Objective To develop an assessment indicator system of function for standardized patients in the objective structured clinical examination for nursing specialty,which provides the basis for the standardized training and assessment of standardized patients.Methods The Delphi method was used to determine this indicator system.Results After two rounds of the Delphi procedure,the assessment indicator system was drawn-up,which included 3 first-class indicators and 12 second-class indicators and 35 third-class indicators with weights.Conclusions The achievements of this study may provide reference for nursing educators to screen standardized patients strictly and improve the quality of standardized patients continuously,and also provide the basis for development of scale or instrument in the further.

Objective To explore the relationship between plasma mannose-binding lectin (MBL), lipopolysaccharide (LPS) and body mass index in pregnant women with gestational diabetes mellitus (GDM). Methods 45 newly diagnosed GDM pregnant women and 45 healthy women (control group) were selected in this study. Plasma concentration of MBL and LPS were measured. All the groups were sub-divided into obesity (BMI ≥ 25 kg/m2) and non-obesity (BMI < 25 kg/m2) subgroup. The relationships of levels of plasma LPS, MBL with BMI were analyzed. Results The level of plasma MBL in GDM group was significantly lower than that in control group(P < 0.05), while the concentration of LPS in serum was much higher than that in healthy pregnant women (P < 0.05). Pearson analysis showed the level of MBL in GDM group was negatively correlated with BMI(r=-0.28, P<0.05), serum LPS concentration was positively correlated with BMI(r = 0.62, P < 0.05) and LPS was negatively correlated With MBL(r = -0.43, P < 0.05) . The above correlations were not found in control group. Conclusion Serum MBL and LPS maybe two important risk factors for those pregnant women being overweight, and could offer great significance for the prevention and treatment of GDM.

Objective To evaluate the efficacy and safety of two kinds of dosage of 5-aminosalicylic acid zinc enteric-coated capsule in treatment of active ulcerative colitis (UC). Methods The muhicentre, double blind, dosage reaction and contrast trial was conducted in six hospitals during March 2004 to Sep. 2004. One hundred and eight patients with UC were randomly allocated into the high dosage (n= 36, 1 g, bid) and the low dosage (n = 36, 0.5 g, bid) of 5-aminosalicylic acid zinc enteric-coated capsule groups, and the Olsalazine sodium group (n = 36, 1 g, tid) with a 8-week treatment. The efficacy and adverse events of 5-aminosalicylic acid zinc enteric-coated capsule were evaluated based on the clinical presentations and endoscopic findings. Results The clinical efficacy was 68.97% in high dosage group, 45. 45% in low dosage group and 62.86% in Olsalazine sodium group with no significant difference (P>0. 05). The endoscopic examination showed that the healing rate of UC in high dosage group and low dosage group was 51.72% and 21.21%, respectively, whereas the efficacy rate was 82.76% and 69.70% respectively. The results showed that high dosage was more effective than low dosage (P=0.023), but was similar to Olsalazine sodium (healing rate of 34.29% and effective rate of 88.57% ,P>0. 05). Diarrhea was main adverse event, which was accounted for 2.8% (1/36) in high dosage group and 2.8% (1/36) in the Olsalazine sodium group. There was no adverse event in low dosage group. Conclusions 5-aminosalicylic acid zinc enteric-coated capsule is an effective agent in treatment of UC, especially in high dosage. It is similar to Olsalazine sodium in treatment of UC, and has advantages in reducing medication times.

Objective To analyze the value of CT and MRI in the diagnosis of intrahepatic peripheral cholangiocarcinoma (IHPCC ). Methods 32 cases of intrahepatic peripheral cholangiocarcinoma were collected and analyzed retrospectively.25 patients underwent plain and enhanced CT scan,while 18 cases underwent plain MRI and MRCP(8 of them underwent MRI dynamic enhancement scanning).6 cases underwent plain and enhanced scan of CT and MRI simultaneously.Results 32 intrahepatic lesions were found,with CT and MRI revealing all lesions.Lesions of IHPCC showed as hypo-or iso-density on the plain CT,slightly hypo-intensity on T1 WI and uneven mild hyper-intensity on T2 WI.During arterial phase of contrast-enhanced scan,18 lesions showed as marginal mild linear enhancement,3 cases with obvious enhancement and 11 cases with no enhancement.During portal phase,venous phase and delayed scan,19 lesions showed as progressive mild-to-mod-erate uneven enhancement,while 6 cases enhanced homogeneously.25 cases showed characteristic significantly delayed enhance-ment.MRCP could display satisfactory of Intra-and-Extra-hepatic bile ducts.Other signs include intrahepatic bile ducts dilation (23 cases),intrahepatic bile duct stones (6 cases),hepatic lobe atrophy (1 5 cases),and depressed liver capsula (8 cases).Conclusion Both CT and MRI are effective methods for diagnosing of intrahepatic peripheral cholangiocarcinoma.Compared with CT,MRI seems more valuable on presentation the tumor size and border,bile duct involvement,the degree of expansion and portal vein inva-sion,etc.It is more valuable to combine CT with MRI for the diagnosis of intrahepatic peripheral cholangiocarcinoma.

ObjectiveTo explore the diagnosis and the surgical operation of concealed penis, and raise the therapeutic efficacy.Methods16 cases of concealed penis were reviewed retrospectively.ResultsAll 16 cases were treated by Devine surgery and got the satisfactory effect, the penis recovered to its good external appearance. All 16 cases had been followed up for four months to two years. The revelation of penis and its external appearance were all satisfied. No complications such as hydrophallus, skin ischemia, haematoma and erection ache occurred.ConclusionThe real concealed penis should be strictly distinguished from buried penis, microphallus and redundant prepuce, and suitable operation pattern can obtain satisfactory effect.

Objective To probe into the pathogenesis of gestational diabetes mellitus (GDM) by studying expression of TLR4 acetylation in peripheral blood mononuclear cells of gravida with GDM as well as its role in TLR4 inflammatory pathway. Methods 30 normal gravidas and 30 gravidas with GDM were enrolled in the study, 15 mL peripheral blood from every participant was collected for extraction of mononuclear cells via density gradient centrifugation and culturing in vitro by LPS. The expression of TLR4 acetylation in the mononuclear cells was detected using immunoprecipitation and western blot and the levels of inflammatory cytokines, TNF-α, IL-1 and IL-10 in the supernatant were detected by ELISA. Results TLR4 acetylation appeared positive in GDM group, and negative in the control group. After the LPS intervention, the degree of TLR4 acetylation was enhanced significantly and the latter was significantly higher than those of the GDM group and the normal + Lps group (P < 0.05). The differences in the levels of inflammatory cytokines, TNF-α, IL-1, IL-10, were statistically significant (P < 0.05). Conclusion TLR4 acetylation exists in mononuclear cells of gravida with GDM, and mediates the release of inflammatory cytokines by influencing the activation of TLR4 inflammatory pathobenesis, which contributes to the promoted antiinflammatory - proinflammatory imbalance in gravidas. In this way, it is involved in the growth of GDM.

OBJECTIVETo analysis the effects of water deficit on the transcript level of SOD, APX, DHAR and MDHAR genes in Scutellaria baicalensis.

METHODThree-month-old S. baicalensis was in glasshouse under water deficit stress, and the transcript level of SOD, APX, DHAR and MDHAR genes were analysis utilized semi-quantitative RT-PCR.

RESULTCompared with the control group, a significant decline of the transcriptional level of APX gene was observed at 70 days after water deficit. The transcript level of DHAR gene was reduced at 30 and 50 days after water deficit. And MDHARI gene was significant declined at 50 days.

CONCLUSIONAsA which is an important antioxidant plays a major role in hydrogen peroxide clear system under water deficit, and maybe have an antagonistic effect to the accumulation of baicalein.

Ascorbate Peroxidases ; genetics ; metabolism ; Ascorbic Acid ; metabolism ; Gene Expression Regulation, Enzymologic ; drug effects ; Gene Expression Regulation, Plant ; drug effects ; Hydrogen Peroxide ; metabolism ; NADH, NADPH Oxidoreductases ; genetics ; metabolism ; Oxidoreductases ; genetics ; metabolism ; Plant Proteins ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Scutellaria baicalensis ; enzymology ; genetics ; metabolism ; Superoxide Dismutase ; genetics ; metabolism ; Time Factors ; Water ; metabolism ; pharmacology

Objective This is the first study to explore clinical application value of serum Dickkopf-1 (DKK-1) detection in diagnosis of heptocellular carcinoma (HCC) by magnetic solid phase chemiluminescent immunoassay.Methods The level of serum DKK-1 and AFP in 205 cases of HCC,40 cases of liver cirrhosis,and 200 cases of healthy control were quantitatively detected by Magnetic solid phase chemiluminescent immunoassay.The area under ROC curve,sensitivity and specificity of DKK-1 and AFP for diagnosing HCC were calculated.Results The serum level of DKK-1 in HCC group was significantly higher than those of the liver cirrhosis group and healthy control group (P<0.01).DKK-1 maintained diagnostic sensitivity for patients with HCC who were alpha-fetoprotein (AFP) negative (66.3%).ROC curves showed optimum diagnostic cut-off value was 2.4 ng/mL,area under curve (AUC) was 0.822 (95% CI:0.783-0.856),sensitivity 65.9%,and specificity 87.5%).Moreover,measurement of DKK1 and AFP together improved diagnostic accuracy for HCC versus all controls compared with either test alone [AUC 0.915,95%CI:0.886-0.940),sensitivity 81.5 %(P<0.05)].Conclusion Serum DKK-1 detection has an important clinical value for diagnosis of HCC,especially for HCC with AFP negative.The combined detection of serum DKK-1 and AFP can greatly increase sensitivity and accuracy for diagnosing HCC.

Objective: To investigate the characteristics of traditional Chinese medicine (TCM) syndromes and their elements in patients with posthepatitic cirrhosis by analyzing the relationships between signs and symptoms and biochemical parameters. Methods: A total of 440 patients with hepatitis B cirrhosis treated in Shanghai Public Health Center and Shuguang Hospital, Longhua Hospital and Central Hospital of Putuo District Affiliated to Shanghai University of Traditional Chinese Medicine during January 2002 to January 2006 were enrolled in this study. Signs and symptoms and biochemical information of patients were collected by using a self-designed questionnaire regarding the four examinations of TCM. Signs and symptoms were firstly analyzed to find the frequency of occurrence. Then, the patients were divided into two groups according to non-existent or existent sign and symptom and the correlations between the signs and symptoms which occurred most frequently and their biochemical parameters were analyzed. Results: Sixteen symptoms which occurred most frequently were fatigue, colored urine, liver palms, opaque complexion, string-like pulse, weakness at waist and knees, dry month and bitter taste in the mouth, profuse dreaminess and poor sleepiness, heaviness of limbs, abdominal distention, yellow eyes, fine pulse, impetuosity and susceptibility to rage, splenomegaly, poor appetite, and distension and fullness in the chest and hypochondrium. A previous study on syndrome differentiation of 900 patients with posthepatitic cirrhosis showed 4 syndrome patterns: internal accumulation of dampness-heat, liver-kidney yin deficiency, internal accumulation of blood stasis-heat, and liver depression and spleen deficiency. Further analysis showed that internal accumulation of dampness-heat syndrome was characterized by obvious hepatic inflammation, poor synthesis function and more asctites. Liver-kidney yin deficiency syndrome was characterized by low-level hepatic inflammation, poor synthesis function and more ascites. Internal accumulation of blood stasis-heat syndrome was characterized by low-level hepatic inflammation, poorer synthesis function, ascites and splenomegalia, and liver depression and spleen deficiency syndrome was characterized by slight hepatic inflammation, synthesis function injury, decreased internal portal vein diameter and less ascites. Conclusion: Different syndrome patterns have different pathological features, showing the complexity and polymorphism of syndrome construction.

Objective To explore the value of transthoracic echocardiography in diagnosis of univentricle and analyze the sonogram typing. Methods The results of 66 patients with univentricle were reviewed retrospectively,and analayzed their typing connected with the reports in the literature. Results There were 3 ultrasonic types in 66 cases:①Type A(single left ventricle) 19 cases,single ventricle with left ventricular shape,residual cavity in front of it. ②Type B(single right ventricle) 38 cases, single ventricle with right ventricular form,and residual cavity in the rear.③Type C (solitary single-ventricle) 9 cases,there was only one ventricle. Thirty-one of them were treated surgically, 5 cases without operation had MRI or cardiac catheterization examination and the remaining 26 patients were only observed by echocardiography,the positive rate of diagnosis in type was 100%, the results were compared with cardiac catheterization or MRI examination and the operation: 1 cases of mixed type total anomalous pulmonary venous connection was misdiagnosed as heart-type total anomalous pulmonary venous drainage. But 1 case of descending aorta limitations narrow complicated patent ductus arteriosus(PDA), PDA was missed. The rest were completely correct diagnosis. Conclusions The transthoracic echocardiography can be used to evaluate types and all containing malformations of univentricle,and offers reliable information for operation.