Objective To investigate the status of clinical practice of master of nursing specialist (MNS) and provide references for completing the clinical practice patterns of master of nursing specialist in intensive care units.Methods Totally 56 clinical nursing postgraduate students were investigated from 10 nursing colleges by questionnaire survey.Results 46.43％ students were not satisfied with effect of clinical practice;69.64％ students though there was little difference between postgraduate and undergraduate students in clinical teaching method; 82.14％ students considered clinical teachers couldn't meet their leaming needs; the main reasons affecting the effect of clinical practice included inadequate teaching method (73.21％),impertinent teaching contents (69.64％) and unreasonable time arrangement (51.79％);55.36％ students wanted to be nursing educators; 50.00％ students wanted to be nursing specialist.Conclusions The effect of clinical practice of clinical nursing postgraduate students did not achieve the target.Clinical teaching couldn't meet the learning needs.Students are lack of recognition to capability and quality of master of nursing specialist.We should highlight the special characteristics of intensive care nursing,regulate the clinical teaching method and strengthen the publicity of master of nursing specialist to optimize structure of nursing talent.

Objective To explore the clinical value of the liquid based cytology test in the sputum/pleural fluid cytology diagnosis.Methods Collect the liquid based cytology test over the past year the sputun/pleural fluid specimen test results with the traditional detection methods of detection results,to compare the differences in the positive rate and other indicators.Results Two by detection of sputum/pleural fluid specimens of 225/136 cases,76/82 cases positive results of the liquid based cytology test; traditional technology for the 41/42 cases; data,P ＜ 0.05,statistically significant differences.Conclusion The liquid based cytology test in the sputum/pleural fluid cytology diagnosis is more superior to traditional methods,under conditions permitting,should be widely applied.

Using apple pomace to produce single cell protein (SPC) with three and four strains respectively, the optimal mixed proportion of inoculation, one of the main factors of multiple strains' fermentation to produce SPC, was studied The experiment and analysis indicated that a practicable method to get the optim al mixed proportion of inoculation was obtained, which will perfect correlative researches of this field

Objective To investigate the effect of astragalus polysaccharides (APS) on the growth and proliferation of hepatocellular carcinoma cells and its effect on adenosine monophosphate activated pro-tein kinase (AMPK) activity.Methods Hepatocellular carcinoma HepG2 cells cultured for 12,24,and 48 hours were treated with 200,300,and 400 mg/L concentration of astragalus polysaccharides.The cell inhibition rate was detected with methyl thiazolyl tetrazolium (MTT),and apoptosis was observed under the fluorescence microscope.Western blot method was used to measure the expression of total AMPK,phosphorylated AMPK (p-AMPK),and phosphorylate mammalian target of rapamycin (p-mTOR) protein expressions.Results Astragalus polysaccharides of each concentration significantly inhibited the proliferation of human hepatoma HepG2 cells (P ＜ 0.01),and the effect of 300 mg/L concentration astragalus polysaccharides was more significant than that of the 200 mg/L concentration (P ＜0.01);while inhibitory effect of 400 and 300 mg/L Astragalus polysaccharides on the proliferation of human hepatoma cell line HepG2 was not significant difference.We found that Astragalus polysaccharides of each concentration could promote the apoptosis of HepG2 cells,and the effect of 300 mg/L Astragalus polysaccharides was more significant.However,astragalus polysaccharide of 400 mg/L concentration could promote the apoptosis no more than the 300 mg/L concentration,which was observed by fluorescent microscope.Western blot results showed that astragalus polysaccharides could increase the expression of p-AMPK (P ＜ 0.05),and inhibit its downstream protein expressions of p-mTOR (P ＜ 0.05).The proliferation effect of astragalus polysaccharides was weakened after accession of AMPK antagonist compound C on hepatocellular carcinoma cells.Conclusions APS can inhibit the growth and proliferation of hepatocarcinoma cells,and its mechanism is related to the AMPK-mTOR pathway.

Objective To evaluate the effect of oral mesalazine combined with metronidazole enema in the treatment of patients with ulcerative colitis and the impact on interferon-γ (IFN-γ),interleukin-4 (IL-4),interleukin-8 (IL-8).Methods A total of 80 patients with ulcerative colitis were selected and randomly divided into control group and observation group,40 cases in each group.The control group was treated with oral mesalazine.The observation group was treated with oral mesalazine and metronidazole retention enema.4 weeks as a course of treatment,the patients were treated for 2 courses.The clinical efficacy,disease activity index(DAI) score before and after treatment,as well as peripheral blood erythrocyte sedimentation rate (ESR),levels of IFN-γ,IL-4,IL-8 changes was compared between the two groups.Results The total effective rate was 90.00％ in the control group,which was significantly higher than 75.00％ in the control group,the difference was statistically significant (x2 =23.52,P ＜ 0.05).Before treatment,there were no significant changes in diarrhea,colonic mucosal inflammation,bloody stool and DAI scores (t =0.32,0.08,0.03,0.05,all P ＞ 0.05).After treatment,there were significant decline in each integral of the two groups,the integral of the observation group declined more than those in the control group,the differences were statistically significant(t =15.35,5.8,11.25,14.12,all P ＜0.05).Before treatment,there were no significant changes in ESR,IL-4,IL-8,IFN-γ of peripheral blood in the two groups (t =0.60,-0.95,0.03,-0.06,all P ＞ 0.05).After treatment,ESR,IL-8,IFN-γ of peripheral blood declined in the two groups,IL-4 was increased,and the changes were more significantly in the control group than those in the control group(t =10.02,4.70,10.23,22.82,all P ＜ 0.05).Conclusion Oral mesalazine enema combined with metronidazole enema has significant clinical effect in patients with ulcerative colitis,it is better than treating with oral mesalazine only,and can effectively improve the clinical symptoms and possibly plays a role by regulating IL-8,IFN-γ,IL-4,and it deserves further clinical application.

Objective To assess the correlation between pre-operative N-terminal-pro-brain natriuretic levels and early survival rate among heart transplantion (HT) recipients in a single Chinese center.Methods According to the pre-operative NT-proBNP level of 284 HT recipients,the recipients were divided into two distinctive groups,≤5000 nmol/L group (237 cases) and ＞5000 nmol/L group (47 cases).The baseline characteristics and mortality for recipients with different primary cardiac diseases and on extracorporeal membrane oxygenation (ECMO) support were compared.Kaplan Meier method was used to calculate the 1-year survival rate of the two groups.Results The pre-operative NT-proBNP ＞5000 nmol/L group had an average pulmonary capillary wedge pressure of (25.1 ± 7.4)mmHg,noticeably higher than in ≤5000 nmol/L group [(21.4 ± 9.2) mmHg,P＜0.05].At the same time,the cardiac index (CI) in ＞5000 nmol/L group was (1.8 ± 0.5) L·min-1·m-2,significantly lower than in ≤5000 nmol/L group [(2.1 ± 0.6) L·min-1 ·m-2,P＜0.05].14.9％(7/47) of recipients in ＞5000 nmol/L group used ECMO support,and the corresponding ECMO-related morbidity was 71.4％ (5/7) and 1-year survival rate was 91.3％.6.8％ (16/237) of recipients in ≤ 5000 nmol/L group used ECMO support and the corresponding ECMO-related morbidity was 12.5％ (2/16) and 1-year overall survival rate was 96.9％.There was statistically significant difference in the ECMO usage,ECMO-related mortality rate and 1-year survival rate between the two groups (P＜0.05).Conclusion Recipients with pre-operative NT-proBNP ＞5000nmol/L have higher peri-operative ECMO-related morbidity and 1-year death rate.So determination of pre-operative NT-proBNP level may be beneficial to the timing of cardiac transplantation.

Objective To compare the cleaning effect of before and after improvement of P′750 type endoscopic infusion pump sensing infusion. Methods 240 cases of urinary calculi patients were divided into experimental group (120 cases) and control group (120 cases) according to the random number table method. Experimental group made improvements on P′750 type endoscopic infusion pump sensing infusion, Took latex transmission pipe, sampling module, metal fittings and parenteral nutrition infusion bags, disposable connecting pipe connection, and surgery using improved sensing infusion. The control group used unimproved sensing infusion. Results Visual inspection of cleaning pass rate before and after improvement sensing infusion were 85.83% (103/120), 99.17% (119/120), 5 times with light magnifier inspection were 78.33%(94/120), 97.50% (117/120), tampons method inspection were 75.83% (91/120), 95.83% (115/120), ATP bioluminescence monitoring were 70.83% (85/120), 91.67% (110/120), dry pass rate were 90.83%(109/120), 100.00% (120/120), cleaning and drying pass rate were significantly improved (χ2=18.296, 29.159, 32.986, 40.976, 11.528, all P<0.01). Cleaning time before and after improvement sensing infusion were (1 020.40±8.22) s, (539.30±8.70) s. Dry time were (1 199.35±26.70) s, (61.50±5.79) s. Cleaning and drying time were significantly shortened (t=440.340, 456.206, all P<0.01). Conclusion Improvement sensing infusion increased the quality of cleaning and drying, shortened the cleaning and drying time, ensured the quality of surgery using equipment, improved work efficiency, and provided a guarantee for the safe and smooth implementation of the surgery.

Objective To investigate the effects of different doses of dexamethasone (Dex) on bone mineral density (BMD) and body composition in Sprague-Dawley (SD) rats. Methods Forty 3-month-old female SD rats were divided into four groups:control group (Cont, saline), low dose Dex group (LDG, 1 mg/kg), medium dose Dex group (MDG, 2.5 mg/kg) and high dose Dex group (HDG, 5 mg/kg). Ten rats for each group. Dex was injected intramuscularly twice a week. The values of BMD and body composition were measured by DEXA densitometer at the beginning and 4-week of treatment. Results The body weights of different doses of Dex intervention groups were decreased after 1 to 4-week intervention compared with those of Cont group (P<0.01). After 4-week intervention, the total BMD, femur BMD, total bone mineral content (BMC), to-tal fat mass, trunk fat mass and leg fat mass were significantly increased in Cont group (P<0.01), while the total lean mass, trunk lean mass were significantly decreased (P<0.01). The total BMC, femur BMD, leg lean mass, leg fat mass were signifi-cantly lower in LDG group and MDG group than those of Cont group (P<0.05). The femur BMD, leg fat mass were signifi-cantly lower in LDG group and MDG group than those of HDG group (P<0.05). Conclusion The doses of 1 mg/kg and 2.5 mg/kg Dex have greater impact on the femur BMD and the leg composition in SD rats than that of Dex (dose of 5 mg/kg ).

Objective To assess the value of hemofiltration in the prevention of contrast induced nephropathy(CIN) post percutaneous coronary intervention(PCI) in severe chronic kidney disease stages(CKD) patients. Methods We evaluated 30 CKD patients who underwent PCI followed by bedside hemofiltration. We measured serum creatinine levels before PCI, 24 hours, 72 hours, and one week after PCI, and calculated creatinine clearance(CrCl) according to Cockcroft and Gault equation.We observed the incidence of CIN, and the short term clinical efficacy of hemofiltralion. Results The average age of the 30 patients was (72.87 ± 8.71) years old, with 21 (70%) male patients. The stages of CKD among the patients included CKD 3 (3 patients, 10%), CKD 4 (20 patients, 66.7%) and CKD 5 (7 patients, 23.3%). The average duration of hemofiltration was (7.5±4.1) hours. Serum creatinine before PCI, 24 hours, 72 hours and 1 week after PCI was (498.7±143.7)μmol/L, (353.2±128.0)μmol/L, (450.0±132.2)μmol/L, (488.0±145.7)μmol/L respectively,and CrCl was (20.3±10.2) ml/min, (36.5±14.3) ml/min, (28.3±10.4) ml/min, (21.0±10.3) ml/min respectively. There was no CIN. Mean follow-up was (3.1 ± 2.6) months. There was no new cardiovascular events, and no new patients need to rely on long term hemodialysis. Conclusions For patients with severe renal insufficiency, hemofiltration may reduce the incidence of CIN, It is an alternative preventive measures to prevent CIN.

Objective Constructing a scientific and practical clinical practice patterns for intensive care nursing masters with professional degree.Methods Based on the competence based education,a clinical practice patterns for intensive care nursing master with professional degree was developed by literature review,questionnaire survey,unstructured interview and Delphi technique.Results 16 experts from 10 third-level and first-class hospitals and 1 Nursing College were consulted,the retrieving rates of questionnaire were 93.75％,100.00％,respectively.The authoritative coefficients were 0.94 and the coordination coefficients were 0.257.The index system consisted of 6 first dimensions,47 second-dimensions and 112 items.Conclusions The positivity and authority of experts in this study were in high degree,the concentration and harmonization of experts' opinions were relatively high.The results had high reliability and feasibility.It can be used to provide objective and quantitative reference for intensive care nursing master with professional degree.