In order to improve the quality of nursing dissertations,we combined the teaching of nursing research with clinical internship to teach nursing dissertation writing,following the process of program input-situation experience-clinical internship-problem study-dissertation writing.Taking problem study as the leading role,students as subject,self experience as the main access and tutors as whole-process instructors,we taught and evaluated nursing dissertations at different stages.Students'interests in scientific research,enthusiasm for participation and quality of dissertations were improved effectively.95.78％ of the students showed positive attitude to this teaching method.

Objective:To explore the usage of system dynamics analyzing the influencing factors of total health expenditure(THE),forecast the trends of total health expenditure based on the method of System Dynamics and put forward relative countermeasures.Methods:According to the literature and expert consultation,the population,elderly,GDP,government health expenditures,drug costs and the number of health workers per thousand population were the important factors for THE.These factors were incorporated into system dynamics model for total health expenditure and conducted the simulation.Results:Based on the examination,the simulation results highly corresponded to historical data (2002-2014) and the official forecast (2015-2020),which showed that the model had good stability and reliability.The simulation results showed that steadily increasing total health expenditure would reach 7 457.12 billion yuan in 2025.Conclusion:The system dynamics approach had superior characteristics to other projection methods in terms of stability and reliability.In order to control the irrational growth of total health expenditure,it needed to increase the prevention investment,decrease the incidence of chronic diseases;sustainably improve the reform of public hospitals,implement the basic drug system;change the income-oriented performance appraisal to realize the labor value of medical staffs.

Compared to the mature monitoring and reporting system of ADRs in developed countries such as the USA and EU,medical institutions in China have played too much a role.Instead,local primary monitoring and reporting system of ADRs should expand their scope of monitoring and reporting,as drug makers,chain drugstores and retailers should develop an effective ADR monitor/report system as well.At present,such a primary system is plagued by insufficient budget and staff,imbalanced urban/rural layout and defective statements.Recommended measures include enhanced surveillance for drug makers,chain drugstores and retailers,for higher reporting ratio of ADRs at primary level; greater publicity and better monitoring and penalty mechanism; better platform for various organizations.

Objective: To establish a microbial limit test method for compound benzocaine gel.Methods: According to the general principles of Chinese Pharmacopoeia (2015 edition), method applicable experiments were performed respectively for the routine method, neutralization method and dilution & neutralization method.Using the recovery ratio of test bacteria as the index, the medium of dilution & neutralization method was adopted in the total aerobic microbial count and total combined yeasts and molds count, and the neutralization method was used for the control bacteria detection.The neutralizing agents were polysorbate 80 and lecithin.Results: The method of dilution & neutralization could eliminate the bacteriostasis of the drug, and the recovery ratio of each test bacteria was within the range of 0.5-2.0, which was in line with the requirements of Chinese Pharmacopoeia.Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus could be detected out in the positive control bacterial test,and bacteria were not detected out in the negative test.Conclusion: The method can be used for the microbial limit test for compound benzocaine gel.

By engineering the subsite +1 of cyclodextrin glycosyltransferase (CGTase) from Paenibacillus macerans, we improved its maltodextrin specificity for 2-O-D-glucopyranosyl-L-ascorbic acid (AA-2G) synthesis. Specifically, we conducted site-saturation mutagenesis on Leu194, Ala230, and His233 in subsite +1 separately and gained 3 mutants L194N (leucine --> asparagine), A230D (alanine --> aspartic acid), and H233E (histidine --> glutamic acid) produced higher AA-2G yield than the wild-type and the other mutant CGTases. Therefore, the 3 mutants L194N, A230D, and H233E were further used to construct the double and triple mutations. Among the 7 obtained combinational mutants, the triple mutant L194N/A230D/H233E produced the highest AA-2G titer of 1.95 g/L, which was increased by 62.5% compared with that produced by the wild-type CGTase. Then, we modeled the reaction kinetics of all the mutants and found a substrate inhibition by high titer of L-AA for the mutants. The optimal temperature, pH, and reaction time of all the mutants were also determined. The structure modeling indicated that the enhanced maltodextrin specificity may be related with the changes of hydrogen bonding interactions between the side chain of residue at the three positions (194, 230 and 233) and the substrate sugars.
Ascorbic Acid ; analogs & derivatives ; chemistry ; Glucosyltransferases ; genetics ; metabolism ; Hydrogen Bonding ; Kinetics ; Mutagenesis, Site-Directed ; Paenibacillus ; enzymology ; Polysaccharides ; chemistry ; Protein Engineering ; Substrate Specificity ; Temperature

Objective To study the effect of Shaoyaozhitong Mixture on stageⅢ-Ⅳendometriosis, and explore its mechanism. Methods Ninty-five cases of stageⅢ-Ⅳ endometriosis were randomly divided into three groups. The traditional Chinese medicine (TCM) group (31 cases) was treated with Shaoyaozhitong Mixture, the GnRHa group (31 cases) was treated with Triptorelin Acetate for Injection, while the expectant group (33 cases) received no medications. The changes of CA125, TNF-α and VEGF levels, visual pain score and SF-36 score, total effective rate, pregnancy and recurrence were compared. Results There were significant increases in CA125, TNF-α and VEGF levels, visual analogue pain score and SF-36 score in all the three groups after treatment (P<0.05). The decline of CA125, TNF-αand VEGF levels and visual analogue pain score in TCM group and GnRHa group was significantly faster and greater than that of the expectant group (P<0.05). The total effective rates of TCM group was 83.9%(26/31), GnRHa group was 87.1%(27/31), and expectant group was 60.6%(20/33), TCM group and GnRHa group were superior to the expectant group, respectively (P<0.05). The pregnancy rate was higher and recurrence rate was lower in TCM group and GnRHa group than that of expectant group, but there was no statistical difference (P>0.05). Conclusion Shaoyaozhitong Mixture is effective in treating endometriosis by inhibiting the growth of ectopic endometrium.

To evaluate the antiosteoporotic effects of benzyl benzoate glucosides from Curculigo orchioides (COBG) in ovariectomized (OVX) rats.

Objective To understand the prevalence and the nursing status of incontinence and incontinence-associated dermatitis (IAD),analyze the risk factors of the occurrence of IAD,and to provide effective measures for the prevention and management of IAD.Methods Using the questionnaire survey, 1 318 hospitalized patients in 2 grade three hospitals of Suzhou were investigated,and then the results were analyzed.Results The prevalence of incontinence was 10.70％(141/1 318),among the prevalence of urinary incontinence was 4.63％(61/1 318),fecal incontinence was 4.32％(57/1 318);with 24.11％(34/141) of incontinent patients having IAD;disposable pad and briefs were the most common containment devices,only 36.17％ (51/141) of the incontinent inpatients using skin protectant after perineal skin clean.Single factor analysis revealed that IAD was related with wards, types of incontinence, character of stools, frequency of feces, antibiotics, modes of nutrition support, Braden scores, level of albumin and prealbumin.Unconditional Logistic regression indicated that risk factors of IAD included the level of serum albumin (OR=0.769, P＜ 0.05), Braden scores(OR=0.335, P＜ 0.05) and frequency of feces(OR=11.076, P ＜ 0.05).Conclusions Incontinence and IAD are common in hospitalized patients,low serum albumin, low Braden scores and high frequency of feces are the risk factors of IAD.The clinical nurses have not paied enough attention on the prevention of IAD, lacked relevant knowledge and skin care regimen.

Objective To determine the main reproductive performance of six SPF mice and rats preserved in our laboratory, including C57BL/6, BALB/c, NIH, KM, ICR mice and SD rats.Methods Inbred mice mated with full sib and random mating.Meanwhile, closed colony animals were bred by cross circular mating.These indexes of reproductive performance were measured in the six kinds of animals during the first birth to the fourth birth, i.e.the average litter size (ALZ), average baby number reared ( ABN) and average weaning number ( AWN), and weaning rate ( WA) were calculated.Meanwhile, the initial mating age in days, initial bearing age in days, first gestation and intervals were measured.Results The ALZ of inbred mice were 6 to 7.The reproductive indexes were basically stable in the first 3 births, however, the various data were dramatically declined in the fourth birth ( P<0.05 ) .The WA of BALB/c mice were 98%to 99%, and that of C57BL/6 mice were 96%to 98%.The ALZ of closed colony animals were 12 to 15, and significantly increased in the second and third births compared with that of the first birth (P<0.05), then was significantly reduced ( P<0.05) .The WA maintained at 98%to 99%in the NIH, KM and ICR mice.In contrast, The WA of SD rats was slightly lower, reaching 95%to 97%.The initial mating age in days of mice was between 70 d to 80 d.The initial bearing age in days and first gestation of rats were less than that of inbred mice, the initial bearing age in days and first gestation of closed colony rats were 136.3 d and 27.7 d, respectively.The pregnancy interval of inbred mice was between 34 d to 40 d,the pregnancy interval of closed colony mice was between 25.5 d to 28.7 d, the pregnancy interval of rats was between 32.8 d to33.8 d.Conclusions The 6 mouse and rat strains have a higher reproductive performance, and the data obtained in this study provide a basis for commercialized production of mice and rats in southern areas of China, and for establishment of rodent experimental animal resource.

Objective To revise the Symptom Distress Scale for postoperative patients with pituitary tumor and to test its reliability and validity. Methods On the base of previous qualitative interview and literature review, Delphi consultation was performed to identify items of the Symptom Distress Scale for postoperative patients with pituitary tumor. By convenience sampling method, totally 191 patients from four first-class ternary hospitals in Jiangsu province were investigated effectively by this scale. Results A scale of 4 factors and 16 items was identified by expert interviews, item analysis, exploratory factor analysis and the four factors could explain 69.812%of the variance. The Cronbachαcoefficient of the scale was 0.920, the content validity index was 0.915, and the interrater reliability was 0.860. Conclusions Symptom Distress Scale for postoperative patients with pituitary tumor has good reliability and validity to assess the symptom distress of pituitary tumor patients after operation.