Objective To explore the application effect of self management mode during internship of nursing interns.Methods 100 nursing students were randomly divided into the experimental group (self management group)and the control group(traditional pattern group),50 cases in each gronp,The control group adopted strict practice management according to the traditional method,the experimental group adopted self management mode.Times of being late,absenteeism,academic achievement and operation performance were compared between two groups.Results Times of being late,absenteeism in the experimental group were less than those of the control group,while academic achievement and operation performance in the experimental group were significantly lower than the control group,the difference between the two groups were statistically significant.Conclusions The implementation of self management mode for nursing interns can effectively improve the nursing students' ability of self management,improving the teaching quality,ensure nursing safety.It is worthy of clinical application.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Foot Diseases ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Pain Management ; Spinal Stenosis ; complications

Objective To clone and to identify the core promoter of human TSLCI used for exploring of transcrip-tion regulatory mechanism.Methods A series of different fragments located in the upstream of translation start site of TSLC1 were amplified from human genomic DNA by PCR,and then constructed into pGL3-Basic luciferase re-porter vector.The activity of different fragments in A549 and NCI-H446 cells was examined by a dual-luciferase as-say after transient transfection,and then the core promoter of TSLC1 was identified.Results Among the different constructs,the fragment of -68 ～ -329 bp located in the upstream of ATG showed the strong activity both in A549 cells and NCI-H446 cells,which played an important role in the transcription of TSLC1.Conclusion The fragment of -68 ～ -329 bp located in the upstream of translation start site of TSLC1 might be the core promoter region.

Objective To investigate the forensic applicability of nuclear factor-kappa B p65 (NF-?B p65) to the diagnosis of early myocardial ischemia in cases of sudden cardiac death. Methods The cases were divided into three groups: the cases with early myocardial ischemia, myocardial infarction and cases used as control. Immunostaining of NF-?B p65 was performed by SP method in cardiac tissues. The intensity of NF-?B p65 was observed under light microscope and analyzed semi-5quantitatively. Results NF-?B p65-positivecardiac cells were detected in cytoplasm and nuclei in the cases with early myocardial ischemia and myocardial infarction, and the intensity of immunoreactivity was approximately the same. No positive immunostaining was found in the control cardiac tissues. Conclusion The results suggest that the early myocardial ischemia may have revealed as the same changes as myocardial infarction at molecular level, indicating that NF-?B p65 may be used as a marker for postmortem diagnosis of the early acute myocardial ischemia by immunohistochemical technique.

Objective To explore the characteristics of narcissism in a sample of violent criminal and analyze the relationship between narcissism and impulsive-premeditated violent aggression.Methods A total of 88 violent criminal were administered by means of cluster random sampling with the Chinese version of the Impulsivepremeditated Aggression Scale and the Narcissistic Personality Questionnaire.Results (1) Comparing with the impulsive violent criminal,premeditated violent criminal had higher level of Overt narcissism,and the difference was statistically significant(59.77±10.89,54.67±10.15; P＜0.05).(2) Overt narcissism had significantly positive correlation with premeditated aggression(r=0.560; P＜0.01) ;and covert narcissism had significantly positive correlation with impulsive aggression(r=0.440; P＜0.01).(3)The authority and self-admiration traits of overt narcissism had significantly positive prediction to premeditated aggression(β=0.442,P＜0.01;β=0.297,P＜0.05);The vulnerability trait of covert narcissism has significantly positive prediction to impulsive aggression(β=0.526,P＜0.01).Conclusion Overt narcissism can result in premeditated aggression;Covert narcissism can result in impulsive aggression.

OBJECTIVE: To evaluate the efficacy and the safety of low dose budesonide/formoterol combination therapy vs.medium dose of budesonide(BUD) dry powder in the management of mild or moderate adult asthma.METHODS: A total of 62 patients with asthma were randomized to Group A(budesonide plus formcterol) or Group B(budesonide).Main outcome measures: daytime symptom and nocturnal symptom,peak expiratory flow(PEF),number of times of using rapid-acting ? 2 agonist and its ADR.RESULTS: After treatment,both groups had significant improvement in daytime symptom and nocturnal symptom(number of times of wakeup),PEF value and lung function,and the dosage of rapid-acting ? 2 agonist was decreased,showing significant differences between the two groups.The ADR was light in degree.CONCLUSION: Inhalation therapy of low dose of glucocorticoid plus long-acting ? 2 agonist is an optimal choice in the management of asthma.The efficacy of glucocorticoid could be enhanced more by combination with low dose and long-acting ? 2 agonist than by simply increasing its own dose.

Objective To analyze the isolation rates and antimicrobial resistance of Acinetobacter baumannii (AB) from intensive care unit (ICU)between 2010 and 2013,and provide evidence for clinical anti-infective therapy. Methods The isolation and antimicrobial resistance of AB from ICU between 2010 and 2013 were analyzed retro-spectively.Results A total of 1 413 pathogenic strains were isolated,556(39.35%)of which were AB,isolation rates in each year were 39.45%,41 .35%,29.44%,and 40.53% respectively.AB were mainly isolated from lower respiratory tract (75.72%).Antimicrobial susceptibility testing results showed that AB had low resistance rates to cefoperazone/sulbactam(5.85%)and amikacin (17.45%);detection rates of multidrug-resistant and extensively drug-resistant AB increased from 9.63% and 3.70% to 42.50% and 31 .88%,respectively (both P < 0.001 ). Conclusion AB is the common pathogen in ICU,antimicrobial resistance is serious,isolation of multidrug-resistant and extensively drug-resistant AB increased year by year;intensifying the monitoring of drug resistance is helpful for the treat-ment and prevention of AB infection.

Objective To investigate the expression of miRNA associated with hepatic fibrosis induced by Schistosoma ja-ponicum soluble egg antigen stimulation in mouse hepatocytes(AML12),so as to lay the foundation for clarifying the mecha-nism of schistosome infection leading to hepatic fibrosis. Methods The expressions of miR-122,miR-182,miR-23b,miR-27b and KSRP in AML12 cells treated with SEA were measured by q-PCR. KSRP protein in cell lyses was measured by Western blotting. AML12 cells were transfected with miR-27b precursor or anti-miR-27b for 24 h,then q-PCR was adopted to determine KSRP mRNA,and KSRP protein was detected by Western blotting. Results The expressions of miR-182,miR-23b and miR-27b were decreased and miR-122 was increased in AML12 cells following SEA treatment(all P<0.05). An increase of mRNA and protein of KSRP expression was also observed in AML12 cells after SEA stimulation(both P<0.05). In addition,KSRP mRNA expression was not changed significantly in AML12 cells transfected with anti-miR-27b or miR-27b precursor,and miR-27b precursor reduced KSRP protein expression as compared with the control. In contrast,the expression of KSRP protein was increased in the anti-miR-27b group and decreased in the miR-27b precursor group. Conclusions After the stimulation of SEA,the expressions of a variety of liver fibrosis-related miRNAs and KSRP change in murine hepatocytes,including miR-27b. And miR-27b can regulate the expression of KSRP. These findings might lay a foundation for further study on the molecular mechanism of fibrosis induced by schistosome infection.

Objective To investigate the risk factors for hemorrhagic transformation (HT) and poor outcomes in patients with acute ischemic stroke after mechanical thrombectomy.Methods The patients with acute ischemic stroke received mechanical thrombectomy were enrolled retrospectively.The demography,vascular risk factors and other clinical data of the patents were collected.The modified Rankin scale (mRS) was used to evaluate the clinical outcomes at day 90.Good outcome was defined as mRS score 0-2.The patients were divided into either a HT group or a non-HT group according to their HT conditions.Multivariate logistic regression analysis was used to identify the independent risk factors for HT and poor outcomes.Results A total of 48 patients with acute ischemic stroke received mechanical thrombectomy were enrolled,including 25 males (52.1％).Their mean age was 64.77± 9.14 years.The mean National Institutes of Health Stroke Scale (NIHSS) score was 17.70 ± 3.77.Twenty-two patients (45.8％) occured HT,of which 9 were symptomatic HT;24 (50.0％) had good outcomes.The proportion of males in the HT group was significantly lower than that in the non-HT goup (30.4％vs.72.0％;x2 =8.293,P =0.004),while the proportions in patients with diabetes (65.2％ vs.36.0％;x2 =4.090,P =0.043) and atrial fibrillation (78.3％ vs.44.0％;x2 =5.880,P =0.015),as well as the baseline fasting blood glucose level (8.514 ± 4.400 mmol/L vs.6.354 ± 1.472 mmol/L;t =2.319,P =0.025) were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that the atrial fibrillation (odds ratio [OR] 6.136,95％ confidence interval [CI] 1.617-23.291;P =0.042) was a risk factor for the occurrence of HT after mechanical thrombectomy.The proportion of diabetic patients (29.2％ vs.70.8％;x2 =8.333,P=0.04) and baseline NIHSS score (16.050±4.865 vs.19.210±4.423);t=2.310,P=0.026) of the good outcome group were significantly lower than those of the poor outcome group,while the proportions of patients in atrial fibrillation (75.0％ vs.45.8％;x2 =4.269,P =0.039),anterior circulation stroke (87.5％ vs.62.5％;x2 =4.000,P =0.046) middle cerebral artery (75.0％ vs.29.2％;x2 =10.113,P =0.006),vertebral basilar artery (37.5％ vs.12.5％;x2 =10.113,P =0.006) occlusion and parenchymal hematoma (33.3％ vs.4.1％;P=0.011) were significantly higher than the poor outcome group.Multivariate logistic regression analysis showed that diabetes (OR 5.898,95％ CI 1.699-20.479;P=0.005),baseline NIHSS score (OR 1.167,95％ CI 1.011-1.347;P =0.035),and parenchymal hematoma (OR 1.295,95％ CI 1.099-1.875;P=0.028) were the independent risk factors for poor outcomes.Conclusions Atrial fibrillation is an independent predictor of HT risk in patients with acute ischemic stroke after mechanical thrombectomy.Diabetes mellitus,higher baseline NIHSS score,and concurrent brain parenchymal hematoma are the independent predictors of poor outcomes.Therefore,the risk of HT and adverse outcomes should be fully assessed before mechanical thrombectomy in patients with acute ischemic stroke.

Objective To evaluate the clinical outcome of Osteoset artificial bone mixed Rifampicin for injection after radical debridement in the treatment of sacroiliac joint tuberculosis,and compare with debridement alone.Methods From May 2005 to August 2010,48 patients with sacroiliac joint tuberculosis patients underwent two different surgical methods were selected as analysis subjects in the Orthopedics Department of Chest Hospital of Hebei Province.Among them,27 cases underwent radical debridement and fusion with Osteoset artificial bone combined with Rifampicin for injection (Grafting group),and 21 case were treated with radical debridement only(Control group).The local wound healing,adverse reactions and regular imaging examination (pelvic X-ray and CT scan) were observed,and the surgical time,the intraoperative blood loss,postoperative 6 months and 12 months,18 months bone graft fusion rate,and Majeed scoring results of the patients were recorded and statistically analyzed.Results All patients were followed up from 20 to 30 months with an average of 24 months.There was no significant difference in terms of surgical time and operative bleeding between the two groups(P＞0.05).The rate of bone fusion in grafting group was 33.33％ (9/27) of 6 months after operation,88.9％(24/27) of 12 months after operation,and 96.3％ (26/27) of 18 months after operation.While that in control group was 4.76％ (1/21) of 6 months after operation,42.85 ％ (9/21) of 12 months after operation,and 42.85％ (9/21) of 18 months after operation.The differences of these parameters between the two groups were significant(x2 =5.85,20.92,15.90;P＜0.05).According to Majeed scoring system,the excellent and good rates were 100％ (27/27) in grafting group,76.19％ (16/21) in control group,the difference was statistically significant(x2=7.18 P＜0.05).Conclusion With Rifampicin loaded Osteoset artificial bone can recruit bone graft mass during the bone fusion for sacroiliac joint tuberculosis,and reduce the adverse reactions,achieve bone fusion earlier than the control group.