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

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 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

OBJECTIVE To discuss the preventive methods of hepatitis B virus reinfection after liver transplantation. METHODS Eighty eight liver transplantation recipients with HBV-related end-stage liver diseases including chronic fulminant hepatitis B,end-stage liver cirrhosis and liver carcinoma were analyzed retrospectively,and were given lamivudine pre-transplantation to prevent hepatitis B virus reinfection.Post-transplantation medicines of lamivudine were administered in 3 cases;lamivudine and hepatitis B immunoglobulin(HBIg) in 85 cases.The follow-up criteria included serum HBV,HBV-DNA,liver biopsy,immunohistochemical study of liver biopsy specimens and clinical manifestations.All of patients were followed-up 6 months at least.RESULTS Two of the three cases who taken lamivudine developed reinfection,the little time is 6 months following liver transplantation.There were three of eighty five cases taken lamicudine and HBIg(small dosage) developed reinfection.CONCLUSIONS Liver transplantation is an effective treatment for HBV-related end-stage liver diseases.Given lamivudine at the pre-transplantation could reduce the levels of the HBV virus copies.Lamivudine and HBIg post-transplantation offer effective prevention against hepatitis B virus reinfection.

Objective By analyzing the mortality of patients with hypertension and cerebral infarction in different blood lipid stratification,the significance of blood lipid stratification management in the treatment of hypertension was clarified.Methods 604 patients with hypertension combined with cerebral infarction were divided into middle risk group (198 cases),high risk group (n=198) and extremely high risk group (n=208) and each group of different stratification according to the serum lipid HCY level,divided into H type hypertension group (HCY=10 μmol/L) and hypertension group ((HCY＜10 μmol/L group) and comparison of the 10 year mortality in each group.Results Comparison of mortality between H type hypertension group and simple hypertension group,among them,the difference between the two groups in middle risk group was statistically significant (x2 =5.095,P =0.024 205).The difference between the two groups in extremely high risk group was statistically significant (x2 =7.859,P=0.005 056).The difference between the two groups in high risk group was statistically significant (x2 =9.961,P=0.001 599).There was a significant difference in mortality between the groups with different blood lipids in simple hypertension group.Among the high-risk group and the middle risk group,the difference was statistically significant (x2=6.575,P=0.010 343),and there was significant difference between high risk group and high risk group (x2 =6.868,P=0.008 774).Comparison of mortality between different lipid levels in H type hypertension group,the difference was statistically significant.There was significant difference between the extremely high risk group and the high risk group (x2 =4.745,P=0.029 388) and there was significant difference between the high risk group and the middle risk group (x2 =11.668,P=0.000 636).Conclusion Hyperlipidemia,especially high LDL and high HCY are the main causes of death in patients with hypertension complicated with cerebral infarction,the clinical use of blood lipid levels can reduce the level of LDL and reduce the mortality of patients by strengthening the control of HCY level.Improve the survival rate of patients.

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.