Objective To explore the feasibility and effect of the multivariate integration teaching in clinical nursing teaching, improve the shortcomings of the traditional single teaching, and enhance the quality of clinical teaching and nursing students' satisfaction. Methods 117 clinical nursing students of the Department of Rheumatoid Immune Kidney of the Nanjing Hospital Affiliated to Nanjing Medical Uni-versity were chosen as the subjects and were divided into two groups, and 57 nursing students who practiced in the Department of Rheumatoid Immune Kidney from 2013 to 2014 were recruited to the experimental group to receive multivariate integration teaching method, with another 60 students who practiced in the Department of Rheumatoid Immune Kidney from 2012 to 2013 as control group to receive the traditional single model teaching method. Two groups of nursing students were given the unified theory test and clinical skills exam-ination as well as the evaluation of comprehensive quality and satisfaction survey. SPSS 20.0 software was used to give the general statistical description of the theoretical results, operating results, comprehensive quality, satisfaction and other measurement data. Examination results were expressed by x±s. t test, rank sum test was used for statistical analysis and the test level was α=0.05. Results Theoretical result of the experimental group was (96.283±2.330), operating result was (93.883±3.173), the compre-hensive quality evaluation result was (46.133±2.111), and satisfaction degree was (45.033 ± 5.966). Theo-retical result of the control group was (87.850 ± 4.953), operating result was (84.333±5.011), the com-prehensive quality evaluation result was (35.650 ±3.804), and satisfaction degree was (33.683 ±7.101). Conclusion Multi-variate integration teaching method is conducive to the cultivation of nursing students' clinical thinking and comprehensive quality, and can improve their ability to communicate with patients and enhance their self-confidence. Therefore it is an effective teaching method, worthy of popularization and application in all departments.

AIM: To optimize the extraction of Weining-Dispersible Tablet(Radix et Rhizoma notoginseng,Radix et Rhizoma ginseng) with the help of central composite design-response surface methodology. METHODS: The main influencing factors of extraction effect included the quantity of ethanol,the concentration of ethanol and extraction time and the extraction conditions were evaluated by the extract yield and the contents of total notoginseng saponins.The optimal extraction of Weining-Dispersible Tablet was selected by central composite design-response surface methodology. RESULTS: The optimal conditions consisted of extraction two times,2 h each time with ten fold of 70% ethanol. CONCLUSION: It is simple,convenient and high predictive to optimize the extraction craft of Weining-Dispersible Tablet by central composite design-response surface methodology.

Clinical data of 899 patients,who received colposcopic examination,were retrospectively analyzed.Both Reid's colposcopic index(RCI)score and biopsy were performed.The study showed that the value of RCI score was positively related to the severity of cervical lesions(F=2.043,P=0.03).The specificity of RCI for cervicitis,cervical intraepithelial neoplasia(CIN)Ⅰ were 98.8%,95.7% respectively;while sensitivity and negative predictive value for CIN Ⅱ,CIN Ⅲ were 77.7%,70.0%and 96.8%.97.4%,respectively.So RCI scoring can increase the diagnostic value of colposcope.

Objective To investigate the relationship among health literacy and treatment compliance and prognosis in patients with diabetes combined tuberculosis.Methods One hundred and eighty-one cases patients with diabetes combined tuberculosis were selected as the objectives and evaluated literacy level,compliance scale by the health literacy scale and compliance questionnaires.The control of tuberculosis,blood glucose control,treatment compliance and prognosis were analyzed in the patients with different health literacy level.Results Of 181 patients,there were 89 cases patients'(basic health literacy group) the total scores of health literacy and compliance were＞80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 84.2％ (75/89) and 93.2％ (83/89);92 cases patients' the total scores of health literacy and compliance were ≤ 80 points,the efficacy of pulmonary tuberculosis control and blood sugar control were respectively 59.7％ (55/92) and 67.4％ (62/92),the differences were significant (x2 =12.78,18.11;P ＜0.05).Pearson correlation analysis showed that the total scores of health literacy were positive correlated with the scores of treatment compliance (r =0.688,P ＜ 0.001).Logistic regression analysis showed that three dimension of health literacy (health knowledge and concept,healthy lifestyle and behavior,health skills) that can combined predict the variance of rehabilitation compliance(P＜0.01).Conclusion The health literacy level of diabetes combined tuberculosis patients can effectively predict the rehabilitation compliance.Measures should be taken to improve the patient's level of health literacy,so as improve the compliance of rehabilitation and prognosis.

ObjectiveTo analyze the serum creatinine level among apparently healthy primary and secondary school students in Inner Mongolia and explore the distribution of serum creatinine by ethnic,regional,gender and age,and establish the reference interval of serum creatinine in different gender and different age groups of primary and secondary school students.MethodsLargesample clinical epidemiological investigation was applied by two-stage clustering sampling method.Random sample of 2630 primary and secondary school students from 9 to 18-year-old was selected from four district in Inner Mongolia including Hohhot,Wulanchabu,Xilin Gol and Bayan Drow from July 2009 to June 2010.After screening outlier individual,the total of 2614 subjects were enrolled,involving 1288 male and 1326 female subjects,1584 Han and1030 Mongolian.The venous blood was collected and serum was separated.The serum creatinine concentration was measured as soon as possible.Furthermore, creatinine levels of different regions,ethnic,gender and age group were compared by analysis of variance or t-test and that of different group were compared by SNK method.Percentile was used to describe the distribution of serum Cr level of different age groups.The reference interval of serum Cr for primary and secondary school students were established by gender and age (P2.5 -P97.5 ).The curve was smoothed using age-specific percentile ( LMS )curve smoothing method.ResultsThe differences of Cr levels were statistically significant between different regions,ethnic,gender and age groups.The reference intervals of creatinine for 9 - 11,12,13 - 14,15,and 16 - 18 year-old males were 35 - 66,37 - 73,39 - 78,47 - 87 and 49 - 91 μmol/L,respectively.The intervals for 9 - 10,11 - 12,13 - 15,and 16 - 18 year-old females were 32 - 60,34 - 63,38 -73 and 40 -74 μmol/L,respectively.Conclusion The reference intervals of serum creatinine for health primary and secondary school students in the Inner Mongolia is established,which is useful for clinicians,especially pediatricians to judge and assess renal function for 9 to 18 year-old patients.( Chin J Lab Med,2012,35:805-809 )

Objective To provide referential information for intelligent construction in hospital pharmacy. Methods Combined with the practical application, this paper introduces the practice and experience of the intelligent construction of pharmacy in our hospital. Results The construction of intelligent hospital pharmacy improves the drug management level, improves work efficiency and increases the accuracy of the drug dispensing, increases medication guide time, improves patient compliance and satisfaction and reduces the work intensity of pharmacists. Conclusion The intelligent construction of hospital pharmacy has promoted the development of pharmacy and laid a good foundation for the comprehensive and in-depth development of pharmaceutical care.

Objective To validate the four chronic kidney disease epidemiology collaboration (CKD-EPI) predictive equations based on serum creatinine (SCr) and cystatin C (Cys C) in Chinese CKD patients,and try to develop the GFR predictive equations for Chinese CKD patients.Methods254 CKD patients were randomly selected from four Grade ⅢA hospitals in different regions in China from September 2007 to December 2010.Clearance of dual plasma sampling 99mTc-DTPA was used to measure glomerular filtration rate (rGFR) in 254 CKD patients.The serum concentration of Cr and Cys C were measured.CKD-EPI SCr equation,Cys C equation,Cys C equation adjusted for age,sex and race,SCr/Cys C combinated equation adjusted for age,sex and race were used to estimate GRF ( labeled as eGFR1,eGFR2,eGFR3 and eGFR4,respectively).The correlation,bias and precision of eGFRs were compared with rGFR by Wilcoxon signed rank test,intraclass correlation coefficient (ICC) and Spearman correlation analysis.The deviation degree between rGFR and different eGFRs was compared via Bland-Altman graph.The accuracy within 15％,25％,30％ ( P15,P25,P30) and the staging correctness of eGFR against CKD at different stages was calculated.ResultsThe rGFR in 254 CKD participants was [ 48.07 (26.19 -92.97 )] ml · min -1·(1.73 m2) -1.The Spearman correlatiou coefficients (CC) of eGFR and rGFR varied within the range of 0.873 - 0.896 ( P =0.000 ).The intra-class CC ( ICC ) varied within the range of 0.920 - 0.942.The correlation of eGFR4 was the best.The absolute deviations of 4 eGFRs and deviation precision were eGFR4 ＜eGFR3 ＜ eGFR2 ＜ eGFR1.The 95％ confidence intervals for the regression line of 4 eGFRs shown by Bland-Altman graphs were 92.5,87.3,83.0 and 76.1 ml · min-1 · ( 1.73 m2 ) -1,respectively,with the best result of eGFR4.For P30,the correctness of 4 eGFRs were eGFR4 ＞ eGFR3 ＞ eGFR2 ＞ eGFR1,but no significant difference was found by Chi square test (x2 =6.448,P =0.092).The overall correctness rate in 4 eGFRs against CKD stages were 48.4％ -57.5％,with the highest consistency of eGFR4,but their staging correctnessratewerenotideal(Kappa values were 0.405,0.348,0.366 and 0.463,respectively).Conclusions Compared with CKD-EPI SCr equation,no advantage was found in CKD-EPI Cys C equation.The Cys C equation adjusted by age and sex shows a little advantages over CKD-EPI Cys C equation in bias,precision,correlation and accuracy.The CKD-EPI SCr/Cys C combinated equation adjusted by age,sex and race has advantage over other three equations not only in bias,precision,correlation and accuracy,but also in staging correctness.However,the validation of this equation is still not fairly ideal for Chinese CKD patients.Based on these findings,it is essential for the Chinese CKD patients to develop SCr/Cys C combined predictive equation which adjusted by age,sex or other factors.(Chin J Lab Med,2012,35:798-804)

Objective To calculate Z-score for mitral and tricuspid color blood flow widths in normal fetuses and fetuses with dilated coronary sinuses ( CS ) using fetal echocardiography ,and explore the application value of Z-score of the color flow widths of atrioventricular valves in normal fetuses and fetuses with dilated CS . Methods Two hundred and thirty-eight normal fetuses (control group) with a gestational age of 16 to 38 weeks were studied by color Doppler echocardiography . Gestational age ( GA ) ,biparietal diameter (BPD) ,femoral length (FL) ,aortic inner diameter (AOd) ,pulmonary artery diameter (PAd) ,and heart area ( HA) were measured as independent variables ,and mitral and tricuspid valve color flow widths were measured as the dependent variables . Z-score models were established by regression analysis . Thirty fetuses with dilated CS (dilated CS group) from 22 to 33 weeks'gestation were involved . The Z-score of the CS fetus was calculated based on the established Z-score models and were compared with those of the normal fetuses . Results The independent sample t-test showed that there were no significant differences in the Z-scores of the blood flow width of the fetal mitral and tricuspid valves between dilated CS group and control group ( P >0 .05) . Conclusions The simple dilated CS does not affect the mitral valve diastolic blood flow ,so there is no significant effect on the filling of left ventricular blood flow .

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

Lupus nephritis (LN), a severe manifestation of systemic lupus erythematosus, poses a substantial risk of progression to end-stage renal disease, with increased mortality. Conventional therapy for LN relies on broad-spectrum immunosuppressants such as glucocorticoids, mycophenolate mofetil, and calcineurin inhibitors. Although therapeutic regimens have evolved over the years, they have inherent limitations, including non-specific targeting, substantial adverse effects, high relapse rates, and prolonged maintenance and remission courses. These drawbacks underscore the need for targeted therapeutic strategies for LN. Recent advancements in our understanding of LN pathogenesis have led to the identification of novel therapeutic targets and the emergence of biological agents and small-molecule inhibitors with improved specificity and reduced toxicity. This review provides an overview of the current evidence on targeted therapies for LN, elucidates the biological mechanisms of responses and failure, highlights the challenges ahead, and outlines strategies for subsequent clinical trials and integrated immunomodulatory approaches.
Humans ; Calcineurin Inhibitors/therapeutic use* ; Immunosuppressive Agents/therapeutic use* ; Lupus Erythematosus, Systemic/drug therapy* ; Lupus Nephritis/pathology* ; Mycophenolic Acid/therapeutic use*