Clinical nursing needs not only skill,but also high moral level,which is important to guarantte the quality of medical care.According to the ethical difficulty and moral problems in clinical nursing,the article makes primary research and discussion on nurse's psychological quality,skill and ability,sense of responsibility and the relationships.It also expounds the importance of nursing in clinic and the relationship between doctor and patient from the two aspects of improving nurse's technique skill level and ethical moral level to promote the development of clinical work and nursing.

Morus alba L. (mulberry) is a well-known deciduous tree, belonging to the genus of Morus of Moraceae famlily. Its leaves, twigs, roots (bark) and fruits are widely used in the traditional Chinese medicine. The active constituents of mulberry contained flavonoids, alkaloids, steroids, coumarins, with the significant hypoglycemic, hypolipidemic, antihypertension, anti-oxidation, anti-inflammatory, anti-bacterial, anti-tumor and immunomodulatory activities. This review summarized the research progress of the major pharmacological activity, pharmacokinetics and drug-drug interaction based on CYPs and transporters of mulberry and its active constituents.

A simple, rapid and sensitive method was developed for the quantification of tenofovir in plasma of Beagle dogs using HPLC-MS/MS analysis. The analytes tenofovir and internal standard (IS) adefovir were separated on a Zorbax SB-C18 column (3.5 microm, 100 mm x 2.1 mm, Agilent, USA) with mobile phase of methanol/water containing 0.3% formic acid using a gradient elution mode at a flow rate of 0.2 mL x min(-1). The plasma sample preparation was a simple deproteinization by the addition of 20% trichloroacetic acid followed by centrifugation. The detection was performed in positive selected reaction monitoring (SRM) mode with an electrospray ionization (ESI) source. The reactions monitored were m/z 288.1-176.2 for tenofovir and m/z 274.1-162.2 for adefovir (IS). Linear detection responses were obtained for tenofovir ranging from 10 to 5 000 ng x mL(-1). The intra- and inter-day precisions (RSD%) was no more than 6.3% with high recovery and good stability for the quantification, indicating the present method was specific, fast, accurate and reliable. The method was successfully applied to the pharmacokinetic study of two tenofovir agents. Tenofovir dipivoxil fumarate (BP0018, test agent) and tenofovir disoproxil fumarate (reference agent) were orally administrated to 8 Beagle dogs according to the 2 x 2 crossover design. Comparing with the reference agent, the longer MRT and t1/2 were obtained in the group of BP0018, while no significant difference was observed in AUC(0-t), AUC(0-infinity), C(max) and t(max) between them, suggesting that tenofovir dipivoxil fumarate was bioequivalent to the tenofovir disoproxil fumarate in Beagle dogs.

It is valuable to establish a chemical-pharmacokinetic (PK)-pharmacodynamics (PD) fingerprint of traditional Chinese medicine (TCM) for comprehensively understanding the TCM integrated conception and revealing the material foundation. The chemical, metabolic in vitro, and PK/PD in vivo fingerprints of Schisandra chinensis (SC) alcoholic extract were established and comparatively analyzed using HPLC-UV-MS method, rat liver microsomes in vitro and CCl4 intoxicated rats in vivo. Four known effective lignans, schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin, were detected as the standard references in SC alcoholic extract with high concentration. SC alcoholic extract and four lignans when incubated with rat liver microsomes produced several metabolites in NAPDH-dependent manner. Chemical fingerprint of some components with bioactivities were also identified in PK and PD fingerprints in normal and ALI rats that explained the material foundation of SC alcoholic extract for multiple pharmacological effects. Schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin could be considered as the "PK marker" of SC alcoholic extract or its relevant preparations, while two metabolites of the four lignans, 7, 8-dihydroxy-schizandrin and another one (M(W) 432), could be recognized as drug-metabolism (DM) Marker. This work provides experimental data for the further studies of metabolism or material foundation of SC components.

Effects of constituents from Schisandra chinensis (Wuweizi) on six liver microsomal CYP450 isozymes (CYP1A2, CYP2C6, CYP2C11, CYP2D2, CYP2E1 and CYP3A1/2) were studied in rats in vivo and in vitro. The in vitro incubation was conducted using liver microsomes of rats after multiple dosing of alcoholic/water extract from Schisandra chinensis. A HPLC-MS method was applied to determine the metabolites formation of six CYP450s probe substrates (phenacetin-CYP1A2, dextromethorphan-CYP2D2, diclofenac sodium-CYP2C6, mephenytoin-CYP2C11, chlorzoxazone-CYP2E1 and midazolam-CYP3A1/2) in rat liver microsomal incubations. The activity of CYP450 isozymes were represented by the formation of metabolites. Alcoholic extract of Schisandra chinensis (28-120 microg x mL(-1)) showed significant inhibitory effect on six CYP450 isozymes to a certain extent in vitro. Multiple dosing of Schisandra chinensis alcoholic extract (1.5 g x kg(-1), qd x 7d) had significant induction on CYP2E1 and CYP3A1/2, inhibition on CYP2D2 and CYP2C11, and no effect on CYP2C6 and CYP1A2. Water extract of Schisandra chinensis (100-500 microg x mL(-1)) also exhibited inhibition on the activity of CYP450 isozymes in vitro, whereas multiple administrations (1.5 g x kg(-1), qd x 7d) had significant induction of CYP2E1 and inhibition on CYP2D2, no effect on CYP2C6, CYP3A1/2, CYP1A2 or CYP2C11. The results suggested that the constituents from Schisandra chinensis exhibited the inhibition and induction on six rat liver microsomal CYP450 isozymes to a certain extent in vivo and in vitro. The possibility of interaction between Schisandra chinensis and coadministrative drugs will be considered base on the levels and subtype of CYP450 involved in the drug metabolism.

Objective:To establish a UVB damage cell model with HaCaT cells to investigate the protective effects of Zinc sulfate on the cell damage caused by UVB and its relevant mechanisms .Methods: The cells were divided into normal group , Zinc group,UVB group,Znic and UVB group.The addition of Zinc sulfate to the HaCaT cells was conducted 24h prior to the irradiation to the cells by UVB.Cell apoptosis was detected by Western blot and the expression of metallothionein and NF -κB/p65 were measured by im-munohistochemistry.Results:Compared with normal and Zn+UVB group, Bax/Bcl-2 rate in UVB group increased.Compared with normal group ,MT expression levels in UVB group ,Zn group increased ,and compared with UVB group ,MT expression level in Zn+UVB group increased .Compared with normal group and Zn+UVB group,NF-κB/p65 expression level in UVB group increased .Conclusion:Zinc sulfate alleviates the apoptosis of HaCaT cell induced by UVB because of the expression of MT .

Objective:To study the influences of sucrose,citric acid and sodium bicarbonate on the adhesion of 3 kinds of adhesives.Methods:60 extracted tooth and 60 zirconia blocks (3 mm × 3 mm × 3 mm) were randomly divided into 3 groups (n =20),namely PULPDENT group,3M ESPE RelyxTM Veneer group and RelyxTM Luting group.Then,the samples of each group fell into 4 subgroups(n=5),namely subgroup A for artificial saliva,subgroup B for 10％ sucrose,subgroup C for 0.2％ citric acid,and subgroup D for 0.03 ％ sodium bicarbonate.After completing the adhesion of the specimens with corresponding adhesives,the specimens of subgroups A,B,C and D were submerged into artificial saliva(the control),sucrose,citric acid and sodium bicarbonate solutions for 2 times/day and 5 min/time,respectively.For the rest of time,all the specimens were submerged in artificial saliva.3 months later,shear bond strength of the specimens was tested,the fracture surface was observed under SEM,20 × microscope,and the fracture model was observed by stereoscopic microscope.SPSS 17.0 software was adopted for statistical analysis of the data.Results:The bond strength of PULPDENT,3M ESPE RelyxTM Veneer groups were higher than that of RelyxTM Luting group(P ＜ 0.05);the bond strength of subgroups B,C and D was lower than that of subgroup A(P ＜0.05);and the difference between the remaining groups was not statistically significant(P ＞0.05).SEM observation displayed that in group RelyxTM Luting,subgroups B,C and D showed increased crack depth,width and length when compared with subgroup A;there was no obvious difference between the remaining groups and the control group;in groups PULPENT,3M ESPE RelyxTM Veneer and RelyxTM Luting,all samples in their subgroups showed interface failure.Conclusion:Compared with PULPDENT and 3M ESPE RelyxTM Veneer adhesive,RelyxTM Luting is more susceptible to the influence of sucrose,citric acid and sodium bicarbonate,so it is not suitable for bonding zirconia blocks.

OBJECTIVETo evaluate the influence of different polishing methods on marginal microleakage of zirconium dioxide full crown.

METHODSThirty extracted premolars were selected and randomly divided into three groups, A, B and C, with 10 in each group. Group A was prepared with MANI TF-13 bur completely without the treatment of shoulder. The shoulder of group B was polished with MANI TR13-EF bur after the preparation using MANI TF-13. The shoulder of group C was polished with the dental pneumatic ultrasonic hand-piece of KaVo SONICflex after the preparation using MANI TF-13 bur. Five specimens after preparation were selected in each group. Fifteen CAD/CAM zirconium dioxide full crowns have been made. The crowns were bonded using PULPDENT resin cement, and the root canals were sealed using nail polish, and apical foramen were closed using flow resin. The test-pieces have been immersed in a 3% solution of methylene blue for 24 h. The condition of shoulder marginal microleakage was observed using light stereomicroscopy and evaluated in classification index. The remaining specimens in each group were used for roughness test and scanning electron microscope(SEM) experiment. The marginal microleakage situations of specimens in three groups was analyzed by SPSS 17.0. The enamel surface of different polishing methods was observed using SEM.

RESULTSThe specimens in group C demonstrated the least marginal microleakage, and those in group B showed an intermediate level of marginal microleakage, and those in group A characterized the most serious marginal microleakage (total, χ2=44.610, P<0.01; among the different groups, P<0.05). The roughness experiment showed that specimens in group C achieve the smoothest results ([0.27±0.03] μm). Preparation shoulder polished using the dental pneumatic ultrasonic hand-piece demonstrated the best result under the SEM among the three groups.

CONCLUSIONSThe anti-microleakage effectiveness of dental pneumatic ultrasonic hand-piece in shoulder refinement is better than ordinary shoulder treatment.

Bicuspid ; Computer-Aided Design ; Crowns ; Dental Enamel ; Dental Instruments ; Dental Leakage ; diagnosis ; prevention & control ; Dental Polishing ; methods ; Dental Prosthesis Design ; methods ; Humans ; Pit and Fissure Sealants ; Random Allocation ; Resin Cements ; Ultrasonics ; Zirconium