Objective To discuss the effect of competency based education practice teaching model on vocational nursing students with ability training.Methods Totally 96 vocational nursing students were divided into control group from July 2014 to May 2015,receiving routine mentoring teaching mode and totally 99 vocational nursing students were divided into learning group from July 2015 to May 2016,receiving competency based education practice teaching model.Theoretical examination and clinical operation skill test as well as self evaluation of caring ability and transitional nursing ability were conducted to both groups after the course to compare the test scores and the change of their caring ability and transitional nursing ability.SPSS 19.0 was used for statistical analysis,and independent samples t test was used between the two groups.Results The theoretical scores of the nursing students in the experimental group ([93.70 ± 4.27) vs.(88.00 ± 4.83)] and skill test [[95.70 ± 2.49] vs.(91.40 ± 2.87)] were higher than those of the control group;caring ability score [(189.3 ± 13.5) vs.(179.4 ± 10.4)],with the average score of cognitive dimension (51.6 ± 9.8) vs.(50.2 ± 10.3)],the dimension of courage (70.2 ± 6.5) [vs.(65.7 ± 8.4)],average patient dimension (63.4 ± 4.8) vs.5.4)];transitional nursing ability score [(124.95 ± 24.06) vs.(118.18 ± 20.41)],the dimension of knowledge sharing [(38.43 ± 8.22) vs.(36.08 ± 7.23)],average score of attitude dimension [(54.08 ± 10.66)vs.(51.02 ± 9.16)],average score of behavior dimension [(32.43 ± 6.25) vs.(32.43 ± 6.25)],which were all increased compared with the control group,and the difference was statistically significant.Conclusion Competency based education practice teaching mode achieves good teaching effect and it is worth recommending in clinical teaching.

Objective To investigate the distribution,epidemiologic features and antibiotic resistance of the enteric pathogens i-solated from children with diarrhea.Methods Enteric pathogens were isolated from children’s stool samples.The children with diarrhea were treated in the outpatient and inpatient of Shanghai Children’s Hospital between 2008 and 2013.Antimicrobial susceptibility testing was conducted by disk diffusion method for Salmonella and Shigella with 6 antimicrobial agents.Results A total of 545 enteric pathogens were collected.Salmonella was the dominant pathogen,accounting for 67.2%,followed by Shigella (20.7%),S.aureus (4.6%),C.jejuni (3.7%),Aeromonas (2.4%),and enteropathogenic E.coli (0.9%).The main serotypes of Salmonella were S.typhimurium and S.enteritidis.Approximately 56.3% of the patients were boys.A-bout 72.7% of the patients were infants under 2 years.The prevalence of diarrhea peaked in summer and autumn (72.9%). The susceptibility of these isolates was only tested with seven antibiotics.Shigella showed higher level of resistance to ampicil-lin and trimethoprim-sulfamethoxazole than Salmonella (P<0.05).Significantly higher percentage of S.flexneri isolates were resistant to sulbactam-ampicillin,ceftriaxone,ciprofloxacin,and chloramphenicol than S.sonnei (P<0.001).Further-more,the prevalence of multidrug resistant strains in Shigella (68.3%)was much higher than that in Salmonella (44.7%,P<0.001).Conclusions A variety of diarrhea-causing enteric pathogens are isolated from the children in Shanghai Children’s Hospital.The isolates are predominantly Salmonella and Shigella species.The epidemiological features of Salmonella and Shigella species are different in terms of gender,age,season and geographical distribution.The resistance to antibiotics is a serious problem and varies with different types of pathogens. Intensive and ongoing surveillance of enteric pathogens and their changing resistant pattern is required to control diar-rhea in children.

Objective To investigate the optimal therapy for patients with acute-on-chronic liver failure induced by hepatitis B.Methods A total of 302 patients with acute-on-chronic liver failure induced by hepatitis B in the Affiliated Infectious Diseases Hospital of Fujian Medical University were enrolled during January 2008 to January 2010.Patients were divided into group A ( medical treatment,n =57 ),group B (medical + antiviral treatment,n =80),group C ( medical + antiviral + artificial liver support system (ALSS),n =124) and group D (medical + antiviral + ALSS + traditional Chinese medicine treatment,n =41 ).Liver and renal function,prothrombin activity (PTA) and HBV DNA load were observed at the baseline,week 1,4,8,12 and the end of the treatment.All groups were followed up for 48 weeks to observe the survival rates.Kruskal-Willis H test was used to compare the efficacies in four groups,and Cox proportional hazards regression model was used for survival analysis. Results There was no difference among four groups in curative effects at week 4 ( H =3.213,P =0.360 ),but there was significant difference at week 12 (H =8.722,P =0.033).The one-year mortality rates for groups A,B,C,D were 36.84％ (21/57),32.50％ (26/80),26.61％ (33/124) and 24.39％ ( 10/41 ),respectively.The death risks of group C and D were 0.566 and 0.396 times of that in group B ( P =0.036 and 0.016).Conclusion Nucleoside analogue and ALSS plus medical treatment can effectively increase the survival rates of the patients with acute-on-chronic liver failure induced by hepatitis B.

Objective A resistin binding peptide (RBP) was selected by phage display in our previous work. Studies had shown that RBP could antagonize the role of resistin on the lipid metabolism and endocrine function of adipose tissue, but whether RBP affects the insulin secretion of pancreatic cells is still unknown. The aim of this study is to assess the effect of RBP on basal insulin secretion in RINm5F insulinoma cells. Methods The cell viability was measured by 3-[4,5-dimethyhhiazol-2-yl]-2,5-diphenyltetra-zolium bromide (MTT) cytotoxicity assay. The supernatants were assayed for insulin content by enzyme linked immunosorbent assay (ELISA). Reverse transcriptase-PCR assay and Western blotting were used to determine the expression of glucose transporter 2 (GLUT2) involved in insulin secretion. Cytosolic Ca2+, the trigger of insulin exocytosis, was analyzed with the fluorescent probe FURA-3/AM. Results RBP did no effect on the cell viability with a concentration of 10-8-10-12mol/L of 2 hours intervention. But it stimulated basal insulin secretion of RINm5F cells, accompanied by up-regulated increased expression of GLUT2 and elevated concentration of cytosolic Ca2+. Conclusion RBP could stimulate basal insulin secretion without affecting the cell viability.

Objective To explore the spatiotemporal distribution pattern, and identify risk cluster of esophageal cancer in Huai’an City so as to provide evidence for control and prevention of esophageal cancer. Methods Data of esophageal cancer incidence at township level in Huai’an City from 2011 to 2015 was collected. Spatial autocorrelation and local indications of spatial autocorrelation (LISA) were implemented to evaluate the spatial pattern of esophageal cancer incidence. Spatial scan statistics was used to examine spatio-temporal clustering of risk areas. Results The average incidence of esophageal cancer in Huai’an from 2011 to 2015 was 67.12/10 million, the incidence of male was significantly higher than that of female. The results of Moran’s I values implyed the spatial autocorrelation at township level. The results of LISA indicated that there were local hot spots and cold spots. The significant high-risk clusters included townships in Huai’an County, Huaiyin County and Jinhu County. The low-risk clusters were located in the main urban area and Xuyi County. Conclusions There are significant spatio-temporal aggregation for the distribution of incidence of esophageal cancer in Huai’an City and same spatiotemporal high-risk clusters between male and female. Our findings have a foundation to explore the multi-factorial etiology of esophageal cancer and have vital practical value for health services and policies implementation.

Objective To investigate the distribution and resistance profile of bacterial isolates in Shanghai Children's Hospital. Methods Antimicrobial susceptibility of all isolates was determined by Kirby-Bauer disk diffusion method according to 2016 CLSI standard. The data were analyzed by WHONET 5.6 software. Results A total of 23 259 non-duplicate strains were isolated from 2011 to 2016, including 10 885(46.8％)gram-postive cocci and 12 374(53.2％)gram-negative bacilli. The average prevalence of methicillin-resistant S. aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)was 35.8％ and 82.2％, respectively. The prevalence of MRSA rose from 27.4％ in 2011 to 42.9％ in 2016. The resistance rate of MRSA and MRCNS strains were significantly higher than methicillin sensitive strains. The resistance rate of Enterococcus faecium strains was significant higher than Enterococcus faecalis. The prevalence of non-susceptible Streptococcus pneumoniae was 31.2％(908). No gram-positive strain was resistant to vancomycin or linezolid. The prevalence of carbapenem resistance increased in gram-negative strains. The resistance rate of Klebsiella pneumoniae to imipenem and meropenem rose from 3.1％ and 4.8 ％ in 2011 to 28.7％ and 37.4％ in 2016, respectively.The rate of Pseudomonas aeruginosa resistance to imipenem and meropenem rose from 13.8％ and 16.5％ in 2011 to 18.8％ and 19.4％ in 2016, respectively, while Acinetobacter baumannii showed resistance rate of 38.3％ and 39.9 ％ in 2011 to 68.4％ and 69.7％ in 2016. Conclusions Increasing prevalence of MRSA, carbapenem-resistant K. pneumoniae, extensively drug-resistant A.baumannii has become a concern in clinical practice. Therefore, antimicrobial resistance surveillance should be highly strengthened in children's hospital.

OBJECTIVETo observe the efficacy differences of acupoints massage for asthenopia of video display terminal (VDT) under different exposure dose.

METHODSOne hundred and two cases (204 eyes) were divided into a low exposure group and a high exposure group, fifty-one cases in each group. The same intervention of acupoints massage on Cuanzhu (BL 2), Jingming (BL 1), Sizhukong (TE 23), Sibai (ST 2) and Taiyang(EX-HN 5) were given to the two groups, one acupoint for 5 min and once everyday, one month of which made a course. The symptom score, tear film break-up time (BUT) and Schirmer I test(SIT) were observed before and after treatment.

RESULTS(1) The correlation coefficient of cubic curve model of the exposure dose was the biggest with symptom improvement index (P = 0.000), which indicated that the lower VDT exposure index was, the more obvious the symptom improved. The symptom improvement indices of low exposure group and high exposure group, which were (52.31 +/- 16.65)% and (28.93 +/- 13.35)% respectively, were statistical significant difference (P = 0.000). (2) Compared to before treatment, the levels of BUT and SIT in the two groups were both significantly higher (P < 0.05). Compared with the high exposure group, the levels of BUT and SIT in the low exposure group were increased by 0.826 s (P = 0.022) and 1.029 mm (P = 0.033), respectively, after the impact of BUT and SIT was corrected before the research.

CONCLUSIONThe acupoints massage can improve the symptoms and ocular physiology for patients with VDT asthenpia, and it is more effective for the low exposure cases.

Acupuncture Points ; Adult ; Asthenopia ; physiopathology ; therapy ; Computer Terminals ; utilization ; Female ; Humans ; Male ; Massage ; Middle Aged ; Occupational Diseases ; physiopathology ; therapy ; Tears ; secretion ; Treatment Outcome ; Young Adult

OBJECTIVETo analyze the spectrometric semen protein profiling of oligospermia patients and healthy controls by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS), and to establish a semen marker pattern for the diagnosis of oligospermia.

METHODSSemen samples of 33 oligospermia patients and 31 healthy controls were collected on the CM01O proteinchip. The spectrometric protein profiling was detected by SELDI-TOF-MS and the data analyzed by Biomarker Pattern Software provided by Ciphergen Corp. A primary diagnostic model of oligospermia was established and evaluated by blind test with the 33 patients and 31 healthy controls.

RESULTSA total of 185 protein peaks were detected at the molecular range of 2000-20,000, among which 23 showed significant differences between oligospermia patients and healthy controls (P < 0.05). The diagnostic model consisted of 3 protein peaks, with a sensitivity of 90.9% (30/33) and a specificity of 93.6% (29/31). And the double-blind test generated a sensitivity of 87.8% (29/33) and a specificity of 90.3% (28/31).

CONCLUSIONThe diagnostic model was successfully established by SELDI-TOF-MS, which could be applied to the differentiation of the spectrometric protein profiling patterns of oligospermia patients and healthy controls.

Adult ; Humans ; Male ; Oligospermia ; metabolism ; Protein Array Analysis ; Semen ; metabolism ; Seminal Plasma Proteins ; metabolism ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods

OBJECTIVE: To investigate the effect of atorvastatin on the expression of angiotensin converting enzyme 2 (ACE2) mRNA and its protein in hypertrophic myocardium in rats. METHODS: Suprarenal abdominal aortic coarctation was performed to create the pressure overload induced left ventricular hypertrophy model in rats. RESULTS: Rats were randomly divided into 5 groups: (1) normal control group (Group A); (2) normal control group treated with atorvastatin [(5 mg/(kg.dd), Group B]; (3) sham group (Group C); (4) atorvastatin given orally by gastric gavage for 4 weeks [5 mg/(kg.dd),Group D]; (5) vehicle group (Group E). Stained pathological section was observed under light microscope to measure cardiomyocyte diameter transversa and collagen volume fraction. ACE2 mRNA and its protein expression were detected by real-time RT-PCR and Western blot. Compared with Group A,B, and C, the left ventricular mass index, cardiomyocyte diameter transversa and collagen volume fraction in Group E increased statistically (P< 0.01), ACE2 mRNA and its protein expression also elevated remarkably (P< 0.01). Compared with Group E, the above mentioned indexes in Group D reduced significantly (P< 0.01). CONCLUSION ACE2 mRNA and its protein expression increase significantly in hypertrophic myocardium in rats; atorvastatin can attenuate cardiac hypertrophy due to pressure overload in rats effectively, and part of this anti-hypertrophy effect may be attributed to decrease ACE2 mRNA and protein expression.
Animals ; Aorta ; Atorvastatin ; Heptanoic Acids ; pharmacology ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; pharmacology ; Hypertrophy, Left Ventricular ; etiology ; metabolism ; Ligation ; Male ; Peptidyl-Dipeptidase A ; biosynthesis ; genetics ; Pyrroles ; pharmacology ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To explore the impact of bundle prevention strategies on the CRBSI incidence.Methods Patients admitted to ICU with central venous catheter were given daily assessment and target monitor from 2008.2 to 2010.2,and divided into infected (117 cases) and non-infected ( 1 288 cases) group according to whether there was CRBSI.Analysis the relationship between the measures of bundle prevention strategies and the incidence of CRBSI,all data applications SPSS 10.0 for windows statistical software package for statistical analysis.Results In the study,1405 cases were collected,and 117 cases were infected while 1288 cases were non-infected.The total number of catheter day was 17 317 days,and the average was 12.85 d.Infection rate was 6.8 per 1 000 catheter days.Sex,age,type of skin plaster and time of changing skin plaster and infusion TPN were not different between the two groups (P＞0.05).The single variable analysis has shown that the in the infection group,severity of clinical patients (APACHE Ⅱ ＞ 20 points) was 78.63％,ICU stay time( ＞ 30days) was 38.46％,emergency intubation method was 17.95％,patients received the frequency of invasive procedures( ＞4 times) was 83.76％,catheter day longer than 7 days was 78.63％ were higher than those in the non-infection group (51.86％,15.53％,7.84％,35.02％ and 31.13％,respectively) and the difference was significant ( x2 =8.071,23.750,10.781,36.56,44.886,respectively; P ＜ 0.05 ) ; the pass rate of maximum sterile barrier (45.30％),the timeliness of joint disinfection on normal operation (68.38％) and catheterization in subclavian vein (40.17％ ) in infection group were lower than non-infeclion group (75.93％,94.33％ and 59.94％,respectively) and the difference was significant (x2 =9.303,4.604,5.076,respectively;P ＜0.05).Multiple regression analysis showed that the joint disinfection timeliness on normal operation was the independence factor of affecting CRBSI incidence ( OR =4.992,P ＜ 0,01 ).Conclusions The implementation of bundle prevention strategies and strengthening the management of catheter connector can reduce the incidence of CRBSI.