Objective To investigate and analyze the effects of problem-based learning used in clinical nursing education. Method The research papers on the effect of problem-based learning used in clinical nursing education were retrieved via CNKI, Wanfang,VIP,PubMed,ProQuest and Google scholar websites and then analyzed by Revman5.0 software.Results Totally 11 RCTs were included.Meta-analysis showed that PBL could significantly promote students’examination scores,self-study ability, critical thinking and clinical skill,but insignificantly improved the effect in improvement of their theory learning,interest and ability in cooperation.Conclusions PBL is a scientific clinical teaching method,which can stimulate students’initiative and exploratory learning and enhance effects of clinical teaching.Meanwhile,we suggest formulating evaluation criteria and implementing rigorous RCT designs in the future.

Objective The aim of this study was to observe the outcome and evaluate the clinical efficacy of pulsed electromagnetic fields (PEMF) on pain management in patients with osteoporosis.MethodsA total of 58 patients with osteoporosis were treated with PEMF stimulation.Pains as main indicators of their symptom were evaluated before and after treatments.The clinical outcomes were assessed by observing the visual analogue scale (VAS).Statistical analysis was carried out to support the data.Results After PEMF treatment,the patients exhibited significant pain relief from mean VAS of 6.97±1.83 to 3.36±1.69(t-test,P＜0.05 ).Of the 58 patients,28 obtained significant symptom alleviation and 18 obtained moderate symptom alleviation,while 8 obtained slight alleviation,indicating the total clinical efficacy of 93%(54/58).Conclusion The current study provides the clinical outcomes indicating that PEMF may help to release the pain from primary osteoporosis and it might be an applicable supplementary treatment method for the osteoporosis related pain.

Objective To explore the changes in fractional anisotropy (FA) among cerebral infarction pa-tients using MR diffusion tensor imaging (DTI), and to verify the relationship between any FA changes and functional recovery. Methods Thirty-eight cerebral infarction patients were divided into two groups according to their recovery level using Brunnstrom's criteria. All the patients accepted routine MR and DTI examination, and FA values were measured during the acute, subacute and chronic stages of their recovery. Results Average FA values in the lesion area were significantly lower than in the corresponding contralateral area, and were highest daring the acute stage.There was no significant difference between the subacute and chronic stages. Conclusions The FA values of cere-bral infarction patients change during the different stages of recovery with a certain regularity. This may be valuable for clinical treatment and prognosis.

OBJECTIVE:To establish a method for the determination of related substances in anastrozole. METHODS:HPLC was performed on the column of Welch Materials XB C18 with mobile phase of acetonitrile-water(35:65,V/V)at a flow rate of 1.0 mL/min,detection wavelength was 210 nm,column temperature of 25 ℃,and the injection volume was 20 μL. RESULTS:Only one impurity(impurity A)was detected in anastrozole,the linear range was 0.1-1.6 μg/mL(r=0.9996);limit of quantitation was 0.1 μg/mL,limit of detection was 0.02 μg/mL;RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 98.95%-105.29%(RSD%=1.78%,n=9). CONCLUSIONS:The method is simple,accurate,and can be used for the determination of related substances in anastrozole.

The association between atrial natriuretic peptide (ANP) polymorphism and coronary heart disease (CHD) was studied in Chinese population. The genotypes of ANP T2238C and ANP C-664G were detected by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) methods in 158 consecutive CHD patients and 165 controls. It was found that the distribution of A2A2 genotype in CHD group was significantly higher than that in control group (P<0.05). Stepwise Logistic regression analysis revealed that male, smoking, history of hypertension, history of diabetes, family history of hypertension, high level of serum cholesterol, and ANP T2238C polymorphism were the possible risk factors in patients with CHD (P<0.05). However, there was no significant difference between the patients with CHD and the control group in the distribution of ANP C-664G polymorphism (P>0.05). The results suggest that A2A2 T2238C genotype could be one of the risk factors for CHD (P<0.05, OR: 1.80, 95 % CI: 1.03-3.15).

Objective To investigate the current status of self-efficacy and care ability among stroke patients′ family caregivers and explore the correlation between them. Method A total of 79 stroke patients and family caregivers were engaged in the investigation by demographical data questionnaires, general self-efficacy scale and questionnaire for assessing the comprehensive care-giving ability of stroke caregivers. Results The score on self-efficacy of the family caregiver was (27.16 ± 5.64) and the total score on care ability was (90.01 ± 16.57). There was a positive correlation between self-efficacy and care ability of family caregivers(P<0.05). Conclusions The self-efficacy and care ability of stroke patient′s family caregivers are at middle level. Their self-efficacy is positively correlated with their care ability. The nurses can improve the ability of daily caring of family caregivers by enhancing their self-efficacy.

Objective To compare the correlation between anti-cyclic citrulinated peptide antibody (anti-CCP), rheumatoid factor (RF) and disease activity, functional capacity, bone erosion of rheumatoid arthritis (RA). Methods The correlation between anti-CCP, RF and disease activity score 28 (DAS28),health assessment questionnaire(HAQ) and bone erosion was assessed. Results Among the 218 RA patients,76% were anti-CCP-positive and 71% were RF-positive. The mean DAS28 score of RA patients with anti-CCP-positive and RF-positive was significantly higher than patients without anti-CCP and RF. The serum an-ti-CCP levels and RF levels showed a significant correlation with DAS28 score. However, the HAQ scores, ESR and CRP levels showed no significant difference between anti-CCP-positive and anti-CCP-negafive patients, RF-positive and RF-negative patients. Among anti-CCP-positive RA patients, the number of patients with erosive disease was significantly higher than patients without anti-CCP. However, the number of patients with erosive disease was not significantly different between RF-positive and RF-negative patients. Conclusion Anti-CCP and RF arc associated with disease activity. Anti-CCP is associated with bone erosion. No association is found between RF and bone erosion.

Objective To investigate the predictive value of rectal aberrant crypt foci(ACF)for colorectal cancer(CRC)and progressive adenomas, and to analyze its risk factors.Methods IndependentSample T test, One-Way ANOVA and Chi-square test were used to analyze the mean number and incidence of rectal ACF.Logistic regression analysis was used to assess the predictive value of rectal ACF for progressive adenomas and CRC, and to identify the independent risk factors of ACF.Results Large number of ACF, i.e.more than 5, was a significant risk factor for CRC and progressive adenomas.Age and smoking were both risk factors of ACF, while aspirin was a protective factor.Conclusion ACF of more than 5 is predictive of CRC and progressive adenomas.For prevention of CRC, great importance must be attached to risk factors of ACF.

Objective To evaluate the value of detecting HCMV-DNA in urine in the diseases of newborn babies ,by comparing the result between HCMV-DNA in urine and HCMV-IgM antibody in blood in different diseases of the newborn babies .Methods The urine and blood samples were collected from 1 520 infants who were in hospital of the neonate department from January 2013 to December 2014 .The HCMV-DNA in urine was examined by fluorescence quantitative polymerase chain reaction(FQ-PCR) .And HCMV-IgM antibody in blood was examined by the method of chemiluminescence(ECL) .Results In the 1 520 cases ,153 had de-tectable HCMV-DNA in their urine samples with a positive rate 10 .07% ,while only 4 cases were positive of the HCMV-IgM anti-body in blood with a positive rate 0 .27% .The two groups was statistically significant difference (P<0 .05) .In the infant diseases of 1 520 cases ,the positive rate of HCMV-DNA in urine was 82 .6% of the hepatitis syndrome while the positive rate of HCMV-IgM antibody in blood was 3 .85% .The positive rate of HCMV-DNA in urine was 8 .95% in the jaundice symptoms ,while the posi-tive rate HCMV-DNA in urine was 4 .62% in the pulmonary infection .Each group of disease was statistically significant difference in the positive rate of HCMV-DNA (P<0 .05) .Conclusion The detection of HCMV-DNA in urine is more beneficial to the diag-nosis of HCM V infection of infants than the detection of HCM V-IgM antibody in blood ,especially in hepatitis syndrome ,neonatal jaundice and pulmonary infection .

Objective To demonstrate the imaging characteristics of pancreatic neuroendocrine neoplasm (P-NEN).Methods The CT and MRI findings of 43 cases of P-NEN confirmed by pathology were analyzed,and compared with pathological results.Results Mean size of 43 lesions in 43 P-NEN patients were (25.00± 1.82)mm.Necrosis cystic degeneration were found in 26 lesions.In CT plain scan,15 lesions were isodense,28 lesions were hypodense.All of 43 lesions were hypointensity signal on T1WI;27 lesions were hypointensity signal,16 cases were isointensity signal on T2WI.Twenty-seven lesions showed envelope;30 lesions showed clear outline.In enhancement images,24 lesions were marked enhancement since arterial phase;8 lesions showed delayed enhancement;5 lesions showed centrality enhancement;6 lesions showed wild enhancement.Conclusion P-NEN has some characteristics on CT and MRI scanning,imaging can play an important role in diagnosis for P-NEN.