Obejective To analyze the related papers on nursing competency in China from 2004 to2014,and to learn the current status and developing trends of nursing competency,so as to provide reference for further research and development of nursing competency.Methods All literature related to nursing competency from 2004 to 2014 were searched in the China National Knowledge Infrastructure(CNKI),VIP Database for Chinese Technical Periodicals (VIP),and Wanfang database.Bibliometric analysis methods were used to analyze the distribution time,area,journal distribution and research categories by using Microsoft Excel.Results Totally 199 articles related to nursing competency were collected and the number of publications increased in recent years.About 78.89％ (157/199) papers were published in the statistical source journal and 34.17％ (68/199) papers were focused on survey research about nursing competency.Conclusions Nursing competency have been paid more attention to,but the quality of the literature still need to be improved.

Objective To investigate the nurses′tasks in community hospitals in southwest China, so as to provide references for building nursing profession advanced examination system matching with the clinical requirements of community. Methods Different Professional Titles Nurses′ Tasks Questionnaire developed by the Ministry of Health was used to investigate 201 nurses in 10 community hospitals that were randomly selected in southwest China. Results Nurse professional title with primary title mainly accounted for 59.20% (119/201),and the nurses who had received secondary and college degree accounted for 43.28%(87/201), 38.81%(78/201). 120 items of nursing tasks were divided into 8 dimensions, the highest of implementation frequency score was the dimension related with drug treatment which scored 3.05±1.18, while the lowest was related with meeting the patients′basic needs which scored 1.40 ± 1.05; the highest of tasks′ importance assess score was the task dimension related with drug treatment which scored 3.36 ± 0.56, while the lowest was the dimension of communications which scored 2.74 ± 0.81. The correlation analysis of execution frequency and importance assess of each dimension showed a significant positive correlation (r=0.161-0.397,P<0.05), except the dimension related with drug treatment(r=0.128,P>0.05). Score difference of tasks’execution frequency and importance evaluation for different Professional titles nurses had no statistical significance (P>0.05). Conclusions The reform of the nurses′career advanced examination should be combined with development status and nurses′tasks in community, in addition, both raising the nurses′ comprehensive quality and improving job responsibilities and functions division of community is the basis of the reform.

Objective To observe the effect of combination of Tju103 and CTLA4-Ig on engraftment, graft versus host disease (GVHD), graft versus leukemia (GVL) and anti-infection post major histocompatibility complex (MHC) haploidentical bone marrow transplantation in mice in order to seek an effective access to transplantation with less GVHD and more potential GVL and anti-infection.Methods In the presence of the recipient's antigen (normal CB6F1, H-2 bd) as a stimulus for induction of specific immune tolerance, T cells from the MHC haploidentical donors (C57BL/6, H-2 b) were first in vitro cultured with Tju103 and CTLA4-Ig, then were transfused with the donors' bone marrow cells into the preconditioned recipients. At last, the effect of combination of Tju103 and CTLA4-Ig on hematopoietic rebuilding, GVHD, GVL and anti-infection was observed in compared with CsA, Tju103 and CTLA4-Ig as controls.Results The only irradiated group (group A): All the mice (10 mice) died of failure of hematopoiesis within 11 days post irradiation, of which most (8 mice) died within 4～7 days post transplantation. The CTX-treated leukemia group (group B): All the mice (10 mice) died of leukemia within 16～23 days post leukemia cells infusion (11～18 days post BMT). CTX treatment prolonged the survival time. The only transplanted group (group C): The mice began to die from day 16 post transplantation, and all (10 mice) died of GVHD within 3 weeks. The CsA prophylaxis group (group D): 4 mice died within 8～22 days after transplantation, of which one died of leukemia, two died of infection and one died of GVHD, and the remaining 6 survived over 30 days post transplantation. The Tju103 treated group (group E): 4 mice died within 9～26 days post transplantation, of which one died of leukemia, one died of infection and two died of GVHD, and the remaining 6 mice survived over 30 days post transplantation. The CTLA4-Ig treated group (group F): 3 mice died within 14～23 days after transplantation, of which one died of infection and two died of GVHD, and the remaining 7 survived over 30 days post transplantation. The Tju103/CTLA4-Ig treated group (group G): one died of GVHD on day 19 after transplantation, and the remaining 9 mice survived over 30 days post transplantation. Conclusions CsA, Tju103 or CTLA4-Ig alone could prolong survival time and reduce incidence and degree of GVHD severity. But CTLA4-Ig could spare much ability of GVL and anti-infection while Tju103, just like CsA, couldn't. Combination of both was the most favorable way for transplantation with the most remarkable efficiency on prolongation of survival time and reduction of GVHD.

Objective To study the damage of hyperhomocysteinemia (HHcy) and asymmetric dimethylarginine (ADMA) on the structure of rats cerebral vessels,and to explore the treatment effect of probucol,folic acid and vitamin B12.Methods Totally,70 male Sprague-Dawley(SD) rats were randomly divided into seven groups:normal control (A),HHcy model (B),low-dose-probucol (C),middle-dose-probucol (D),high-dose-probucol (E),folic-acid plus vitamin B12 (F),folic-acid plus vitamin B12 plus probucol(G)group.Group A was fed plain feedstuff and water.Other groups were fed homomethionin feedstuff and water,probucol (340,510,680 mg· kg-1 · d-1),folic acid and vitamin B12,folic acid plus vitamin B12 plus probucol respectively.The plasma concentrations of homocysteine(Hcy) and ADMA were assayed by high-performance liquid chromatography method (HPLC) at the beginning,and at the end of 8 and 12 weeks.The analysis of rats cerebral vessels was performed with electron microscope at the end of 12 weeks.Results (1) After adding high concentrations of methionine feedstuff for 8 weeks,the levels of Hcy in group B (60.4±11.9) μmol/L were significantly raised compared with group A(7.1±1.4) μmol/L.Meanwhile,ADMA levels in group B(1.3±0.4)μmol/L were higher than group A(0.4±0.1) μmol/L.At the end of 12 week,the levels of Hcy and ADMA were lower in groups C[(49.9±11.4)μmol/L,(1.0±0.2)μmol/L],D [(46.8± 10.9)μmol/L,(0.9±0.1)μmol/L],E[(44.3±11.4)μmol/L,(0.9±0.1)μmol/L],F [(16.3 ± 4.9)μmol/L,(0.7 ± 0.2)μmol/L] compared with group B [(69.5 ± 11.4)μmol/L,(1.6 ±0.5)μmol/L],but higher than group A[(6.7±1.3)μmol/L,(0.5±0.1)μmol/L].The levels of Hcy and ADMA in group G[(8.9±1.9) μmol/L,(0.6±0.2) μmol/L]were also lower than those in group B (P＜0.05],but they did not show statistically significant differences compared with group A(P＞0.05).(2) According to correlative analysis,Hcy levels were positively correlated with ADMA levels (P＜0.05).(3) On electron microscope,we observed that the cerebral artery and cerebral cortex of group B were seriously damaged.After the intervention with probucol,folic acid and vitamin B12,the structure of rats cerebral vessels were improved in group C,D,E,F and G as compared with group B,and group G were especially improved more obviously.Conclusions The HHcy and ADMA could damage the structure of rats cerebral vessels.Probucol,folic acid and vitamin B12 may alleviate the cerebral vascular damage by decreasing the levels of Hcy and ADMA,and the effect is more significant by the combined drug regimens of Probucol,folic acid and vitamin B12.

Chronic atrophic gastritis is a common and intractable disease of digestive in clinical. Chinese medicine is an important treatment method of this disease. It is said in Yellow Emperor that you must know the reason to seize the key. So explore the pathogenesis of the disease is the key to understanding the disease and the premise of Chinese medicine treatment of disease in traditional Chinese medicine. In recent years, many medical literature for chronic atrophic gastritis were reported. This article focuses on organizing the etiology and pathogenesis of the research literatures to comprehensively analyze the formation mechanism of the disease, and lay a solid foundation for further effective treatment search.

Objective To investigate the association of primary liver cancer(PLC)with the mutations of HBV precore and basic core promoter(BCP)genes.Methods The serum markers of hepatitis B and the quantities of serum HBV DNA were detected in 144 HBsAg-positive PLC patients.The precore and BCP gene mutations in patients with HBeAg-negtive and HBV DNA-positive were detected by real-time PCR.One hundred and twenty chronic hepatitis B(CHB)patients were randomly selected to serve as the conol.Results There were 46(3 1.94%)patients with HBeAg-positive and 98(68.06%)patients with HBeAg-negative.In 98 HBeAg-negative patients,56(57.14%)were HBV DNA-positive,in which 43 (76.79%)were with precore 1896 gene mutations,50(89.29%)were with BCP1762/1764 gene mutations.and 38(67.86%)were with both gene mutations.Precore 1896 and BCP1762/1764 gene mutation rates in PLC patients were much higher than those in CHB patients(χ2=9.36 and 5.77,P＜0.05).Conclusion PLC may be associated with the mutations of HBV precore anti BCP genes.

Objective To observe the anatomical and histological features of anterolateral ligament (ALL)in the knee of Chinese adults,so as to identify the existence of ALL and provide an anatomical foundation for clinical reconstruction.Methods Ten adult knee specimens were randomly selected to be dissected,and the femoral,tibial and meniscus attachment points of the ALL were observed.The length,width and thickness were measured using the vernier caliper after the dissection.Three specimens were subjected to histological staining in the end.Results (1)ALL originated from the lateral femoral condyle—the same point of the lateral collateral ligament femoral side or the distal-anterior side,with its body divided into two branches,located in the tibia and the lateral meniscus respectively.The starting point of tibial side ALL was located at the mid-point of Gerdy's tubercle to fibula head,below tibial cartilage edge,with the meniscus point located in the lateral meniscus anterior horn and body junction area.(2) The average length of ALL is 38.89 ± 4.67 mm.The width in the femur,tibial attachment point was fan-shaped spread connected with sclerotin,being the narrowest at the joint line.The width at the femur,tibial attachment point and the joint line was 8.49 ± 1.36 mm,8.15 ± 1.38 mm and 6.49 ± 1.09 mm respectively,with the thickness of 1.33 ± 0.38 mm.The distance from tibia attachment points to the Gerdy's tubercle,fibular head and tibia cartilage margin was 22.59 ± 3.04 mm,21.15 ± 2.78 mm and 5.76 ± 0.57 mm respectively.(3) HE staining showed that ALL was dense connective tissue consisting of parallel arranged collagen fibers,while S-100 staining indicated that ALL contained sensory motor nerve fibers.Conclusion ALL is independent of the joint capsule and originates from the femoral lateral condyle.Its body is divided into two branches,located in the tibia and the lateral meniscus respectively.

Objective To observe the effect of Ly49A transfected lymphocytes on graft versus host disease (GVHD) and graft versus leukemia (GVL) effect post allogeneic bone marrow transplantation. Methods Ly49A gene was transfected into lymphocytes of C57BL/6 mice by retrovirus and the expression rate of Ly49A receptor was detected by flow cytometer. The murine model of allogeneic acute GVHD was established in this way: the donor was C57BL/6(H 2 b). The recipient was BALB/c(H 2 d), which was injected EL9611 cells. After the irradiation (TBI, 60 Co 9.0 Gy) the recipient accepted the transplantation of mixed spleen cells and bone marrow cells to establish the GVHD model. The effects of Ly49A transfected spleen cells on GVHD and GVL post allogeneic bone marrow transplantation were detected. Results The expression rate of Ly49A receptor was ( 42.20 ? 4.87 )?% for lymphocytes transfected with pLXSN Ly49A; ( 18.67 ? 2.48 )?% for lymphocytes transfected with pLXSN and ( 18.73 ? 3.82 )?% for untransfected control respectively. In the case of allo BMT (C57BL/6 H 2 b→BALB/c H 2 d), survival time was ( 6.50 ? 2.41 ) days for the irradiation group; ( 20.90 ? 2.88 ) days for cyclophosphomide therapy group; ( 17.10 ? 4.65 ) days for bone marrow cells mixed with lymphocytes transplantation group; ( 17.40 ? 5.32 ) days for bone marrow cells mixed with pLXSN transfected lymphocytes transplantation group; ( 35.20 ? 12.52 ) days for bone marrow cells mixed with Ly49A transfected lymphocytes transplantation group, which was much longer than the survival time of any of the above group ( P = 0.000 ). Conclusion The Ly49A transfected lymphocytes transplantation could alleviate GVHD and retain GVL effect on acute GVHD model post allo BMT.

Objective To investigate the clinical efficacy of preoperative full reset combined with minimally invasive treatment of extreme distal pilon fractures.Methods A retrospective analysis was made on 34 patients (35 ankles) with tibial fractures extremely close to the distal articular surface treated surgically between January 2011 and January 2015.There were 21 mnales and 13 females,aged 20-71 years (mean,36.2 years).Injury resulted from traffic accidents in 32 patients and high falls in two.Using the AO/OTA fracture classification system,type 43-B3 was noted in three patients,43-C1 in five patients,43-C2 in 18 patients and 43-C3 in eight patients.Calcaneal traction combined with manipulative reduction was used to correct fracture displacement preoperatively.All fractures were stabilized by minimally invasive percutaneous plate osteosynthesis (MIPPO) through single or combined medial,anteromedial and anterolateral approaches while minimizing damage to bone attachment and continuity of soft tissue,after soft tissue swelling subsided.For the patients with articular surface collapsing with severe comminution,a series of procedures were done under direct vision including using the talus articular surface as a mold,stable fixation with fine Kirschner (1-1.5 mm) and thin screws (2.1-2.7 mm series) and impaction bone grafting below subchondral bone.Thereafter,distal tibia anatomical short multi-directional locking plate fixation,distal nail support and early ankle joint functional exercise were done.Burwell-Charnley radiological evaluation system was used for radiological assessment,and TeenyWiss scoring system for ankle clinical symptoms and function.Postoperative complications were recorded.Results Follow-up lasted for 11-38 months (mean,16.6 months).No infection,wound disunion,or plate exposure occurred.Burwell-Charnley radiological evaluation system showed anatomic reduction in 32 patients,unsatisfactory reduction in one,and poor reduction in one.According to the Teeny-Wiss scoring system,the results were excellent in 31 patients,good in two and poor in one,with the excellentgood rate of 97％.Three patients suffered traumatic arthritis after operation and alleviated after oral administration of painkiller.Conclusion With use of full reset combined with manipulative reduction to correct fracture displacement,minimally invasive locking plate,distal row of nails,impaction bone grafting and limited fixation,the patients with extremely distal tibial pilon fractures achieve satisfactory reduction,stable fixation,and early functional exercise.

Objective To investigate the effect of rosuvastatin on the morphine tolerance in rats and the underlying mechanism.Methods Forty-eight male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 6 groups (n =8 each):control group (group C),morphine tolerance group (group MT),rosuvastatin control group (group RC),rosuvastatin 0.4 mg/kg group (group R1),rosuvastatin 2.0 mg/kg group (group R2)and rosuvastatin 10.0 mg/kg group (group R3).Morphine tolerance was induced by subcutaneous injection of morphine 10.0 mg/kg at 8:00 and 16:00 everyday for 5 consecutive days.The equal volume of normal saline was given in groups C and RC.Normal saline 10 ml/kg was injected through a gastric tube into stomach everyday at 30 min after subcutaneous injection of normal saline or morphine for 5 consecutive days in groups C and MT.Rosuvastatin 10,0.4,2.0 and 10.0 mg/kg were injected through a gastric tube into stomach everyday at 30 min after subcutaneous injection of normal saline or morphine for 5 consecutive days in groups RC,R1,R2 and R3,respectively.The paw withdrawal latency to nociceptive thermal stimulation was measured 1 day before (T1) and 1 day after morphine tolerance was induced (T2).The percentage of maximal possible effect (MPE) was calculated.The rats were sacrificed after the last measurement of pain threshold and the L5 segment of the spinal cord was removed for determination of the expression of extracellular signal-regulated kinase (ERK) and phosphorylated ERK (p-ERK)(by Western blot) and contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) (by ELISA).Results Compared with group C,MPE was significantly decreased at T2 and the expression of p-ERK and contents of IL-1β and TNF-α were increased in groups MT and R1 (P ＜ 0.05).Compared with group MT,MPE was significantly increased at T2 and the expression of p-ERK and contents of IL-1β and TNF-α were decreased in groups RC,R2 and R3 (P ＜ 0.05).There was no significant difference in the indicators mentioned above between groups R2 and R3,and in the expression of ERK between the six groups (P ＞ 0.05).Conclusion Rosuvastatin can attenuate the morphine tolerance in rats by inhibiting the phosphorylation of ERK and decreasing the level of IL-1β and TNF-α.