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.

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 To evaluate the therapeutic effect of antituberculosis therapy in elderly patients with smear-negative pulmonary tuberculosis by low-dose computed tomography (CT).Methods Forty-seven elderly patients diagnosed as smear-negative pulmonary tuberculosis were rechecked with low-dose chest CT scan (120 kV, 20 mAs) after 1-12 months of antituberculous therapy respectively. These images were compared with common CT before treatment (120 kV, 200-280 mAs). Results In the elderly patients with smear-negative pulmonary tuberculosis, the most common CT signs before treatment were acinus consolidation (100%) and lobar or segmental consolidation (77%), but the cavity was seen less. After effective antituberculous therapy, tree-inbud was improved after one to three months, the acinus consolidation and lobular or segmental consolidations were improved after four to nine months, and the cavitations were slowly improved after six months. Conclusions Low-dose CT can provide sufficient information for the therapeutic effects of antituberculous therapy of smear-negative pulmonary tuberculosis in the elderly and could be used for rechecking.

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 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 explore the genetic mechanism of acupoint catgut embedment in inhibiting hippocampal neuron apoptosis in rats with status epileticus (SE). [Methods] Forty SD rats were randomized into 5 groups: blank control (A), model (B), dilantin (C), routine acupuncture (D) and acupoint catgut embedment (E). Rat models of SE were established by intra-abdominal injection of penicillin. With immunohistochemical method, the expressions of apoptosisrelated genes of c-jun and bcl-2 were observed in the vulnerable neurons of the hippocampus 24 hours after modeling. [Results] Compared with SE model group, the expression of c-jun was decreased and the expression of bcl-2 was increased in group C, D and E 24 hours after modeling; c-jun expression was positively related with the apoptotic index (AI) and bcl-2 expression was negatively related; the effects in group E much differed from those in model group. [Conclusion] The possible mechanism of the acupoint catgut embedment in treating epilepsy is related to the inhibition of the hippocampal neuron apoptosis by prohibiting the expression of c-jun and promoting the expression of bcl-2.

Objective To evaluate an improved modification of TTC staining method for measuring myocardial in-farct size after ischemia-reperfusion in rats.Methods Twenty healthy SPF male 8-week-old SD rats were randomly divided into two groups:Group A with conventional TTC staining, and group B with the modified TTC staining method for measuring myocardial ischemia-reperfusion injury.The infarct size was caculated and the serum cTnI levels were determined.Results The infarcted myocardium was well detected in both groups A and B.There were no significant differences in the myocardial infarct sizes measured in the groups A and B (48.69 ±5.37 %vs.47.41 ±3.28%, P>0.05).There were no significant differences in the serum cTnI levels assayed in the groups A and B (4.51 ±0.88 ng/mL vs.4.70 ±0.71 ng/mL, P>0.05). But compared with the group A, the color contrast of stained myocardial slice and the distinguishing infarction area and non-infarction area were much clearer in the group B.Conclusions Our modified TTC staining technique using in vivo staining is an economic, convenient, fast and efficient method, being easy to control, time-saving and inexpensive, and enhances the staining effect in evaluating the size of myocardial ischemia/reperfusion injury more accurately.

Objective: To analyze the short-term and long-term effects of non-operative therapy in the treatment of prolapsed lumbar intervertebral discs. Methods: One hundred and sixty-five subjects were randomized in single-blind method into traction group (A), Tuina group (B), and Tuina and exercise group (C); after 2 courses of treatment, the short-term effects were evaluated. Moreover, 102 cases with significant short-term effects were randomized in single-blind method into exercise group (D) and control group (E). The relapse rates in the two groups were survey one year after treatment; and the lumbar functions were assessed respectively six months and twelve months after treatment. Results: Groups B and C had obviously better effects than group A (χ2=8.359, P＜0.01); the relapse rate after one year was strikingly lower in group D than group E (χ2=12.631, P＜0.01). Conclusion: Tuina plus functional exercise is an effective method in the prevention and treatment of prolapsed lumbar intervertebral discs.