Objective To explore the effect of the situation-background-assessment-recommendation mode of SBAR communication on the clinic communication competence of nurses.Methods 20 obstetric nurses were selected for the study,the mode of SBAR communication was applied to the communication between doctors and nurses,nurses and nurses,nurses and patients.The clinic communication competence was investigated by the questionnaire of clinic communication competence before and after using the mode of SBAR communication.Results The scores of the clinic communication competence after using the mode of SBAR communication was (56.41±6.32),which was higher than that before the implementation,(48.15±5.26),there were statistically significant differences,P＜0.05.The scores of communication competence between doctors and nurses,between nurses and nurses,between nurses and patients were higher after implementation of SBAR compared with those before,(4.06±1.26)vs.(2.62±1.31),(4.05±1.41)vs.(3.59±1.46),(3.98±1.32) vs.(3.36±1.36),there were statistically significant differences in all of them,P＜ 0.05.Conclusions SBAR communication mode helps improve clinic communication competence of nurses,promote the establishment of harmonious team between doctors and nurses,ensure patients' safety and quality of care.

Objective In this study,we aim to investigate and evaluate the application of peer education on the teaching of medical graduate students and to evaluate the teaching effect,in order to provide the basis for subsequent practice reform.Methods 49 graduate students majoring Internal Medicine-Pulmonology were randomly divided into traditional teaching(24) and peer education groups (25).We chose the primary culture technology of rat distal pulmonary arterial smooth muscle cells to be the teaching contents.For the traditional teaching group,we used the mode of class lecture giving and experimental skills learning under the assistance of the teachers; while in the peer education group,students benefited from the combination of class lecture given by the teacher and the seniors fixed teaching in which seniors help younger students.We selected the experimental operating time,cell purity and the practicing time to reach a standard culture as the evaluation indexes by filling a follow up questionnaire.The SPSS 13.0 was applied to the related data forx2 or t test.Results In the traditional teaching group,the average time to reach three times of standard culture was(3.2 ± 0.5) hour,which was(2.3 ± 0.4) hour in the peer education group.The cell purity was 80.1 ± 3.6％ in the traditional teaching group,while(85.4 ± 5.9)％ in the peer education group.The average practicing time was(6.3 ± 1.0) in the traditional teaching group,while(4.9 ± 0.6) in the peer education group.The peer education group master the teaching content better than the traditional teaching group (P=0.00).95.8％(23/24)of the students in the peer-education group considered the teaching contents simple,which was statistically higher(P=0.00) than traditional group (62.5％,15/24).Meanwhile,95.8％ (23/24)of the students in the peer-education group considered the teaching methods easy to accept,which was also statistically higher(P=0.02) than traditional group(70.8％,17/24).The difference was statistically significant (P=0.02).Conclusion The application effect of peer education is good and there is high degree of acceptance among the students.Besides,peer education accords with the medical postgraduate experiment teaching rules,and can cultivate medical graduate students' spirit of cooperation and communication ability in the process of implementation.

AIM:To observe the expressions of cathepsin B (CB) and cystatin C (CC) in different stage of diabetic rats and to investigates their potential roles.METHODS:Sixty rats were divided into diabetes mellitus group induced by intravenous injection of streptozotocin (55 mg/kg) and normal group injected with citrate buffer. Ten rats were sacrificed respectively at the end of fourth week,eighth week and sixteenth week in both groups. 24 h urine excretion was collected in rats before sacrifice. The blood and the kidney were also collected. The mRNA and protein expressions of CB and CC in kidney were detected by real time PCR and immunohistochemical staining,respectively.RESULTS:At the end of eighth week,the expression of Ccr,24 h urinary protein excretion,CB,CC in diabetic rats increased significantly,compared to the results at the fourth week (P

Objective:To describe the clinical characteristics , overall survival as well as to evaluate the prognostic factors in Chinese diffuse large B cell lymphoma ( DLBCL) patients.Methods: DLBCL pa-tients who were initially diagnosed and treated in Peking University Cancer Hospital from January 1995 to December 2008 were identified and analyzed ,retrospectively .The 5-year OS rates were estimated with Ka-plan-Meier.Log-rank test was used to compare the survival curves of the different groups .The multivari-ate analysis of prognostic factors was conducted with Cox regression model , which included all statistically significant prognostic factors in the univariate analyses .Results:A total of 525 DLBCL patients were in-cluded in this retrospective analysis , of whom , 294 were male and 231 female ( male∶female=1 .27∶1 ) . The median age at the initial diagnosis was 55 (range 16-90) years, and 37.0% (n=194) were 60 years and above .Regarding the clinical staging at the initial diagnosis , 54 patients (10.3%) were diag-nosed as Stage Ⅰ of the disease, 152 (28.9%) as Stage Ⅱ, 117 (22.3%) as Stage Ⅲ and 202 (38.5%) as Stage Ⅳ.The ‘B symptoms’ and increased serum LDH were presented in 206 (39.2%) and 192 (36.6%) patients, respectively.A total of 197 (37.5%) patients were treated with rituximab (R).The survival follow-up continued till 31 January 2014 with a median follow-up time of 77.5 ( range:0-205) months.A total of 267 patients (50.9%) died during the follow-up period.The medi-al overall survival ( OS) time was 84 months, and 5-year OS rate was 52.3%.There were six statistically significant prognostic factors that were identified in both univariate and multivariate analyses : gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment .The relative risk ( RR) of these prognostic factors in the multivariate analyses were: age >60 years /≤60 years=1.380 (95%CI 1.078 -1.765), male /female =1.315 (95%CI 1.025 -1.687), stage Ⅲ/stageⅠ=3.034(95%CI 1.667-5.522), stage Ⅳ/Ⅰ=3.748(95%CI 2.102 -6.681), with B symp-toms/without B symptoms=1.278(95%CI 0.999-1.636),serum LDH increased/LDH not increased=1.351(95%CI 1.057 -1.726), without R treatment /with R treatment =1.543(95%CI 1.182 -2 .015 ) .Compared with the IPI , age >50 years/≤50 years was a statistically significant factor in both univariate and multivariate analyses RR =1.478 (95%CI 1.148-1.902), P=0.002.Conclusion:Six factors were related to DLBCL survival:gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment .Compared with the IPI , several specific factors may predict a poor prognosis in Chinese DLBCL patients:male , age>50 years and the presence of ‘B symptoms ’ .But this result is not conclusive until these factors are further tested .

Objective To explore the effects of the extracellular regulated protein kinase’s (ERK1/2) inhibitor PD98059 and ino-sitol triphosphate kinase (PI3K/PKB) signaling pathway’s inhibitor LY294002 on extracellular matrix (ECM) deposition in pulmonary arterial smooth muscle cells (PASMCs) stimulated by connective tissue growth factor (CTGF). Methods PASMCs of SD rat were cul-tured in vitro. The PASMCs were divided into control group, CTGF group, CP (CTGF+PD98059) group, CL (CTGF+LY294002) group and CPL (CTGF+PD98059+LY294002) group. Real-time lfuorescent quantitative RT-PCR was used to detect the expression of colla-gen III and ifbronectin mRNA of PASMCs, and the expression of collagenШprotein of PASMCs was detected by immunohistochem-istry and western-blot. Results The expressions of collagenШand ifbronectin mRNA of PASMCs stimulated with CTGF (50 ng/ml) for 48 h were signiifcantly higher than those in control group, and the collagen proteinШof PASMCs was decreased signiifcantly after stimulation with CTGF (50 ng/ml) for 72 h (P<0.05). The expressions of collagenШand ifbronectin mRNA in PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 48 h was signiifcantly lower than those in CTGF group (P<0.05). The collagen proteinШin PASMCs cultured with PD98059 (20μmol/L) and/or LY294002 (10μmol/L) for 72 h was increased (P<0.05). The expres-sions of collagenШand ifbronectin mRNA of PASMCs stimulated with both PD98059 and LY294002 were more signiifcant. Conclu-sions CTGF may increase the expression of collagenШand ifbronectin mRNA in PASMCs, which may contribute to the deposition of ECM in PASMCs during pulmonary vascular remodeling. PD98059 and LY294002 may repress ERK1/2 and PI3K/PKB signaling pathways and interfere with the biological effect of CTGF.

OBJECTIVE: To explore the effects of Salvia miltiorrhiza on renal morphology and renal function of rats with streptozotocin diabetes. METHODS: Thirty male Wistar rats were randomly divided into three groups, which were normal control group, untreated group and Salvia miltiorrhiza-treated group. Diabetic nephropathy was induced in rats of the last two groups by intraperitoneal injection of streptozotocin after unilateral nephrectomy. Then the rats in the normal control and untreated groups were fed with normal saline while those in the Salvia miltiorrhiza-treated group were fed Salvia miltiorrhiza preparation for 8 weeks. The glomerular volume (VG), kidney-to-body weight ratio (KW/BW), urinary albumin excretion rate (UAER) and creatinine clearance (Ccr) were observed. The expression levels of transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF), fibronectin (FN) and plasminogen activator inhibitor-1 (PAI-1) were detected by real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) at the end of the experiment. RESULTS: UAER, Ccr, VG and KW/BW ratio were significantly higher in the untreated group than those in the normal control group (P<0.05). The expression levels of TGF-beta1, CTGF, PAI-1 and FN in the untreated group were also significantly higher as compared with those in the normal control group (P<0.05). UAER, Ccr, VG, KW/BW ratio and the levels of TGF-beta1, CTGF, PAI-1 and FN in the Salvia miltiorrhiza-treated group were obviously lower than those in the untreated group (P<0.05). CONCLUSION: Salvia miltiorrhiza can protect rats with streptozotocin diabetes from diabetic nephropathy by suppressing the over-expressions of TGF-beta1, CTGF, PAI-1 and FN in renal cortex.

AIM:To investigate the effect of hydrogen sulfide ( H2 S) on high glucose ( HG)-induced injury of the mouse podocyte cell line MPC5.METHODS: The cultured MPC5 cells were randomly divided into 4 groups: HG group, normal glucose (NG) group, NG+DL-propargylglycine (PPG) group, and HG+NaHS group.After treated for a certain time, the cells were collected for further detection .The expression of zonula occludens-2 (ZO-2), nephrin,β-cate-nin and cystathionine γ-lyase ( CSE) was determined by Western blotting .RESULTS:High glucose significantly reduced the expression of nephrin, ZO-2 and CSE (P<0.05), while the level of β-catenin was elevated obviously (P<0.05), all in a time-dependent manner.NG+PPG inhibited the levels of ZO-2 and nephrin significantly (P<0.05), and increased the level of β-catenin (P<0.05), all in a PPG concentration-dependent manner.HG+NaHS induced a more significant increase in the levels of ZO-2 and nephrin as compared with HG group (P<0.01), whereas a severe reduction of β-cate-nin in HG+NaHS group was observed as compared with HG group .Compared with NG group , the expression of ZO-2 and nephrin was decreased obviously , and the level of β-catenin was increased in HG +NaHS group.CONCLUSION:Down-regulation of CSE contributes to hyperglycemia-induced podocyte injury .Exogenous H 2 S protects against hyperglycemia-in-duced podocyte injury , possibly through up-regulation of ZO-2 and subsequent suppression of Wnt/β-catenin pathway .

AIM:To investigate the effect of liraglutide ( LG) on the expression of fibronectin type Ⅲdomain-containing protein 5 (FNDC5) in the C2C12 myotubes.METHODS:The C2C12 mouse myoblast cell line was induced to differentiation.Differentiated cells were stimulated with gradient concentrations (1 ~1000 nmol/L) of LG for different time (0 ~24 h).The effects of LG on the expression of FNDC5 and the activation of adenosine 5'-monophosphate ( AMP)-activated protein kinase ( AMPK) signaling pathway were determined .After pretreated with glucagon-like peptide-1 ( GLP-1 ) receptor antagonist exendin 9-39 , the inhibitor of Ca 2+/calmodulin-dependent protein kinase kinase 2 (CAMKK2), STO609, or the inhibitor of AMPK, Compound C, the LG-induced FNDC5 expression in C2C12 myotubes was examined.The expression of FNDC5 and the activation of AMPK were determined by Western blot .RESULTS: In C2C12 myotubes, LG promoted the expression of FNDC5 in a dose-and time-dependent manner .LG also activated AMPK signaling pathway .These effects of LG were partly abolished by exendin 9-39 , STO609 and Compound C .CONCLUSION:LG promotes the expression of FNDC5 via GLP-1 receptor in the C2C12 myotubes possibly through activation of the CAMKK2/AMPK signaling pathways .

AIM:To observed the protective effect of diminazene aceturate ( DIZE) , an angiotensin-converting enzyme 2 (ACE2) activator, on diabetic nephropathy (DN) rats.METHODS:Male Wistar rats (n=30) were randomly divided into normal control (NC) group, DN group and DIZE group (each group consisted of 10 rats).The rats in DN group and DIZE group were induced by intraperitoneal injection of streptozotocin at dose of 65 mg/kg.After 12 weeks, the rats in DIZE group and DN group received subcutaneous injection of DIZE (15 mg· kg -1 · d-1 ) or vehicle for 4 weeks. The samples of blood and urine were collected at week 16, and ratio of kidney weight to body weight (KW/BW), plasma glucose (GLU), 24 h urinary protein (24UP) and serum creatinine (SCr) were measured.The renal pathological changes in each group were observed by periodic acid-Schiff ( PAS) staining and immunohistochemistry .The levels of AngⅡ and Ang-(1-7) in the plasma, and TGF-β1 and VCAM-1 in the renal tissues were measured by ELISA .The mRNA and protein levels of collagen I and FN were determined by quantification real-time PCR and immunohistochemistry .The effects of DIZE on the expression of ACE2 in DN rats were determined by Western blot .RESULTS:DIZE remarkably increased the expression of ACE2 and Ang-(1-7) in DN rats.Compared with NC group , the GLU, KW/BW, 24UP, SCr, and the ex-pression of collagen I , FN, TGF-β1 and VCAM-1 in DN group and DIZE group were increased .However , after treatment of the DN rats with DIZE, these indicators were decreased except the KW/BW.The GLU showed no significant change . CONCLUSION:DIZE raised the activity of ACE2 and increased the expression of Ang-(1-7), thus alleviating fibrosis and inflammation in the kidney and having therapeutic potential for diabetic nephropathy .

Objective: Enriching secoiridoid glycoside in Gentiana manshurica kitag. Methods: Gentiana manshurica kitag. was extracted with 70% EtOH by cold macerating and purified with AB 8 macroreticular resin. Results: The content of gentiopicrin in the extract is 28.69%. Conclusion: AB 8 macroreticular resin fits in purification of water soluble secoiridoid glycoside in Gentiana manshurica kitag.