Objective To investigate and analyze the effects of problem-based learning used in clinical nursing education. Method The research papers on the effect of problem-based learning used in clinical nursing education were retrieved via CNKI, Wanfang,VIP,PubMed,ProQuest and Google scholar websites and then analyzed by Revman5.0 software.Results Totally 11 RCTs were included.Meta-analysis showed that PBL could significantly promote students’examination scores,self-study ability, critical thinking and clinical skill,but insignificantly improved the effect in improvement of their theory learning,interest and ability in cooperation.Conclusions PBL is a scientific clinical teaching method,which can stimulate students’initiative and exploratory learning and enhance effects of clinical teaching.Meanwhile,we suggest formulating evaluation criteria and implementing rigorous RCT designs in the future.

Objective To investigate the sleep self-adaptation for Chinese military personnel and the correlations with sleep quality. Methods 857 soldiers completed the Sleep Quality Scale of Chinese Military Personnel (SQSCMP) and the Soldier Sleep Self-Adaptation Scale (SSSAS). Results The average level of sleep selfadaptation of Chinese military personnel was 2.89, below the theoretical midpoint score 3. There were significant positive correlations between the sleep quality and the global level of sleep self-adaptation and its 5 factors ( r =0. 16 ～ 0. 533, P ＜ 0.001 ), except the factor of perceived importance of sleep ( r = -0.027 ). Multiple stepwise regression analysis showed that the major determinants of the sleep quality were the factors of positive attitudes about sleep,the positive self-suggastions on sleep and the ability of anti-disturbance of sleep. Conclusion The positive and appropriate attitudes and beliefs about sleep are of benefit to sleep quality.

Objective To explore the clinical value of transvaginal three-dimensional color Doppler ultrasound in assessing effects of Chinese herbal drugs on improving endometrial receptivity in patients with thin endometrium.Methods A total of 76 cases of patients diagnosed with thin endometrium in Jiangbei District Hospital of Traditional Chinese Medicine from June 2015 to October 2016 were selected and treated with Chinese herbal prescription for three months.The endometrial thickness,endometrial volume and blood flow indexes before and after treatment were measured by using transvaginal three-dimensional color Doppler ultrasound.Results After 3 months treatment,the endometrial thickness and endometrial volume were increased,and the pulse index (PI) and resistance index (RI) of endometrial blood flow were decreased,compared with those before treatment,there were statistically significant differences(P＜0.05).The results of three-dimensional color Doppler ultrasound indicates that after 3 months treatment the vascularization index (VI),flow index (FI) and vascularization flow index (VFI) were significantly higher than those before treatment,there were statistically significant differences (P＜0.05).Conclusion The Chinese herbal prescription could increase the thickness and volume of endometrium,augment blood supply,and improve endometrial receptivity significantly.Transvaginal color three-dimensional Doppler ultrasound is a convenient and objective method for evaluating clinical efficacy of Chinese herbal prescription in patients with thin endometrium,which has high practical value.

Objective To evaluate the changes of left atrial structure and function in the patients with atrial fibrillation who accepted bi -polar radio frequency current ablation .Methods All patients in our study were divided into three groups including the ones who had accept -ed bipolar radio frequency current ablation because of atrial fibrillation ,the ones who refused to accept ablation operation in despite of atrial fibrillation and the ones who maintained sinus rhythm before operation .All patients accepted TTE before and after operation .Results The rate of transverse diameter change of ablation group (24.24 ±8.67)%was larger than those of other two groups (P<0.05).Left atrial chan-nel capacity volume change rate of ablation group (17.18 ±3.26)%were larger than the values of the group who were suffering atrial fibrilla-tion but refused ablation advice (0.86 ±0.26)(P<0.05).Left atrial total ejection fractions of ablation group (202.41 ±81.59)%were lar-ger than the values of the group who were suffering atrial fibrillation but refused ablation advice (109.53 ±60.91)%( P<0.05) .And its ac-tive ejection fractions(12.18 ±3.48)%,total ejection fractions(41.31 ±8.26)%and so forth were less than the group who maintained si-nus rhythm before operation(21.33 ±5.61)%,(45.05 ±7.37)%,respectively (P<0.05).Left atrial posterior wall center and cardiac basal segment strain(14.34 ±9.47)%,(13.20 ±8.38)%,respectively,and strain rate values after operation of ablation group were less than other segments .Conclusion Left atrial structure remodeling inversion was not obviously 3~6 months after bipolar radio frequency cur-rent ablation .And at the same time ,the improvement of left atrial storage function was not obviously compared with the group who refused ab -lation advice,left atrial channel function compensation degree descended obviously left atrial co -pumping function in ablation group increased obviously,left atrial posterior wall center and cardiac basal segment systolic and distolic function were less than other segments of left .

Objective To investigate the current status of self-efficacy and care ability among stroke patients′ family caregivers and explore the correlation between them. Method A total of 79 stroke patients and family caregivers were engaged in the investigation by demographical data questionnaires, general self-efficacy scale and questionnaire for assessing the comprehensive care-giving ability of stroke caregivers. Results The score on self-efficacy of the family caregiver was (27.16 ± 5.64) and the total score on care ability was (90.01 ± 16.57). There was a positive correlation between self-efficacy and care ability of family caregivers(P<0.05). Conclusions The self-efficacy and care ability of stroke patient′s family caregivers are at middle level. Their self-efficacy is positively correlated with their care ability. The nurses can improve the ability of daily caring of family caregivers by enhancing their self-efficacy.

Objective To analyze the demands and to evaluate training effect on the knowledge and technology of prevention and treatment about hypertension among doctors in county and countryside hospitals of Xinjiang.Methods 336 doctors were trained about knowledge of prevention and treatment of hypertension and technology of useful therapeutic regimen,and were investigated for demands of the knowledge and technology and self-evaluation of training effect by questionnaire.Results The knowledge of prevention and treatment about hypertension and the technology of useful therapeutic regimen were needed urgently by 94.8％ subjects.91.3％ trained doctors thought that the technology suited practically in county and countryside hospitals,and 96.7％ hospitals had condition of carrying out the technology.97.9％ trained doctors expected this kind of technology on hypertension prevention and treatment to be trained again.74.1％ trained doctors comprehended the technology,and the percent of doctor practically using the technology increased from pre-training 12.3％ to post training 62.1％.Conclusion The knowledge of prevention and treatment about hypertension and technology of useful therapeutic regimen were needed urgently and were comprehended with training for the most doctors in county and countryside hospitals of Xinjiang.

Blood-brain barrier(BBB)is mainly composed of brain microvascular endothelial cells(BMECs).According to the special cell membrane transport system and the extensive tight junctions,the brain microvascular endothelial cells play an important role in the CNS.Also,there is a close relationship between BMECs and the cerebrovascular diseases,such as cerebral ischemia,cerebral edema,and so on.Therefore,the culture of brain microvascular endothelial cells provides a new tool for studying the cerebrovascular diseases in vitro.The researches in recent years have been reviewed in this test,approaching the cultivation of the rat brain microvascular endothelial cell from the segregation,purification and culture in turns,in order to provide a foundation for the studies of the brain microvascular endothelial cell;in vitro.

The paper introduced the general picture of Xiangya Hospital in the past five years in its development of ahigh-level research hospital of international influence.Aiming at this strategic goal, the hospital proceeds by means of discipline development,talent training,research platform building, international academic exchange,performance appraisal and incentive,budget guarantee and system development.All these efforts contribute to the building of a mutual-supportive,efficient and sustainable medical science innovation system tailored to large hospitals.

Objective To study whether the organs besides digestive system of musca domestica Ⅲ instar larvae have the capability of produceing musca β-glucosidase.Methods Tissues of malpighian tubules,trachea,epiploon and body wall of musca domestica Ⅲ instar lar-vae were dissected under anatomic microscope,and the expression of β-glucosidase gene in these dissected tissues were detected by reverse transcription PCR.And the tissue localization of β-glucosidase mRNA was further identified by in situ hybridization.Moreover,anti-cellulase was used to determinate the tissue distribution with immunohistochemical staining.The relative mRNA expression levels of musca domesticaβ-glucosidase gene in these organs were tested by real-time quantitative PCR.Results The reverse transcription PCR showed that the ampli-fication products of β-glucosidase gene were observed in tissues of malpighian tubules,trachea and body wall.β-glucosidase mRNA was shown in the epithelium cells of malpighian tubules,trachea and body wall by in situ hybridization,and it was almost the same in the results of im-munohistochemical staining.The real-time quantitative PCR showed that the relative expression quantity of β-glucosidase gene in malpighian tubules and body wall were higher than that in foregut,while it was lower in itrachea than that in foregut.And it was of statistical difference in gene expression level of β-glucosidase among these organs (P <0.05).Conclusion Malpighian tubules,trachea and body wall of musca domestica Ⅲ instar larvae have the function of secreting β-glucosidase.Combining with the characteristics of secreting β-glucosidase in most organs of digestive system,it may provide a new biological method for the prevention and treatment of human diseases transmitted by musca domestica with the use of taget gene β-glucosidase.

OBJECTIVETo observe the clinical efficacy of treating chronic persistent bronchial asthma (CPBA) children with abnormal myocardial enzyme spectrum (AMES) by Yupingfeng Powder (YP) combined routine therapy.

METHODSFrom January 2010 to December 2012, 156 CPBA children patients with AMES were randomly assigned to the treatment group (80 cases) and the control group (76 cases). All patients received routine treatment (inhaled corticosteroids and/or leukotriene regulator). Besides, those in the treatment group took YP. The treatment duration was 3 months. The scores of children asthma control test (C-ACT), pulmonary function (FEV,% and PEF%), myocardial enzyme spectrum were observed before and after treatment, and 3 months before and after treatment. The myocardial enzyme spectrum of 40 healthy children at the baby clinics during the same period were recruited as the control.

RESULTSCompared with the control group, creatine kinase isoenzyme (CK-MB), creatine kinase(CK), and lactate dehydrogenase (LDH) increased in the two treatment groups (P <0.01), but there was no statistical difference in AST (P >0.05). Compared with before treatment in the same group, CK-MB, CK, LDH, and AST decreased in the treatment group after treatment and 3 months after treatment (P <0.01). CK-MB, CK, LDH, and AST decreased in the control group 3 months after treatment (P <0.01, P <0.05).Compared with after treatment, CK decreased in the control group 3 months after treatment (P <0.01). C-ACT score, FEV(1),%, and PEF% all increased in the two groups after treatment and 3 months after treatment (P <0.01, P <0.05). Compared with after treatment in the same group, CK decreased in the control group 3 months after treatment (P <0. 01). Compared with the control group in the same period, post-treatment CK-MB and CK decreased (P <0. 01, P <0. 05), while post-treatment C-ACT score, FEV, %, and PEF% increased (P <0.05) in the treatment group (P <0.05).

CONCLUSIONYP could strengthen specific and non-specific immunity of the organism, and improve clinical symptoms and the level of myocardial enzyme spectrum.

Asthma ; therapy ; Child ; Chronic Disease ; therapy ; Creatine Kinase, MB Form ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; L-Lactate Dehydrogenase ; metabolism ; Myocardium ; enzymology