[Purpose] To discuss about the graduation internship quality control system for undergraduate students majoring in nursing. [Method] First, de-velop a graduation internship quality control system; Second, monitor during the graduation internship process; Third, assess the comprehensive skil s after graduation internship. [Conclusion] Developing and implementing the graduation internship quality control system leads to better process and better quality of the graduation internship.

Objective To explore the surgical treatment effect of hyperthyroidism.Methods The clinical datas of 508 hyperthyroidism patient operation cure were reviewed.Results 2 cases had hypothyroidsim,no signs indicated injuries of superior laryngeal nerve and recurrent laryngeal,no recurrence of hyperthyroidism,no one died.Conclusion The thyroidectomy is the best treatment for the hyperthyroidism.Sufficient prepare before operation can reduce complications.

Objective To explore the role of Th17-and Treg-derived catecholamines during collagen-induced ar?thritis (CIA) progression. Methods Eighteen male DBA/1 mice were randomly divided into control group, CIA model groupⅠ(day 35) and CIA model groupⅡ(day 55). The CIA models were induced by typeⅡcollagen (CⅡ) injection from tails. mRNA expression of Th17 specific transcription factor include ROR-γt, cytokines, IL-17 IL-22, Treg specific transcription factor, Foxp3, cytokines, TGF-βand tyrosine hydroxylase (TH) in lymph nodes were examined by real-time PCR. Co-local?ization of ROR-γt or Foxp3, with TH, vesicular monoamine transporter-2 (VMAT-2) or monoamine oxidase (MAO) in lymph nodes were observed by immunofluorescence staining. Results In lymph nodes of mice in CIAⅠgroup and CIAⅡgroup, mRNA expression of ROR-γt, IL-17, TH and IL-22 were upregulated, while mRNA expression of Foxp3 and TGF-βex?pression was downregulated compared to those expression in control group. The upregulated expression of IL-17 was signifi?cantly reduced in CIAⅡgroup compared with that in CIAⅠgroup. In the lymph nodes of both intact and CIA mice, co-lo?calization of ROR-γt or Foxp3 with TH, VMAT-2 or MAO was seen in some cells. The numbers of cells that are double-pos?itive of ROR-γt/TH,ROR-γt/VMAT-2 and ROR-γt/MAO IL-17 were increased in CIA groups compared to those in con?trol group. And they are significantly reduced in CIAⅡgroup compared with those in CIAⅠgroup. Conclusion The abili?ty to synthesize catecholamines in Th17 cells was increased in lymph node in mice from CIA groups compared to that in con?trol group. The increased catecholamines production from Th17 cells in lymph nodes may be involved in the anti-inflammato?ry progression in CIA.

Aim The potentiality as a differentiation inducer of the new steroidal drug(NSC67657) had been studied.Then the expression differences of protein between treated and untreated HL60 cell line could be analysed.Method Firstly,the expression patterns of C/EBP alpha gene and protein were observed between treated and untreated HL60 cell line.Then the proliferation of HL60 cell line could be investigated by MTT.At the same time cellular chemical staining could be employed to investigate which direction HL60 cell line would be induced by NSC67657.Then the flow cytometry(FCM) could be employed to detect the profile of differentiation of HL60 cell line induced in different time and at different drug concentrations,by which the most suitable drug concentration and inducing time could be found. Following that,the information of cellular cycle and ultramicrostructure could be analysed by FCM and electronmicro scope,by which whether the apoptosis had happened or not under the drug treatment could also be found. Finally,the protein of these two group HL60 cell lines could be separated by modified two-dimensional electrophoresis (2-DE).Results The expression of C/EBP alpha gene and protein could be promoted under the treatment of NSC67657.Then the proliferation of HL60 cell line was inhibited significantly.From cellular chemical staining,the monocytic differentiation could be easily found and the perfect inducing time and drug concentration were defined as 10 ?mol?L-1NSC67657 and constantly inducing HL60 cell line within 5 days.The cellular number of G0~G1 was increased and hardly any apoptosis which might be happened during drug inducing ability could be seen.The protein of HL60 cell lines were separated by modified 2-DE technology.Then there were 14 protein spots which could only be found in the differentiated gels,on the other hand,20 protein spots could only be found in the undifferentiated gels,which would have been analyzed by MALDI-TOF.Conclusions HL60 cell line could be induced to monocyte by NSC67657 which could also stimulate the C/EBP? in the early stage.2-DE could separate the protein directly which expressed differentially,from which some proteins essential in cellular differentiation might be found.

Objective To explore the effect of comprehensive intervention on anxiety in patients of acute myocardial infarction (AMI) undergoing intra-aortic balloon pump (IABP). Methods 50 patients with AMI undergoing IABP with the score of Hamilton Anxiety Rating Scale (HAMA) more than 14 points, were divided into conventional intervention group (n=25) and comprehensive intervention group (n=25). The conventional intervention group received all the conventional nursing measures including cognitive behavioral intervention, and the comprehensive intervention group received propofol intravenous pumping in addition with Ramsay sedation at II-III level. The vital signs, HAMA scores, major cardiovascular events, and vascular complications were recorded before and the 1st-5th days after intervention. Results The HAMA scores, systolic blood pressure, diastolic blood pressure and mean pressure decreased in most of the time points after intervention in the comprehensive intervention group (P<0.05). And there was no complication such as low blood pressure, respiratory depression. The incidence rates of cardiac arrhythmias, puncture hematoma/bleeding and catheter displacement were lower in the comprehensive intervention group than in the conventional intervention group (P<0.05). Conclusion Comprehensive intervention can improve the symptoms of anxiety in the patients with AMI undergoing IABP, and reduce the incidence of arrhythmia, vascular complications and catheter displacement.

Objective To observe the clinical efficacy ofFufang Shenlu Granule for kidney-yang deficiency aplastic anemia (AA) and its effects on CD4+ T lymphocyte subsets, and explore its mechanism.Methods Forty AA patients were randomly divided into treatment group and control group, 20 cases in each group. The treatment group was treated withFufang Shenlu Granule combined with conventional western medicine therapy, while the control group was only treated with conventional western medicine therapy. The treatment lasted for 6 months, and follow-up visits lasted for at least one year. The clinical efficacy and T lymphocyte subsets ratio changes before and after treatment in the two groups were observed.Results The clinical efficacy of treatment group was better than that of control group (P<0.05). After treatment, the blood cell counts of the two groups were improved than those of before treatment (P<0.05,P<0.01). After treatment, the red blood cell count and hemoglobin of treatment group were higher than those of control group (P<0.05). Compared with the data before treatment in treatment group, the ratio of CD4+CD25+ cells in all CD4+ cells, and the ratio of CD4+CD25+FoxP3+ cells in all CD4+CD25+ cells increased (P<0.05); the ratio of Th1 and Th2 cells in all CD3+CD4+ decreased (P<0.05). The ratio of Th2 cells was lower than that before treatment in the control group (P<0.05).ConclusionFufang Shenlu Granule can enhance the treatment efficiency of AA with kidney-yang deficiency syndrome. The mechanism may be related to the decrease of Th1 cells, the increase of CD4+CD25+Tregs and their FoxP3 expression.

Objective To investigate the mRNA expression and methylation status of IL-13 receptor(IL-13R)α1 gene in peripheral T lymphocytes of patients with systemic lupus erythematosus(SLE).Methods Venous blood samples were obtained from 10 SLE patients(5 in active phase,5 in inactive phase)and 6 normal human controls.CD4+ and CD8+ T cells were isolated from these samples via magnetic activated cell sorting(MACS).Real-time quantitative PCR was used to test the mRNA expression of IL-13Rα1 gene,and methylation specific PCR to detect the methylation status.Results The expression level of IL-13Rα1 mRNA was 2.224±0.251,1.712±0.132.and 1.104±0.044 in CD4+ T cells of active SLE patients,inactive SLE patients and controls,respectively;the difference between the three groups was statistically significant(all P＜0.05).The expression level of IL-13Rα1 mRNA in CD8+T cells was significantly higher in active SLE patients than that in the normal controls(1.672±0.142 vs 1.238±0.106,P＜0.05),while no difference was noted between inactive and active SLE patients or normal controls.The methylation index of IL-13Rα1 gene was 0.454±0.023.0.635±0.065.0.844±0.097 in CD4+T cells of active SLE patients,inactive SLE patients and normal controls,respectively,and the difference between the three groups was significant(all P＜0.05),while no significant difference was observed in the methylation index in CD8+T cells among these groups(P＞0.05).The IL-13Rα1 mRNA expression in CD4+T and CD8+T cells was positively correlated with SLE disease activity index(SLEDAI)score(r=0.79,0.76,P=0.007,0.02 respectively).A negative correlation was found between the methylation level Of IL-13Rα1 in CD4+T cells and SLEDAI score(r=-0.89.P＜0.0 1).as well as between the IL-13Rα1 mRNA expression and its methylation level(r=-0.84,P＜0.0 1).Conclusion The development of SLE may be related to the overexpression of IL-13Rα1 gene induced by DNA hypomethylation in T cells.

Objective To explore the diagnostic value of reticulocyte related parameters in thalassemia and iron deficiency anemia(IDA) .Methods Ret％ ,Ret# ,IRF ,LFR ,MFR ,MFR and Ret-He were detected in 56 cases of IDA (IDA group) ,48 cases of thalassemia (thalassemia group) and 45 healthy individuals undergoing the physical examinations(control group) by adopting the XN-1000 automated blood cells analyzer .Then the results were compared among 3 groups .Results Ret％ ,Ret # ,IRF ,MFR and HFR in the IDA group and thalassemia group were higher than those in the control group ,the differences were statistically significant (P<0 .05);Ret-He and LFR in the IDA group and thalassemia group were lower than those in the control group ,the differences were statistically significant (P< 0 .05) .The Ret-He level had statistically significant difference between the IDA group and thalassemia group (P<0 .05) .LFR％ in the thalassemia group was sig-nificantly decreased compared with the IDA group (P<0 .05) .Conclusion The reticulocyte parameters have the important significance in clinical differentiation diagnosis of thalassemia and IDA .

Objective To investigate the distribution of pathogens and their drug resistance in elderly patients with community-acquired pneumonia. Methods A total of 222 elderly patients with community-acquired pneumonia admitted to our hospital from February 2017 to January 2018 were enrolled in this study.Lower respiratory tract secretions or morning sputum were collected by using the sterile culture method. According to the clinical microbiological examination procedures ,pathogenic bacteria were cultured and identified. The pathogenic bacteria strains and the drug resistance were analyzed. Results The bacteria examination rate of the patients was 100.0% (222/222 patients) , and the rate of positive cultures was 64.9% (144/222 ).216 strains of pathogenic bacteria were identified ,and 75 strains(34.7% )were Gram-positive bacteria ,of which the most common pathogenic bacteria were Staphylococcus aureus ,Streptococcus pneumoniae and Staphylococcus epidermidis. And 127 strains(58.8% )were Gram-negative bacteria ,of which the most common pathogenic bacteria were Klebsiella pneumoniae ,patina Pseudomonas ,Escherichia coli ,Stenotrophomonas maltophilia and Haemophilus influenza. The drug susceptibility test showed that Gram-positive bacteria were sensitive to nitrofurantoin ,cotrimoxazole ,vancomycin and teicoplanin ,and Gram-negative bacteria were sensitive to piperacillin ,tazobactam ,cefepime ,amikacin ,levofloxacin and imipenem cilastatin. Conclusions The pathogenic bacteria are mainly Gram-negative bacteria in the elderly patients with community-acquired pneumonia ,but the majority of pathogenic bacteria have higher resistance to antibacterial drugs. The analyses of distribution of pathogens and their drug resistance are of great significance for the reasonable selection of antimicrobial agents and for the obvious decrease of lung infection and mortality rate.

Objective:To analyze the effect of implementing information-motivation-behavior skill model (IMB) home care in elderly patients with chronic obstructive pulmonary disease (COPD).Methods:From October 2017 to October 2018, patients with COPD who were discharged after treatment in Wuxi Fifth People′s Hospital were included and divided into control group and observation group by block randomization method. The control group was given routine health education, discharge guidance and follow-up guidance after discharge. The observation group received the information-motivation-behavior home care based on IMB. The general information before intervention, the level of disease cognition, quality of life before and after the intervention and the health behavior after the intervention were compared between the two groups.Results:The Bristol COPD Knowledge Questionnaire (BCKQ) score in the observation group was higher than that in the control group [(58.36±6.68) vs. (52.14±5.80) points] ( P<0.05). The scores of physical activity, health responsibility, stress management, nutrition, and spiritual growth in the Health Promoting Lifestyle Profile-Ⅱ (HPLR-Ⅱ) after the intervention in the observation group were higher than those in the control group [(26.01±3.95) vs. (23.25±3.48) points, (38.65±4.33) vs. (34.64±4.05) points, (16.98±2.51) vs. (14.20±1.80) points, (19.87±2.20) vs. (15.65±3.51) points, (20.32±2.85) vs. (17.35±2.89) points] ( P<0.05). The symptoms, mobility, and disease impact scores of the St George′s Respiratory Questionnaire (SGRQ) in the observation group were lower than those in the control group [(40.32±4.30) vs. (45.36±4.50) points, (43.21±4.87) vs.(45.33±4.25) points, (38.41±4.37) vs. (42.35±4.01) points] (all P<0.05). Conclusion:Implementing the home care model based on IMB in elderly patients with COPD can improve patients′ disease awareness and improve their health behaviors and quality of life.