Conclusions The sensitivity and diagnose accordance rate of 3D-TVS was higher than that by 2D-TVS,3D-TVS plays an important role in the diagnosis and differential diagnosis of intrauterine lesions.

Objective To examine the reliability and validity of Chinese version of the achievement goal questionnaire(AGQ).Methods The English version of the AGQ was translated into Chinese which was then translated into English again to verify that the Chinese version was the same constructs as the original version.Stratified chester sampling method was used for 1115 university students.Additionally,internal consistency,test-retest and confirmatory factor analyses were analyzed.Results (1) All of the NFI (0.941),CFI (0.953),TLI (0.924),x2/df (2.386),REMEA (0.046) met the criteria standards for adequacy of fit.The factors loadings ranged from 0.47 to 0.93 ; the squared multiple correlations were 0.22-0.86.(2) The invariance of the AGQ across gender was supported.(3)The Cronbach's α coefficient of the AGQ was 0.83;the test-reliability coefficient was 0.77 ;the mean interitem correlation coefficients ranged from 0.40 to 0.57.(4) The correlation coefficients of the four factors with the total scale score ranged from 0.54 to 0.77,and the correlation coefficients among the four factors ranged from 0.06 to 0.61.Performance approach and master approach goal was significantly positive correlations with self-esteem.Performance avoidance and mastery avoidance goal was significantly negative correlations with self-esteem,but positively with anxiety.Master approach goal was significantly negative correlations with anxiety.Conclusion The Chinese version of the AGQ is a reliable and valid method for assessing achievement goal in Chinese-speaking sample.

Objective: Our aim was to study whether the cellular bronchoalveolar lavage fluid (BALF) profile was associated with the parameters of pulmonary function tests. Methods：Lung function tests and BAL were carried out in 18 untreated, non-smoking patients suffering from sarcoidosis and 18 normal subjects. Results：（1）Lung function tests were normal at rest in patients with sarcoidosis（P＞0.05）, the single breath carbon monoxide diffusing capacity decreased (P＜0.05)，and the small airway function decreased too (P＜0.05).（2）The percentage of lymphocytes in BALF of sarcoidosis increased comparing with the normal subjects（P＜0.01），and the ratio of CD+4 to CD+8 in BALF increased significantly in sarcoidosis（P ＜0.05）, furthermore, the increase of both the percentage of lymphocytes and the ratio of CD+4 to CD+8 in BALF of sarcoidosis were well nagatively correlated with the decrease of the percentage of DLCO (r=-0.67, P＜0.01 and r=-0.55, P＜0.05, respectively), the decrease of mid-expiratory flow at 50% of vital capacity (FEF50%) was well correlated with the increase of the percentage of lymphocytes in BALF of sarcoidosis (r=-0.54, P＜0.05). Conclusion：Pulmonary diffusing capacity（DLCO) was significently correlated with BALF lymphocyte phenotype，so was small airway function，and can act as the marker of activity of sarcoidosis.

AIM: To investigate the effects of Lipopolysaccharide(LPS) and interieukin 1 receptor antagonist (IL- 1ra) on mesangial cells proliferation and nitric oxide synthesis. METHODS: Glomerular mesangial cells from SD rats were cultured. The first and second passages of cultured cells were used for the experiment. LPS and LPS plus IL- 1ra were added in cell cultures, respectively. By using chemical method the nitrite in supernatants was measured ,3H- TaR incorporation was determined to evaluate the GMC proliferation. Northern and slot hybridizations were performed to detect the expression of iNOS mRNA. RESULTS: There were expression of iNOS mRNA, more production of nitrite(0.64 + 0.25 vs 0. 12 + 0.06 nmol/104 cell) in supernatants and GMC proliferation(3735 + 1177.9 vs 1785 + 280.6) in LPS group compared to the control. While compared with LPS group, in LPS + IL- 1ra GMC group, expression of iNOS mRNA decreased by 40%, nitrite increased(3.28 + 0.33 nmol/104 cell), proliferation of GMC decreased (818 + 77.27). CONCLUSION: LPS could activate the GMC to express iNOS mRNA and produce more nitrite. IL - 1ra could partially inhibit the effects of LPS on the expression of iNOS mRNA in GMC, but not nitrite. There is no synchronous correlation between NO production and GMC proliferation.

Objective: To study the pharmacological action and clinical curative effect of Linglongqingre microenema. Methods: The actions of relieving fever and calming hypnotism. anti convulsions of Linglongqingre Microenema on rabbit, mouse and rat were observed. Also children's fever illess was treated to judge preliminary curative effect. Results: Linglongqingre Microenema has obvious action of relieving fever, more effective than Chaihu injection, as same as Antipyrine (80mg/kg) on subcutaneous injection. It was used to treat children's feverillness on 38 cases, markedly effective rate 60.53%, total effective rate 86.84%. Among them body temperature of one third case fell over 1.5?C in two hours. Conclusion: Linglongqingre microenema is a new quick effective pharmaceutical preparation which is suitable for emergency treatment of traditional Chinese medicine

Objective: To establish a method for controlling the quality of Agkistrodon halys's crude venom. Methods: The method of PAGE was carried out to identificate the Agkistrodon halys' crude venom, And the protein of crude venom was also assayed by Lowry's method. Results: The Agkistrodon halys's crude venom could be identified by the method of PAGE. The determintion of protein of crude venom showed a good linear relationship in a concentration range of 25 ?g?mL -1 ～250?g?mL -1 , the regression equation was Y=0.0147+ 1.4553X , and the correlation coefficient was 0.9992. The average recovery of the content reached 100.09, RSD=1.765(n=6). Conclusion: The method is simple, feasible, accurate and available, can be used to controlling of the quality of Agkistrodon halys's crude venom.

Objective To explore the effect of xuezhikang on blood lipids,vascular endothelial function and redox balance in patients with carotid atherosclerosis.Methods A total of 108 inpatients with carotid atherosclerosis in cardiology department were randomly divided into two groups:xuezhikang group (n = 54) and cholestyramin group (n= 54).Before and after treatment,the levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),nitric oxide (NO),endothelin-1 (ET-1),reduced glutathione (GSH) and oxidized glutathione (GSSG) of all patients were measured.The GSH/GSSG as redox potentials were calculated according to Nernst equation.Results After 12 weeks of treatment,the levels of blood lipids were lower than before treatment in xuezhikang group [TC:(3.94±1.36) mmol/L vs.(5.68±1.47) mmol/L;LDL-C:(2.28±1.11) mmol/L vs.(3.43±1.36) mmol/L;TG:(1.54±0.59) mmol/L vs.(1.73±0.66)mmol/L;t=3.915,4.160,2.187;P<0.01,0.01,0.05,respectively],and the levels of blood lipids also decreased in cholestyramin group [TC:(4.15 ± 1.29) mmol/L vs.(5.73 ± 1.52)mmol/L;LDLC:(2.56± 1.06) mmol/L vs.(3.37± 1.35) mmol/L;TG:(1.69±0.57) mmol/L vs.(1.72±0.67) mmol/L;t=3.760,4.035,1.893;P<0.01,0.01,>0.05,respectively].In xuezhikang group,ET-1,GSSG and GSSG/GSH ratios decreased significantly [(121.71 + 59.11) ng/L vs.(154.43±63.06) ng/L;(30.42± 1.59) μmol/L vs.(33.93±1.74) μ mol/L;-146.1±4.4vs.-142.3±4.3;t=2.168,2.325,4.168;P<0.05,0.05,0.01,respectively],and NO,NO/ET-1 ratios,GSH and GSH/GSSG increased significantly [(64.40 ± 18.86) μmol/L vs.(48.41 ±16.53) μmol/L;(0.54±0.19) vs.(0.33±0.16);(321.27±56.47) μmol/L vs.(286.11±38.23)μmol/L;(10.56±1.70) vs.(8.65±1.18);t=3.725,3.987,3.894,4.168;all P<0.01].Conclusions For patients with carotid atherosclerosis,both xuezhikang and cholestyramin could lower blood lipids efficiently,but only xuezhikang could protect vascular endothelial function partly,and makes plasma redox imbalance shift the balance.

ObjectiveTo investigate the extracorporeal clearance rate of imipenem in severe infection patients in the mode of continuous vena-venous hemofiltration (CVVH) during continuous renal replacement therapy (CRRT), in order to approach if the concentration of imipenem in plasma could achieve effective levels of anti-infection, and to explore the effect of time and anticoagulation measure on imipenem clearance during CRRT treatment.Methods A prospective observational study was conducted. All adult severe infection patients complicating acute kidney injury (AKI) in the Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University from March 2013 to September 2014, who were prescribed imipenem as part of their required medical care, and CRRT for treatment of AKI were enrolled. 0.5 g doses of imipenem was administered intravenously every 6 hours or 8 hours according to random number table, and infused over 0.5 hour. The unfractionated heparin was used for anticoagulation in the patients without contraindications, and no anticoagulation strategy was used in the patients with high risk of bleeding. At 24 hours after first time of administration, postfilter venous blood and ultrafiltrate samples were collected at 0, 0.25, 0.5, 0.75, 1, 2, 5, 6, and 8 hours after imipenem administration. The concentration of imipenem in above samples was determined with liquid chromatography-mass spectrometer/mass spectrometer (LC-MS/MS).Results A total of 25 patients were enrolled. Thirteen patients received imipenem intravenously every 6 hours, and 12 patients, every 8 hours. The anticoagulation was conducted with heparin in 13 cases, and 12 cases without anticoagulation. The intra-day precision, inter-day precision, matrix effect, and recovery rate in low, medium, and high concentration of plasma and ultrafiltrate, and the stability of samples under different conditions showed a good result, the error of accuracy was controlled in the range of±15%. With the application of Prismaflex blood filtration system and AN69-M100 filter, under the mode with CVVH, the total clearance rate of imipenem was (8.874±2.828) L/h when the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1, the total CRRT clearance rate of imipenem in vitro was (2.211±0.539) L/h, which accounting for (30.1±15.7)% of the total drug clearance. In 6 hours interval dosage regimen, the percentages of the time> 4×minimum inhibitory concentration (MIC) at specific 4×MIC of 2, 4, 6, and 8μg/mL of imipenem were more than 40% of the dosing interval. But in the 8 hours interval dosage regimen, when the level was above the 4×MIC of 4μg/mL, maintaining time would drop below 40% of the dosing interval, with significant differences compared with that in 6 hours interval dosage regimen [4×MIC = 2μg/mL: (60.84±20.25)%vs. (94.01±12.46)%,t = 4.977,P = 0.001; 4×MIC = 4μg/mL: (39.85±15.88)% vs. (68.74±9.57)%,t = 5.562, P = 0.000; 4×MIC = 6μg/mL: (27.58±13.70)% vs. (53.97±8.36)%,t = 5.867,P = 0.000; 4×MIC = 8μg/mL:(18.87±12.43)% vs. (43.48±7.83)%,t = 5.976,P = 0.000]. No significant change in sieving coefficient of imipenem was found within a short time (6 hours), which indicated that there was no effect of anticoagulation on clearance of imipenem by AN69-M100 filter, and no statistical significance was found with repeated measure analysis (F = 0.186, P> 0.05).ConclusionsThe clearance rate of imipenem is increased significantly in vitro under the mode of CVVH with the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1 in severe infective patients with severe sepsis complicating AKI, affecting the level of plasma drug concentration, need to adjust the dosage regimen. When the time of the dosing interval was shortened, the concentration of imipenem in patients' plasma could be increased significantly. In a short period of time, the sieving coefficient of imipenem through AN69 filter is not affected by anticoagulation measures and time cleaning efficiency will not decline.