Based oncompetence-basedphilosophy of education, core competences of Master of Nursing Specialist (MNS) postgraduates serve as a benchmark for the education quality. Furthermore, the evaluation of core competences is a key link. Our research mainly summarizes the evaluation methods of core competences of MNS at home and abroad, thus providing suggestions to the improvement of domestic core competences evaluation methods of MNS.

Objective To design a questionnaire to explore nursing care behavior demand from patients'vision, and verify its reliability and validity. Methods The nursing care behavior index entry pool were summed up through literature analysis and discussion, and then a questionnaire containing 40 items was designed through per-investigation. A total of 150 patients from 30 departments in general hospital of Shenyang military region were selected for questionnaire survey using the convenience sampling method. The SPSS 19.0 was used to test the reliability and validity. Results Totally 149 effective questionnaires were recycled. Finally the questionnaires contained 6 dimensions and 35 items. Six factors were extracted with exploratory factor analysis, which explained 57.976% variance respectively. Total questionnaire Cronbach alpha coefficient was 0.892, the dimension Cronbach alpha coefficient was 0.747-0.914; Total remeasuring reliability was 0.824, the remeasuring reliability was 0.733-0.867. Binary validity was 0.806, binary coefficient was 0.748-0.872. Conclusions This study scientifically and reliably built a nursing care behavior demand questionnaire from patients′vision, which can be used to survey patients′satisfaction on nursing humanities.

Objective To analyze the language structure of nursing records and the application of defined vocabulary in nursing records of community child care,and to explore the possibility of structuralization and standardization of community nursing records by researchers' consulting International Classification of Nursing Practice (ICNP(R)2.0).Methods Convenient sampling method was used.A total of 432 handbooks about child health care were extracted from three community health service centers in Liaoning province.By analyzing the nursing records,the vocabulary was selected,and a coding book was built.Then researchers compared them with ICNP(R)2.0 Chinese version.Results Totally 567 terms were extracted.All phrases in nursing records about community child health care can be classified into three categories and seven shafts,which were nursing phenomenon,nursing action and nursing outcome.Our community nursing records about child health care could not fully meet shaft level of nursing record writing requirements from the International Council of nurses.Only 146 records were labeled as perfect fit with ICNP(R)2.0 terminology,223 records as not fit at all.The difference of different levels of suitability distribution about nursing phenomenon,nursing action and nursing outcome had statistically significant difference.Words of able to adapt and can't adapt about nursing action had larger proportion.Words that can't adapt about nursing phenomenon and nursing outcome had larger proportion.Conclusions There is still certain gap between domestic nursing records and ICNP(R)2.0 terminology.The list of terms from comparison nursing records about community child health care with ICNP(R)2.0 can lay the foundation for nursing language system structure and perfect community nursing record language in our country.

This study aimed to investigate the involved immunologic mechanism of pure total flavonoids from Citrus (PTFC) on the development of non-alcoholic steatohepatitis (NASH). C57BL/6 mice were fed with high .fat diet for 16 weeks to induce the NASH model, and from the 7th week three dosages (25, 50 and 100 mg x kg(-1) x d(-1)) of PTFC were administrated intragastric for 10 weeks respectively. Serum TG, CHOL, ALT, AST were determined by biochemical assay, histopathological changes of the liver tissue were observed by HE staining, expression of RORyt and Foxp3 mRNA of the liver tissue was detected by Real-time PCR, and serum IL-17, IL-6, IL-10 and IL-4 were determined by.Cytometric Beads Array. As a result, we find that after the administration of PTFC, the in- flammation of the liver tissue of NASH mice was attenuated, liver function was improved, and the expression of RORgammat mRNA was higher in the liver tissue while which was lower of Foxp3 mRNA, the level of proinflammatory cytokines IL-17 and IL-6 decreased and the level of suppressive cytokines IL-10 and IL-4 increased. These data show that PTFC protects the development of NASH through regulating the Th17/Treg balance and attenuating inflammation.
Animals ; Citrus ; chemistry ; Cytokines ; blood ; Flavonoids ; pharmacology ; Male ; Mice ; Mice, Inbred C57BL ; Non-alcoholic Fatty Liver Disease ; immunology ; prevention & control ; T-Lymphocytes, Regulatory ; drug effects ; Th17 Cells ; drug effects

OBJECTIVETo observe the effect of pure total flavonoids from Citrus (PTFC) on the hepatic fatty degeneration, inflammation, oxidative stress and SIRT1/PGC-1alpha expressions in mice with non-alcohol steatohepatitis (NASH), and discuss the action mechanism of PTFC on NASH.

METHODMice were given high-fat diet for 16 weeks to induce the NASH model. Since the seventh week after the model establishment, the mice were intervened with 100, 50 and 25 mg x kg(-1) x d(-1) PTFC for 10 weeks. The pathologic changes in hepatic tissues were observed with HE staining. The contents of TG, CHOL in hepatic tissue, as well as the levels of AST, ALT in serum were detected by using the biochemical process. The expression of SIRT1, PGC-1alpha and MnSOD mRNA in hepatic tissues were detected with Real-time PCR assay. SIRT1, PGC-1alpha protein and 8-OHdG expressions were determined with the immunohistochemical method. The SOD level in hepatic tissues was tested by the xanthine oxidase method. The MDA content in hepatic tissues was examined by the thiobarbituric acid method.

RESULTThe contents of TG, CHOL, NAFLD activity scores and ALT level in serum in hepatic tissues of mice in the model induced by fat-rich diet were obviously higher than that of the normal group (P < 0.010. The SIRT1, PGC-1alpha, MnSOD mRNA and protein expression in hepatic tissues were significantly lower than that of the normal group (P < 0.01). The expression of 8-OHdG and the content of MDA in hepatic tissues were obviously higher than that of the normal group (P < 0.01). After the intervention with different doses of PTFC, the NAFLD activity scores, the content of TG and the level of AST in serum were notably lower than that of the normal group (P < 0.01, P < 0.05); whereas the SIRT1, PGC-1alpha, MnSOD mRNA and protein expression were obviously higher than that of the normal group (P < 0.01, P < 0.05), with the significant decrease in the expression of 8-OHdG and the content of MDA (P < 0.01).

CONCLUSIONOxidative stress/lipid peroxidation enhancement in in NASH mice induced by high-fat diet may be related to the changes in SIRT1/PGC-1alpha signal transduction pathway. PTFC could enhance the anti-oxidant capacity in liver, relieve the damage of reactive oxygen during the fatty acid metabolic process, and prevent NASH from the occurrence and development by regulating the SIRT1/PGC-1alpha signal pathway.

Animals ; Citrus ; chemistry ; Fatty Liver ; drug therapy ; genetics ; metabolism ; Flavonoids ; chemistry ; pharmacology ; Inflammation ; drug therapy ; genetics ; metabolism ; Liver ; drug effects ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Non-alcoholic Fatty Liver Disease ; Oxidative Stress ; drug effects ; genetics ; Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha ; Sirtuin 1 ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism

OBJECTIVETo investigate the therapeutic effect of IL-6 mAb on experimental autoimmune myocarditis (EAM) in rats, and search the mechanism of the role of IL-6, helper T cells 17 (Th17) and regulative T cells (Treg) in EAM pathogenesis.

METHODSThirty-four Lewis rats were divided into three groups randomly, i.e. control group (n = 6), EAM group (n = 12), and IL-6 mAb intervention group (n = 16). Rats in EAM group and IL-6 mAb intervention group were injected intracutaneously with myosin to establish EAM model. Rats in IL-6 mAb intervention group were injected intraperitoneally with 1 mg IL-6 mAb on 1st, 7th to 20th day after cardiac myosin immune injection. Myocardial inflammation was examined by HE stain, Masson stain, and TdT assay (TUNEL reaction) on 21st and 84th day after IL-6 mAb therapy in order to assess the therapeutic role. Spleen cells were analyzed by flow cytometry to illustrate Th17 and Treg cells? number and function. The serum concentration of IL-6, IL-10, IL-17, and TGF-beta in each group was measured by ELISA, concentration of STAT3, RORgammat, and Foxp3 mRNA in each group was determined with RT-PCR. Spleen cells derived from EAM were stimulated by IL-6 mAb in vitro, and the concentration of IL-10, IL-17 and TGF-beta was measured by ELISA.

RESULTSInflammation score, fibrosis score, and apoptosis index in IL-6 mAb intervention group were significantly decreased as compared with those in EAM group (P < 0.01). The number of Th17 and Treg cells in EAM group on the 21st day (experimental acute peak stage) were increased, and those in intervention group on the 21st day were significantly inhibited (P < 0.01). The concentration of serum IL-6, IL-10, IL-17 and TGF-beta in intervention group on the 21st day was decreased dramatically in comparison with that in EAM group on the same day (P < 0.01). The levels of peripheral blood STAT3, RORgammat, Foxp3 mRNA in intervention group on the 21st day was decreased significantly as compared with that in EAM group (P < 0.01). The expression of IL-10, IL-17 and TGF-beta was increased significantly (P < 0.01) by stimulation of IL-6 mAb on spleen cells derived from EAM in vitro.

CONCLUSIONSIL-6 mAb could neutralize IL-6, and ameliorate myocarditis and reduce heart autoimmune responses. IL-6 mAb has significantly protective effects on EAM by suppressing Th17 and Treg cells.

Animals ; Antibodies, Monoclonal ; therapeutic use ; Autoimmune Diseases ; drug therapy ; immunology ; Disease Models, Animal ; Forkhead Transcription Factors ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-17 ; metabolism ; Interleukin-6 ; immunology ; Male ; Myocarditis ; drug therapy ; immunology ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; metabolism ; Rats ; Rats, Inbred Lew ; STAT3 Transcription Factor ; metabolism ; Th17 Cells ; immunology ; Transforming Growth Factor beta1 ; metabolism

Treatment based on syndrome differentiation is an essential feature of traditional Chinese medical diagnosis. The interventions based on changes of syndrome types in randomized controlled trials are complicated, leading to the difficulty of blind method enforcement. This article described a double-blind method. It could be used in randomized controlled trials under the condition of different syndrome types and different medications. It numbered drugs in two stages, and in two phases to achieve double-blind. This method not only guaranteed investigators and subjects to be in blinded conditions, but also achieved using different medications for patients of different syndromes. It also caused no drug waste. It was scientific and feasible.
Double-Blind Method ; Humans ; Medicine, Chinese Traditional ; Randomized Controlled Trials as Topic ; Single-Blind Method

Objective To evaluate the diagnostic value of the metabolic parameters for differentiating focal autoimmune pancreatitis (F-AIP) and pancreatic cancer (PC) by dual time 18F-FDG PET/CT scan.Methods Ten F-AIP patients and 20 PC patients in Changhai Hospital from May 2011 to November 2014 were enrolled in this study.All the AIP patients were histological confirmed or diagnosed by clinical follow up.The PC patients were histological confirmed and gender-and age-matched with F-AIP patients.50％ SUVmax was set as the threshold to fine-tune the boundary of interest.The extracted parameters included SUV SUV metabolic tumor volume (MTV),total lesion glycolysis (TLG),target-to-background ratio (TBR) and the retention indexes(RI) of all the parameters above.The PET/CT imaging features were also observed.Results The high metabolic lesions were observed in both F-AIP patients and PC patients.There were 6 F-AIP patients whose lesion was located in pancreas head,4 F-AIP patients whose lesion was located in pancreas body and tail.There were 12 PC patients whose lesion was located in pancreas head,8 PC patients whose lesion was located in pancreas body and tail.In F-AIP patients,2 cases had dilated pancreatic duct,6 had dilated biliary duct,8 had increased metabolism in mediastinal lymph node and 2 had abdominal lymphadenopathy,which were 8,5,5 and 14 cases in PC patients.The positive rate of mdeiastinal lymphadenopathy in F-AIP patients was statistically higher than that in PC patients,while the positivity rate of abdominal lymphadenopathy in AIP patients was lower than that in PC patients.The difference was statistically significant (both P ＜ 0.05).There were no statistical differences on the positivity rate of the dilated pancreatic duct,intra-and extra-hepatic bile duct between two groups.SUVmax,SUVmean and MTV in F-AIP were 5.37 ± 0.88,3.48 ± 0.66,21.79 ±15.60 in early stage and 6.45 ±1.51,4.23 ± 1.10,19.36 ± 14.63 in delayed stage,and those in PC were 8.31 ±3.08,5.41±1.95,9.26±8.35 in early stage,and 9.75±3.86,6.36±2.56,9.09±10.71 in delayed stage.SUVmax and SUVmean in F-AIP were lower than those in PC,whereas MTV were larger in F-AIP than that in PC.ROC curves for SUVmax,SUVmean and MTV were made.The AUC of SUV was the highest at 0.85,the cut-off value was 4.45,the corresponding sensitivity was 65％ and the specificity was 90％.TLG,TBR and RI of all the parameters were not statistically different in F-AIP and PC.Conclusions The 18F-FDG PET/CT metabolic parameters,such as SUVmax,SUVmean,MTV,could be of special diagnostic significance in discriminating F-AIP from PC.

OBJECTIVE To explore the therapeutic effect of basic fibroblast growth factor (bFGF) coacervates on diabetic peripheral neuropathy (DPN) in diabetic rats.METHODS Poly (ethylene argininylaspartate diglyceride) (PEAD), heparin and bFGF were dissolved in saline at the mass ratio of 50:10:1 to obtain bFGF coacervates. The loading efficiency of bFGF in the coacervates was analyzed by Western blotting. The release profile of bFGF from the coacevates was detected by ELISA. Male SD rats were ip injected with streptozotocin 65 mg · kg- 1 to establish a diabetic model,and DPN occurred 8 weeks later. The DPN rats were randomly divided into free-coacervate group, bFGF group and bFGFcoacervate group. For bFGF group, bFGF 200 μg·kg-1 was im injected once daily for 3 d. In bFGF-coacervate group, bFGF coacervate solution (244 μL) equal to bFGF 200 μg · k - 1, was im given only once. DPN rats in free- coacervate group were im given the same volume of vehicle(PEAD + heparin) only once. Ten normal age peer rats were taken as normal control group.Footprint analysis was conducted each week to evaluate motor function. On the 30th day after treatment,the rats were sacrificed, and sciatic nerves of both sides were harvested for pathological observation through HE staining. Apoptosis in nerve tissue was detected by DAPI staining, and Ki67 and proliferating cell nuclear antigen (PCNA) protein levels were detected by Western blotting. RESULTS Western blotting and ELISA analysis indicated that bFGF-coacervates were well prepared at a mass ratio of 50:10:1,and controlled bFGF release for at least 35 d. The result of rat behavior evaluation and pathological index test indicated that, compared with normal control group, the sciatic function index (SFI) in free-coacervate group decreased significantly(P<0.01), the internal nerve fibers were accompanied by irregularity and serious demyelination, and there was a large number of apoptotic nuclei and low expressions of Ki67 and PCNA proteins (P<0.01).After injection with bFGF or bFGF-coacervates, the SFI increased progressively (P<0.05, P<0.01), and the proportion of fibers with myelin abnormalities and apoptotic cells was significantly reversed. Moreover, the levels of Ki67 and PCNA was evidently enhanced on the 30th day post- operation (P<0.05, P<0.01). Compared with bFGF group, the results of those detection indicators in bFGF-coacervate group were better (P<0.05, P<0.01). CONCLUSION PEAD and heparin complex can load bFGF with high efficiency, and control its release in a steady manner. For DPN rats,treatment with bFGF-coacervates is more effective than bFGF alone.

Objective To evaluate the distribution of pathogens causing bone and joint purulent infections and the bacterial resistance to antibiotics,and to provide reference of clinical antibiotic therapy.Methods A total of 514 patients who had bone and joint purulent infections in Department of Orthopedics of Shangrao People’s Hospital from Jan 2009 to Jun 2013 were retrospectively analyzed. Results 296 strains of Gram-negative bacteria were isolated,the infection rate was 47.2%,among which 296 strains of Escherichia coli were the most common infection pathogen,the infection rate was 15.6%,followed by Acinetobacter baumannii,Pseudomonas aeruginosa,and the infection rates were 11.8%,11.3%.331 strains of Gram-positive bacteria were isolated,the infection rate was 52.8%.Staphylococcus epidermidis,Staphylococcus aureus,were the common infection pathogens,following the infection rates were 21.5%,13.7%.Gram-negative bacteria had the highest sensitivity to imipenem,while Gram-positive bacteria had sensitivity to vancomycin.Conclusion Gram-positive bacteria is the main pathogens with bone and joint purulent infections.Selection of antibiotics according to the drug sensitive test has important clinical significance.