Objective To investigate the effect of applying core competence training for grading nursing in ICU.Methods The nurses in ICU were divided into high qualification nurses group and low qualification nurses group according to professional ability;make clear the post responsibility, clinical educational training and management were performed according to grades.The nursing department and head nurse evaluated the training;the scores were analyzed and fed back.Results After applying core competence training for grading nursing the satisfaction of patients and nurses and the operational standard-reaching rate were significantly higher (p<0.05).Conclusion The core competence training for grading nursing could give full play to nurses at all levels, provide basis and ladder of sustainable development for nurse's career, deserve the clinical expansion.

Objective To evaluate the endothelialization of Chinese nitinol atrial septal defect occlud-er device. Methods Atrial septal defect with controllable size was created by the Brockenborough needle and Rashkind balloon atrial septostomy, the occluder devices were implanted in six piglets (mean weight 7. 5 kg). Two pigs were killed each time after 1 month, 3 months and 6 months after the device implantation and then the explanted devices were examined by scanning electron microscope (SEM). Results The devices were found covering with collagen fibrosis together with diffuse endothelial cells spreading over the primer 1 month after implantation. The implants were covered mostly by ncointima 3 months after implantation and completely covered by confluent endothelial cells 6 months after the implantation. Endothelial cells were not found on the smooth marker band at 3 months, however, did exist by 6 months. Conclusions Home-made atriatseptal defect occluder devices were mostly endothelialised 3 months after the implantation and did completely at 6months.

Objective To investigate the regional distribution and morphological features of nesfatin-1/NUCB2 in digestive system of the humans, Sprague-Dawley (SD) rats and the institute of cancer research (ICR) mice, so as to lay the foundation for further study of its functions in the digestive system. Methods The specimens were obtained from SD rats and ICR mice as well as 20 patients with digestive disease, who were admitted to the First hospital affiliated to Nanjing Medical University and receired surgercal treatment. The specimens from patients with malignant tumors were obtained 5 cm apart from cancerous tissues and from patients with benign tumors were obtained near the focus. The resected tissues included pancreas, stomach, duodenum, esophagus, liver, small intestine or colon. The distribution of nesfatin-1/NUCB2 was examined with immunohistochemical (IHC) staining and its protein level in each organ was measured using Western blotting. Results The immuinohistocemical study revealed the similar distribution pattern of nesfatin-1/NUCB2 in the digestive system of the patients, SD rats and ICR mice. Nesfatin-1/NUCB2 was found to localize in the center of the pancreatic islets, the lower 1/3 to 1/2 of the gastric mucosal glands, as well as the submucosa of the duodenum. Western blotting examination showed the expression of NUCB2 in all tissues from patients, SD rats and ICR mice, whereas the protein level of the nesfatin-1/NUCB2 was higher in pancreas (0.84±0.03, 0. 84±0.05 and 0. 84±0.04, respectively), stomach (0.86±0.06,0.81±0.02 and 0. 78±0.02, respectively) or duodenum (0.79±0.09,0. 79±0.04 and 0.78±0.05)than that in esophagus (0.43±0.04,0.44 ± 0.02 and 0.47 ± 0.06, respectively), liver (0.42±0.01,0.44±0.04 and 0.43 ± 0.01, objectively), small intestine (0.32±0.04,0. 32 ± 0. 04 and 0.34 ±0.04, respectively) or colon (0. 29±0.01,0.32±0.03 and 0. 28±0.03, respectively)(all P values=0. 000). Conclusion Nesfatin-1/NUCB2 is widely expressed in the pancreatic islets, gastric mucosal glands and duodenum of the patients, SD rats and ICR mice, which indicates that nesfatin-1/NUCB2 may be involved in the regulation of food intake, carbohydrate metabolism and gastrointestinal motility.

Seventy newly diagnosed diabetic patients were enrolled in the study, including 37patients aged over 60 (elderly-onset diabetes, EOD group) and 33 patients under 60 (adult-onset diabetes,AOD group) ; 30 elderly healthy subjects served as controls. Serum melatonin levels were determined with ELISA and the expression of inducible nitric oxide synthase (iNOS) mRNA in peripheral blood leucocytes (PBL) was detected by reverse transcription polymerase chain reaction (RT-PCR). The results showed that serum melatonin levels were significantly lower in EOD group than those in control group [ (6. 6 ± 1.3 )ng/L vs. (7.7 ± 1.4) ng/L, P ＜0. 01 ], the expression of iNOS mRNA was significantly higher than that in AOD group [ (36 ± 3 )% vs. (30 ± 4)%, P ＜ 0. 01 ]; and i NOS mRNA was not detected in control group.Logistic regression analysis indicated that decreased serum melatonin levels and up-regulated iNOS mRNA might be independent risk factors for diabetes mellitus in the elderly.

ObjectiveTo analyze the association of human urate transporter 1 ( hURAT1 ) gene promoter single-nucleotide polymorphisms(SNPs) with primary hyperuricemia ( HUA ) in Chinese Han people.MethodsA total of 215 patients with HUA and 323 healthy subjects were chosen to be investigated of SNP of hURAT1 promoter by PCR and sequencing.ResultsFive SNPs were identified,including-454A/T,-434T/C,-382C/T,-87C/T,and + 118G/A.Pairwise linkage disequilibrium analysis displayed a high linkage disequilibrium between the five SNPs ( r2 =0.99).In HUA group,the heterozygous genotypos ( AT,CT,CT,CT,AG ) frequencies were significantly lower than those in control group ( P＜0.05 ).Logistic regression analysis showed that the heterozygosis genotypes ( AT,CT,CT,CT,AG) were protective factors of HUA ( OR 0.68-0.75 ).The minor allele ( T,C,T,T,A ) frequencies for both SNPs were significantly different between two groups ( P =0.022,P =0.038 ).ConclusionThese findings indicate that -454A/T,-434T/C,-382C/T,-87C/T,and + 118G/A SNPs of hURAT1 gene promoter area are associated with HUA in Chinese Han population.

As the importance of clinical risks management grows hospital management,reducing hospital medical errors for patients safety has become a key quality management process.Failure Mode and effect analysis( FMEA) is a proactive technique for error detection and reduction.In this paper,based on a brief review of it's history of development,described in detail the implementation method and steps of FMEA,mainly introducing the research progress for using FMEA in reducing hospital medical errors.

Objective: To pre-assess the occupational hazards in a waste ecological landfill project using comprehensive exposure index with analogy method,and to provide reference for improvement of protective measures and prevention of occupational diseases. Methods: Some enterprises which were comparable with the project in landfill storage capacity,disposal scale,techniques,occupational hazards and occupational health management were selected to carry out on-site occupational health survey,and were evaluated by occupational exposure limits（OEL）. The risk of occupational hazards of the project was assessed by analogy and comprehensive index method. Results: The occupational hazards of analogous enterprises were hydrogen sulfide,ammonia,other dust and noise in ash solidification workshop,paving post in landfill area,spraying post and inspection post in sewage disposal area;manganese and its inorganic compounds,welding fume and arc light in welding post. Except for the noise intensity of spraying post exceeding the national OEL,the other items were qualified. The results of the pre-assessment of the project showed that in the posts with vacant OEL,the hazards of paving compaction post exposed to high temperature in summer,spraying post exposed to high temperature in summer,cypermethrin and machine repairing post exposed to heat,ozone and noise were at moderate risk;in the posts qualified by OEL,the hazards of paving compaction and sewage disposal posts exposed to noise were neglectable,paving compaction and transportation post exposed to other dust were at low risk,others were at moderate risk;unqualified spraying post exposed to noise was at moderate risk. Conclusion Medium-risk occupational hazards exist in paving compaction,spraying,sewage disposal and machine repairing posts. Comprehensive index method combined with analogy method can comprehensively achieve the occupational hazard pre-assessment of a proposed project.