Objective To establish an appraisal system of clinical comprehensive competence for nursing undergraduates.Methods The level construction tree model was established by questionnaire survey based on Delphi method,and the weights of each indicator in three grades were calculated.Results The appraisal system of clinical comprehensive competence for nursing undergraduates was ultimately established which contained 6 first-level indicators,21 second-level indicators and 69 third-level indicators.In third-level indicators,the indicators with the highest weight value was The students can use the communication skills when assessing,carrying out,evaluating and giving health education,the indicators with the lowest weight value was The research point had some value. and The research novelty met needs.Conclusions The appraisal system is scientific and reliable,and can provide basis for appraising the clinical comprehensive competence for nursing undergraduates.

Objective To investigate the significance of procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC) and other inflammatory markers in the diagnosis of pediatric patients with HFMD.Methods 138 cases of pediatric patients with foot and mouth disease(study group)and 50 cases of healthy children(control group)were recruited in the study.Procalcitonin (PCT),white blood cell(WBC),neutrophil count(NC),lymphocyte count(Ly),immunoglobulins,C-reactive protein and other indi-cators were determined and compared.Results PCT,CRP,WBC,NC,Ly% and IgM levels were higher in study group than those in control group,the differences were all statistically significant(P <0.05 );IgG,IgA levels in control group were lower than that in control group,the differences were statistically significant(P <0.05).Conclusion PCT,WBC,NC,Ly,CRP and IgA,IgG,IgM can provide experimental evidence for diagnosis of children with hand foot and mouth disease.

Adult ; Bronchoalveolar Lavage ; methods ; Bronchoalveolar Lavage Fluid ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy

ObjectiveTo investigate the clinical efficacy of warm needling moxibustion plus tricolor medicinal paste in treating knee osteoarthritis.MethodNinety-one patients meeting the diagnostic criteria were randomly allocated to a treatment group (45 cases) and a control group (46 cases). The treatment group was given warmneedling moxibustion plus tricolor medicinal paste and the control group, warm needling moxibustion alone. The clinical therapeutic effect and the WOMAC score were observed in thetwo groups. An improvement in the symptoms of knee osteoarthritis was assessed in the patients after treatment.ResultIn both groups, there were statistically significant pre-/post-treatment differences in the pain and daily activity scores and the WOMAC total score (P<0.05) but not in the morning stiffness score (P>0.05). There were statistically significant differences in the daily activity score and the WOMAC total score (P<0.05) but not in the pain and morning stiffness scores (P>0.05) between the two groups.Conclusion The study shows that warm needling moxibustion plus external application of tricolor medicinal paste has a marked improving effect on the pain, swelling and physiological functions in patients with knee osteoarthritis. Improving lower limb function further in daily activities can produce a satisfactory and stable therapeutic effect.

Objective To analyze the effectiveness of antithymocyte globulin(ATG) combined with cyclosporin(CSA)in treatment of pediatric severe aplastic anemia(SAA).Methods Seven children with SAA were treated with ATG and CSA,ATG 4-5 mg/(kg?d),5 days,methyprednisone 2-3 mg/(kg?d) to reduce anaphylaxis,CSA 3-5 mg/(kg?d),assisting with transfusion and G-CSF.Results The complete remission rate was 28.57%(2/7),the partial remission rate was 14.29%(1/7),and the obvious improvement rate was 28.57%(2/7),1 child died.The overall response rate was 71.43%.Transfusion volumes in 4 to 6 months post treatment decreased obviously comparing to the first 3 months(P

Objective To explore the risk factors of neonatal necrotizing enterocolitis(NEC)and assess the effect of prophylactic use of probiotics(Bifico)in prevention of NEC and observe changes of weight.Methods Five hundred and twenty-four cases of prematures who were inpatients were divided into 2 groups randomly(prevention group,n=276,no-prevention group,n=248)and the morbidity of NEC and the increase of eight during hospitalization were observed.A case-control study and conditional Logistic regression model multifactorial analysis were made to 20 cases NEC neonates and 80 cases non-NEC neonates.Results The prevention group(276 cases)had 5 cases of NEC and the average weight increase was(8.114?8.137)g/d,the no-prevention group 248 cases had 17 cases of NEC,and the average weight increase was(6.595?5.337)g/d.The occure rate of NEC in prevention group was significantly lower than that of no-prevention group(?2=5.57 P

Keratorefractive surgery changes the central corneal thickness (CCT) and corneal curvature, which could influence the Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT) measurements of intraocular pressure (IOP), but not dynamic contour tonometer(DCT). During the procedure of LASIK, there is a transient rise of IOP, which increases the risks of optic nerve damage. Meanwhile, the presence of functioning filtering blebs may affect the choice and outcome of refractive surgery, or even becomes a contraindication of surgery. Steroids are typically used after keratorefractive surgery, which could lead to IOP elevation. Hence it is important to monitor IOP after LASIK and to be aware of inaccurate IOP readings due to corneal flap interface fluid. Treating patients with postoperative elevated IOP after keratorefractive surgery is similar to that for patients with glaucoma. This review will address the issues surrounding the safety, relevant complications and implications of keratorefractive surgeries on glaucoma and relevant diagnostic tests.

Objective:To investigate the feasibility of periodontal mechanical therapy for chronic periodontitis and coronary heart disease patients with low dose of aspirin.Methods:Sixty nine chronic periodontitis patients with coronary heart disease were randomly selected as the experimental group (medication group,group A),the control group (withdrawal group,group B) including 20 chronic periodontitis patients with coronary artery disease,stopping the drug for one week and another control group with 50 chronic periodontitis patients (group C).The three groups were examined with pocket probing,and received supragingival scaling,subgingival scaling,and root planning.Local bleeding after operation was observed.In 30 minutes after periodontal mechanical treatment,there was still a need to take some hemostatic measures (containing the oxidized cellulose putting in the periodontal pocket,gauze oppressing,and suturing).Nd:YAG laser was used to stop bleeding 60 minutes after operation.Results:At baseline,there was no significant difference in the three groups,as to the plaque index (PLI),the probing depth (PD),and the attachment loss (AL).The bleeding index (BI)in group A was significantly higher than that in group C (P =0.024),higher than that in group B (P =0.088).The platelet maximum aggregation rate (Aggmax) was detected in some subjects.The average Aggmax value group A was 15.2％,which was much greater than that in group B (60.7％) and group C (62.5 ％).The three groups were all safe in the treatment of periodontal therapy.There were five cases of active bleeding in group A,one case in group B and one case in group C in 30 minutes after operation.In 60 minutes after operation,there was one case of bleeding actively in group A.Nd:YAG laser was used to stop bleeding successfully.Conclusion:The chronic periodontitis and coronary heart disease patients with long-term oral administration of low dose of aspirin can be safely treated with periodontal mechanical treatment,and the effect of local hemostasis is positive without stopping the drug.

Objective： To study the expression and role of IL-6, IL-6 receptor(IL-6R) and acute phase reaction factor (APRF) in PMNC of multiple myeloma(MM) patients. Methods:The bioactivity of IL-6 and the level of sIL-6R in sera of MM patients were measured using IL-6 dependent cell line 7TD1 and ELISA respectively. The APRF activity of PMNC DNA binding protein was observed by gel blocking electrophoresis (EMSA). Results:The bioactivity of IL-6 and the level of sIL-6R in MM sera were significantly higher than those of the control and the level was coordinated with that of the tumor. The results of PMNC DNA binding protein EMSA showed that PMNC of MM patients expressed APRF after stimulation of IL-6,whereas there was no activity of APRF in the normal PMNC. Conclusion:In MM,some regulation machines of IL-6 signal transduction pathways changed (eg.protein kinase), resulting in the activation of transcription of acute phase reaction element(APRE), APRF may have a role in pathogenesis of MM.

OBJECTIVE: To evaluate the effectiveness and safety of internal heat-type acupuncture needle (IHTAN) the-rapy in the treatment of post-stroke shoulder pain in apopletic patients. METHODS: According to the random number table, 96 patients with post-stroke shoulder pain were divided into IHTAN group and warm needle moxibustion group (n＝48 in each one). Jianyu (LI15), Jianliao (TE14), Jianzhen (SI9), Binao (LI14) and Ashi points (Extra) on the affected side were selected in the two groups. For patients of the IHTAN group, internal warmth controllable acupuncture needles were inserted into the above-mentioned acupoints, and then connected to an internal heat acupuncture apparatus for stimulating the acupoints at 42 ℃， 20 min every time, once a week, for 4 weeks. For patients of the warm needle moxibustion group, the above mentioned acupoints were stimulated with filiform needles attached with an ignited moxa-stick, once every other day, for 4 weeks. If the shoulder pain disappeared or basically disappeared, it was considered to be healed, if the pain was relieved, it was considered to be effective, ot-herwise, it was considered to be ineffective. The incidence of local skin injury including burn, empyrosis, silt blue, hematoma and infection, the heart rate, respiration, blood pressure, oxyhemoglobin saturation, blood routine (hemoglobin level, white blood cell [WBC] count, platelet count), creatase and dipolymer levels were recorded or detected. Additionally, the patients' satisfaction rate about the treatment environment was recorded. RESULTS: Following the treatment, of the 45 and 47 cases in the warm needle moxibustion and IHTAN groups, 5 (11.11%) and 20 (42.55%) were cured, 26(57.78%) and 21(44.68%) experienced marked improvement, and 14 (31.11%) and 6 (12.77%) had no apparent changes in their shoulder pain severity, with the total effective rates being 68.89% and 87.23%, respectively. The curative rate and total effective rate of the IHTAN group were significantly higher than those of the warm needle moxibustion group (P<0.01，P<0.05). The incidence of skin injury of the IHTAN group was evidently lower than that of the warm needle moxibustion group (P<0.01), and the patients' therapeutic environment satisfaction rate was remarkably higher in the IHTNA group than in the warm needle moxibustion group (P<0.05). No significant differences were found between the two groups and between pre- and post-treatment in each group in the heart rate, respiration frequency, systolic and diastolic pressures, oxyhemoglobin saturation, hemoglobin content, WBC count, platelet count, and plasma dipolymer, creatine kinase, lactic dehydrogenase, and beta-hydroxybutyrate dehydrogenase levels (P>0.05). CONCLUSION: The IHTAN therapy is effective, safe and reliable in the treatment of post-stroke shoulder pain. In terms of the incidence of skin injury and the satisfaction degree of therapeutic environment, the internal heat-type acupuncture needle therapy is obviously superior to the warm needle moxibustion therapy.