Objective To study the application effect of PDCA management mode in the teaching process of practice nurses in spine surgery to reduce the occurrence of nursing errors. Methods A total of 35 practice nurses in spine surgery from March 2014 to March 2015 received the routine teaching mode were set as control group, and 35 practice nurses from April 2015 to April 2016 implemented PDCA management mode were set as intervention group. The occurrence rate of nursing adverse events in two years was observed, and the interns for clinical teaching evaluation model of quality and satisfaction and the intern examination results were summarized. Results The incidence of nursing adverse events was 22.86% (8/35) in control group, and 2.86% (1/35) in intervention group, the difference was statistically significant (χ2= 17.85, P = 0.00). The intern teacher for clinical teaching content arrangement, teaching attitude, detail guidance and skills training indicators evaluation score were (15.46±1.03), (14.18±1.06), (14.61±1.11), (13.30±1.07) points in control group, and (18.26±1.00), (18.48±0.51), (19.43±0.21), (19.16± 0.28) points in intervention group, the differences were statistically significant (t = 11.54- 31.34, P <0.01). The interns given theory and skills examination results were (80.15±1.61), (85.16±1.02) points in control group, and (93.10±2.01), (91.06±2.03) points in intervention group, the difference was statistically significant (t = 29.75, 15.36, all P = 0.00). The clinical teaching satisfaction was 57.14% (20/35) in control group, and 80.00% (28/35) in intervention group, the difference was statistically significant (χ2=12.12, P=0.00). Conclusions PDCA management model applied to clinical practice in department of orthopedics teaching process, can effectively improve the intern theory knowledge and skills to master the ability, most of the interns examination results are more optimistic, and for this kind of management pattern for the process of teaching evaluation of higher satisfaction, the teachers care under the guidance of intern nursing mistake, nursing adverse events is low, this method is worthy of promotion.

Objective:To prepare monoclonal antibodies with high specificity against different regions of N protein and to analyze antigenic epitopes of SARS-CoV N protein.Methods: Balb/ c mice were immunized with purified different region N protein to prepare McAb by hybridoma technique and select by indirect ELISA.Both of these McAbs were characterized for their antibody titre in the culture supernatant as well as ascites,class,subclass and affinity analysis.The antigen specificity for McAb were evaluated and confirmed by Western blot.The binding site and capability of McAb were observed by ELISA additive assay.Results: Seven hybridoma cell lines secreting monoclonal antibodies against SARS-CoV N1 and two hybridoma cell lines secreting monoclonal antibodies against SARS-CoV N2 were obtained.About the immunoglobulin subclass of McAb,six were IgG1,two were IgG2b and one was IgG3.Western blot showed that the McAbs reacted specifically with SARS-CoV N protein.ELISA additive assay indicated that two antibodies against SARS-CoV N1 recognized same epitopes,while others recognized distinct epitopes.Conclusion: We successfully obtained nine specific McAbs against the different region SARS-CoV N protein after expression and purification of the different part SARS-CoV N protein.It shows that the N1 McAb recognizs the N-terminus of the N protein whereas the N2 McAb recognizs the C-terminus.

Objective to analyze the major problems existing in laboratory medicine and put forward the improvement measures. Methods The dissertations of 69 graduates in Laboratory medicine major in 2008 were analyzed. Results A total of 62 teachers guided 69 students to complete their thesis,and the dissertation score was normal with outstanding dissertations accounting for 4.38% and good dissertations accounting for 65.21%;and medium accounting for 30.43%. Conclusion: The quality of graduation thesis should be promoted from the start of each aspect of the thesis,and quality control should be implemented in the whole process.

Objective To explore the usefulness of enhanced patient education in increasing the patients' knowledge and awareness of peripherally inserted central catheter (PICC) protection.Methods Totally 200 patients with PICC in Neijiang First People's Hospital from June 2009 to June 2012 were divided into control group (odd numbers,conventional patient education,n =100) and observation group (even numbers,enhanced patient education,n =100) according to their admission numbers.The patients' knowledge and awareness of PICC protection were analyzed after treatment,and the incidences of adverse events and catheter indwelling time were also compared between these two groups.Results Compared with the control group,the observation group had significantly higher PICC protection knowledge rate (91％ vs.78％,P =0.001),awarehess rate (95％ vs.80％,P=0.011),lower incidence of adverse events (1％ vs.5％,P =0.034),and longer PICC indwelling time [(125.8 ± 10.6) d vs.(106.7 ±8.2) d,P =0.026].Conclusion Enhanced patient education can effectively enhance the patients' knowledge and awareness of PICC protection.

Atherosclerosis is a multifactorial disease and mediated by chronic inflammation from initiation to progression. Inflammatory factors of this process, such as C-reactive protein, interleukin-6, cell adhesion molecules and tumor necrosis factor-a, not only involve in atherosclerosis-related disease process, but also indicate the risk of cardiovascular events. Inflammatory factors level plays a significant role in diagnosis, treatment and prognosis of atherosclerosis-related disease, such as acute coronary syndrome. Recent studies have shown that there is a marked inflammatory response after stenting, which plays an important role in the vascular remodeling process, especially in-stent restenosis. Therefore, it is necessary to explore the molecular mechanism and pathological changes in the process of inflammation and to study prevention and treatment of the inflammation. We believe that inflammatory processes will be new targets of therapy in preventing or treating atherosclerosis and its complications.

Objective To analyze the risk factors of ANCA-associated systemic vasculitis with pulmonary infection to improve the alertness of clinicians to imprave the survival of patients.Methods Seventyfive AASV patients in Shanghai Renji Hospital from January 2010 to June 2013 were selected,and logistic regression models was applied to analyze the correlation.Results Of 75 AASV patients,39 (52％) cases were males,36(48％) cases were females,the average ages were (56±19),56(75％) cases were MPA,17(23％) cases were WG and 2(3％) cases were CSS.42(56％) cases were diagnosed to have pulmonary infection.Among the patients with pulmonary infection,23 (55％) were males,19 (45％) were females,24 (57％) were older than 60 years old,17(12％) had WG,37(88％) had MPA,and 8(19％) died.Meanwhile,11(26％) had bacterial infection,2(5％) had tuberculosis,2(5％) had fungi infection,and 27(64％) had mixed infections respectively.8(19％) cases died.Multivariate logistic regression analysis showed that those who were older than 60 years (OR=15.13,95％CI 2.16-106.04,P＜0.01),who were diagnosed as MPA (OR=9.00,95％CI 1.37-59.14,P＜0.05),who had hypoproteinemia (OR=17.61,95％CI 3.14-98.74,P＜0.01) and interstitial lung disease (OR=11.83,95％CI 2.19-63.85,P＜0.01) were more likely to complicate with pulmonary infection.Conclusion Those who are elders,diagnosed as MPA,with hypoproteinemia and interstitial lung disease have higher risk to have pulmonary infection among AASV patients,which underscores that clinicians should pay more attention to this complication of AAV patients.

Objeetive To investigate the clinical effects and nursing interventions of endoscopic sphincterotomy(EST)for treating elderly patients with choledocholithiasis.Methods The clinical data of 73 cases of patients operated by EST were retrospectively analyzed.Before surgery the psychological nursing,examination and preparation were meticulously performed,the changes of vital signs and nursing were closely observed during surgery,the respiratory tract nursing,cardiovascular disease and diabetes nursing,pain nursing and complications treatment were performed after surgery.Results There were 69cases of 73 patients were successful,the success rate was 94.5%;8 cases of concurrent hyperamylasemia were given conservative treatment and had clinical recovery;2 cases of fever occurred and white blood cell count elevated and were treated by effective antibiotic treatment;there was no perforation,wound bleeding and death.Conclusions Using the EST to treat the choledocholithiasis of elderly patients has good clinical effects and low risk;through careful observation and nursing,can reduce complications,promote the patients'early recovery and improve quality of life of elderly patients with choledocholithiasis.

Objective To compare the diagnostic value for hysteromyona with trans-abdominal ultrasound (TAS) and trans-virginal ultrasound(TVS). Methods Two empirical doctors detected respectively 82 patients by TAS and TVS in double blind method. The results were compared with pathological results. Result The correct rate of diagnosis in 82 patients with 123 hysteromyoma focus by TVS and TAS was 96.75% and 86.18% respectively.There was statistical difference between TAS and TVS. The correct rate of combining use of the two method was 98. 37%. Couclusion Either TVS or TAS had its own merit and defect, Combining use of the two method could raise the correct rate.

ObjectiveTo study the effect community health education on the quality of life in chronic obstructive pulmonary disease (COPD) patients.Methods Three hundred and sixty patients with COPD in remission were set as the observation group, while another 212 COPD patients during the same period as the control group.The control group received conventional health education and the obseravation group received systematic,targeted health mode.The two groups were compared in respect of the quality of life.Results Before intervention,the two groups showed no significant differences in the total score on quality of life as well as its dimensions (P>0.05).After intervention,the study group was higher than the control group in the total score on quality of life as well as its dimensions (P<0.05).Conclusion The community health education is effective for improving the quality of life of COPD patients.