This article analyzed the entry qualification,organization system,teacher training selection standard,assessment methods,training materials and continuous authentication system about existing emergency nurse training base in our country.The study put forward that optimization of base training system and the organization scheme,establish and improve relevant laws system are the urgent problems in the training base of emergency nurses.

Objective To analyze the epidemiological characteristics of adverse drug reaction (ADR) induced by Brucea Jananica Oil Injection,through literature review and to provide theoretical support for rational use in clinic.Methods With retrospective case study,analyzed ADR induced by Brucea Jananica Oil Injection,which were searched from revelent domestic pharmaceutical database from January 1990 to September 2016.Results Totaliy 76 cases were collected,and most were middle-aged and aged patients.Males patients were more than female patients (61.84％).ADR appeared in every period.The main ADRs of Brucea Jananica Oil Injection were allergic reactions (27.71％),digestive system damage (26.51％),and skin and accessories damage (19.28％).Conclusion Brucea Jananica Oil Injection can induced various ADRs and the occurrence of ADRs was associated with a variety of factors.Clinical monitoring should be enhanced,so as to ensure safety and efficacy of medication.

Objective To study the effect of electrical stimulation of the fastigial nucleus of the cerebellum (FNS) on learning,memory and the expression of growth-association protein-43 (GAP-43) after cerebral ischemia and reperfusion.Methods Sixty healthy,adult,male Sprague-Dawley rats were randomly divided into a normal group,a sham-operation group (sham group),a model group and an FNS group,with 15 rats in each.Left middle cerebral artery occlusion and reperfusion (MCAO/R) was administered to the rats in the FNS and model groups using the thread embolism method.The rats of the FNS group were given FNS treatment using a pair of needle electrodes inserted into the cerebellar fastigial nucleus 3hrs after the MCAO/R.Needle electrodes were similarly inserted in the model group rats,but no electrical stimulus was applied.Then the rats' learning and memory abilities were tested using a Morris water maze on days 1,3 and 7 after the MCAO/R modeling.The expression of GAP-43 mRNA on the side of the cerebral infarction was detected using a quantitative,real-time polymerase chain reaction.Results The average escape]atencies of the rats in the model and FNS groups were significantly longer than those of the normal and sham groups at all time points,but the FNS group rats demonstrated a significantly shorter average escape latency than the rats of the model group at each time point.The normal and sham groups showed a significantly lower expression of GAP-43 mRNA than the model and FNS group rats at all time points.The FNS group rats had a significantly higher level of GAP-43 mRNA than the rats of the model group.Conclusion FNS improved the rats' learning and memory abilities.This might be associated with the up-regulation of GAP-43 mRNA in neurons on the side of the cerebral infarction which could promote the regeneration and repair of peripheral nerve axons in the area of the infarction.

Objective: To study the chemical constituents from Scolopendra multidens. Methods: Compounds were isolated and purified by a combination of chromatographic techniques including silica gel, ODS, Sephadex LH-20 column chromatography, middle and low pressure preparative chromatograms, and pre-HPLC. The structures were elucidated on the basis of physicochemical properties and spectroscopic analyses. Results: Ten compounds were separated and identified as uracil (1), 7, 8-dimethyl-isoalloxazine (2), indole-3-acetamide (3), N-(2-phenylethyl) acetamide (4), (3S)-1, 2, 3, 4-tetrahydro-β-carboline-3-carboxylic acid (5), cyclo-(L-Ile-L-Pro) (6), cyclo-(L-Leu-L-Pro) (7), cyclo-(L-Phe-L-Pro) (8), cyclo-(L-Phe-L-Tyr) (9), and cyclo-(L-Val-L-Pro) (10). Conclusion: All the compounds are isolated from S. multidens for the first time.

BACKGROUND:Anterior cervical plate can maximize the intervertebral space height,expand intervertebral foramen,restore cervical physiological antecurvature,prevent instability due to implant micromovement,and increase graft fusion.However,the selection of entire autologous bone or Ti-mesh bone graft remains uncertain in application of anterior cervical plate.OBJECTIVE:To compare the complications of three different intervertebral fusion methods in anterior cervical decompression surgery.METHODS:A total of 92 cases of cervical spondylotic myelopathy were treated by anterior cervical decompression and three different intervertebral fusion methods.They were followed up for at least 3 months.Of them,6 underwent bone grafting alone,21 underwent autogenous bone graft with cervical plate-screw fixation,and 65 underwent pyramesh with anterior cervical plate-screw fixation.Complications were observed in all cases.RESULTS AND CONCLUSLON:A total of 2 of 6 autogenous bone grafting cases suffered from graft bone dislocation,1 suffered from pseudoarthrosis formation,and 1 suffered from donated ilium.Six of 21 autogenous bone graft with cervical plate-screw fixation suffered from loss of intervertebral height,and 3 suffered from pain of donated ilium.Eleven of 65 pyramesh with anterior cervical plate-screw fixation suffered from titanium mesh subsidence,1 case suffered from breakage of fixation screw.Simple autogenous bone grafting surgery was rarely used due to long duration of external fixation and too much complications.Autogenous bone grafting with anterior cervical plate-screw fixation surgery has shortage of grafted bone absorption and pain of donated ilium.Pyramesh with anterior cervical plate-screw fixation surgery overcomes the shortage of donated iliac pain,but remains the shortage of titanium mesh subsidence and lose of intervertebral height.

ObjectiveTo evaluate the effectiveness of PBL teaching model for medical students in surgery bed side teaching.MethodsThe method of meta-analysis.ResultsFinally,twenty-six documents met the requirement.The resuhs of Meta-analysis showed that,in the aspect of theory improvement for medical students,WMD=6.46,95 ％ CI 为 2.56 ～ 10.36,P＜0.01 ; in the aspect of skill ability improvement,WMD=5.32,95 ％ CI 为 2.47 ～ 8.16,P ＜0.01.ConclusionThe model of PBL teaching could significantly improve the effectiveness in theoretical knowledge and skill ability.

Objective To discuss the relationship between c-reactive protein and prognosis of acute coronary syndrome.Methods C-reactive protein of 60 acute coronary syndrome aged patients was evaluated.The patients were divided into two groups:one group with higher CRP level and another group with normal CRP level.The following-up duration was 6 months.After correct therapy,the morbidity of re-angina,arrbythmia,heart failure,re-infarction and cardiac death was compared.Results The morbidity of re-angina,arrhythmia,heart failure,re-infarction,cardiac death was 46.3%(19/41),43.9%(18/41),9.8%(4/41),22.0%(9/41),7.3%(3/41)respectively in higher Clip levd group;The morbidity of re-angina,arrhythmia,heart failure,re-infarction was 15.8%(3/19),10.5%(2/19),5.3%(1/19),5.3%(1/19)respectively in normal CRP group and there was no cardiac death accident.There was significant difference between the two groups.Conclusion CRP plays an important role in the onset of acute coronary syndrome,and its level is related with the higher morbidity of re-angina,arrbythmia,heart failure,re-infarction and cardiac death.

Objective To observe the effect of Danshen in the treatment of severe hand-foot-and-mouth disease and investigate its mechanism.Methods One hundred and forty cases of children with severe hand foot and mouth diseases who hospitalized the intensive care unit were enrolled in the study from February 2012 to July 2014.The children were randomly divided into a control group and an observation group,with 70 cases in each group.The control group was given antiviral to reduce the intracranial pressure and intravenous immunoglobulin and the observation group was given Danshen in addition to the control group.The levels of neuron specific enolase (NSE)、S-100βprotein、TNF-α and IL-6 were detected at admission and checked again seven days after treatment.The changes of the above indicators and the clinical curative effect were compared before and after therapy.Results The total effective rate of the control group and the observation group was 80.0% and 92.9% respectively,showing statistical significance(P<0.05). After treatment, observation group of serum NSE (9.42 ± 2.56μg/Lvs. 11.71 ± 3.21μg/L,t=2.159), S-100β (177.34 ± 87.28 ng/Lvs. 286.14 ± 159.69 ng/L, t=2.315), TNF-α (15.98 ± 4.35 ng/Lvs. 23.17 ± 4.80 ng/L, t=4.297), IL-6 (41.72 ± 6.64 ng/Lvs. 52.05 ± 9.33 ng/L,t=3.492) , the level of were lower than those in the control group(P<0.05 orP<0.01). In the observation group, serum. The fever clearance time、the disappearance time of rash and the hospitalization time in the observation group (3.55 ± 1.02 d vs.4.55 ± 1.09 d, 7.14 ± 1.04 d) were shorter than those in the control group (4.46 ± 0.97 d vs.5.88 ± 1.44 d, 8.68 ± 1.06 d;t=5.409, 6.161, 8.677 respectively, P<0.01).Conclusions On the basis of conventional therapy,Danshen can effectively alleviate the systemic inflammatory response in children with severe hand foot and mouth diseases, reduce brain damage and improve the clinical efficacy.

Objective To investigate the effect and mechanism of exogenous leptin on liver injury in severe acute pancreatitis rat .Methods Thirty male SD rats were randomly divided into the sham operation group ,SAP group and leptin intervention group . The SAP rat models was established by retrograde injection of 3 .5% sodium taurocholate into the biliopancreatic duct .The leptin intervention group was intraperitoneally injected with leptin 20 μg/kg .The rats in each group were sacrificed at 12 h after model‐ing .The pancreas and liver tissues were taken for HE staining and detecting the nuclear factor kappa B (NF‐κB) .The cell apoptosis in situ labeling method was adopted for detecting the liver tissue cell apoptosis index .ALT ,AST and AMY were detected . Results Compared with the sham operation group ,the liver tissue pathology score in SAP group and leptin intervention group were significantly increased(P<0 .05) .The liver tissue pathology scores in the leptin intervention group were lower than those in the SAP group(P<0 .05) .The NF‐κB expression of liver tissue in the SAP group and leptin intervention group was obviously increased compared with the sham operation group ,the expression in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .The liver cell apoptosis index in the leptin intervention group and SAP group was significantly higher than that in the sham operation group (P<0 .05) ,and which leptin intervention group was decreased compared with the SAP group (P<0 .05) . The results of ALT ,AST and AMY in the SAP group and leptin intervention group were increased significantly compared with the sham operation group(P<0 .05) ,while which in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .Conclusion The exogenous leptin may play the protective effect on SAP complicating liver damage by lowering the liver tis‐sue NF‐κB expression and reducing the liver cell apoptosis index .

Objective To investigate the antagonist effects of sodium salicylate(NaSA) on the cisplatin(CDDP) induced hearing impairment in guinea pigs.Methods 60 guinea pigs were randomly divided into four groups: ①CDDP +NaSA(50 mg/kg) group,②CDDP +NaSA(100 mg/kg) group,③CDDP +NaSA(150 mg/kg) group and ④CDDP +NS(normal saline) control group.Auditory brainstem response(ABR) and distortion product otoacoustic emission(DPOAE) were used to evaluate their effects on hearing threshold and DPOAE amplitudes.Results The ABR responses of groupsⅠ,Ⅱ and Ⅲ were significantly lower than in the control group(P0.05).The ABR responses for group Ⅰ were significantly higher than group Ⅲ(P