How to cultivate and evaluate the nursing students′clinical competency is an important part of the process of higher nursing education .Objective structured clinical examination is regarded as an effective assessment method to evaluate the clinical com -petency of medical students .However , it is still at the initial stage in the nursing education in China .This article presents an overview on the design of nursing objective structured clinical examination , the present application of objective structured clinical examination in cultivating and evaluating the nursing clinical competency and the effectiveness of objective structured clinical examination .

Objective To investigate the effects of occupational therapy based on International Classification of Functioning, Disability and Health (ICF) on activities of daily living of patients with hemiplegia after stroke. Methods From May to November, 2013, 60 patients with hemiplegia after stroke were randomly divided into observation group (n=30) and control group (n=30). Both groups received routine treatment, while the control group received routine occupational therapy and the observation group received occupational therapy based on ICF. They were assessed with modified Barthel Index before and 40 days after treatment. Results The scores of items of MBI improved after treatment in both groups (t>14.86, P<0.001), and improved more in the observation group than in the control group (t>18.65, P<0.001). Conclusion The occupational therapy based on ICF can further improve the activities of daily living of patients with hemiplegia after stroke.

Objective To explore a best operative method in order to improve operative manipulated skill of simultaneous pancreas-kidney transplantation(SPKT),a model of SPKT was established in dogs.Methods 12 dogs of SPKT were performed in animal model.A renoportal end-to-end anastomoses between the renal and the spleen vein.Only two vascular end-to-side anastomoses between the donor portal vein and recipient ilio-vein,and between the donor celiac arteries and recipient abdominal aorta were constructed.Pancrease was placed in the right iliac fossa and kidney in the left.Pancreatic exocretion goes through bladder drainage.Results Combined resection was successfully performed in 6 dogs and the other underwent simultaneous pancreas-kidney transplantation.Satisfactory result was obtained in 5 survival dog for a mean of (1 5?0 8)days,although 1 dog died from hypopiesis.Conclusions The model is practically feasible and might be used in studying the problems involved in SPKT,which is effective for the treatment of end-stage diabetic nephropathy.

[Objective] To investigate the effect of the ER stress on the process of nonalcoholic fatty liver disease which is induced by methionine-choline deficient diet.[Methods] C57/BL mice were randomly divided into 8 groups (n =10),group 1-4was given normal diet,5-8 group was given MCD diet.Then took one group from both normal diet and MCD diet in the 2nd,4th,6th,8th week,recorded each group's body weight and liver weight.The liver fibrosis and inflammation in mice were analyzed by histopathological staining and NAS.The expressions of endoplasmic reticulum stress markers such as p-PERK,p-eIF2α,CHOP were detected by Western Blot and real time fluorescent quantitative PCR (q-PCR).[Results] ①The ALT and AST in serum,TG and TC in liver tissue were both higher in MCD group,the same as NAS;②The expressions of PERK,eIF2α,CHOP were significantly higher than the nommal diet group,while the GADD34 expression was lower.What's more,as time went by,the difference was more obvious;3.There was a significant correlation between the ERS index and NAS score in MCD group.[Conclusion]The liver damage and inflammatory response was lifted gradually in the mice fed with MCD diet.The ER stress may take an important role in this process.

Dialysis patients become more and more with the development of dialysis technology , but their quality of life is menaced by all kinds of complications which resulted in physical and psychological dysfunction . However, exercise therapy may help patients return social.

Objective Investigate animal model of experimental myasthenia gravis with peptide 125-147(T?125-147)of the acetylcholine receptor(AchR)?-subunit.Methods 12 Lewis rats of experiment group were injected in hypo with synthesized peptide T?125-147 of AchR of electric eel.The muscle fatigability,repetitive nerve stimulation(RNS)for decrement response and ELISA assay for serum AchRAb titers were observed and compared with control group.Results A week after the second inoculated,6 rats of experiment group appeared weakness.The RNS and serum AchRAb titers of 11 rats of experiment group were positive,none of the control group appeared weakness,all RNS were negative,serum AchRAb titers of 7 rats were negative and of 1 rat was probable positive.There were significant differences between experiment group and control group(all P

Objective To study changes of?-glutamyltransferase(GGT)and its isoenzyme in urine and renal cortex of rats with subacute cadmium exposure.Methods Sixty healthy SD male rats were chosen and divided randomly into control group,middle dose group and high dose group,which were orally dosed daily with feed containing0,5and10mg cadmium per kg for six weeks.The activities of GGT and its isoenzyme in urine and renal cortex of the rats were determined in the3rd and6th week respectively.Re sults During the whole experimental period,the body weights and kidney to body weight ratios of control group,middle dose group and high dose group showed no significant differences.The GGT activities of middle dose group and high dose group increased significantly with the prolongation of exposure to cadmium and the increase of cumulative exposure compared with those in the control group.Unusual bands of GGT isoenzyme in the urine and renal cortex homogenate were found in the3rd week and the incidence of unusual bands of GGT isoenzyme was100percent in the6th week in the cadmium-treated rats of middle dose group and high dose group.Con clusion The GGT activities and the unusual bands of GGT isoen-zymes in the urine and renal cortex could be used as sensitive indexes to identify the renal toxic effects induced by cadmium.

Objective To investigate the number of osteoclast (OC) precursor in the peripheral blood of patients with ankylosing spondylitis (AS) and its relationship with serum receptor activator of nuclear factor KB-ligand (RANKL) and Osteoprotegerin (OPG) concentration as well as the disease activity. Methods The peripheral blood mononuclear cells from 8 cases of AS patients and 5 healthy controls were cultured in the medium containing macrophage colony-stimulating factor (M-CSF) (25 ng/ml) and RANKL (40 ng/ml). After being cultured for 14 days, cytochemistry was applied to detect tartrate-resistant acid phosphatase (TRAP) expression and the cells with TRAP expression and ≥3 nuclei were counted and defined as OC. Bone resorption assay was used to demonstrate OC function. ELISA was used to measure serum RANKL and OPG concentration in 23 cases of AS and 17 healthy controls. The relationship was analyzed in AS patients between the number of OC precursors and serum RANKL and OPG concentration as well as the disease activity. The indicators of disease activity were Bath ankylosing spondylitis disease activity index (BASDAI), Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). T test, t' test and Spearman correlation were selec-ted. Results ① Significantly higher OC production was observed in the peripheral blood of AS patients than that of healthy control group. The OC number per ten fields was 10.9±3.4 and 6.2±1.3 respectively (P<0.05); ② There was significant difference between AS patients and healthy controls in serum concentration of OPG and RANKL and the ratio of RANKL/OPG. OPG was significantly higher in AS patients [(157±49) pg/ml] than in healthy controls [(105±20) pg/ml] (P<0.05). RANKL was significantly higher in AS patients [(5.4± 3.8) pg/ml] than in healthy controls [(1.6±0.8) pg/ml] (P<0.05). The ratio of RANKL/OPG was significantly higher in AS patients (0.037±0.026) than in healthy controls (0.016±0.008) (P<0.01 );③Significantly positive correlation was observed between the OC number and the serum concentration of RANKL (r=0.692, P=0.009), the ratio of RANKL/OPG (r=0.813, P=0.001);④ In AS patients, serum concentration of OPG was found to have significantly negative correlation with BASDAI (r=-0.444, P=0.044). Serum RANKL concentration was found to have significantly positive correlation with BASDAI (r=0.543, P=0.011). The ratio of RANKL/OPG was found to have significantly positive correlation with BASDAI (r=0.672, P=0.001). Conclusion ① More OC precursors exist in the peripheral blood of AS patients. These cells may differentiate into osteoclasts, which might play a role in joints destructions in AS;② The mechanism of high OC production is likely to be due to high RANKL concentration which is caused by inflammatory reaction.

Objective To investigate the effectiveness of arthroscopic reduction and percutaneous fixation (ARPF) for the treatment of tibial plateau fractures. Methods Seventeen cases of tibial plateau fractures from April 1999 to June 2002 were reviewed. The fractured tibial plateau was reconstructed by “drag-and-draw” reduction and iliac crest bone graft under arthroscope. And percutaneous cancellous bone screw fixation was conducted. Results Clinical bone union was achieved in all the patients at the third postoperative month. No infection or severe osteoarthritis occurred. Conclusions ARPF for tibial plateau fractures has advantages of reduction under direct view, reliable fixation and facilitation for early activities.

Objective To investigate the expression of osteopontin(OPN) mRNA and its correlation with clinicopathologic features of glioma. Methods The expression of OPN mRNA was detected by semi-quantitive RT-PCR in 60 cases of gliomas and their correspondent normal tissues.The relationship between the relative content of OPN mRNA and clinicopathologic features of glioma was also analyzed. Results The positive rate of OPN mRNA expression was 73.3%(44/60) in our group.The OPN mRNA expression in normal brain tissue was all negative.Furthermore,the OPN mRNA expression was associated with the pathological grade of glioma.All patients were followed up for an average of 12 months.We did observed that the OPN mRNA expression positive group(44 cases) had recurrence in 36 patients and the negative group(16 cases) had only 2 case with recurrence (P