Objective To explore the correlation between caring behavior and critical thinking of nursing students in clinical practice. Methods Totally 203 nursing students in clinical practice were investigated with Critical Thinking Disposition Inventory- Chinese Version (CTDI- CV) and Caring Behavior Scale (CBS). Results The structural model obtained a good fit. Critical thinking and caring behavior were positively correlated with each other(β=0.46,P<0.01). Conclusions Nursing students′caring behavior could improve their critical thinking. With the cultivation of critical thinking of nursing students, nursing educators should pay attention to improving their caring behavior.

Aim To study the effect of simvastatin(Sim) on left ventricular remodeling and heart function in rats with myocardial infarction(MI).Methods Myocardial infarction models were successfully induced by ligation of anterior descending coronary artery.24 h later the survivals were randomly divided into 3 groups.① MI group;② 20 mg Sim group(20 mg?kg~(-1)?d~(-1));③ 40 mg Sim group(40 mg?kg~(-1)?d~(-1)).The rats with sham ligation formed sham group.After 8 weeks,hemodynamic parameters,blood serum lipids,the ratio of RV and LV weight to body weight(RVWI,LVWI) were examined.The pathomorphological change and the collagen volume fraction(CVF) were analyzed by PSR dyeing.Results There were no significant differences in values of serum lipids among 4 groups.Compared with sham group,the left ventricular end-diastolic pressure(LVEDP) was increased and left ventricular systolic pressure(LVSP) was depressed significantly in MI group; the RVWI and LVWI and the CVF in border infarcted zone and Ⅰ/Ⅲ ratio were increased in MI group too.Compared with MI group,Sim partially normalized LVSP and LVEDP;abated ventricular weight index;reduced CVF in non-infarction zone in both Sim groups.Conculusion Simvastatin improves LV remodeling and heart function in rats with MI,which is associated with the effect of limiting myocardial hypertrophy and interstitial fibrosis.

Aim To assess the effect of HMG-CoA inhibitors simvastatin on collagen remodeling in rats after myocardial infarction. Methods Myocardial infarction models were induced by ligation of anterior descending coronary artery. 24 hours later the survivals were randomly divided into 3 groups: (1) MI group; (2) 20 mg Sim group(20 mg? kg-1? d-1); (3) 40 mg Sim group(40 mg? kg-1? d-1). Rats with sham ligation formed into Sham group. After 8 weeks, the ratios of LV and RV weight to body weight (RVWI, LVWI) were examined and the collagen content was detected. The type Ⅰ and type Ⅲ collagen volume fraction (CVF) and Ⅰ/Ⅲ ratio in infarcted and non-infarcted zones were examined with PSR dyeing; also the mRNA expressions of type Ⅰ and type Ⅲ collagen in non-infarcted zone (NIZ) were detected with RT-PCR.Results Comparing with Sham group,the RVWI and LVWI in MI group increased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were increased in MI group. The mRNA expressions of type Ⅰ and type Ⅲ collagen in NIZ in MI group were higher than those in Sham group. Comparing with MI group, the RVWI and LVWI in both Sim groups were decreased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were depressed in both Sim groups, and the mRNA expressions of collagens were also lower than those in MI group, but higher than those in Sham group. Conculusion Simvastatin could attenuate the development of myocardial interstitial fibrosis in non-infarction zone to improve myocardial interstitial remodeling in rats after MI.

Objective To understand the relationship among nurses′ emotional labor, workgroup emotional climate and mental health. Methods Cluster sampling was used to pick up 250 samples, which consisted of nurses from a 3-A-grade hospital in Nanjing-the Second Affiliated Hospital of Nanjing Medical University. Self-designed general questionnaires, Emotional Labor Scale (ELS), Workgroup Emotional Climate Scale (WECS), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were administrated to the study participants. Results The scores of nurses′emotional labor among three dimensions were in descending order: deep acting (5.16 ± 1.30), emotional display requirement (3.54 ± 0.57) and surface acting (3.35 ± 0.1). Nurse′s surface acting was negatively related to other-focused positive WEC (OP) and ego-focused positive WEC (EP) (r=-0.162,-0.154, P < 0.05), while positively related to ego-focused negative WEC (EN) and other-focused negative WEC (ON) (r=0.358, 0.176, P <0.01), Emotional display requirement was negatively related to ego-focused negative WEC (EN) and other-focused negative WEC (ON) (r=-0.239,-0.269, P < 0.01), and was positively related to other-focused positive WEC (OP) and ego-focused positive WEC (EP) (r=0.276, 0.339, P<0.01);nurses′anxiety score=35.502+1.203 × EN-0.496 × deep acting+0.27 × surface acting;nurses′depression score=53.438+1.259 × EN-1.115 × OP. Conclusions Nurse managers must know that constructing high qualitydepartment emotional culture is very important. Nursing managers discover individual negative emotions, improve their ability to control the mood and reduce the number of surface acting, increase the number of deep acting, in order to effectively change nurses′anxiety and depression levels.

Objectives To evaluate the preliminary effectiveness,investigate the clinical methods and prevent the complications of the epiphysis preservation operation by using custom-made prosthesis in children with distal femoral osteosarcomas.Methods Between August 2012 and July 2013,3 patients (from 8 to 14 years old) who were diagnosed of osteosarcoma underwent tumor segmental resection and epiphysis preservation operation and reconstruction with custom-made prosthesis.Patients were assigned neoadjuvant chemotherapy 1 to 2 cycles.The effect of neoadjuvant chemotherapy was then evaluated by X-ray,CT and MRI.Patients were determined the disease field by MRI,customized prosthesis by computer and had surgery of tumor segmental resection and reconstruction with custom-made prosthesis.All individuals were given appropriate functional exercise after operation,standard chemotherapy after incision healing one week,and long-time follow-ups.Results The operation times were 3 hours,4 hours and 6 hours.The bleeding losses during operation were 300 ml,500 ml and 2200 ml,respectively.The functional scores according to the scoring system of the Musculoskeletal Tumor Society (MSTS) after 12-24 months follow-ups were 24,26 and 13,respectively.And excellent functional results were obtained in short-time follow-ups.1 patient had prosthesis infection and amputation was taken after failing in conservative treatment.Unequal lengths of both lower extremities in 2 patients were less than 2 cm.Conclusion For the pediatric distal femoral osteosarcomas that has surgical indications,a new theory and therapy idea on combination of epiphysis preservation operation with custom-made prosthesis and neoadjuvant chemotherapy and standardized postoperative chemotherapy is suggested.And it has advantages of effective curative effect,easy operation,short operative time and quick recovery.However,long-term outcomes of complications should be observed further.

Objective To investigate quantitatively the thermal sensation characteristics of the patients with facial palsy and the value of quantitative thermal test (QTT) in prognostication.Methods The QTT threshold of the fore ear and cheek of 30 patients with peripheral facial palsy was tested,their facial nerve conduction velocity was measured,and House-Brackmann facial nerve grading system was used to estimate facial nerve function at 2～3 weeks,a month,two months and half a year post onset.Results It was found that 12 out of 30 patients had abnor- mal QTT threshold value;the majority of them suffered from herpes virus and diabetes.In those with abnormal QTT, 8 were with diabetes mellitus (account for 66.7%),3 with partial shingles (account for 25%),and 1 with positive serum virus infection (account for 8.3%).Those with normal QTT were significantly different from those with abnor- mal QTT,with regard to the House-Brackmann rating scores after 2 and 6 months post onset (P

With patients' general situation, medication use, occurrence time of adverse drug reaction/event (ADR/ADE), clinical manifestations and prognosis as reference items, a retrospective study was made for 315 cases with ADR/ADE induced by Gastrodin in Chongqing from January 2008 to June 2014, in order to analyze the characteristics of ADR/ADE and provide reference for rational clinical medication. The results showed that among the 315 cases with ADR/ADE, 143 cases (45.4%) were males and 172 cases (54.6%) were females, most of them (74.9%) were aged above 45; 60 cases (19.0%) with ADE were caused by off-label indications and 66 cases (21.0%) with ADE were caused by over dosage; ADR/ADE cases induced by intravenous drip mainly happened within 30 min (85.5%), ADR/ADE cases induced by oral administration mainly happened within 2 h (74.4%), and all of ADR/ ADE cases induced by intramuscular injection happened within 10 min. Totally 593 ADR/ADE cases were reported, which were mainly damages in gastrointestinal system, skin and its adnexa; And 61.9% of ADR/ADE cases were newly reported. It is suggested that medical workers shall learn about the regularity and characteristics of ADR/ADE induced by gastrodin, apply it in clinic with standards, pay close attention to changes of patients' situations and attach importance to the monitoring of ADR/ADE, so as to enhance the safety of medication.
Adolescent ; Adult ; Aged ; Benzyl Alcohols ; administration & dosage ; adverse effects ; Child ; Child, Preschool ; China ; epidemiology ; Drug-Related Side Effects and Adverse Reactions ; epidemiology ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Gastrointestinal Tract ; drug effects ; Glucosides ; administration & dosage ; adverse effects ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Skin ; drug effects ; Young Adult

To investigate the effect and possible mechanism of echinacoside-containing serum on the osteogenic differentiation in rat bone marrow mesenchymal stem cells. Rat bone marrow mesenchymal stem cells were cultivated by the whole bone marrow adherence method. The 3rd generation of cells were divided into 3 groups: the blank control group, the classic osteogenic-induced group and the 10% echinacoside-containing serum group. The expression of alkaline phosphatase and osteocalcin were detected by ELISA. The ex- pression of ZHX, protein was detected by Western blot technique. RT-PCR technique was used to detect the expression of ZHX₃mRNA. According to the result, the expressions of the alkaline phosphatase and osteocalcin in the classic osteogenic-induced group and the 10% echinacoside-containing serum group were significantly higher than that of the blank control group (P <0. 01). And expressions of the alkaline phosphatase activity and osteocalcin in the 10% echinacoside-containing serum group were significantly higher than that in the classic osteogenic-induced group (P < 0.01). Meanwhile, the classic osteogenic-induced group and the 10% echinacoside-containing serum group showed obviously higher ZHX₃ protain and mRNA expression than that of the black control group, with significant differences (P < 0.01); the 10% echinacoside-containing serum group showed obviously higher ZHX₃ protain and mRNA expression than that of the classic osteogenic-induced group, with a significant difference (P < 0.01). In conclusion, 10% echinacoside-containing serum can promote the differentiation of the bone marrow mesenchymal stem cells cultured in vitro. Its mechanism may be correlated with the increase in the ZHX₃expression.
Animals ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Female ; Glycosides ; blood ; pharmacology ; Homeodomain Proteins ; genetics ; metabolism ; Male ; Mesenchymal Stromal Cells ; cytology ; drug effects ; metabolism ; Osteogenesis ; drug effects ; Rats ; Rats, Sprague-Dawley ; Serum ; chemistry ; Transcription Factors ; genetics ; metabolism

Objective To summarize the clinical features, diagnosis and treatment of autoimmune pancreatitis (AIP). Methods From March 2003 to January 2008, a total of 16 cases of AIP were reviewed retrospectively. Results The ratio of male: female was 15:1, with a mean age of 61 years old (range:47-79 years old). Jaundice was the main clinical presentation in 81.2% patients. 68.8% patients presented with high serum gammaglobulin, while 66.7% with high serum IgG, 56.2% with elevated ESR, 50.0% with positive rheumatoid factor(RF), 43.7% with eosinophilia, 26.7% with positive antinuclear antigen(ANA),31.2% with elevated lipase, 18.7% with elevated amylase, and 25.0% with elevated CA19-9. 93.7%patients showed diffuse swelling of the pancreas on CT and/or endoscopic ultrasound. Stricture of the main pancreatic duct was seen in 100% patients. Distal common bile duct stricture was seen in 87.5%, while thickened wall of bile duct was seen in 50%. Histological findings of the pancreas EUS-FNA showed nonspecific results in one patient, while no tumor cell was detected in other 5 patients; lymphocytes infiltration was noted in 3 patients; pancreatic fibrosis was seen in 2 patients. 75.0% patients was found to have diabetes or abnormal sugar tolerance, enlargement of the celiac lymph nodes in 43.7%, splenic vein or inferior cava vein involvement in 42.9%, swelling of the maxillary glands in 18.7%, the lacrimal glands in 12%. Prednisone was given to 11 patients, among them 5 patients underwent endoscopic stent placement, and 10 patients responded well while 1 patient discontinued therapy due to intolerance. 2 patients underwent endoscopic stent placement alone and jaundice disappeared. 3 patients received conventional medical treatment. Steroid therapy exerted different effects on levels of the blood glucose, the enlarged maxillary and lacrimal glands improved after steroid therapy. Conclusions AIP occurred in middle aged and senior male predominantly, painless obstructive jaundice was the main clinical presentation, and patients may be accompanied with elevated levels of IgG, hypergammaglobulin, positive RF and ANA, diffuse or focal pancreatic enlargement, pancreatic duct stricture and distal common bile duct stricture. Stent placement could improve the symptoms, and steroid therapy was effective.

Objective:To evaluate the clinical value of percutaneous transhepatic cholangial drainage (PTCD) and percutaneous transhepatic cholangial stent(PTCS)implantation therapy for malignant biliary obstruction in the elderly patients.Methods:Fifty three patients over 60 years-old were treated with PTCS implantation (n=35),PTCD for internal-external drainage(n=11),or single external drainage(n=7). The imaging examination was performed for all the patients one week after surgery. The serum levels of total bilirubin (TBIL) and alanine aminotransferase (ALT) were detected before and after surgery.Rusults:Metallic stents were successfully implanted in 32 patients during the surgery, and 3 patients were implanted 5 to 7 days later after PTCS. Both total serum levels of TBIL and ALT were significantly decreased at one week after surgery (P<0.05). The mean survival periods were 11.5 months for stent implantation patients and 5.5 months for PTCD patients. Conclusion:PTCD and PTCS are easy to perform and safe and effective in the treatment of malignant biliary obstruction of elderly patients.