This article reviewed the definition of competence and competency model, and its modeling methods, also the status of consruction of comperency model in nursing field at home and abroad, then pointed out the limitions, so as to provide references to building competency model for different nurses.

OBJECTIVEThis study was performed to determine the feasibility of digital virtual positioning of braces in clinical applications.

METHODSWe determined the positions of brackets in 28 teeth of 15 cases according to positioning methods that use bracket height or root information. Final status was generated by OrthoRx software. Treatment results were assessed with American board of orthodontics objective grading system (ABO-OGS).

RESULTSThe deduction points in the marginal ridge height were significantly decreased after treatment using the two methods (P<0.05). However, no statistically significant difference was found in the deduction points in the marginal ridge height between the two methods (P>0.05). No improvement was found in the deduction points in root parallelism with both methods. No statistical significance was found in the deduction points in root parallelism before and after treatments using both methods. The deduction points in alignment and the three scoring components were significantly decreased after treatment using the two positioning methods. In addition, statistically significant differences were found in the deduction points in alignment between two methods (P<0.05).

CONCLUSIONBy using OrthoRx software, we achieved effective therapeutic treatment in reconstructing three-dimensional digital modes using two different bracket-positioning methods. The positioning method that used root information is more accurate compared with the bracket height positioning method. This study provides an experimental basis for bracket accuracy in the mouth.

Bicuspid ; Humans ; Models, Biological ; Orthodontic Brackets ; Orthodontics ; Software

Objectlve To observe the influence of Tourmaline on peripheral neuropathy with diabetes mellitus(DM).Methods Tourmaline bedding series were applied to pafients with DM peripheral neuropathy,observeA the changes of subjective symptoms and nervous function,and thus analyzed the therapeutic effects of Tourmaline on DM peripheral neuropathy.Results AfarTourmalinewas usedfor halfa year,some symptoms of the diseasc were alleviated,and after one year's usage.symptoms of spontaneous pain,numbness.and burning sensation improved greatly.Body examinations showed tendon reflex.vibration sense,nerve conducfion velocity,and autonomic nerve were improved on different levels,and progress of disease was obviously coming down.Conclusion Tourmaline bedding series has the function of improving peripheral neuropathy,whichis aconvenientand safety healthcaremethodto CalTyon.

Objective:To explore the morphological characteristics, treatment strategies and clinical results of complex hyperextension tibial plateau fractures.Methods:From October 2017 to January 2019, data of 27 patients with complex hyperextension tibial plateau fractures were retrospectively analyzed. There were 19 males and 8 females with an average age of 43.4 years (range, 23-68 years). According to Schatzker classification of tibial plateau fractures: there are 8 cases of type IV, 5 of type V, and 14 of type VI; according to the three-column theory classification: there are 8 cases of two-column fracture and 19 cases of three-column fracture. Bicondylar fractures were treated with medial Tomofix locking plate and anterolateral L-shaped locking plate through medial and anterolateral approach; tibialmedial condylar fractures was treated with T-shaped plate and posteromedial locking plate through extended medial approach. Patients with anterior tibial fractures were treated with horizontal strip plate through modified anterior median approach. Combined soft tissue or bone injury was repaired. The fracture healing and reduction were evaluated by X-ray and CT scan. The reduction of tibial plateau fracture was evaluated by Rasmussen radiology standard, and the knee joint function was evaluated 12 months after the operation by the score of American hospital for special surgery (HSS).Results:All the 27 surgeries were performedsuccessfully. The operation time was 130-350 minutes, with an average time of 165 minutes. Twenty-seven cases were followed up for 12-24 months, with an average period of 15.8 months. All fractures were healed. The average clinical healing time was 13.5 weeks (range, 10-18 weeks). Twelve months after operation, Rasmussen's radiology score was 13-18, with an average of 16.7 points, among them there were 19 excellent and 8 good. Twelve months after the operation, the score of HSS knee joint was 82-98, with an average score of 93.2 points, and there were 22 cases excellent, 4 cases good and 1 case fair. The excellent and good rate was 96.2% (26/27).Conclusion:Complex hyperextension tibial plateau fractures often combined with tibial bicondylar, medial tibial condyle or anterior tibial fractures. According to the morphological characteristics of complex hyperextension tibial plateau fractures, using appropriate surgical approach and internal fixation, repairing ligament soft tissue structure and reconstructing knee joint stability can achieve satisfactory results.

The deepening and popularization of visual management methods provide a solution for the difficult problems in clinical nursing management, which is of great significance for simplifying clinical nursing procedures, improving work efficiency and ensuring patient safety. The purpose of this paper is to introduce the connotation of visual management and the status of clinical nursing application in China, and to explore the existing problems in the application process and the enlightenment to the nursing staff, to look forward to its future development trend, and provide reference for the further research and visualization management of nursing managers.

Objective: To investigate the effects of combined exposure to black carbon and lead on the expression of cell adhesion molecules and their regulating microRNAs (miRNAs) in the rat choroid plexus epithelial Z310 cells. Methods: i) Z310 cells were randomly divided into control group, black carbon exposure group, lead exposure group and combined exposure group. The lead exposure group and black carbon exposure group were treated with 10 μmol/L lead acetate and 10 mg/L black carbon, respectively, and the combined exposure group was treated with both in the above doses. After 12.0 hours, the expressions of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and mucosal vascular addressin cell adhesion molecule-1 (MAdCAM-1) in Z310 cells was detected by Western blotting. The expression of miR-326, miR-328-3p and miR-542-3p which regulated ICAM-1 was detected by real-time fluorescent quantitative polymerase chain reaction. ii) Z310 cells or Z310 cells transfected with miRNA-326 mimic were randomly divided into control group, miRNA-326 transfection control group, combined exposure group and miRNA-326 transfection combined exposure group. Cells in the two control groups were not treated. The two combined exposure groups were treated with 10 mg/L black carbon and 10 μmol/L lead acetate for 12.0 hours. The expression of ICAM-1 was detected by Western blotting. Results: i) The relative expression of ICAM-1, VCAM-1 and MAdCAM-1 in the cells of black carbon exposure group and ICAM-1 in the lead exposure group was higher than those in the control group (all P<0.05). The relative expression of ICAM-1 and MAdCAM-1 in the combined exposure group was higher than those in the other three groups (all P<0.05). The relative expression of VCAM-1 in cells of combined exposure group was higher than those in the control group and lead exposed group (all P<0.05). The relative expression of miR-326 in cells of the lead exposure group and black carbon exposure group was lower than those in the control group (all P<0.05). The relative expression of miR-326 in the combined exposure group was lower than that in the other three groups (all P<0.05). There was no significant difference between miR-328-3p and miR-542-3p in the four groups (all P>0.05). ii) The relative expression of ICAM-1 in cells of the miR-326 transfection control group cells was lower than that in the control group (P<0.05), while in the cells in the combined exposure and miRNA-326 transfection combined exposure group, it was higher than that in the control and miRNA-326 transfection control groups (all P<0.05), and lower in the miRNA-326 transfection combined exposure group than in the combined exposure group (P<0.05). Conclusion: Black carbon or lead exposure can upregulate the expression of ICAM-1, VCAM-1 and MAdCAM-1 in Z310 cells. Black carbon and lead combined exposure lead to a synergistic effect on upregulation of ICAM-1 and MAdCAM-1 expression, particularly ICAM-1. The combined exposure of black carbon and lead may upregulate the expression of ICAM-1 by downregulating the expression of miR-326.

Objective The effects of dynamic prediction table in ICU were discussed based on the theory visualization management. Methods A self-designed dynamic prediction table of critical patients is used to record the monitoring points and precautions of patient's situation, and evaluating the application effect after 6 months. Results The incidence of unclear shift, missed shift, misplaced shift and accumulated defective shift of observation group was 7.64％(11/144), 3.47％ (5/144), 3.47％ (5/144) and 14.58％(21/144), which was lower than 21.53％(31/144), 12.50％(18/144), 9.72％(14/144)and 43.75％(63/144) of control group(χ2=11.150, 7.986, 7.564, 29.647, P<0.05);nurses on the mastery condition of critically ill patients of observation group was (91.17±3.96), which was higher than(27.83±3.66)of control group(t=-4.813, P<0.01);the satisfaction of doctors with nurses of observation group was(32.22±2.71), which was higher than(23.86 ± 2.76) of control group(t=-12.98, P<0.01); the satisfaction of family members of patients with nurses of observation group was(33.77 ± 2.31), which was higher than(25.42 ± 4.43) of control group(t=-18.326,P<0.01); nurses have a good experience with the new methods. Conclusions Application of dynamic prediction table in ICU can promptly remind nurses work priorities, enhance their awareness of risk warning, strengthen the information communication of department and help to improve the quality of nursing care.

Purpose: This study developed an in-service training program for patient safety and aimed to evaluate the impact of the program on nurses in the operating room (OR). Methods: A pretest–posttest self-controlled survey was conducted on OR nurses from May 6 to June 14, 2020. An in-service training program for patient safety was developed on the basis of the knowledge–attitude–practice (KAP) theory through various teaching methods. The levels of safety attitude, cognition, and attitudes toward the adverse event reporting of nurses were compared to evaluate the effect of the program. Nurses who attended the training were surveyed one week before the training (pretest) and two weeks after the training (posttest). Results: A total of 84 nurses participated in the study. After the training, the scores of safety attitude, cognition, and attitudes toward adverse event reporting of nurses showed a significant increase relative to the scores before the training (p < .001). The effects of safety training on the total score and the dimensions of safety attitude, cognition, and attitudes toward nurses’ adverse event reporting were above the moderate level. Conclusion The proposed patient safety training program based on KAP theory improves the safety attitude of OR nurses. Further studies are required to develop an interprofessional patient safety training program. In addition to strength training, hospital managers need to focus on the aspects of workflow, management system, department culture, and other means to promote safety culture.

Objective    To study the hemocompatibility of bioprosthetic heart valve materials respectively based on glutaraldehyde and non-glutaraldehyde treatment. Methods    Fresh bovine pericardium was treated with glutaraldehyde or non-glutaraldehyde after adipose tissue was removed. To evaluate the hemocompatibility of the two bioprosthetic heart valve materials, hemolysis test, in vitro fibrinogen adsorption experiment, platelet adhesion experiment, thrombin-antithrombin complex (TAT) test, complement activation assay and ex vivo circulation experiment were performed. Results    The hemolysis test results demonstrated that both of the materials showed hemolytic rates lower than 5%. The results of TAT test and complement activation assay showed no statistical differences among the two materials and the blank control group. Compared to the bioprosthetic heart valve materials with glutaraldehyde-based treatment, the materials with non-glutaraldehyde-based treatment showed significantly decreased fibrinogen adsorption, platelet adhesion and thrombosis. Conclusion    Compared to the bioprosthetic heart valve materials with glutaraldehyde-based treatment, the materials with non-glutaraldehyde-based treatment show better hemocompatibility.

INTRODUCTIONThis study examines the effectiveness of double-marker analysis for α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) combined with measurement of nuchal fold thickness (NT) in the detection of Down's syndrome (DS) in Mainland Chinese subjects during second trimester prenatal screening.

MATERIALS AND METHODSWe examined pregnant women with a singleton pregnancy between 15 and 21 weeks of gestation who underwent second trimester screening for DS using double-marker analysis for AFP and β-hCG combined with ultrasound measurement of NT. The combined risk of DS was calculated. A cut-off of 1/270 was used to define a pregnancy at high-risk of DS. Amniocentesis was offered to all patients with high-risk pregnancies.

RESULTSUsing double-marker analysis for AFP and β-hCG in combination with measurement of NT, the detection rate of DS increased from 66.7% to 77.8% when compared with double-marker analysis alone with similar false-positive rates (4.35%, 4.83% respectively). Using receiver operating characteristic curve (ROC) analysis, we determined that the double-marker analysis combined with measurement of NT exhibited an increased area under the curve (AUC) of 0.835 (95% CI: 0.743 to 0.927) when compared to double-marker analysis alone, which had an AUC of 0.748 (95% CI: 0.635 to 0.860). In addition, both methods were more effective than any other single test such as AFP, free β-hCG or NT measurement.

CONCLUSIONSecond trimester prenatal screening using double-marker analysis for AFP and β-hCG combined with measurement of NT is effective for the detection of DS in Mainland Chinese pregnancies.

Adult ; Biomarkers ; China ; Chorionic Gonadotropin, beta Subunit, Human ; blood ; Down Syndrome ; diagnosis ; diagnostic imaging ; Female ; Gestational Age ; Humans ; Mass Screening ; Nuchal Translucency Measurement ; methods ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; Risk Assessment ; Young Adult ; alpha-Fetoproteins ; analysis