Objective To construct a scientific,valid evaluation system for excellent clinical nurses.Methods Based on the framework of competency theory,systematic literature reviewing,nursing experts discussion and the Delphi method were used to determine the primary indexes for the evaluation system.The evaluation system was determined from three perspectives,doctors',nurses' and patients'.Analytic Hierarchy Process (AHP) was then used to determine the weight of each index.Results The weight of doctors',nurses' and patients' perspective was 0.2,0.4,0.4 respectively.Doctors' and nurses' perspective(hereinafter referred to as staff's perspective) had the same evaluating indexes,which both consisted of 5first-dimensions,22 second-dimensions.The patients' perspective contained 3 first-dimensions,14 seconddimensions.In two-round Delphi technique,the rates of questionnaire retrieve were 91.2％ (31/34),100.0％(31/31),respectively;the colleagues' coordination coefficients were 0.784,0.858,respectively,and the patients' coordination coefficients were 0.05,0.216,respectively.Conclusions A evaluation system of high reliability and validity for excellent clinical nurseshas been successfully constructed.It may be utilized as a tool to for nursing administrator selection,training,assessment of excellent clinical nurses.

Objective To explore the diagnostic and prognostic significances of platelet parameters changes in Kawasaki disease(KD).Methods The platelet total(PLT),mean platelet volume(MPV),platelet distribution width(PDW)and plateletcrit(PCT)were measured in 23 cases of KD on acute febrile phase and early recovery phase.It was compared with 33 cases suffered from other febrile diseases during the same period and in similar ages.Each KD child should accept the cardiology ultrasonic examination.Results The level of PLT,PCT increased in KD patients.It was more significant in early recover period than in acute febrile period(P0.05).PLT negatively correlated with MPV,PDW(r=0.358,0.268 Pa0.05).Conclusions The changes of platelet parameter play a very important role in diagnosis of KD.But it still can not be certain that whether the changes can help us estimate the variety of the patients condition and prognosis of KD children.It requires further study.

Brain ; pathology ; Humans ; Infant, Newborn ; Lung ; pathology ; Male ; Seizures ; etiology ; pathology ; Tomography, X-Ray Computed ; Tuberous Sclerosis ; complications ; pathology

Objective To establish a new determination method for the measuring of alkaline phosphatase activity (ALP) with p-acetyl phenyl phosphace (PAP-PNa_2) as substrate.Methods With the help of Vital semiautomatic analyzer,researched a continuous-monitoring procedure and set up experimental parameters.Results When using this assay,the wavelength of PAP's absorption was 325 nm and the Km of ALP was 0.376 mmol/L.The molecular extinction coefficient of PAP at 340 nm was 23 390 L?mol~(-1)? cm~(-1) and the concentration of citrate buffer was 0.438 mol/L.During the process,we found that the optimum pH of enzyme was 10.4,and the concentration of substrate was 5.0 mmol/L.The time of linear reaction was 900 seconds,and the linear range was 0-1 110 U/L.Serum total ALP were 63.1-118.3 U/ L(male) and 52.5-89.0 U/L(female),based on results from 60 heath adults.Conclusions The method is practical in its repetition and convenience,saves time and is not liable to be affected by bilirubin in serum.It is especially suited to the use of automatic analyzers.

Using the Gram-positive Staphylococcus aureus as the indictor bacterium,fourteen antibacterial strains were initially obtained by the bilayer-media screening method from the raw milk samples,and one isolate was found to exhibit the higher antibacterial activity against the indicator. This isolate was further studied on its individual and cultural morphology features,partial physiological and biochemical reaction activities,G+C content,the sequence features of the 16S rDNA and the species-specific N-acetylmuraminidase gene(acmA) ,consequently,it was identified as the Lactococcus lactis subsp. lactis strain,named as MB191. An evaluation of the antimicrobial spectra of MB191 was subsequently performed,it showed the remarkable activities against not only the tested Gram-positive bacteria,but also several Gram-negative bacteria including Pseudomonas syringae and P. fluorescens,as well as the yeast Debaryomyces hansenii,which was a distinctive feature that was not reported prior to this study.

To lead students to think actively and develop their innovative abilities,we adopted approaches of self-study,question and answer teaching as well as presentation and discussion teaching,perfected teaching contents and system of basic experiments, formed comprehensive experiments and exploratory experiments,established excellent courseware and carried out network education constructed scientific and reasonable exam systems.These reforms are strong guarantees for cultivating high quality talents in the 21st century.

ObjectiveTo find out if the immune system derived thyroid stimulating hormone(TSH) β splice variant(TSHβ-Ⅴ) would be regulated by circulating thyroid hormone levels to get a further understanding of the function and mechanism of this TSHβ-Ⅴ in thyroid homeostasis.MethodsA total of 20 weaning Balb/c mice (half male and half female) were selected and randomly divided into two groups according to their body mass and gender(n =10).Mice of control group were fed with common diet and deionized water.Mice of the low-iodine(LI) group were fed with low-iodine diet(containing iodine 20 - 40 μg/kg,iodine-intake about 0.25 μg/d) and deionized water.The experimental period was 3 months.At the end of the experiment,mice were executed and the blood was collected to observe the levels of TSH and thyroid hormone by chemiluminescence immunoassay (CIA) ; bone marrow (BM),peripheral blood(PBL),thyroid gland and pituitary were collected to assay the TSHβ-Ⅴ mRNA expression by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR).ResultsThe serum free thyroxine(FT4) and total thyroxine(TT4) levels in LI group of mice[(0.47 ± 0.70)nmol/L,(2.41 ± 0.28)pmol/L] were significantly lower than that of the control group of mice [(55.2 ± 3.68) nmol/L, (32.72 ± 1.02) pmol/L,t =43.81,86.04 、all P ＜ 0.01 ] and the serum total triiodothyronine(TT3) and free triiodothyronine(FT3) reduction in LI group of mice[ (0.76 ± 0.08)nmol/L,(4.01 ± 0.40)pmol/L] were significantly lower than that of the control group of mice [ (1.10 ± 0.06)nmol/L,(5.40 ± 0.38)pmol/L,t =9.81,7.5 1,P ＜ 0.01 ].Iodine insufficiency strongly elevated the serum TSH in LI group of mice[ (35.67 ± 17.39)mU/L] than that in control group of mice[ (0.24 ± 0.10)mU/L,t =- 6.11,P ＜ 0.01 ].The mRNA levels of TSH β-Ⅴ in BM (9.62 ± 0.60) and in PBL( 9.25 ± 0.83 ) of LI group of mice were lower than those in control group of mice (7.69 ± 0.36,7.11 ± 0.41,t =6.77,5.64,P ＜ 0.01),while the mRNA level of TSH β-Ⅴ in pituitary of LI group of mice (1.99 ± 0.61) was increased compared with that in control group of mice (5.75 ± 0.98,t =- 8.02,P＜ 0.01).Compared with control group of mice(9.12 ± 0.62),the level of thyroid TSH β-Ⅴ mRNA in LI group of mice (9.32 ± 0.91 ) was not significantly changed (t =0.45,P ＞ 0.05).There was no detectable native TSHβ in BM,PBL and thyroid.The mRNA level of native TSHβ in pituitary in LI group of mice( - 7.17 ± 1.78) was dramatically elevated compared to that in control group of mice( - 1.43 ± 0.51,t =- 7.60,P ＜ 0.01 ).ConclusionsThe mRNA levels of TSHβ-Ⅴ are suppressed in BM and PBL in low iodinediet induced hypothyroidism mice,which suggest that immune system derived TSHβ-Ⅴ may be more important thannative TSHβ in immune-thyroid regulation.

Objective To observe the clinical efficacy of Huoxue Rongluo Particles combined with acupuncture in the eight confluent points of spastic cerebral infarction paralysis and its effects on Glu and Asp levels of serum. Methods Totally 60 patients were divided into two groups: the experimental group and the control group. Both groups received basic Western medicine treatment, and the experimental group received Huoxue Rongluo Particles additionally, one dose a day for two times orally taken; Acupuncture was on eight confluent acupoint, every two days. 15 d is a treatment course, with 6 courses in total. Clinical spasticity index (CSI) and TCM symptom scores before treatment and the treatment of half month, 1 month, 3 months were observed. The levels of Glu and ASP in serum were detected, and TCM clinical efficacy was observed. Results The CSI score, levels of Glu and Asp in serum and TCM symptom scores of the patients after half-month, one-month, and three-month treatment were lower than those before treatment (P<0.05, P<0.01). There was no statistical significance in CSI score after half month treatment between the two groups (t=0.329, P=0.743). The CSI score in the experimental group after one-month and three-month treatment was lower than the control group (t=-2.636, P=0.024; t=-4.213, P=0.021). There was statistical significance in the levels of Glu and Asp between the two groups after half-month and one-month treatment (P<0.05, P<0.01). There was no statistical significance in the levels of Glu and Asp in the two groups after three-month treatment (P>0.05). The TCM symptom scores in experimental group was lower than the control group after half-month, one-month and three-month treatment (P<0.05). The total TCM effective rate was 86.67% (26/30) in experimental group, and 80.00% (24/30) in the control group, with the experimental group better than the control group (P<0.05). Conclusion Huoxue Rongluo Particles combined with acupuncture eight confluence acupoints in the treatment of spastic cerebral infarction paralyzed patients can relieve spasm degree, improve TCM clinical symptoms, which mechanism may be related to reducing serum excitatory neurotransmitters.

Objective: Based on nationwide cardiovascular surgery registry database, to analyze the current status and future development of minimally invasive cardiovascular surgery (MICS) in China.
Methods: There were 45 institutions from 19 provinces nationwide involved in Chinese cardiovascular surgery technique registry study. A total of 16480 adult patients with cardiovascular surgery from 2010-09 to 2012-03 were divided into 2 groups, Conventional surgery group, n=14503 and MICS group, n=1977. The basic clinical conditions were analyzed and compared between 2 groups in order to explore the current status and future development of MICS in China.
Results: Compared with Conventional surgery group, the patients in MICS group had the younger age, better and stable pre-operative condition. In MICS group, compared with 4 other common procedures, the patients who received hybrid procedure had obviously shorter cardiopulmonary bypass (CPB) time, aortic occlusion time, ventilator using time, ICU and in-hospital stay time, meanwhile decreased post-operative drainage volume;except for Robotic surgery, it required less red blood cells and plasma at during and post-operative time, all P<0.01. There were 12 (0.6%) in-hospital death in MICS group, the total complication rate was at 4%.
Conclusion: MICS are widely used in China, its short-term safety and efifcacy are conifrmed. Upon cardiovascular disease spectrum changing, the MICS procedures will be adjusted accordingly.

Linezolid is the first oxazolidinone antibacterial drug approved by the FDA, which can effectively treat various gram-positive bacterial infections, including blood infections, skin and soft tissue infections, community and hospital-acquired pneumonia. It has become one of the most commonly used antibiotics in clinical. In addition to the recently launched tedizolid phosphate (TR701) and contezolid (MRX-I), several oxazolidinone anti-infective candidates are currently under clinical research. This review briefly introduces the oxazolidinone antibiotics that have been marketed and are in clinical trials, and recent progress on the structure optimization of oxazolidinone drugs is also summarized.