Objective The main purpose of this study was to discuss the current situation of our nursing education from the perspective of educate,and to provide enlightenment for the higher nursing education reform.Methods The current situation of the development of nursing education questionnaire was adopted to conduct the survey.Results Nursing education in our country faced with the problems such as imperfection of the education concept,lack of humanistic curriculum,less practice classes,theory was divorced from practice,single evaluation tools of teaching.Conclusions Our country should carry on the reform of education mode,build international nursing personnel training system,improve the training quality and competition of nursing personnel.

Henoch-Sch?nlein purpura(HSP)is an IgA-associated leukocytoclastic small-vessel vasculitis, commonly occurred in children.Recent studies have shown that its pathogenesis is closely related to the disturbance of humoral immune response mediated by B cells.CD4 + T cells have the function of help B cells.Each subgroup of CD4 + T cells has unique functions of promoting or regulating immune inflammatory response.There are abnormal changes in the proportion of CD4 + T cells subsets in HSP patients, including the imbalance of Th1/Th2, increasing numbers of Th17 and Tfh cells, together with decreasing Treg cell numbers.The changes are closely related to the occurrence, development and the clinical phenotype of HSP.It is suggested that the detection of CD4 + T cells plays critical roles in guiding the evaluation of HSP, and is expected to provide a new idea for the clinical diagnosis and individualized treatment of HSP.

Objective:To understand the drug purchase behaviors and prescription flows of outpatients and their influencing factors. Methods: After selecting and investigating tertiary hospitals, secondary hospitals, community health service centers ( one per each level) in Beijing, Zhengzhou, Guangzhou, this paper uses structured question-naire method to analyze 3,155 valid questionnaires. A logistic regression analysis is performed to understand the fac-tors influencing the drug purchase behaviors. Results:The factors influencing the drug purchase behaviors of outpa-tients mainly include the region where the patient is, level of the hospital, type of health insurance that the patient has, frequency of drug purchase, etc. Conclusions: This paper suggests hospital administrators to take measures to improve prescription flows, such as reforming the health care insurance to make payment system more suitable for pharmacies standardizing supply channels in order to make varieties consistent between hospitals and pharmacies, strengthening education and publicity to raise the outpatients’ awareness for drug purchase outside of hospitals, etc.

Objective To evaluate the effect of surgical treatment for primary hepatocellular carcinoma(HCC) with bile duct thrombi(BDT).Methods Eleven cases were diagnosed as HCC with BDT by B ultrasound,CT,MRCP or ERCP.Hepatectomy and choledochotomy were performed,resecting the primary tumor and cleaning the BDT completely,followed with TACE.Results No patients died during operation.The survival time of 9 patients who received hepatectomy and BDT clearance ranged from 3 to 38(average 18.5) months,and that of the other two patients received TACE and BDT clearance survived 6 and 11 months respectively.Conclusion Accurate diagnosis and radical hepatectomy with complete BDT clearance are effective treatment for HCC with BDT.

Background and purpose: Cervical cancer is one of the most common malignant tumors and poses a great threat to women's fitness. Monitoring its present status and variations over the past 3 decades could provide scientific basis for prevention and control strategies of cervical cancer in China. Methods: This study collected the mortality rates of cervical cancer data in Chinese women from 1987 to 2014, described the features and trends of age-standardized rates and truncated rates, and estimated the variations via joinpoint regression models. Results:The mortality rates of cervical cancer for rural women were roughly higher than those for urban women. It showed downward trends for both urban and rural women, and the average rate of decrease for rural women (AAPC=3.94％, P<0.01) was higher than that for urban women (AAPC=1.79％, P<0.01). The gap between urban and rural areas was narrowing, with urban rates exceeding rural rates after 2010. The mortality rates of cervical cancer increased with time for urban women aged from 30 to 54, decreased with time for the elderly urban women and all the rural women. Conclusion: The overall mortality rates of cervical cancer took a desirable turn in China over the past 3 decades, while the status for the middle-aged urban women was getting worse as well as the elderly in both urban and rural areas during the past 10 years.

Objective To investigate the effects of keratinocyte growth factor on peritoneal adhesion formation in rats. Methods Thirty Sprague-Dawley( SD) female rats were randomly assigned to 3 groups, KGF group( n = 10), positive control group (n = 10) , and negative control group (n = 10). Seven days after surgery, rats were killed and the adhesion degree was evaluated by Leach scale. Immunohistochemical technique was used to identify the expression of tPA and PAI-1. Stained with HE,the histomorphology changes of the adhesion tissue were observed by light microscope. Picrosirius-polarization method was used to observe the expression of type Ⅰ or Ⅲ collagens in two groups. Results In the KGF group,lower collagen fibers were noted and the gross adhesion scores was significantly lower than that in positive control group (4. 8 ± 1. 0 vs 7. 6 ± 1. 0; t = 5.422; P ＜ 0. 01). The expression level of type Ⅰ collagens was significantly lower in the KGF group than in positive control group (69 ±11 versus 55 ±9;t = 3. 214 ;P ＜0. 01) ,but there was no significant difference in the expression of type Ⅲ collagens among the two groups (48 ± 7 versus 50 ± 10; t = 0. 481; P ＞ 0. 05). The immunohistochemistry showed that the expression of tPA significantly increased in the KGF group than in positive control group and negative control group(88 ±4.0 versus 112 ±4.0, 101 ±2.0;F = 109. l,P＜0. 01) , However, no statistically significant difference for the expression of PAI-1 was noted among the three groups ( F = 1. 391, P ＞ 0. 05). Conclusions Keratinocyte growth factor promotes mesothelium repair, increases mesothelial fibrinolytic activity, inhibits the deposition of collagen and reduces the intensity of postoperative adhesions.

Objective To investigate the effects of ulinastatin (UTI) combined with magnesium isoglycyrrhizinate (MgIG) on the expression of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) in lung tis?sue of rats with pulmonary fibrosis induced by bleomycin (BLM). Methods Ninety Wistar rats were randomly divided into five groups: BLM group, methylprednisolone (MTH) group, UTI group, MgIG group and UTI combined with MgIG (UTI+MgIG) group, n=18 for each group. The rat model of pulmonary fibrosis was established by injecting bleomycin through tra?chea in five groups. Twenty-four hours after treatment with BLM,rats were treated with normal saline every day in BLM group, and rats were treated by corresponding drugs in other groups. Six rats of each group were killed at the 7th,14th and 28th day respectively. The pathological changes of alveolitis and pulmonary fibrosis were evaluated by HE staining, and ex?pression levels of TGF-β1 and CTGF in lung tissues were detected by immunohistochemistry method. Results (1) Com?pared with BLM group, the degree of alveolitis and pulmonary fibrosis was reduced in other groups. There was significant dif?ference in alveolitis at the 7th and 14th day between UTI+MgIG group and BLM group. And there was significant difference in pulmonary fibrosis at the 14th and 28th day between UTI+MgIG group and BLM group (P<0.05). (2) Compared with BLM group, the expression levels of TGF-β1 and CTGF were decreased in other groups. In UTI+MgIG group, the expres?sion levels of TGF-β1 were significantly lower at the 7th and 14th day compared with those in UTI group and MgIG group, and which were significantly lower at the 28th day than those in MTH group, UTI group and MgIG group (P<0.05). The ex?pression levels of CTGF were significantly lower at the 7th day in UTI + MgIG group than those in UTI group and MgIG group, and which were significantly lower at the 14th and 28th day than those in MTH group, UTI group and MgIG group (P<0.05). Conclusion The combination of UTI and MgIG can alleviate alveolitis and fibrosis in BLM-induced pulmonary fibrosis rats, which might related with the down-regulation of TGF-β1 and CTGF expressions.

AIM To study the therapeutic effects of Neiyi Kangfu Tablets (Trionycis Carapax,Ostreae concha,Rhei Radix et Rhizoma,etc.) on adenomyosis and its possible mechanism of action.METHODS The mouse model for adenomyosis was set up by the pituitary allograft,and received the gavage of Neiyi Kangfu Tablets,Dan'e Fukang Decoction (Salviae miltiorrhizae Radix et Rhizoma,Curcumae Rhizoma,Paeoniae Radix rubra,etc.) and gestrinone,respectively,for three months.Western blot,real-time PCR,IHC were used to measure the expression of GPER-Ras-STAT3 in ectopic endometrium and entopic endometrium.RESULTS High doses of Neiyi Kangfu Tablets could significantly lower GPER protein and gene expression;down-regulate the Ras and STAT3 protein expression;reduce the lesion severity score of ectopic tissue morphology.Its curative effect was better than Dan'e Fukang Decoction and gestrinone.CONCLUSION Neiyi Kangfu Tablets may control the development of ectopic lesions by inhibiting the GPER-Ras-STAT3 pathway activity and weakening the production of estrogen.

Objective To construct the recombinant plasmid containing human filaggrin gene,purify and identify the immunoreactivity of the recombinant protein,and establish the indirect ELISA to detect AFA for diagnosis of RA.Methods The constructed plasmids were transformed into E. Coli Rosettagami(DE3).This fusion protein was purified by NAT chromatography.ELISA coated with the fusion protein Was established to detect the AFA in serum of patients,which included 114 cases of RA,56 cases of SLE,32 cases of OA and 40 cases of normal controls. The correlation between the results of AFA and anti-CCP in RA group were compared. Results 321 bp fragment of filaggrin gene was amplified and the recombinant expression vector pET-28a( + )-filaggrin was constructed. The sequence of filaggrin gene was the same as the sequence reported in the literatures. The Rosetta-gami (DE3) strains of E. Coli with recombinant vector showed high level of filaggrin protein after induction. The SDS-PAGE showed that the plasmid expressed the filaggrin fusion protein with molecule weight of 14 000 Da. The expression protein could be purified by Ni-NAT with activity. The absorbance value of AFA in RA group was 0.473 ±0. 248 while they were 0. 160 0. 088, 0. 121±0. 070, 0.050 0. ±018 in SLE, OA and normal groups respectively. There were significant differences of absorbance values of AFA between RA and SLE, OA, control group (t = 12.004, 14. 464, 18.078, P<0. 01, respectively). The positivities of anti-filaggrin in RA, SLE and OA were 48.2%, 5.4% and 3. 1% respectively. The positivities of AFA were significantly different between RA, OA and normal control groups (x~2 = 67. 088, P < 0. 01). There was positive correlation of results between AFA and anti-CCP antibody (r = 0.42, P < 0. 05 ) . The consistency rate of results between AFA and anti-CCP was 70. 1%. Anti-CCP was negative in 10 out of 114 patients with AFA positive. AFA can be used to diagnose RA with sensitivity of 48. 2% , specificity of 96.9% , positive predictive value of 93. 2% and negative predictive values of 67. 9% . Conclusions The purified human filaggrin fusion protein is successfully purified. The indirect ELISA method based on the recombinant protein shows good sensitivity and specificity. Joint detection with AFA and anti-CCP can improve the positive rate of detection.

Objective To explore the mechanism of rapamycin-eluted stent in vascular endothelial injury. Meth?ods (1)Rapamycin (rapamycin group) was injected to rabbit dorsum muscle to simulate rapamycin-eluted stent implanta?tion into muscles. Control group and acetone control group were established at the same time. Morphological change in mus?cle was observed and serum calcium levels were measured after rapamycin injection.(2)HUVECs were incubated with 0.1, 1, 10 and 100μg/L rapamycin for 48 h respectively or with 1μg/L rapamycin for 6, 12, 24 and 48 h respectively.Cell via?bility was examined by MTT and its relationship with drug concentration and treatment time were analyzed.(3)HUVECs were divided into control group and 1μg/L rapamycin group. After 48 h,morphological changes of HUVECs were assessed by HE staining,the production of nitric oxide was examined by Nitric Oxide Assay Kit and the intracellular calcium ion con?centration was tagged with Fluo-3/AM. Results (1) Organizational morphology in local muscle with rapamycin injection represent stent implantation of rabbit,and calcium content in local muscle increased significantly in rapamycin group com?pared with nomal control group and acetone control group(P<0.05). (2) Cell survival rate decreased significantly upon ad?ministration of rapamycin in both concentration and time dependent manner(P<0.01). (3) In rapamycin group, cytoplasm vacuoles, nucleus pycnosis and nuclear fragmentation were observed;compared with control group,the levels of intracellular free Ca2+increased while the levels of nitric oxide was reduced. Conclusion Rapamycin treatment lead of injury to vascular endothelial cells which might through up-regulating intracellular Ca2+level.