Our hospital adopted a series of measures in its nursing reform so as to meet the needs of its pa- tients and improve its nursing quality. The steps include: appointing head nurses via competition; rewarding the best performing nurse and firing the worst one; adopting a ranking list with regard to nursing quality; implementing the mode of holistic nursing; carrying out flexible shifts and shift according to the needs of both patients and the hospital; changing the flow of nursing work; and improving the model of nursing management. Nursing reform in our hospital inspired the enthusiasm of the nursing personnel, enhanced the efficacy of nursing management and ensured nursing quality. [

Objective To investigate and analyze the economic burden and family burden among patients with depression.Methods 180 patients who diagnosed with depression according to Diagnostic and Statistical Manual of Mental Disorders-version Ⅳ (DSM-Ⅳ) had been enrolled randomly.The self-made economic costs questionnaire and the Family Burden Scale of Diseases (FBS) were utilized for investigation.168 participants finished this study.Results The per capita total economic cost of patients was 21 650 Yuan,direct economic costs was 6 806 Yuan,indirect costs was 14 844 yuan.The total economic costs,direct economic costs and direct medical costs of hospitalized patients were significantly higher than outpatients.The total economic cost per capita,indirect economic costs,costs decreased by work delays and work ability impairment of urban patients were significantly higher than rural patients.Four factors of FBS such as subjective feeling,family life,home entertainment and mental health had higher positive answer rate,which was above 60％.The positive answer rate of family relationship and physical health was lower than 40％.Conclusions Patients with depression suffered high economic burden and family burden.

Objective: To study the effect of seed oil of Hippophae rhamnoides L.(SOHR) on experimental hepatocirrhosis in mice. Methods: CCl_(4) was used in the experiment to form the model of experimental hepatocirrhosis in mice.In order to measure the possible changes of GPT and SOD in serum and SOD and MDA in tissues,we fed these mice with different concentration of SOHR for 45 days.The Does-Effect Curve was set up based on the data of this experiment. Results: SOHR could control the increase of GPT in serum and the decrease of SOD evidently,as well as the increase of MDA in tissues.The relationship of that the Hippophae rhamnoides dose with the decrease of GPT is significant. Conclusion: SOHR protects the experimental hepatacirrhosis in mice.

Objective To study the views of clinical nursing staff about current nursing quality evaluation so as to find the problems in nursing quality evaluation.Method 25 head nurses and nurses were interviewed using semi-structured open interview about nursing quality evaluation.Result The current nursing quality evaluation system was lower in sensitivity,focusing more on nursing skills but less on nursing evaluation of nursing specialties.Conclusions The system of current nursing quality evaluation lacks of nursing evaluation of nursing specialties and therefore cannot meet the requirements for the development of nursing specialty. Therefore,it is urgent to regulate an evaluation system for nursing specialties.

Objective To research on the proliferation and differentiation in vitro of primordial germ cells. Methods We got plenty of primordial germ cells(PGCs) by co-culture of PGCs with sertoli cells(SCs).The primary cells formed embryoid bodies(EBs) by suspension culture.furthermore,these EBs were plated on gelatin-coated culture plates for spontaneous differentiation. Results We got plenty of PGCs by coculture.Primary PGCs and passaged PGCs for histochemistry staining with AKP and immunohistochemistry staining for SSEA-1 display positive character.The EBs by suspension culture differentiated into epithelial-like,fibroblast-like and neuronal-like cells in vitro. Conclusion Primordial germ cells can proliferate and keep the character of stem cells by co-culture with SCs.PGCs can form EBs by suspension culture,most of these EBs can differentiate into neuronal-like cells,they also can differentiate into epithelial-like and fibroblast-like cells in vitro.

The paper analyzes the challenge of big data environment to the traditional medical information services,presents the practical significance and basis of constructing the medical information service platform,introduces the construction objectives,architecture,function feature of the platform,describes the medical information service mode based on the digital platform,including medical information resource services,intelligence study services and health decision-making support services,etc.

Objective To investigate the pulmonary morphologic changes and pulmonary surfactant protein A (SP-A) mRNA expression in fetal rats with maternal intrahepatic cholestasis of pregnancy (ICP).Methods Animal models of intrahepatic cholestasis of pregnancy were induced by 17-α-ethinylestradiol and progesterone.Histopathologic examination of the fetal lungs was performed under light and electronic microscopes.The expression of SP-A mRNA in the fetal lungs was measured by reverse transcription-polymerase chain reaction technique.Results (1) Compared with the control group,histopathologic examination showed that fetal pulmonary tissues had dilated and congested interstitial lung capillaries,thickened alveolar septum,mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore,reduced microvilli,mitochondrion vacuolization,cytoplasm disintegration and increased lamellar body evacuation were observed in alveolar epithelial cell II in ICP group under light and electronic microscopes.(2) Expression of SP-A mRNA in fetal lungs of ICP group (0.71 + 0.10) was significantly lower than that in control group (1.00±0.27),t=3.093,P＜0.05.Conclusions Hyperbileacidemia in ICP maternal rat might lead to pathological changes in fetal pulmonary tissues.Low expression of SP-A mRNA might contribute to lesions of fetal lung with ICP.

The prevalence of prediabetes is increasing rapidly in China, and with higher prevalence in coronary heart disease and hypertension patients. Diabetes can be controlled and prevented, previous studies have confirmed that lifestyle interventions and drug interventions can delay the progression of prediabetes to diabetes, and acarbose can be used for the primary prevention of cardiovascular events in impaired glucose tolerance(IGT) and diabetic patients, but benefits of drug intervention for secondary prevention of cardiovascular disease in IGT population are uncertain. The Acarbose Cardiovascular Evaluation(ACE) Study is a multicentre, randomized, placebo-controlled, double-blind study, with the aim of assessing the use of acarbose to reduce the risk of cardiovascular events and the onset of diabetes in IGT patients with cardiovascular disease in China , the results will be very meaningful and valuable for the prevention and treatment of diabetes. We will predict the results of ACE Study based on previous evidences.

Objective The objective of this study was to determine the effect of curative chemotherapy regimen on breast cancer cells and its mechanism.Methods A tumor-bearing mouse model was established and routine dose of capecitabine was given as a conventional chemotherapy group.Continuous low-dose capecitabine chemotherapy was used as a radiotherapy group and no chemotherapy was used as a control group.The expression of microvessel density(MVD),vascular endothelial growth factor(VEGF)and thrombospondin 1(TSP-1)were measured by flow cytometry.The percentage of myeloid-derived suppressor cells(MDSCs),NK cells and macrophages in the program was observed.The tumor size and blood leukocyte count were measured after chemotherapy.Results MVD and VEGF in the radiotherapy group were significantly decreased and TSP-1 was significantly increased in comparison with the conventional chemotherapy group(P<0.05).The proportion of MDSCs in the radiotherapy group was significantly decreased,the proportion of NK cells and macrophages were significantly increased when compared to the conventional chemotherapy group(P<0.05).The tumor volume was no difference between the control and chemotherapy groups(P>0.05).However,the white blood cell count in the radiotherapy group was significantly higher than that in the conventional chemotherapy group(P<0.05).Conclusion Capecitabine chemotherapy at continuous low-dose inhibits neovascularization and adjusts the proportion of immune cells to suppress tumor formation.Thus,this chemotherapy could reduce side effects caused by chemotherapy and improve the quality of life.

Objective To investigate the influence of intrahepatic cholestasis of pregnancy (ICP) on the pulmonary morphologic changes of fetal rats.Methods Twenty pregnant SD rats at 15 days of gestations were randomly divided into ICP and control group.Rats in the ICP group were subcutaneously injected with 17-α-ethinylestradiol and progesterone for 5 consecutive days to establish the rat ICP model, and those of the control group received subcutaneous injection of sirasimeyu also for 5 days.The levels of serum alanine aminotransferases (ALT), aspartate transamlnase (AST), and total bile salt (TBA) were measured before and after the treatment, respectively.Maternal rats were sacrificed on 21 days of gestations and hysterotomies were performed immediately.Histopathologic changes of mammal rats' livers and fetal lungs were observed under light and electron microscopes.Results (1) The maternal serum levels of ALT, AST, and TBA showed no significant difference between the ICP and control group [ALT: (55 ± 15) vs (49 ±12) U/L; AST:(146±16)vs (145±20) U/L; TBA: (13±4) vs (14 ±4) μmol/L, P>0.05, respectively]before the ICP models were established, but higher levels were shown in the ICP group after [ALT: (94±12) vs (59±17) U/L; AST: (245±26) vs (163±27) U/L; TBA: (44±16) vs (17± 3) μmol/L, P <0.05, respectively].(2) The livers of maternal rats' in the ICP group were gloomy with blurred margins, however those of the control group were normal.Microscopic observed swollen and degenerated hepatocytes with narrowed hepatic sinusoid, dilated bile duct and necrosis of hepatocytes occasionally in the ICP group, while the morphology of hepatocytes and structures of lobuli hepatis in the control group were normal.(3) The fetal pulmonary tissues in the ICP group were dark, and normal in the control group.Histopathologic examination showed matured fetal pulmonary tissues with dilated and congested interstitial lung capillaries, thickened alveolar septum, mild focal inflammatory exudation and focal hemorrhage in alveolus.Furthermore, reduced microvilli, mitochondrion vacuolization, cytoplasm disintegration and increased lamellar body evacuation were observed in type Ⅱ pneumonocytes in ICP group under light and electron microscopes.While fetal pulmonary tissues of the control group did not show any significant lesions.Conclusions Rat model of ICP can be established with the combination of estrogen and progestin.Hyperbileacidemia in ICP rat may lead to pathological changes in fetal pulmonary tissues.