To cultivate advanced nursing talents is the fundamental demand of nursing education in twenty-first century.This paper elaborated on the present application of university cooperative learning in clinical nursing practice aiming at combining the teaching theory with clinical practice,arousing nursing students' interest in learning and improving their team spirits and communication skills.Meanwhile,it is also conducive to the development of innovative experiment and further improvement of practical teaching quality.

A 63-year-old man presented with non-pruritic urticaria for 14 months,fever of unknown origin for nearly 12 months,and arthralgias of both lower limbs for 10 months.The fever,which was unrelated to the occurrence of skin lesions,appeared once a week on average,and might be as high as 39 ℃.Physical examination revealed irregular fever and lymphadenopathy in both inguinal and axillary regions.Skin lesions,consisting of rosecolored,slightly elevated plaques and papules,affected the trunk,both upper extremities and thighs.Skin biopsy showed perivascular infiltration of neutrophils and lymphocytes in the superficial dermal layer.Laboratory examination exhibited leukocytosis,elevated erythrocyte sedimentation rate and increased C-reactive protein level.Serum protein electrophoresis revealed an IgM-κ component in the γ-globulin zone.Radiographic examination suggested slight hepatosplenomegaly and hepatic cysts.Positron emission tomography/computed tomography (PET-CT) revealed bilateral knee joint effusion,degeneration of cervical vertebrae and lumbar vertebrae,as well as lymphadenectasis in both axillary,inguinal and popliteal regions as well as around external iliac vessels.Wholebody bone scan showed abnormalities of bilateral shoulder joints,elbow joints and knee joints,which were suggestive of arthritis.A diagnosis of Schnitzler syndrome was made.The patient was given prednisone 30 mg per day,and body temperature returned to normal with the improvement of condition on the second day.Subsequently,glucoside tripterygium total 20 mg thrice daily was additionally given,and the dose of prednisone was gradually decreased to 15 mg per day,with a satisfactory control of condition,disappearance of fever,skin eruptions or other discomfort,and marked relief of ostalgia and arthralgia.

Objective To explore the association between serum neutrophil‐to‐lymphocyte ratio (NLR) and DR in T2DM patients . Methods A total of 128 T2DM patients were recruited and divided into three groups :PDR group (n=22) ,NPDR group(n= 44) ,and simple T2DM group(n=62) .The levels of FPG ,HbA1 c ,TC ,TG and NLR were measured in each group . Results Spearman correlation analysis revealed that DR was positively correlated with T 2DM duration ,SBP ,DBP ,FPG ,HbA1 c ,TC , TG ,LDL‐C ,NLR ,CKD (r= 0.524 ,0.277 ,0.279 ,0.194 ,0.271 ,0.208 ,0.223 ,0.358 ,0.621 , 0.362 ,P<0 .05 or P<0 .01) .Logistic multiple regression analysis showed that ,T2DM duration ,NLR and CKD were independent risk factors for DR . Conclusion NLR level is associated with DR .

In order to explore the risk factors of osteoporosis , a 1:1 matched case-control study was conducted on 157 pairs of intellectuals with age above 40 years. Bone mineral density of distal radius was measured using single photon absorptiometry and radiograph of calcaneus was classified according to Jhamaris's method.Multivarious factors related to diet, physical exercise, tea drinking, smoking,menstrual and reproductive history were significantly associated with osteoporosis. In a multiple conditional logistic regression model, low calcium intake, exercise index before 40 years of age, average time of exercise per week above 40 years old, tea consumption, and the number of years after menopause in women were the most important and predictive factors. The risk led by lower calcium intake was higher in women than in men. The risk due to lack of regular exercise was more prominent in men,but for both sexes lack of exercise in early years of life was more risky than that in later years. As many people have habit of excessive tea drinking, the exact effect of tea on osteoporosis deserves further study.

OBJECTIVE:To establish a HPLC method for content determination of forsythin in qingreling granules by C 18 solid phase extraction to purify the forsythin in qingreling granules.METHODS:The column of Dikma Diamonsil TM C 18 ,a mob_ ile phase of acetonitrile-water(30∶70),the flow rate of1.0ml/min,the detection wavelength of230nm,and the column temperature of30℃.RESULTS:The calibration curve of forsythin was linear in the range of10.0～200.0?g/ml(r=1.0000),the average recovery was98.1%(RSD=1.91%).CONCLUSION:The present method is accurate,reliable,simple and with good reproducibility,the sample was purified completely,and little interference and it can be used for quality control of qingreling granules.

Cervical cancer, a common malignant tumor in female reproductive system, seriously threatens women's life and health. The standard surgery for early cervical cancer is radical hysterectomy + pelvic lymphadenectomy±para-aortic lymph node sampling. Lymph node metastasis is an independent risk factor for the prognosis of cervical cancer patients. Several researches showed that the incident of lymph node metastasis in early cervical cancer was approximately 20%. Giving the complications and sequelae of systematic lymph node resection, its application in early cervical cancer is still doubted. The sentinel lymph node, where lymph node metastasis firstly occurs, attracts much attention in the surgical treatment of malignant tumors. Hence, sentinel lymph node biopsy (SLNB) came into being. Recent studies have indicated that SLNB is safe and feasible for early cervical cancer and SLNB is recommended to patients with early cervical cancer. This article will introduce the application of SLNB in cervical cancer in the recent years and discuss its clinical value and related challenges.

Adenocarcinoma ; metabolism ; pathology ; Adult ; Desmin ; metabolism ; Diagnosis, Differential ; Humans ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Melanoma ; metabolism ; pathology ; Rhabdomyosarcoma, Alveolar ; metabolism ; pathology ; surgery ; Sarcoma, Alveolar Soft Part ; metabolism ; pathology ; Testicular Neoplasms ; metabolism ; pathology ; surgery ; Testis ; metabolism ; pathology

MicroRNAs and hypoxia inducible factor have extensive and important biological functions, both of them play an important regulatory role in angiogenesis. The interaction between them has an important significance for the profound understanding of the regulatory mechanism of angiogenesis. This article mainly summarizes the mutual regulation of microRNA and hypoxia inducible factor and its effect on angiogenesis in recent years.

Continuity of care is one of the core attributes of primary care, which interacts with first-contact, accessibility, coordination and comprehensiveness in a mutual, supportive, and strengthening way to form an interactive mechanism of primary care.This paper first reviews the current literature on definitions and concepts of continuity of care, ascertain the key elements of continuity, and pinpoint the relationship between the dominant and recessive elements.Then, it defines the connotations of continuity of care and their boundaries in the context of primary care, according to the principles of controllability, exhaustion and exclusiveness.Finally it conceptualizes the primary care continuity to lay the foundation for further studies on operationally defining the primary care attributes of general practice.

Accessibility is one of the core attributes of primary care, which is closely associated with first-contact, positively interacts with comprehensiveness, and is very influential to continuity and coordination.This paper first reviews the current literature on definition and concept of accessibility and highlights the characteristics and contents of primary care accessibility, then simplifies the overlapping between accessibility and other core attributes of primary care, and finally provides the definition of primary care accessibility and its core elements to lay the foundation for the development of measurement and evaluation tools for the core attributes of general practice.