Background Optic neuritis is one of the common clinical neuro-ophthalmic diseases.Recurrent optic neuritis can cause irreversible axonal damage and visual impairment,and no prevention method is effective up to now.Its pathogenesis is considered to be associated with the body's immune imbalance.Objective This proposal tried to establish experimental autoimmune encephalomyelitis (EAE) and explore the immunomodulatory effects of T helper (Treg),Th17 cell in the model of optic neuritis.Make the immune mechanism of demyelinating optic neuritis clear.Methods EAE model was established to observe the clinical symptoms and visual electrophysiological changes of optical neuritis in mice;hematoxylin-eosin staining to observe the histological changes in the mouse models of EAE; immunohistochemical staining to detect optic nerve axon damage markers β-amyloid peptide precurso (β-APP) protein expression quantity changes;reverse transcription PCR (RT-PCR) to detect the dynamic expression of forkhead/winged helix transcription factor p3 (Foxp3),transforming growth factor-β (TGF-β),interleukin-1β (IL-1β),IL-17,IL-10 in optic nerve tissue.Results After immunization 11 days,neurological symptoms of EAE mice started to appear,hematoxylin-eosin staining showed optic nerve tissue infiltration of inflammatory cytokines; immunohistochemical staining showed enhancement of axonal injury markers β-APP positive staining; flash visual evoked potential(F-VEP) test showed 7,11,14,19,23,28 days,compared with the normal mice,P1 prepatents of model group were prolonged after modeling,the differences were statistically significant (t =4.487,15.203,16.364,11.540,11.959,16.163,all at P＜0.05).When 7 days after modeling,the difference of N1-P1 amplitude between normal group and model group was no statistical significance (t =-0.992,P =0.378); while 11,14,19,23,28 days after modeling,compared with normal mice,N1-P1 amplitudes of model mice were significantly lower,the differences were statistically significant(all at P＜ 0.05).The expressions of TGF-β,IL-1β,IL-17,Foxp3,IL-10 mRNA among different time points had stastistie significant differences (F =12.721,15.015,14.343,69.374,68.290,all at P =0.000),compared with the normal group,when 11 days,14 days after modeling,TGF-β mRNA levels were significantly increased ; 19 days,23 days after modeling,IL-1β mRNA levels were significantly increased;7 days,11 days after modeling,IL-17 mRNA levels were significantly increased ;7,11,14,19,23,28 days after modeling,Foxp3 mRNA levels were significantly lower; 19,23,28 days after modeling,IL-10 mRNA levels were significantly lower,the difference were statistically significant (all at P＜ 0.05).Conclusions Th17 cells launch demyelinating optic neuritis immune injury,and Th1 subgroup performs the function of maintaining inflammatory lesions,Treg cell subgroup is abnormal much earlier than that of the Th2 subgroup.The imbalance of Th17/Treg cell may be involved in the pathogenesis of demyelinating optic neuritis.

Objective To share for the nursing adverse events resources in the region, which would provide scientific data for nursing security management. Methods The form of nursing adverse events reporting was first designed by researchers. Then with the help of computer engineers the module on regional collaborative information platform was constructed. Preliminary running was used to modify and improve. Through continuous improvement the module function of adverse events reporting, query and statistics was finally made out. Results The module on regional collaborative information platform for nursing adverse events reporting and analysis was constructed, and it worked well. Conclusions The module realizes the sharing of nursing adverse events resources in the region. It can improve the level of nursing safety management in each hospital, which helps to reduce the incidence of nursing adverse events.

Objective To build the dynamic management system of nursing staff allocation in general pediatric wards based on working hours measurement.Methods 30 general pediatric wards of 25 general or children hospitals of upper first class were selected to measure working hours.Depending on the average nursing hours required for pediatric patients in different care levels by each positions,we achieved the nursing staffing formulas.Results 7 nursing posts under double-shift turn and three-shift turn were collected.The average hour that nursing posts provide for one different nursing grade patient was made out.Taking a ward which had 20 patients as nursing grade one and 20 patients as nursing grade two for example,it would need 8-9 responsible nurses,2-3 long night shift nurses,1-2 general affairs nurses,2 night assistance nurse,1 day assistance nurse by double-shift turn,meanwhile,it would need 8 responsible nurses,4 early night shift nurses,3 late night shift nurses,1-2 general affairs nurses by three-shift turn.Conclusions Using the formulas based on measurement of working hours to calculate the number of nursing staff could provide a way to help the managers.

Objective:To study the coronal microleakage of flared root canal teeth restored with computer aided design and computer aided manufacturing (CAD/CAM)fiber post and core.Methods:60 extracted human mandibular premolars with single canal were divided into 3 groups randomly(n =20).The roots of the teeth were restored with CAD/CAM glass fiber post and core(group A), prefabricated glass fiber post(group B)and gold alloy dowel-and-core(group C)respectively.The specimens were immersed in India ink for 4 weeks.Subsequently all teeth were demineralized,dehydrated and rendered transparent.Then coronal microleakage was ob-served with stereomicroscope.Nonparametric data were analyzed.After that,All the specimens was demineralized completely in nitric acid,Then the interface between the post,resin cement and canal wall was observed and recorded.Results:The microleakage was found in all the 3 groups,group A and C showed less microleakage than group B(P <0.05).But no difference was detected between group A and C(P >0.05).Microleakage mostly appeared at the interface between post and resin cement in group A and C,while in group B,it appeared between resin cement and the wall of root canal totally.Conclusion:CAD/CAMfiber post and core demonstrates less coronal microleakage than prefabricated glass fiber post.

Objective In order to analyze the research situation,development tendency and deficiencies in the aspects of nursing competency through investigating about 10 kinds of core nursing periodicals published from the year 2009 to 2013 in China.Methods Using bibliometrics methods to analyze the researches about nursing competency in the periodical literature including Chinese Journal of Nursing,Journal of Advanced Study for Nurses,Chinese Journal of Practical Nursing,Chinese Nursing Research,Journal of Nursing Science,Journal of Nursing Administration,Nursing Journal of Chinese People's Liberation Army,Chinese Nursing Management,Shanghai Nursing,Modern Clinical Nursing published from 2009 to 2013.Results There were 215 research papers about nursing competency in periodicals in the past five years,and a quantity of papers increased stably each year.The study contents mainly involved nursing education,training,competency model and standard system based on nursing competency and so on.Conclusions The researches on nursing competency are getting started in China.The quantity is keeping increase and the related research contents become more colorful and deeply than before.

Objective To investigate the level and influencing factors of subjective well-being of nurses and establish a model of the relationship of job stress, self-efficacy and subjective well-being. Methods Totally 438 nurses from 5 hospitals in Changchun city were investigated with the self-designed demographic questionnaire, General Well-Being Scale, Nurse Job Stressors Scale and Self-Efficacy Scale. Results The total score of subjective well-being was (71.36 ± 18.83) points. Single factor analysis found that age (F=1.759, P<0.01), department (F=1.712, P<0.01), professional title (F=1.364, P<0.05), years of working (F=1.420, P<0.05) and monthly income (F=1.632, P<0.01) were statistically significant. Multiple linear regression analysis showed that sex (t=-2.447, P<0.05), the first factor of job stress (t=-5.033, P<0.01), the second factor (t=-2.478, P<0.05), the third factor (t=-2.315, P<0.05), the fifth factor (t=-5.862, P<0.01) and self-efficacy (t=10.705, P<0.01) were the predictive effectton of subjective well-being. The result of path analysis shows that self-efficacy has a significant effect of adjustment on job stress and subjective well-being (direct effects=-0.62, indirect effects=-0.24, P<0.01). Conclusions The nurse subjective well-being is in the medium level. Hospitals and all related departments should take effective measures to reduce or eliminate unfavorable factors and increase the protective factors, and then improve the level of nurses′subjective well-being and nursing quality.

Objective Through the investigation and analysis to "Chinese Medical Digest" and its relative periodicals to get a general idea of the survival and situation of these periodicals and to establish the pattern for their survival and development. Methods Such methods as telephone consultation, questionnaire survey, interview, and conference discussion were adopted to collect the relative information of medical digest periodicals and thus an analysis was made upon it. Results There were 18 kinds of "Chinese Medical Digest" periodicals originally. Of all these 18 kinds of the periodicals, 6 kinds are still publishing, 10 kinds have transferred its nature to first-hand literature periodical, and 2 kinds have ceased their publishment. Conclusion As a result of the computer, the network and the full text database development, the survival of medical digest periodicals are endangered. However, regarding to the different domain of subject, different reforming measures should be taken.

Objective To investigate the correlations of plasma homocysteine(Hcy)level and apolipoprotein E gene polymorphism with Alzheimer' s disease(AD)and mild cognitive impairment (MCI).Methods A case-control study in 66 AD patients(AD group),64 MCI patients(MCI group) and 54 healthy controls(control group)was conducted.Plasma Hcy level and ApoE polymorphism were determined and analyzed.Results Plasma Hcy levels were significantly higher in AD and MCI groups than in control subjects(both P＜0.001).AD patients also showed increased plasma Hcy levels as compared with MCI patients(P＜0.001).Logistic regression analysis indicated that the increased plasma Hcy level was a risk factor for AD and MCI(OR＝ 1.435 and 1.312,both P＜0.001).ApoE ε3/3 was the most common genotype in AD,MCI and control groups,and ε3/4 and ε4/4 genotypes were more common in AD group and MCI group than in control group(both P＜0.05).The ε4 allele frequency of ApoE was 24.2％ and 23.4％ in AD or MCI group respectively,and 6.5％ in control group(AD or MCI vs.control,P＜0.05).The analysis by multiplicative interaction model showed that the odd ratio for MCI was 23.3 in patients with only hyperhomocysteinemia(Hhcy,Hcy＞ 15 μmol/L),12.6 in patients with carrying ε4 allele,and 46.7 in patients with both Hhcy and carrying ε4 allele,which indicated that there was interaction between hyperhomocysteinemia and carrying e4 allele.Conclusions Hyperhomocysteinemia and ApoE ε4 allele are correlated with dementia and also have additive interactions.

Objective To explore the influence of introducing standardized patient (SP) into problem-based learning (PBL) to the autonomous learning abilities for undergraduate nursing students based on clinical thinking training. Methods To select 2 classes randomly from full-time professional nursing undergraduate classes enrolled in 2012 from Tianjin university of traditional Chinese medicine, was divided into the experimental group and the control group by random number table method. The control group uses PBL teaching mode, and the experimental group adopts introducing SP into PBL teaching mode. Course lasts for 4 weeks, a total of 18 hours. To evaluate two groups nursing students′the percentage of asking questions by themselves and examination results in the end of the course, and evaluate nursing students′autonomous learning ability before and after the course and after three months of clinical practice respectively. Results The percentage of asking questions by themselves and examination results of the experimental group were 87.80%(36/41) and (84.24±5.12) points, (87.85±5.44) points, the control group were 68.89%(31/45) and (81.51±6.63) points, (84.40±7.96) points, the difference was statistically significant (χ2=4.46, t=2.13, 2.37, P<0.05);There was no statistical significance between two groups in the score of autonomous learning ability before the course (P>0.05), while after course and after three months of clinical practice of the experimental group were (93.71±9.56) points, (103.27±11.92) points, the control group were (85.47 ± 9.28) points , (91.36 ± 10.56) points, the difference was statistically significant (t=3.56, 4.89, P<0.01). Conclusions The teaching mode of introducing SP into PBL can train and improve the autonomous learning ability of undergraduate nursing students,and can provide reference for nursing teaching mode reform.

BACKGROUND:The hip is a complicated structure and irregular in shape. It is hard to measure stress distribution and transmission. OBJECTIVE:To establish a three-dimensional finite element model of the hip joint and upper femur, and analyze the stress distribution and transmission characteristics of the acetabulum region under different loads, and explore mechanics mechanism of hip fracture based on CT data. METHODS:The three-dimensional finite element hip and femur model were reconstructed in Mimics 14.0 based on the CT data of a healthy adult man. After dividing mesh, assigning material and transforming into finite element model, the stress distributions of anterior wal , the top, and the posterior wal of the acetabulum, the stress of acetabulum areas and displacement of acetabular unit were calculated with finite element software Ansys 13.0 software under 300, 600, 900 and 1 200 N. RESULTS AND CONCLUSION:(1) A three-dimensional finite element model of the hip and the femur was successful y established, consisting of 284 183 nodes and 160 665 units. (2) The characteristics of the stress distribution of acetabulum region:the maximal stress was concentrated on the posterosuperior part of acetabular crest, fol owed by the posterior wal and the anterior wal in order in upright position under different loads. The stress transmitted by four ways:from acetabular crest to ilium, along linea terminalis of pelvis to sacroiliac joint, in the acetabular sockets, and along the pubic ramus. The stress and the propagation distance were increasing as the loads increased. Acetabular element stress variable was increased. (3) Above results indicated that three-dimensional finite element model of the human hip joint established by Mimics 14.0 based on CT data matches the anatomical structure in a great degree, could be used in the biomechanics analysis under different loads, and has a guiding significance for design of artificial hip prosthesis.