Objective To research and discuss the scientificalness and effectiveness of professional core competence training in the operating theatre so as to seek for a way for the professional growth of operating room nurses.Methods Under the guidance of Guideline on Core Competence Building of Professional Nurses compiled by Department of Health of Guangdong Province in 2009,in accordance with the theory of core competence training and taking into account of different yearly salaries and levels of 21 nurses,we made respective plans and carried them out.Results After implementing professional core competence training,the rate of operating nurses' mastering basic knowledge and techniques reaches 92.50％,the rate of mastering professional knowledge and techniques reaches 86.25％,the ability of clinical thinking increases by 85％,the ability of education and research development increases by 78.50％,the ability of self-training raises by 98.20％,safe management raises by 91.50％,and the emergency ability raises by 93.60％.The analysis and compare are based on seven aspects,therefore are of statistical significance.Conclusion The training of the core competence in the operating theatre is practical,scientific and feasible in-service education which not only improves operating room nurses' abilities of clinical thinking and solving clinical nursing problems,but also provides career progress for operating room nurses.

Objective: To analyze and discuss the social factors and clinical characteristics of oral poisoning in children, so as to provide reference for preventing and treating children poisoning. Methods: The clinical data of 173 pediatric patients with oral poisoning diagnosed and treated in Department of Pediatrics, the Fourth Military Medical University in Tangdu Hospital from January to December 2017 were retrospectively analyzed. Results: Pesticide and insecticide poisoning topped the list(68 cases, 39.31%)and the clinical manifestations of different poisons were varied.Geographically, the urban and rural distribution was mainly rural(118 cases, 68.21%), among which 103 cases(87.29%)were left-behind children in rural areas.Within one year, the number of urban children fluctuated slightly, with a small peak in March and the number of rural children fluctuated greatly, with a large peak in July.In addition, urban children were mainly poisoned by oral internal medicine(34 cases, 61.82%), while rural children were mainly poisoned by oral pesticide and insecticide(64 cases, 54.24%). The gender distribution was mainly male(101 cases, 58.38%), with the highest incidence in early childhood(97 cases, 56.07%). The main reasons for taking poison included children′s misadministration(123 cases, 71.10%), parents′ accidental feeding(24 cases, 13.87%), and elder children′s self-administration due to emotional factors(26 cases, 15.03%). The treatment methods were gastric lavage, emetic stimulation and enema according to the type and time of poisoning of administration, and timely use of specific antidote and symptomatic treatment was also the key to treatment. Conclusion The situation is more serious in rural areas of oral poisoning in children, especially for left-behind children in rural areas, who are at the highest incidence in early childhood.Oral pesticides, insecticides and oral drugs are the most prominent, and misadministration is the main reason.Family poison management should be strengthened for prevention, and treatment should vary according to the type and time of taking poison.

Objective To investigate the value of double-balloon enteroscopy and CT enterography for the diagnosis of intestinal Crohn disease ( CD ) . Methods Data of 125 patients with suspected CD undergoing double-balloon enteroscopy and CT enterography were reviewed. Diagnosis was made based on pathological,endoscopic findings and clinic follow-up results. Detection rates and diagnostic rates of double-balloon enteroscopy and CT enterography for intestinal CD were compared. Results The detection and diagnostic rates of intestinal CD by double-balloon endoscopy were 62. 4％( 78/125) and 94. 8％ ( 74/78) , respectively. The sensitivity, specificity and accuracy of double-balloon enteroscopy in the diagnosis of intestinal CD were 100. 0％, 92. 2％ and 96. 8％, respectively. The detection and diagnostic rates of intestinal CD by CT enterography were 44. 8％( 56/125 ) and 89. 3％ ( 50/56 ) , respectively. The sensitivity, specificity and accuracy of CT enterography in the diagnosis of intestinal CD were 67. 6％, 88. 2％ and 76. 0％, respectively. Both the detection rate and the diagnostic rate of double-balloon enteroscopy in intestinal CD were higher than those of CT enterography. Conclusion Double-balloon enteroscopy shows high application value for the diagnosis of intestinal CD, but CT enterography before enteroscopy can guide the selection of endoscopic approach, reduce economic expenditure and alleviate patients' pain, so CT enterography could be the first choice for intestinal CD patients with contraindications of enteroscopy.

OBJECTIVE To explore the role of clinical pharmacists in identifying paroxysmal spasms caused by drugs， and provide reference for rational drug use. METHODS Retrospective analysis was conducted on pharmaceutical care provided by clinical pharmacists for a patient with ceftazidime-avibactam （CZA-AVI） induced paroxysmal spasms. The clinical pharmacists identified， analyzed and summarized the clinical manifestations， risk factors and treatment methods of the nervous system toxicity caused by antibacterial drugs. According to the patient’s clinical symptoms and test results， the clinical pharmacists recommended temporarily discontinuing the use of polymyxin B and montelukast sodium， and halving the dose of CZA-AVI. The physicians did not adopt the recommendation to halve the dose of CZA-AVI， and when the patient’s neurologic toxicity did not improve， the clinical pharmacists again recommended discontinuing CZA-AVI， which was accepted by the physicians. RESULTS Clinical pharmacists analyzed the condition and checked related drugs that caused paroxysmal spasms of extremities one by one， and finally determined that CZA-AVI might be the drug that caused paroxysmal spasms of extremities in the patient. After stopping the drug， the patient’s symptoms improved and was transferred to a community hospital for rehabilitation treatment. CONCLUSIONS The dose of CZA-AVI should be adjusted according to the renal function and the neurotoxicity should be guarded against， especially for patients with advanced age， renal insufficiency， and the combined use of multiple drugs related to nephrotoxicity and neurotoxicity.

ObjectiveTo observe the therapeutic effect of Shugan Huazheng prescription on hepatic fibrosis model rats induced by carbon tetrachloride （CCl₄） and explore whether it plays its role through hypoxia-induced factor-1α/vascular endothelial growth factor/transforming growth factor-β₁ （HIF-1α/VEGF/TGF-β₁） pathway. MethodA total of 54 male SPF SD rats were randomly divided into six groups： blank group， model group， colchicine group （0.2 mg·kg^-1）， and high-， medium-， and low-dose groups （29.52， 14.76， and 7.38 g·kg^-1） of Shugan Huazheng prescription， with nine rats in each group. The molding was conducted three times a week for eight weeks. Administration began the day after the first injection， and the drug intervention was once a day for eight weeks. On the day after the last administration， the rats were deprived of food and water， and they were killed the next day， during which the physiological status of each group of rats was dynamically monitored. The pathological changes in the liver were observed by hematoxylin-eosin （HE） staining， and the content of hydroxyproline （HYP） and angiotensin Ⅱ （AngⅡ） in liver tissue were detected by enzyme-related immunosorbent assay （ELISA）. Real-time fluorescent quantitative PCR （Real-time PCR） was used to determine the mRNA expression levels of HIF-1α， VEGF， and TGF-β₁ in liver tissue， and immunohistochemical method （IHC） and Western blot were used to detect the protein expression levels of HIF-1α， VEGF， and TGF-β₁ in liver tissue. ResultCompared with the blank group， the overall condition of rats in the model group decreased significantly. The proliferation of connective tissue and the increase in adipose cells between hepatocytes were obvious. The content of HYP and Ang was increased. The mRNA and protein expressions of HIF-1α， VEGF， and TGF-β₁ were increased to varying degrees （P<0.05）. Compared with the model group， the proliferation of connective tissue and inflammatory cell infiltration in the liver tissue of colchicine and Shugan Huazheng prescription groups were reduced. The content of HYP and Ang was decreased. The mRNA and protein expression levels of HIF-1α， VEGF， and TGF-β₁ were decreased， and the colchicine group and high-dose group of Shugan Huazheng prescription were the most significant （P<0.05）. ConclusionShugan Huazheng prescription has an obvious therapeutic effect on CCl₄-induced hepatic fibrosis model rats. Its therapeutic mechanism may be related to the regulation of the HIF-1α/VEGF/TGF-β₁ signaling pathway and the improvement of hepatic hypoxia， vascular remodeling， and the syndrome of Qi deficiency and blood stasis in hepatic fibrosis.