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.

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 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.

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.

The immune effect of two recombinant protein fragments of spike protein in severe acute respiratory syndrome coronavirus (SARS CoV) was investigated in Balb/c mice. Two partial spike gene fragments S1 (322 1464 bp) and S2 (2170 2814 bp) of SARS coronavirus were amplified by RT-PCR, and cloned into pET-23a prokaryotic expression vector, then transformed into competent Escherichia E. coli BL21 (DE3)(pLysS) respectively. Recombinant proteins were expressed and purified by Ni2+ immobilized metal ion affinity chromatography. The purified proteins mixed with complete Freund adjuvant were injected into Balb/c mice three times at a two-week interval. High titer antibody was detected in the serum of immunized Balb/c mice, and mice immunized with S1 protein produced high titer IgG1, IgG2a, IgG2b and IgG3, while those immunized with S2 protein produced high titer IgG1, IgG2a, but lower titer IgG2b and IgG3. Serum IFN-concentration was increased significantly but the concentrations of Il-2, IL-4 and IL-10 had no significant change. And a marked increase was observed in the number of spleen CD8+ T cells. The results showed that recombinant proteins of SARS coronavirus spike protein induced hormonal and cellular immune response in Balb/c mice.

Background Retinal development continues during the early postnatal period in mammals.Correct arrangement of layers and precise location of various cells in the retina are vital for forming normal visual function during critical period plasticity.Spectral-domain optical coherence tomography(SD-OCT)provides highquality in vivo retinal imaging and the possibility to measure retinal thickness longitudinally. Objective The present study was to investigate the changes of retinal thickness during critical period plasticity in rats. Methods In vivo consecutive scanning of retinal image was performed in 10 SPF Sprague-Dawley rats at postnatal day 14(P14),P18,P21,P24 and P42 with SD-OCT,and retinal histopathological examination was used to detect retinal morphologic changes at the same postnatal ages in 20 matched rats.The whole retinal thickness,the thickness from inner limiting membrane(ILM)to inner plexiform layer(IPL),the thickness of inner nuclear layer(INL)and the thickness from outer nuclear layer(ONL)to retinal pigment epithelium(RPE)were measured using Cirrus HD-OCT system and HMIAS-2000 Imaging System in retinal sections.The measurement parameters by Cirrus HD-OCT and those by hematoxylin-eosin staining were compared.The use of animals followed the Statement of National Institute of Health (USA). Results In vivo high-resolution images of rat retinas with SD-OCT compared well with histology,which enabled quantitative comparison of the SD-OCT and histological data during critical period plasticity in rats.From P14 to P42,the retinal thickness gradually decreased with the increase of rat ages(F=15.425,P=0.000),and so were the thickness from ILM to IPL,the thickness of INL and the thickness from ONL to RPE(F=3.973,P=0.007;F=17.529,P=0.000;F=7.038,P=0.000).The retinal thickness,thickness of INL.thickness from ONL to RPE measured by Cirrus HD-OCT were significantly correlated with those measured by retinal sections among P14,P18,P21,P24 and P42 rats(r=0.794,P=0.000;r=0.784,P=0.000;r=0.681,P=0.000). Conclusion SD-OCT is a demonstratably valuable technology to study the structure of retinas in rats.The retinal thickness is shown to reduce in thickness throughout the development of the retina during critical period plasticity due to the decrease in thickness of INL and the distance from the ONL to RPE,as illustrated by OCT scanning.