In the early 20th century,the term Nursing was introduced into China.In 1884,with the arrival of the first batch of missionary nurse,modern nursing initiated by Nightingale was introduced into China and greatly changed the way of care.The missionary nurses were full of enthusiasm for the spreading Gospel of Christ,the love for nursing care and the empathy for Chinese people;and encountered the lack of staff and material,the mis-understanding and resistance from the local people and other multiple tests.With the untiring effort of them and the trained local nurses,China had led the international care in nursing education and practice standard.Based on this,nursing in Shandong gradually rose and had an unprecedented development as a new medical subject.By clearing up and consulting Chinese and English historical materials,this paper reviewed the 60 years of the mission-ary nurses in China,saw the early development of nursing in our country from the budding and development of Shandong nursing and provided more insights for understanding and solving the complex problems contemporary Chinese nursing faces.

Objective To analyze the overall deployment of Class-A large medical equipments in China.Methods Data of Class A large medical equipments deployed from 2007 to 2015 were collected and classified regionally,for the purpose of measuring the overall deployment,growth level and plan performance.Results There were 403 large medical equipments in China,a rapid rise of deployment,yet still far below developed countries in terms of per capita deployment.Regional differences were significant.With PET-CT as an example,the plan performance in the east(92.19%)was much higher than the west of China(68.57%);plan performance of Class-A equipments was better,conducive to regulating the increase and distribution.Conclusions The deployment level of Class-A equipments in China is low in general,and calls for better regulation regardless of the planning and management progress.

Objective To investigate the influence of stroke volume variation (SVV)-guided fluid therapy on postoperative cognitive function in elderly patients undergoing the unilateral total knee arthroplasty(UTKA).Methods One hundred patients undergoing the UTKA were randomly di-vided into two groups,group A(SVV 4%-9%)and group B(SVV 10%-14%).The liquid manage-ment,serum markers (CRP,IL-6)and the incidences of deflating-tourniquet-related hypotension and preoperative, 5 d after surgery of the occurrence of POCD in two groups were recorded. Results There was no significant difference in general information between the two groups. Compared with group B,group A needed more fluid transfusion and had a higher 24 h urine volume. The CRP and IL-6 was significantly higher in group B than that in group A;The incidence of defla-ting-tourniquet-related hypotension in group A [22(44%)]was also lower than that in group B [43 (86%)].However,there was no significant difference in the incidence of POCD between the two groups.Conclusion Sufficient blood volume can help to reduce the incidence of deflating-tourniquet-related hypotension,and reduce the inflammatory reaction in elderly patients.

Adolescent ; Angiofibroma ; pathology ; Humans ; Male ; Nasopharyngeal Neoplasms ; pathology ; Pharynx ; pathology

Objective To evaluate whether changes in neonatal intensive care have improved outcomes for extremely low birth weight (ELBW) infants in neonatal intensive care unit (NICU). Methods A prospective phase-lag cohort study was performed in a tertiary level NICU. A meticulous nursing strategy based on neonatal individual developmental care assessment program theory and feasible ELBW minimization stimulus was developed. Conventional care was applied in 2013 (period Ⅰ) and gently caring was applied in 2014 (period Ⅱ). The outcomes of ELBW between these 2 periods were compared. Results During these two periods, thirty-seven infants were included in period Ⅰ and 41 infants in period Ⅱ. In periodⅠ46.0%(17/37) of the infants needed oxygen for at least 28 days, but in period Ⅱ it decreased to 24.4%(10/41), there was significant difference (χ2=3.990, P=0.046). The rate of breastfeeding increased from 27.0%(10/37) in periodⅠto 61.0%(25/41) in period Ⅱ, there was significant difference (χ2=9.061, P=0.003). There was no significant difference in the mortality rate and chronic lung disease (P>0.05). The incidence of intracranial hemorrhage decreased from 21.6%(8/37) to 4.9%(2/41), there was significant difference(P=0.041). Conclusions Gently caring may have resulted in less intracranial hemorrhage and improve breastfeeding rate. Parents are satisfied with gentle care and in light of these findings, gentle care deserves further exploration.

Objective To evaluate the role of sonic hedgehog (SHH) signaling pathway in spinal neurons in morphine tolerance (MT) in mice.Methods Pathogen-free healthy female Kunming mice,weighing 20-25 g,aged 8-10 weeks,were used in the study.MT was induced with morphine 10 mg/kg injected subcutaneously twice a day for 7 consecutive days.The experiment was performed in two parts.Experiment Ⅰ Forty-eight mice were randomly assigned into 2 groups:control group (group C,n =8) and MT group (group M,n=40).The thermal pain threshold (TPT) was measured at 1 day before morphine injection and 1,3,5,7 and 14 days after the end of injection.Eight mice in each group were sacrificed at 2 h after measurement of TPT at each time point after the end of injection in group M or at 2 h after the last measurement of TPT in group C,and the lumbar segment (L4-6) of the spinal cord was removed.Experiment Ⅱ Forty-eight mice were randomly assigned into 6 groups (n=8 each):SHH inhibitor cyclopamine plus MT group (group CP+M),cyclopamine solvent plus MT group (group D1 +M),SHH agonist SAG plus MT group (group SAG+M),SAG solvent plus MT group (group D2+M),MT plus cyclopamine group (group M+CP) and morphine plus cyelopamine solvent group (group M+D1).At 15 min before morphine injection,cyclopamine 10 mg/kg was injected subcutaneously in group CP+M,and SAG 5 mg/kg was injected subcutaneously in group SAG+M.Cyclopamine 10 mg/kg was injected subcutaneously once a day during the 1-3 days after the end of morphine injection in group M+CP.The TPT was measured before injection of morphine,at 30 min after the first injection of morphine every day and at 1-3 days after the end of morphine injection.The animals were sacrificed at 2 h after the last measurement of TPT,and the lumbar segment (L4-6) of the spinal cord was removed for determination of the expression of SHH signaling pathway-related proteins SHH,ptch1,smo,gli1 and gli3 using Western blot.Results Experiment Ⅰ Compared with group C,the TPT was significantly decreased at 1 and 3 days after the end of morphine injection (P＜0.05),no significant change was found in TPT at 5-14 days after the end of morphine injection (P＞0.05),and the expression of SHH,smo and glil at 1-5 days after the end of morphine injection,of ptchl at 1 and 3 days after the end of morphine injection and of gli3 at 7 days after the end of morphine injection was up-regulated in group M (P＜0.05).Experiment Ⅱ Compared with group D1+M,the TPT was significantly increased,the expression of SHH,ptchl,smo and glil was down-regulated,and gli3 expression was up-regulated in group C P+M (P＜0.05).Compared with group D2+M,the TPT was significantly decreased,the expression of SHH,ptch1,smo and glil was up-regulated,and gli3 expression was down-regulated in group SAG+M (P＜0.05).There was no significant difference in the parameters mentioned above between group M+CP and group M+D1 (P＞0.05).The TPT was significantly lower on 3rd-7th days after beginning of morphine injection and 1-3 days after the end of morphine injection than at 30 min after the first injection of morphine in group CP+M (P＜0.05).Conclusion The mechanism underlying the development of MT is partially related to activation of SHH signaling pathway in spinal neurons of mice,however,the maintenance mechanism has no marked relationship with it.

Objective In order to accumulate data for the final evaluation and acceptance of the Twelfth Five-Year Plan of National Endemic Disease Prevention and Control,we investigated the endemic scopes and basic situation of Keshan disease (KD) in Harbin.Methods According to the Criteria for Diagnosis of Keshan Disease (WS/T 210-2011),we conducted clinical survey of KD prevalence in 10 KD endemic counties in Harbin in 2013.2011-2015,we detected and searched for cases in 10 ward counties of Keshan disease.According to the Delimitation and Classification of Keshan Disease Areas and the Evaluation of Endemic Disease Control and Elimination,we determined the regional type,the situation of control and elimination of the disease,at the same time all KD patients were positioned by global positioning system (GPS).Results There were 2 KD endemic counties,12 endemic townships,and 37 KD patients in Harbin.All 12 townships were the light endemic regions of KD.Other townships were conformed to be the history regions with KD.The management index scores of KD reached the elimination requirements which were more than 85 points in every region county (city).Ten region counties got to technical standards for KD elimination.Harbin basically reached the index of KD elimination.The GPS satellite positioning of KD patients were concentrated in the 45.1-45.5 degrees north latitude,and 127.7-128.3 degrees east longitude.Conclusion The regions of KD endemic areas have narrowed down and the prevalence rate has declined significantly in Harbin,which have reached the basic elimination standards of KD by the 12th Five-Year Plan.

Objective To investigate the setup error for nasopharyngeal carcinoma (NPC) patients with poor compliance using kV cone-beam computed tomography,and to calculate the expansion margin from the clinical target volume (CTV) to planning target volume (PTV).Methods In 45 NPC patients from 2013 to 2015,the setup error,95％ confidence interval (CI)-1 for random error,and PTV-1 value were calculated.Moreover,in 16 NPC patients with poor compliance based on five verifications (random error not within 95％ CI-1),the setup error,95％ CI-2 for random error,and PTV-2 value were calculated.For the 16 special patients,PTV-1 and PTV-1 combined with PTV-2 were used to develop the plan-1 and plan-2,respectively.The dosimetric difference between plan-1 and plan-2 was evaluated.Results Both PTV-1 and PTV-2 had the largest expansion margin in the y direction.The CTV of plan-1 could not meet the requirement of the prescription dose after the setup error was introduced.Compared with plan-1,the V95％ and D95 values for the CTV of plan-2 were increased by 6.26％ and 4.43％,respectively.The D01 value was significantly larger in plan-2 than in plan-1 (P=0.005),which,however,met the clinical requirement.Conclusions In patients with poor compliance,the dose to target volume can be effectively elevated and the normal tissue can be spared from damage when PTV-1 combined with PTV-2 is selected as expansion margin.

Objective To explore whether emotion regulation mediates the relationship between occupational stress and job burnout in a large sample of nurses, in order to provide a targeted intervention. Methods Chinese Nurses Stressor Scale, Maslach Burnout Inventory-Human Services Survey, Emotion Regulation Questionnaire and Ruminative Responses Scale were used to investigate 602 nurses working in three tertiary hospitals in Jinan. SPSS 16.0 and AMOS 17.0 software were used to analyze the data. Results Job burnout were positively correlated with stressors, expression suppression and rumination (r=0.112–0.576, P<0.01), and negatively correlated with cognitive reappraisal (r=-0.277, P<0.01). Stressors were positively correlated with expression suppression and rumination (r = 0.140–0.403, P <0.01), and negatively correlated with cognitive reappraisal (r =-0.110, P < 0.01). Occupational stress could make a positive role on job burnout directly. Moreover, in the indirect approach, occupational stress could make a positive role on job burnout through the mediating role of cognitive reappraisal and ruminative, but not expression suppression. Conclusions Cognitive reappraisal and ruminative partially mediated the relationship between occupational stress and job burnout.

This study was aimed to develop an HPLC method for the determination of hesperidin,magnolol,honoki-oland liquiritin in Soft Capsule Jia-Wei Huo-Xiang Zheng-Qi (JWHXZQ). AKromasil C18 column (250 mmí4.6 mm, 5 μm) was used with water-methanol as mobile phasegradient elution. The flow rate was 1.0 mL·min-1, and the de-tecting wavelength was at 287 nm. The results showed that the linearity ranges ofhesperidin,magnolol,honokioland liquiritinwere 4.47-178.70 μg·mL-1, 3.42-136.96 μg·mL-1, 3.49-139.48 μg·mL-1, 3.92-157.20 μg·mL-1, respec-tively (r>0.999). The average recoveries of them were 99.48%, 99.05%, 99.57% and 99.79%, respectively. It was concluded that the method was accurate, sensitive and specific for quality control of Soft Capsule JWHXZQ.