Objective To improve th current teaching situation,increase clinical teaching quality in order to ensure the nursing students to adapt to new nursing model and social development.Methods The main problems existing in clinical nursing teaching of our country was analyzed,furthermore countermeasures were put forward.Results At present clinical nursing teaching of our country lacked perfect management system,teacher resources were weak,teaching time was not reasonably arranged,training of comprehensive quality for nursing students was lack.Conclusions Through analysis of current situation of clinical nursing teaching,we propose the corresponding ponder,guarantee the clinical nursing teaching quality and do fully preparatory work for training of nursing reserve forces with high quality.

Objective To analyze the relationship between the serum CysC,lipoprotein(a) [Lp(a)] and the urinary microalbumin/creatinine ratio in elderly type 2 dibetic (T2CM) patients.Methods A total of 102 elderly patients with T2CM who were treated in our hospital from December 2014 to December 2015 were selected.The patients were divided into diabetic nephropathy(DN) group(mALB≥20 μg/min,48 cases)and non-diabetic nephropathy(NDN) group (mALB<20 μg/min,54 cases) according the levels of urinary mALB,while 30 cases of healthy controls were selected from physical examination center.The biochemical indexes,CysC,Lp(a) and UACR were detected among all cases.The correlation between indexes and UACR was analyzed by Pearson correlation analysis,risk factors for UACR among DN patients were analyzed by Logistic regression analysis.Results There were significant differences in levels of low density lipoprotein cholesterol(LDL-C),Lp(a),urea,creatinine,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),Cysc,and UACR among these groups (P<0.05).No correlation between CysC、Lp(a) and UACR was found in normal-control group and non-diabetic nephropathy group.In diabetic nephropathy group,there was a positive correlation between CysC,Lp(a) and UACR(r=0.658,P<0.01;r=0.525,P<0.05).The Logistic regression analysis showed that diabetes duration,CysC,Lp(a) were independent risk factors for UACR(P<0.05).Conclusion In patients with diabetic nephropathy,CysC,Lp(a) are positively correlated with UACR,and CysC is a sensitive index that reflect early renal damage in T2DM patients.Lp(a) level is one of the independent risk factors for UACR,which can reveal the kidney damage in DN patients.

Objective To evaluate the efficacy of modifiedXiaochengqi decoction in treatment of gastroparesis syndrome (GS).Methods A total of 81 patients with GS from 2010 July to 2013 July in HuiZhou Municipal Central Hospital were selected and randomly recruited into a control group and a treatment group. The control group was treated with domperidone, 15-30 min before the meal, while the treatment group was additionally treated with modifiedXiaochengqi decoction on the basis of the control group. Both groups were treated for 4 weeks. The clinical curative effect, and the symptoms in both groups were observed. The serum motilin and gastrin concentration were measured by radio-immunity, the preprandial and postprandial electrogastrography was performed.Results The total effective rate in the treatment group was significantly higher than that in the control group (72.5%vs. 31.7%;χ2=11.911,P=0.000). The serum levels of motilin (treatment group: 532.8±16.7 ng/Lvs. 355.2±14.3 ng/L,t=51.089,P=0.000; control group: 505.1 ± 21.3 ng/Lvs. 372.9 ± 18.4 ng/L,t=30.074,P=0.000) and gastrin (treatment group: 69.8 ± 15.3 ng/Lvs. 54.3 ± 13.8 ng/L, t=4.758,P=0.000; control group: 62.6 ± 14.2 ng/Lvs. 53.4 ± 12.3 ng/L,t=3.136,P=0.002) were significantly reduced, and their decrease in the treatment group were greater than those in the control group (t values were 6.503, 2.196, allP<0.05). After the treatment, the dominant power (preprandial period: 84.5 ± 14.8μVvs. 72.3 ± 15.0μV, t=3.684,P<0.01; postprandial period: 100.5 ± 17.3μVvs.89.3 ± 15.9μV,t=5.713,P=0.000) and dominant frequency (preprandial period: 4.3 ± 0.4 cpmvs. 3.9 ± 0.2 cpm,t=3.035,P=0.000; postprandial period: 4.7 ± 0.5 cpmvs. 4.4 ± 0.5 cpm,t=2.700,P=0.000) were significantly higher, while the percentage of bradygastria (preprandial period: 50.6% ± 16.6%vs. 60.1% ± 16.3%,t=2.599,P=0.000;postprandial period: 36.6% ± 14.8%vs. 57.4% ± 15.3%,t=6.217, P=0.000) was significantly lower in the treatment group compared with the control group at preprandial and postprandial periods.ConclusionXiaochengqi decoction can obviously promote the gastric motility, and reduce the serum levels of motilin and gastrin in patients with GS.

Objective To observe the therapeutic efficacy and safety of acupuncture and epidural anesthesia during full-term labor. Method A total of 199 eligible subjects experiencing natural labor were randomized into four groups. The acupuncture group was intervened by acupuncture at acupoints; the epidural group was given epidural anesthesia;the combined analgesia group was given acupuncture at acupoints plus epidural anesthesia; the control group was not given any interventions for analgesia. The Visual Analogue Scale (VAS) was adopted to record and compare labor pain (cervix dilation 3 cm at 0 min, 30 min, and 60 min, and at full cervix dilation); meanwhile, the active period of the first stage of labor, cervix dilation speed, the second stage of labor, Caesarean section (C-section) rate, instrumental delivery rate, Apgar score, and post-labor bleeding amount (2 h) were also recorded. The contents of blood β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) were monitored during the first stage of labor. Result Compared with the control group, the VAS scores dropped in the other three groups, and the decreases were similar in the epidural group and combined analgesia group, while the decrease in the acupuncture group was the least significant. Regarding the labor-related indexes, the cervix dilation speed was higher in the acupuncture group than in the control group(P<0.05), while there was no significant difference between the acupuncture group and control group in comparing the duration of the second labor stage(P>0.05). There were no significant between-group differencesin comparing the post-labor bleeding amount and Apgar score of the new-born babies(P>0.05), but compared with the epidural group, there was no use of assisted delivery. The content of blood β-EP during the first stage of labor increased in the acupuncture group and combined analgesic group(P<0.05), but there were no significant changes in the epidural group and control group(P>0.05). Conclusion Acupuncture analgesia can reduce labor pain and shorten labor duration without affecting the second stage of labor and security-related indexes.

Objective To explore the definition,classification and imaging characteristics of abdominal enterogenous cysts in in-fant.Methods 18 patients with abdominal enterogenous cyst in infant,confirmed by surgical pathology,with complete imaging data (including ultrasonography,CT and enhanced CT),have been enrolled in the study.The imaging findings and pathological character-istics have been analyzed,and the classification of diagnosis has been conducted.Results According to the positions and imaging fea-tures of the pathological changes,abdominal enterogenous cysts could be further classified as:gastrointestinal wall type,mesenteric type and retroperitoneal type.In this study,gastrointestinal wall type in 1 1 patients (outside intestinal wall in 2,inside intestinal wall in 8,and outside gastric wall in 1);mesenteric type in 4 and retroperitoneal type in 3 were identified.Conclusion Classification of diagnosis can be conducted according to the enterogenous cyst’s special imaging findings,which provides a reference for the surgical operation.

Objective To investigate the effect of the continuing quality improvement on PICC-related phlebitis in breast cancer patients undergoing chemotherapy. Methods Eighty breast cancer patients undergoing PICC for chemotherapy in our hospital from September to December 2014 were selected as control group, receiving routine nursing care. Another eighty patients undergoing PICC for chemotherapy from January to March in 2015 were selected as experiment group and the quality control cycle was used, the measures including investigating the present situation aiming to theme, goal setting and analyzing, working out and using countermeasures and effect comfirming. Result After applying continuing quality improvement in the experiment group the incidence rate of phlebitis in the continuing quality improvement group was significantly lower than those before continuing quality improvement and in the control group (P<0.05). Conclusion The implementation of continuing quality improvement activities can reduce the incidence of pzce-related phlebitis in patients with breast cancer during chemotherapy. It can improve the safety of PICC catheter and therefore, it is worthy of popularization.

Objective To understand the prevalence and risk factors of Enterobius vermicularis among preschool children in kindergartens in Luohu District Shenzhen City. Methods A total of 489 children in 6 kindergartens were selected by the stratified sampling method and investigated for E. vermicularis infection by the cellophane anal swab technique. The information of sanitary condition of the kindergartens personal hygiene and family hygiene were investigated by questionnaire. Results The infection rate of E. vermicularis was 10.2% 50/489 . The single factor analysis indicated that the following factors might re?lated to the infection the different classes of kindergartens grades ground of bed room private toilet types of taps and beds bed management education levels of parents frequency of shower and washing anus and washing hands before meal and after WC. The multivariate Logistic analysis indicated that the bed management education level of mothers frequency of washing anus and private toilet were independent risk factors for E. vermicularis infection. Conclusion To control the infection of E. vermicularis the circumstance and management of kindergartens parents knowledge of E. vermicularis infection and chil?dren s healthy habit need improve.

Objective To explore the effects of simvastatin and cilazapril on the expression of transforming growth factor-?_1 (TGF-?_1) and insulin-like growth factor-Ⅰ (IGF-Ⅰ) in the cultured human glomerular mesangial cells. Methods Human embryo glomerular mesangial cells were cultured in media with lower (5.6 mmol/L) or higher (30 mmol/L) glucose concentrations. Forty-eighthoursafteraddingsimvastatin(10 ?mol/L)and/or cilazapril (10 ?mol/L) to the cultured media, the concentrations of TGF-?_1, fibronection, laminin, type Ⅳ collagen proteins in the supernatant of cultured mesangial cells were determined by ELISA and radioimmunoassay and the expressions of TGF-?_1 and IGF-Ⅰ mRNA in cultured mesangial cells were also evaluated by RT-PCR. Results Compared with lower glucose control, the mesangial cells in the medium with higher glucose concentration showed excessive proliferation and higher expressions of TGF-?_1 and IGF-Ⅰ mRNA, and the levels of TGF-?_1, fibronection, laminin, and type Ⅳ collagen in the supernatant were also significantly increased. The expressions of TGF-?_1 and IGF-Ⅰ mRNA in the mesangial cells and the concentrations of TGF-?_1 and the extracellular matrix (ECM) proteins in the supernatant were all decreased after addition of simvastatin and cilazapril. Combination of simvastatin and cilazapril resulted in more profound suppressive effect on the expression of TGF-?_1 mRNA than either of them alone. Conclusion High concentration of glucose stimulates the cultured human mesangial cells excessively to express the TGF-?_1, IGF-Ⅰ and ECM proteins, and the high glucose-induced changes are suppressed by either simvastatin, cilazapril alone or combined treatment.

Objective To explore the effect of standardized rehabilitation training and acupuncture therapy on knee osteoarthritis(KOA).Methods One hundred KOA patients were evenly divided into the treatment group and the control group by random digits table.The control group were treated by acupuncture plus general functional exercise guidance and the treatment group by standardized rehabilitation training and treatment for 3 courses(10 d as 1 treatment course).After 3 courses,the two groups were observed in terms of knee joint pain,joint function improvement and clinical curative effect.Result After treatment,the treatment group was significantly better than the control group in terms of knee joint pain,joint function improvement and clinical curative effect(all P<0.05 ).Conclusion The standardized rehabilitation training combined with acupuncture therapy may be effective in the reduction of the knee pain and improvement of knee function for patients with osteoarthritis.

Medical preparedness and response to radiation emergency are challenged by the fast development of nuclear energy and nuclear technology, the rapid use of radiological source and devices,and terrorist threats involving radiological material. Against this background, hospitals play a vital role in medical response to radiation emergency. In this article, we discussed the hospital's responsibility in medical response to radiation emergency, and raised a series of requirements to the medical bases engaged in radiation emergency, which cover the planning, personnel, facilities, equipments and drugs stockpiling, and medical management technique of such bases. Adequate preparedness in advance makes the best guard for such bases, to effectively handle nuclear and radiological emergency, minimizing casualties and health damage and protecting people's health and safety.