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 explore the diagnostic values of Wells score and YEARS algorithm in the patients with pulmonary embolism and to compare the areas under receiver operating characteristic (ROC) curves (AUC) of Wells score and YEARS algorithm, and to find the more suitable score method for pulmonary embolism in clinic. Methods: A total of 139 patients who were suspected with pulmonary embolism were collected, among them 48 patients were clinically as confirmed pulmonary embolism. The disease history, clinical manifestation and results of auxilliary examinations of the patients were collected. All the patients were assessed by Wells score and YEARS algorithm, respectively; the computed tomographic pulmonary angiography (CTPA) was considered as golden standard. The sensitivities, specificities, misdiagnosis rates and omission diagnostic rates, and the accuracies of Wells score and YEARS algorithm of the patients in two groups were analyzed with SPSS 22.0 software; the conformities of results of Wells socre, YEARS algorithm, and CTPA were analyzed. Then ROC curves of Wells score and YEARS algorithm in diagnosis of pulmonary embolism were made, and the AUC was calculated and compared. Results: Compared with YEARS algorithm, the specificity and accuracy of Wells score in diagnosis of pulmonary embolism were markedly increased (P<0.05), the misdiagnosis rate was decreased (P= 0.037), however the sensitivity and the misdiagnosis rate had no significant differences ( PX). 05). The Kappa value of Wells score and CTPA was 0. 45, the conformity was moderate; the Kappa value of YEARS algorithm and CTPA was 0.22, the conformity was passable; the Kappa value of Wells score and YEARS algorithm was 0. 11, the conformity was bad. The AUC of Wells score and YEARS algorithm were 0. 753 + 0. 044 ( P<0. 01) and 0. 585 + 0. 049 ( P=0. 101). Conclusion: The Wells score is superior to the YEARS algorithm in the diagnosis of pulmonary embolism.

Objective To compare the characteristics of food and nutrition intake in type 2 diabetes mellitus (T2DM) patients with or without carotid atherosclerosis and analyze the relationship between diets/C-reactive protein (CRP) and carotid intima-media thickness (C-IMT). Methods Sixty patients with T2DM were enrolled and divided into two groups based on C-IMT: group A (C-IMT ＜ 1 mm, n=30) and group B (C-IMT≥1 mm, n=30). All subjects were investigated with questionnaires including 3-day food recall They all took somatometric measurement. Blood and urine samples were collected in all subjects to examine the levels of high sensitive-CRP,C-peptide, blood glucose, glycosylated hemoglobin, blood lipid, renal function, urine microalbumin, and other indicators. Results The intakes of vegetables, fruits, and aquatic products were significantly higher in group A than in group B ( P ＜ 0. 05 ). The intake of vitamin C in group A was significantly higher than that in group B ( P ＜0. 05 ). The levels of CRP in group B was significant higher than that in group A (P = 0. 000). Positive correlation was found between CRP level and C-IMT in T2DM patients ( r = 0. 36, P = 0. 004). Furthermore, CRP was negatively correlated with the intakes of vegetables and fruits ( r = - 0. 334, P = 0. 01 ), aquatic products ( r = -0. 315, P = 0. 016), and vitamin C ( r = - 0. 2786, P = 0. 038 ), respectively. The intake of fruits was negatively correlated with C-IMT (r, = -0. 33, P = 0. 01 ). Conclusions T2DM patients without carotid atherosclerosis intake more vegetables, fruits, aquatic products and vitamin C than those with atherosclerosis. Vegetables, fruits,sea foods and vitamin C may be the protective factors against atherosclerosis in T2DM patients. CRP is associated with the development of atherosclerosis in T2DM patients.

etary oil with MCT can improve insulin resistance.

AIM: To investigate the effects of lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) on the expression of MCP-1 in the cultured human unbilical vein endothelial cells (HUVECs). METHODS: Cultured HUVECs was incubated with ox-LDL, or preincubated with carrageenan and polyinosinic acid. LOX-1 and MCP-1 mRNA and protein were determined by RT-PCR and Western blot. RESULTS: Incubation of HUVECs with ox-LDL (from 0-100 mg/L) for 24 h markedly increased the expression of LOX-1 and MCP-1 (mRNA and protien) in a concentration-dependent fashion. Preincubation of HUVECs with carrageenan and polyinosinic acid, the chemical inhibitors of LOX-1, for 2 h, ox-LDL-mediated upregulation of LOX-1 and MCP-1 was suppressed (P

Jaundice is frequent clinic symptoms with high incidence especially among the critical patients. The sepsis complicated with jaundice has drawn more and more consideration. However, the pathogenesis about sepsis complicated with jaundice is not confirmed and it is sometimes identified incorrectly as cholestatic jaundice. This article summarises the pathogenesis and elucidate the management about sepsis complicated with jaundice.

Objectives:To observe the influence of PN treatment on the postoperative patients of advanced ovarian cancer. Methods:The patients were divided into two groups.Thirty cases of patients(PN group) were treated with PN after the operation for the ovarian cancer.Thirty five cases of patients(control group) were treated regularly without PN.The biochemical indicators,complications and mortality rate were compared between the two groups. Results:The biochemical indicators in PN group were better than those in control group.The incidence of complications and mortality rate in PN group were significantly lower than those in control group. Conclusions:PN can improve the general status of postoperative patients with advanced ovarian cancer and decrease the complication incidence and motality rate.

AIM: To explore the effect of lysophosphatidylcholine(LPC) on cholesterol efflux from macrophage foam cells, and to offer experimental evidence for research on prevention and treatment of atherosclerosis.METHODS: Peritoneal macrophages and LDL were seperated from mice and serum of healthy volunteers, respectively. The foam cells were derived from macrophages in the presence of Acylated LDL (AcLDL). Cholesterol efflux from cells and LDH activity were measured by enzymetic fluorometry and LDH kit, respectively.RESULTS: After incubated with LPC for 24 hours, cholesterol efflux from macrophage foam cells increased significantly compared to control, and cellular cholesterol was lower than that in control group. At the same time, medium LDH activity of LPC group was not increased obviously. CONCLUSION: Within the dosage of 10-80 ?mol/L, LPC can promote cholesterol efflux from macrophage foam cells in a dose-dependent manner, and this effect has nothing to do with cytotoxity of LPC.

AIM: To study the role of scavenger receptor A(SR A) in the uptake of oxidized low density lipoprotein(OxLDL) in mouse peritoneal macrophages(MPM). METHODS: Comparing the difference of the uptake of OxLDL in SR A-deficient and wild-type MPM. RESULTS: The results showed that the binding of OxLDL wasn't apparently reduced in SR A-deficient MPM. The association of OxLDL was reduced by 35.8% and degradation of OxLDL was reduced by 42% in SR A-deficient MPM compared with those in wild-type MPM. CONCLUSION: Studies showed that SR A didn't play an important role in the uptake of OxLDL in MPM. Approximately 70% of the uptake of OxLDL in macrophages is attributable to non-SR A receptor.

OBJECTIVE:To discuss the pharmaceutical care trustworthiness imperfection from the perspective of eco?nomics and to put forward some suggestions for the reduction of trustworthiness imperfection behavior in the pharmaceutical care.METHODS:The behavior of the pharmaceutical care trustworthiness imperfection was analyzed from the perspective of profits maximum,information dissymmetry,and trade cost etc.in the economics theory.RESULT&CONCLUSION:It is of positive meaning to reduce pharmaceutical care trustworthiness imperfection behavior by establishing and improving related laws and rules,popularizing the medicine knowledge,strengthening monitoring,reforming the salary mode of the pharmaceuti?cal technical personnel.