Objective To establish a reasonable method to evaluate nursing quality with both the quantity and quality of nursing taken into account.Methods Quantity indexes of nursing were analyzed with decision tree method (CHAID)in SPSS18.0,which included the number of patients admitted to wards,first grade' s nursing days,critically ill patients,emergencies,operations,intravenous infusions,intramuscular injections,oxygen inhalations,urinary tract catheterizations,gastric tube catheterizations,enemas and the average turnover rate of beds.After the quantity analysis,the nursing units were divided into different groups according to their workload.Then,we made a comprehensive evaluation of nursing quality with 12 indicators on the same group.Results Decision tree analysis can identify hierarchy relationship of various nursing quantity indicators and high-priority work quantity variables.Furthermore,it can establish the hierarchical rule based on the distribution of high-priority variables,and serve the purpose of classifying nursing units based on nursing workload.Conclusion The decision tree method can provide a same-level nursing workload platform for quality examination.This has minimized the influence of nursing workload discrepancies on nursing quality examination,and made nursing quality more comparable with nursing workload units of the same level,thus a scientific method for comprehensive nursing quality evaluation.

BACKGROUND: External preparations treatment of fractures in traditional Chinese medidne are mostly ordinary hard-paste, cream, ointment, which lack of modernized traditional Chinese medicine transdermal delivery systems, and the treatment has poor drug absorption and simple process. The treating procedure needs to be used repeatedly, which would affect fracture external fixation and lead to unsatisfactory therapeutic effect. In this Paler, the extemal treatment of traditional Chinese medidna was combined with advanced micro-nano-technology to develop a new medical complex functional materials-micron traditional Chinese medicine functional lining material, which is an organic combination of diaplasis, fixation and local drug remedy, which provides a better treatment for fractures. OBJECTIVE: To explore the effect of micron tradifional Chinese medicine functional lining material on the healing of fracture in rabbits, METHODS: After model preparation, rabbits were randomly divided into 4 groups: rabbits in the micron group were treated with micron traditional Chinese medicine functional lining material plus plaster external fixation; those in the traditional Chinese medidna control group were treated with ordinary Chinese medicine functional material plus plaster extemal fixation; those in the lining material control group were treated with ordinary lining material added plaster extemal fixation; those in the natural healing control group had no special treatments. The effect of fracture healing was evaluated by X-ray at 2, 4 and 6 weeks after modeling. The serum concentration of alkaline phosphatase, calcium and phosphorus was detected respectivaly before modeling and at 2, 4 and 6 weeks after modeling. RESULTS AND CONCLISION: ①X-rap examination:After 6 weeks the external was almost copletly absorbed and medullary cavity was completely recanalizad in the micron group, while fracture line disappeared and the external callus began to be absorbed and medullary cavity was not recanalized in the traditional Chinese medidne control group. Additionally, there were case of non-union stump hardening in natural healing group. ②Serum biochemistry:The activity of alkaline phosphatase reached a peak after 2 weeks in micron group, which was 2 weeks ahead of time compared with that in traditional Chinese medicine control group. And the peak concentration of alkaline phosphatase in micron group was higher than other groups. After 4 weeks serum calcium concentration started to fall significantly and phosphorus concentration started to rise significantly in micron group, as was statistically significant compared with other groups. After 6 weeks serum calcium concentration in micron group had fallen to normal level, while that in other groups was higher than normal. And phosphorus concentration in micron group increased significantly, which was statistically significant compared with natural healing group. The results demonstrated that micron feature traditional Chinese medicine lining matedat can enhance the activity of alkaline phosphatase, decrease the serum concentration of calcium and increase the serum concentration of phosphorus and the product of calcium and phosphorus, therefore, promote the healing of fracture, It shows that micron traditional Chinese medicine functional lining matedal plays a stronger effect on promoting the healing of fracture than that of ordinary Chinese medicine functional lining material.

Peking University Third Hospital is one of the first hospitals for experiments in clinical pathway selected by the Ministry of Health,which keeps optimizing the clinical pathway management mechanism and function of information system in its 4-year practice.This article described the combination strategy of clinical pathway management and information system applications,in terms of reasonable design of the management plan,standardized clinical pathway,strengthened execution control and improvement of the quality control.The purpose is to balance the relationship between clinical pathway management norms and user-friendliness of the system,enhance rationality and feasibility,improve efficiency and provide high-quality service to ensure medical safety.

Objective To explore relevant factors influencing self-management of diabetic patients and the effects on whole course health education and nursing. Methods Clinical data of 248 diabetic patients who were admitted to Peo-ple's Hospital of Xinchang County from May 2012 to January 2014 were retrospectively analyzed. They were assigned to two groups according to their nursing methods. Control rate of blood sugar, master rate of knowledge on diabetes,self-management rate and satisfaction of patients were compared between both groups. Results Scores of knowledge on diabetes, self-efficacy, social support, age and cultural background were independent influencing factors for self-management of diabetic patients. Control rate of blood sugar, master rate of knowledge on diabetes, self-management rate and satisfaction of patients in the observation group were all higher than those in the control group, and the dif-ferences were statistically significant (P<0.05). Conclusion Patients' age,cultural background,knowledge on diabetes,self-efficacy and social support are main influencing factors for self-management of diabetes. In clinical settings,whole course health education and nursing can be carried out, so as to improve patients' master rate of knowledge on diabetes,and optimize self-management levels.

AIM: To explore the protective role of ornithine decarboxylase (ODC)/polyamines system in the myocardium induced by ischemic preconditioning in rats.METHODS: The experiment model of simulating myocardial ischemia-reperfusion was replicated by Langendorff perfused rat heart. The hearts were randomly divided into six groups: control group, ischemic-reperfusion group (IR), weak ischemic preconditioning group (IPCw), strong ischemic preconditioning groups (IPCs) and inhibitor groups (DF-EG-IPCw and DF-EG-IPCs). The expression of ODC was quantified by Western blotting analysis. The contents of polyamines (putrescine, spermidine, spermine) in cardiac tissue were detected with high performance liquid chromatography. The hemodynamics was obtained using the PowerLab 8/SP TM data acquisition system. The infarct size was measured using triphenyltetrazolium chloride (TTC) staining and the apoptosis cardiomyocytes were observed under optic microscope after TUNEL method treatment. RESULTS: In contrast with control group, in IR group the putrescine contents increased, the expression of ODC was down-regulated, the contents of spermine and the total polyamine pool decreased (P<0.05). At the same time, the cardiac function declined, with an increase in myocardium infarct size and the apoptosis rate of cardiomyocytes (P<0.05). When compared with IR group in terms of LVDP, HR and CF, both IPCw and IPCs groups had significant improvements in cardiac functions (P<0.05). These two groups also had smaller myocardium infarct size (P<0.01) and apoptosis rate of cardiomyocytes (P<0.01). When compared with IR group, the expression of ODC, the contents of spermine and the total polyamine pool increased in both IPCw (P<0.05) and IPCs groups (P<0.01), but the putrescine contents declined. In the respective inhibitor groups of the weak and ischemic preconditioning, the expression of ODC and the levels of putrescine, spermidine, spermine and the total polyamine pool decreased remarkably (DF-EG-IPCw vs IPCw, P<0.05; DF-EG-IPCs vs IPCs, P<0.01), while the myocardium infarct size and apoptosis rate of cardiomyocyte were relatively bigger in both inhibitor groups (P<0.05). Also, the heart function decreased significantly in terms of LVDP, HR and CF compared to their matched ischemic preconditioning group (P<0.05).CONCLUSION: Ischemic preconditioning significantly up-regulates the ODC / polyamines system in Langendorff perfused rat hearts and provides protective effects on myocardium with ischemia/reperfusion injury. Inhibition of bio-synthesis of polyamine abolishes the cardiac function improvement and the decreases the infarct size and apoptosis rate induced by ischemic preconditioning. It reveals that the ornithine decarboxylase (ODC) /polyamines system may be involved in the protection of myocardium induced by IPC in rats.

ObjectiveTo investigate the protective effect of modified Huangqi Guizhi Wuwutang （MHGW） on endoplasmic reticulum stress in the sciatic nerve of diabetes rats based on the pathways of inositol-requiring enzyme 1α （IRE1α） and CCAAT/enhancer-binding protein homologous protein （CHOP）. MethodSixty rats were fed on a high-sugar and high-fat diet for six weeks， followed by intraperitoneal injection of streptozotocin at a dose of 35 mg·kg^-1. Random blood glucose levels were measured three days later and rats with a sustained blood glucose level ≥ 16.7 mmol·L^-1 were included in study （n=48）. The rats were randomly divided into a model group， an α-lipoic acid group （0.026 8 g·kg^-1·d^-1）， a high-dose MHGW group （2.5 g·kg^-1·d^-1）， and a low-dose MHGW group （1.25 g·kg^-1·d^-1）. Another 10 rats were assigned to the normal group. The intervention lasted for 16 weeks. After 16 weeks， the sciatic nerve structure of the rats in each group was observed under light microscopy using Luxol fast blue （LFB） staining. Transmission electron microscopy was used to observe the ultrastructure of the sciatic nerve. Chemiluminescence method was employed to measure the serum reactive oxygen species （ROS） levels. Western blot and real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） were used to evaluate the expression of p-IRE1α protein， IRE1α mRNA， CHOP protein， and CHOP mRNA in the sciatic nerve of the rats. ResultCompared with the normal group， the model group showed elevated serum ROS levels （P<0.01）. In contrast， the serum ROS levels were significantly reduced in the treatment groups compared with those in the model group （P<0.01）. The sciatic nerve of the model group showed pathological changes compared with that in the normal group， while the treatment groups exhibited improvement in sciatic nerve pathology compared with the model group. The protein expression of p-IRE1α and CHOP in the sciatic nerve significantly increased in the model group as compared with that in the normal group （P<0.01）. However， the treatment groups showed a significant decrease in the protein expression of p-IRE1α and CHOP in the sciatic nerve compared with the model group （P<0.05， P<0.01）. Furthermore， compared with the normal group， the model group showed upregulated mRNA expression of IRE1α and CHOP in the sciatic nerve （P<0.01）， while the treatment groups exhibited a significant decrease in the mRNA expression of IRE1α and CHOP compared with the model group （P<0.01）. ConclusionMHGW can alleviate endoplasmic reticulum stress-induced cell apoptosis and improve the structure and function of the sciatic nerve in diabetes rats by inhibiting the expression of IRE1α/CHOP pathway-related proteins and mRNA， thereby preventing and treating peripheral neuropathy in diabetes.

ObjectiveTo investigate the effect of modified Huangqi Guizhi Wuwutang （MHGW） on the protein and mRNA expression of B-cell lymphoma-2-associated X protein （Bax） and cysteinyl aspartate specific proteinase-12 （Caspase-12） related to the apoptosis of sciatic nerve cells in diabetes rats to explore the mechanism of MHGW in the treatment of peripheral neuropathy in diabetes. MethodAnimal experiments were conducted. A diabetes model was induced in sixty male sprague-dawley （SD） rats by feeding on a high-sugar and high-fat diet combined with streptozotocin （STZ） intraperitoneal injection. Rats with random blood glucose levels ≥ 16.7 mmol·L^-1 for three consecutive days were considered to have successfully developed diabetes. Forty-eight rats that successfully developed diabetes were randomly divided into a model group， an α-lipoic acid group （0.026 8 g·kg^-1·d^-1）， a high-dose MHGW group （2.5 g·kg^-1·d^-1）， and a low-dose MHGW group （1.25 g·kg^-1·d^-1）， with 12 rats in each group. Another 10 rats were assigned to the normal group. Body weight and random blood glucose levels of the rats were monitored. At the end of a 16-week intervention period， the sciatic nerve conduction velocity of the rats was measured using the Key point electromyography collection system. The protein and mRNA expression of Bax and Caspase-12 in the sciatic nerve cells was detected by Western blot analysis and real-time quantitative polymerase chain reaction （Real-time PCR）， respectively. ResultCompared with the normal group， the model group showed a significant decrease in body weight （P<0.01） and a significant increase in random blood glucose levels （P<0.01）. After a 16-week intervention， compared with the model group， the high-dose MHGW group exhibited a significant increase in body weight （P<0.05）， while there were no statistically significant differences in body weight changes among the other treatment groups. Random blood glucose levels significantly decreased in all treatment groups （P<0.01）. After 16 weeks of intervention， compared with the normal group， the model group had significantly reduced motor and sensory nerve conduction velocities （P<0.01）. Compared with the model group， all treatment groups showed significant increases in motor and sensory nerve conduction velocities （P<0.05， P<0.01）. The expression of Bax and Caspase-12 proteins in the sciatic nerve cells was significantly elevated in the model group compared with that in the normal group （P<0.01）. In contrast， all treatment groups showed significant reductions in the expression of Bax and Caspase-12 proteins in the sciatic nerve cells as compared with that in the model group （P<0.01）. The expression of Bax and Caspase-12 mRNA in the sciatic nerve cells significantly increased in the model group compared with that in the normal group （P<0.01）. Compared with the model group， the α-lipoic acid group and the high-dose MHGW group showed significant reductions in the expression of Bax mRNA in the sciatic nerve cells （P<0.05， P<0.01）， while the low-dose MHGW group showed a decreasing trend in the expression of Bax mRNA. The expression of Caspase-12 mRNA in the sciatic nerve cells significantly decreased in all treatment groups （P<0.01）. ConclusionMHGW may improve and repair sciatic nerve damage in diabetes rats by inhibiting sciatic nerve cell apoptosis.