The problems in nursing postgraduate training in China are summarized,which include the ambiguity of subject orientation,absence of unified standard on training objective,imperfection of tutor team,uncertainty of research direction,lack of scientific research funds,etc.The countermeasures are then proposed,and the direction of nursing postgraduate education reform in China is discussed.

Objective To explore the effects of microstructure grinded on the labial face of porcelain fused to metal crown (PFM) in esthetic prosthesis for anterior teeth. Methods 193 patients with single maxillary incisor tooth defects were repaired with 2 crowns for each one. After the crowns being blent colour and molded, the crown A was not grinded particularly on the labial face and the crown B was done according to the records of the microstructure.The patients were allowed to choose the most satisfied one when 2 crowns were cemented temporarily. Results 36 patients chose the crown A and 157 chose B.The difference was significant ( P0.05). Conclusion The crown has great vitality and accordes with the esthetic standards of the patients by way of being grinded microstructure on the labial face.

Objective To investigate the clinical efficacy of Xi-Cleft point acupuncture plus surrounding electro- acupuncture in treating occipital neuralgia.Methods Forty-eight patients with occipital neuralgia were randomly allocated to treatment and control groups, 24 cases each. The treatment group received Xi-Cleft point acupuncture plus surrounding electroacupuncture and the control group, surrounding electroacupuncture alone. The VAS score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups (P<0.05). There was a statistically significant post-treatment difference in the VAS score between the treatment and control groups (P<0.05). The total efficacy rate was 95.8% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Xi-Cleft point acupuncture plus surrounding electroacupuncture is an effective way to treat occipital neuralgia.

Objective To investigate the relationship between the expression of estrogen receptor (ER),progesterone receptor(PR)and epidermal growth factor receptor(EGFR)in uterine leiomyoma and the recurrence after myomectomy.Methods Eighty cases underwent myomectomy were enrolled in this study.ER,PR and EGFR expression in uterine leiomyoma tissue and normal myometrium tissue were examined by immunohistochemical technique.All the patients were followed up regularly after myomectomy.Results The positive expression rate of ER,PR and EGFR in uterine leiomyoma tissue were significantly higher than those in normal myometrium tissue[88.8％(71/80)vs.48.8％(39/80),92.5％(74/80)vs.30.0％ (24/80),86.2％(69/80)vs.57.5％(46/80),P ＜ 0.05].The recurrence rates in ER,PR and EGFR positive expression patients were significantly higher than those in negative expression patients[42.3％(30/71)vs.22.2％(2/9),41.9％(31/74)vs.16.7％(1/6),42.0％(29/69)vs.27.3％(3/11),P ＜ 0.05].The recurrence times in ER,PR and EGFR positive expression patients were significantly shorter than those in negative expression patients(P ＜0.05).The expression of EGFR had positive correlation with ER and PR(r =0.837,0.702,P ＜ 0.05).Conclusions The recurrence of uterine leiomyoma may have correlation with high expression of ER,PR and EGFR in uterine leiomyoma.

Objective To investigate the influence of Trisialoganglioside-GTlb combined with Edaravone Injection on clinical effect and serum related indicators in patients with acute cerebral infarction.Methods A total of 126 cases of patients with acute cerebral infarction in our hospital from October 2010 to May 2016 were selected and divided into observation group and control group,63 cases in each group.Patients in the control group were treated with regular treatment and Edaravone Injection,and patients in the observation group were treated with regular treatment,Edaravone Injection and Trisialoganglioside-GTlb.The clinical effect,NIHSS scores,Barthel index scores,serum level of neuron specific enolase (NSE),S100β protein,superoxyde dismutase (SOD),advanced oxidation protein products (AOPP) and malondiadehyde (MDA) were compared.Results The total effective rate of the observation group (90.48％) was significantly higher than that of the control group (76.19％),the difference between the two groups was statistically significant (P ＜ 0.05).After two weeks of treatment,two groups of NIHSS and Barthel index scores were significantly lower than before treatment,the difference was statistically significant (P ＜ 0.05);and the NIHSS and Barthel index scores of observation group were significantly lower than that of control group,the difference was statistically significant (P ＜ 0.05).NIHSS scores,Barthel index scores of the observation group were significantly better than that of the control group (P ＜ 0.05);The serum level of NSE,S100,AOPP,MDA of two groups after treatment were significantly lower than that before treatment,the difference was statistically significant (P ＜ 0.05);and the above indexes of the observation group was significantly lower than the control group,the difference was statistically significant (P ＜ 0.05);SOD levels of two groups were significantly increased than before treatment,the difference was statistically significant (P ＜ 0.05);and the SOD levels of observation group was significantly higher than that of control group,the difference was statistically significant (P ＜ 0.05).Conclusion Trisialoganglioside-GT1b can synergy improve the clinical effect of Edaravone Injection in patients with acute cerebral infarction,and be good to recovery the neurologic function and ability of daily living,and these may be related to the change of the serum level of NSE,S100β protein,SOD,AOPP and MDA.

Objective To investigate the effect of calpeptin on diaphragmatic injury and atrophy under controlled mechanical ventilation in rats.Methods A total of 24 SPF Sprague-Dawley (SD) rats were randomly divided into anesthetized control group (CON group),24-hour controlled mechanical ventilation group (CMV group),and 24-hour CMV + treatment with calpeptin group (CMVC group),with 8 rats in each group.Animals in the CON group received an intraperitoneal injection of pentobarbital sodium without CMV and continuous infusion of pentobarbital sodium.A small-animal ventilator was used for 24 hours in rats of CMV group.Rats of CMVC were treated with a specific calpain inhibitor calpeptin (4 mg/kg).The drug was injected subcutaneously 2 hours before and 8,15 and 23 hours after mechanical ventilation.Changes in diaphragm ultrastructure,light microscopic picture,and myosin heavy chain (MHC) expression were observed.Results ① Alignment of myofilaments and normal Z-band,and the shape of mitochondria were maintained in CON group as revealed by electron microscope.The signs of misalignment of myofibrils,disruption of Z-band and vacuolar mitochondria were found in CMV group,and they were obviously improved in CMVC group.The density of muscle injury (× 10-2/μm2) in CMV group was significantly higher than that in control group (36.8 ± 13.7 vs.6.4 ± 6.3,t=6.373,P=0.001),and that in CMVC group was significantly lowered (17.6 ± 9.1 vs.36.8 ± 13.7,t=3.694,P=0.002).② In CON group,the diaphragm fibers appeared regular in cross section without pathologic change under light microscopy.Fuzzy muscle striations,irregular muscle fibers,centralized nuclei and swelling of capillary endothelial cells were observed in CMV group,while pathological changes in the CMVC group were milder significantly.③ In CMV group,the density of MHCslow and MHCfast was lower compared with that of CON group,and the gray value was lowered by 61.1％ (t=8.138,P=0.001) and 77.1％ (t=8.844,P=0.001),respectively,especially in MHCfast.However,the gray values of MHCslow and MHCfast were increased by 1.51 folds (t=4.601,P=0.010),and 1.33 folds (t=2.859,P=0.011),respectively,after treatment with calpeptin,and the elevation was more significantly in MHCslow.Conclusions Diaphragmatic injury and atrophy were found after CMV for 24 hour.Calpeptin could reverse the detrimental effects of CMV,and it suggested that calpain plays an important role in modulating the ventilator-induced dysfunction of the diaphragm.

Objective To study the clinical efficacy of self-made Shengji ointment on wound healing of postoperative perianal abscess. Methods 80 hospitalized patients with simple low anal abscess after surgery were randomly divided into control group and treatment group according to random digital table method, 40 cases in each group.The self-made Shengji ointment was smeared perianally and covered with gauze in treatment group, and Mayinglong shexiang zhichuang ointments was smeared perianally and covered with gauze in control group.VAS pain score and the granulation tissue scoring criteria were used to evaluate the growth status of the granulation.Results The VAS score in two groups were lower on the 3rd, 7th and 15th day than that on the 1st day (P<0.05);the VAS score on 1st day of two groups had no statisticall significant difference, but the VAS score in the treatment group were significantly lower than that in control group on the 3rd, 7th and 15th day, respectively (P<0.05).Duration of pain in treatment group was significantly lower than that of control group (P<0.05).The granulation tissue score in two groups on the 3rd, 7th and 15th day were lower than that on the 1st day,respectively (P <0.05); the granulation tissue score on the 1st day of two groups had no statistically significant difference, but the granulation tissue score in treatment group on the 3rd, 7th and 15th day were significantly lower than that in control group, respectively(P <0.05). Conclusion Self-made Shengji ointment could significantly relive the pain in wound, and promote the growth of granulation tissue, which has better effect in the treatment of wound healing of postoperative perianal abscess than Mayinglong shexiang zhichuang ointments.

BACKGROUND:Percutaneous vertebroplasty with bone cement injection has the advantages of minimal invasion, short time, effectively restoring vertebral body height, preventing further colapse of the vertebral body and obvious analgesic effect, which has became an effective method for the treatment of elderly osteoporotic compression fractures. OBJECTIVE:To observe the therapeutic effect of percutaneous vertebroplasty with bone cement injection on elderly osteoporotic compression fractures. METHODS:Sixty-two patients with osteoporotic thoracolumbar vertebral compression fracture, including 22 males and 40 females, aged 55-92 years, involving 86 vertebrae, were included and subjected to percutaneous vertebroplasty with polymethyl methacrylate bone cement injection under C-arm X-ray fluoroscopy. During the postoperative folow-up of 12 to 36 months, visual analogue scale scores, Cobb angle and Oswestry disability index scores were compared before and after the treatment. RESULTS AND CONCLUSION: At 12 to 36 months after treatment, there were 11 cases of complications, including 7 cases of bone cement leakage, 2 cases of adjacent vertebral fractures, 1 cases of bone cement tailing and 1 case of unsatisfactory pain relief. In the final folow-up, Cobb angle, visual analogue scale scores, Oswestry disability index scores were significantly improved compared with those before treatment (P < 0.05).These results demonstrate that percutaneous vertebroplasty with polymethyl methacrylate bone cement injection in the treatment of elderly osteoporotic compression fractures can not only restore vertebral shape, reduce kyphosis, reconstruct spinal stability, but also significantly reduce the pain caused by fractures and improve the life quality of patients. The curative effects in short and medium term are positive.

Objective To analyze the treatment of chemotherapy?failed advanced lung adenocarcinoma cases and the adverse reactions with apatinib. Method Twenty?two patients received treatment of apatinib at a dose of 425 mg/day for two weeks,then at a dose of 675 mg/day for two weeks if could be tolerated. The efficacy was evaluated by the imaging,CEA and NSE. Results The clinical evaluation of patients were complete remis?sion( CR) 0 case,partial remission( PR) 5 cases,steady( SD) 13 cases,progress( PD) 3 cases,1 case termina?ted the treatment due to adverse reactions,and the objective response rate was 23. 8%(5/21),disease control rate was 85. 7%(18/21). After 4 weeks treatment,CEA and NSE were significantly reduced than the previous ((97. 45±79. 05) mg/L vs. (47. 05±31. 89) mg/L,(20. 27±6. 88) mg/L vs. (11. 09±8. 92) mg/L;t=2. 45, 3. 56;P<0. 05) . The impacts on prognosis of different metastatic sites were no statistical significant difference( P>0. 05) . The main side effects were hypertension and proteinuria( 72. 7%,59. 0%) . Conclusion The treatment of chemotherapy?failed advanced lung adenocarcinoma with apatinib has better exact effect,and toxicity could be controlled,so it was worthy of clinical treatment and evaluation of long?term efficacy.

Objective To explore the effect of the straight line and the auxiliary incision of lip skin on repairing unilateral incomplete cleft lip.Methods 120 cases of unilateral incomplete cleft lip repaired with the straight line method and reconstruction of the orbicularis oris muscle with the auxiliary incision of lip skin.Results 2 cases of cleft relapse by tumble.The wound of 115 children were healed one stage.3 children were healed two stage.All children didn't present vermilion deficiency.The upper lip presented natural labial groove between affected and unaffected side.Both sides of nostrils were symmetry and scars were not ovbious.Conclusion This new method was simple and effective in repairing unilateral incomplete cleft lip.