Objective To establish a set of teaching evaluation index system for clinical practice which can embody education cocept of modern nursing,accord with reform direction of nursing education, and is scientific,reasonable and easy to operate. Methods Teaching evaluation index system for clinical practice was preliminarily established using literature data, theoretical analysis, expert evaluation,collective argument by evaluator and who were evaluated. Results 32 first-order indices,169 second-order indices and value assignment of weight were confirmed after establishment of teaching evaluation index system, which was satisfying to the evaluator, who were evaluated and nursing students. Conclusions The evalu-ation index satisfy the requirement of teaching quality evaluation for practice,the degree of approval, coordi-nation and reliability is relatively high, so it can be used for teaching quality evaluation for nursing practice.

Objective To investigate the clinical efficacy of electrothermal acupuncture in treating ankylosing spondylitis.Method Sixty patients were randomly allocated to treatment and controlgroups, 30 cases each.The treatment group received electrothermal acupuncture and the control group took methotrexate plus sulfasalazine.The extent of chestexpansion, the severity of sacroiliac joint tenderness, the number of tender joints and morning stiffness time were examined,Schober's testscores at different time points were recorded and interleukin-1 (IL-1) and interleukin-6 (IL-6) contents were measured before and after 4 and 8 weeks of treatment.Result In the treatment group, there were statistically significant differences in the extent of chestexpansion, the severity of sacroiliacjoint tenderness, the number of tender joints, morning stiffness time andSchober's testscores after 4 and 8 weeks of treatment compared with before treatment (P<0.05).There were statistically significant pre-/post-treatment differences in IL-1 and IL-6 contents in the two groups (P<0.05). The total efficacy rate was 80.0% in the treatment group and 73.3% in the control group; there was no statistically significant difference between the twogroups(P>0.05). ConclusionElectrothermal acupuncture has a marked therapeutic effect onankylosing spondylitisand is of high safety.The mechanism of electrothermal acupuncture treatment forankylosing spondylitismay be related to its regulating IL-1 and IL-6 levels in the body.

Objective: To investigate target organ response by recording mean arterial blood pressure (MAP) fluctuation corresponding to nerve-tract discharges from the nerve innervating acupoint of Zusanli (ST 36) in the hind limb evoked by MA in anesthetized rats. Methods: Male SD rats anesthetized with chloral hydrate were randomly divided into 3 groups which were treated with manual acupuncture (MA), injection of lidocaine followed by MA and injection of normal saline (NS) followed by MA, respectively. The right carotid artery was canulated for persistent measurement of the blood pressure and meanwhile nerve discharges from the nerve-tract were recorded for analysis with amplitude spike counts for every 5 s. Results: The results showed that there were significant nerve discharges recorded from the nerve-tract when applying MA at Zusanli (ST 36) and simultaneous decrease in the MAP, while there was no response when inserting a needle into the Zusanli (ST 36) without manipulation (P<0.05). Furthermore, the reduction of MAP during MA could be completely abolished after blockade of peripheral nerve discharges with an injection of lidocaine into the tissue around Zusanli (ST 36) but not with that of normal saline (NS). Conclusion: These results indicate that MA at Zusanli (ST 36) can elicit the peripheral nerve discharges from the nerve innervating the acupoint; such kind of nerve discharges may contain acupuncture signal regulating blood pressure via somato-cardiovascular reflex.

Objective: To establish the quality criteria for xiaozhining tablet. Methods: TLC method was applicated to determine and differentiate the Scutellaria , the Radix salviae miltiorrhizae, the Rheum, the Leonurus of the tablet. HPLC method was used for detecting the content of emodin in xiaozhining Tablet. Results: Four main components of the tablet was determined well. The regression equation by HPLC was A=2.43?10 7C+6.06?10 4(r=0.999 7). Curcumin had good linear relation within the range of 0.5～0.05 mg/ml. The average recovery rate was 96.70%(RSD=1.06%). The average value of emodin was 0.021 4 mg. Conclusion: The method of determination is reliable. It can be used as the basis for the quality control of xiaozhining Tablet.

OBJECTIVE:To observe the effectiveness and safety of liraglutide combined with insulin and glipizide in the treat-ment of subclinical hypothyroidism(SCH)complicated with type 2 diabetes in the elderly patients. METHODS:Totally 82 elderly patients with SCH complicated with type 2 diabetes were selected from our hospital during Dec. 2013-Dec. 2015,and then divided into trial group(40 cases)and control group(42 cases)according to random number table. Control group was given Insulin in-jection+Glipizide tablets. Trial group was additionally given Liraglutide injection 0.6 mg,sc,qd,on the basis of control group. Treatment courses of 2 groups lasted for 12 weeks. The levels of blood glucose [fasting glucose,postprandial 1 h and 2 h glucose,mean of daily differences(MODD),mean amplitude of glycemic excursions(MAGE)],glycosylated hemoglo-bin,body weight,total cholesterol,blood pressure [systolic blood pressure(SBP),diastolic blood pressure(DBP)],thyroid stimulating hormone(TSH)and homeostasis model assessment(HOMA-B)were observed in 2 groups before and after treat-ment. The occurrence of ADR was recorded. RESULTS:Totally 4 patients of control group withdrew from the study,and no one withdrew from the study in trial group. Before treatment,there was no statistical significance in the levels of blood glu-cose,glycosylated hemoglobin,body weight,total cholesterol,blood pressure,TSH and HOMA-B (P>0.05). After treat-ment,body weight and total cholesterol level of trial groups were significantly decreased and lower than those of control group,with statistical significance (P<0.05). The levels of blood glucose,glycosylated hemoglobin,blood pressure (SBP, DBP)and TSH in 2 groups were decreased significantly,while HOMA-B levels were increased significantly,and trial group was significantly better than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between trial group (12.5%) and control group (19.0%)(P>0.05). CONCLUSIONS:Liraglutide com-bined with insulin and glipizide for elderly patients with SCH complicated with type 2 diabetes can effectively reduce blood glucose level,keep blood glucose stable,control the increase of body weight and improve islet B cell function with good safety.

Introduction of problem-based learning (PBL) teaching is the demand of teaching reform.Teaching and research section of physiology in Chongqing medical university implemented PBL teaching throughout the whole process of clinical medicine undergraduate education.The overall quality of students and the teaching quality were improved by constructing a new mode suitable for physiology teaching,focusing on training students' active learning ability and stimulating students' enthusiasm for learning.

Objective: To clarify effect of electroacupuncture (EA) on relieving chronic visceral pain and the underlying neurobiological mechanism for such an effect, we observed the effect of EA on the Irritable bowel syndrome (IBS) rat and then examined spinal expression of N-methyl-D-aspartate (NMDA) receptor-1 in rats. Methods: Daily mechanical colon distention was performed on male Sprague-Dawley neonatal rats to produce IBS model. EA was applied at acupoints of Zusanli (ST 36) and Shangjuxu (ST 37) in each hind leg. Abdominal withdrawal reflex (AWR) assessment or rectus abdominis electromyograms (AEMG) recordings were then performed after EA treatment. The mRNA expression of the NMDA subtype of glutamate receptors in the spinal dorsal horn (L4-5) before and after EA was investigated by RT-PCR analysis in IBS rats. Results: The results demonstrated that EA could significantly decreased both AWR scores from behavioral test and AEMG discharges from electrophysiological recording in IBS model rats elicited by colorectal distension (CRD) stimuli with strengths of 20, 40, 60 and 80 mmHg, respectively (P<0.05). Meanwhile there was a significant decrease in mRNA expression of NMDA receptor-1 in the spinal dorsal horn of IBS rats treated by EA (P<0.05), but no such effect was observed in IBS rats treated by sham EA (inserting needles without electrical stimulation). Conclusion: These results indicate that EA can relieve chronic visceral hyperalgesia in IBS rats and this effect might be correlated with the down-regulation of NMDA receptor- 1 in the dorsal horn of the spinal cord.

Objective:To clarify effect of electroacupuncture (EA) on relieving chronic visceral pain and the underlying neurobiological mechanism for such an effect,we observed the effect of EA on the Irritable bowel syndrome (IBS) rat and then examined spinal expression of N-methyl-D-aspartate (NMDA)receptor-1 in rats.Methods:Daily mechanical colon distention was performed on male Sprague-Dawley neonatal rats to produce IBS model.EA was applied at acupoints of Zusanli (ST 36) and Shangjuxu (ST 37)in each hind leg.Abdominal withdrawal reflex (AWR) assessment or rectus abdominis electromyograms (AEMG) recordings were then performed after EA treatment.The mRNA expression of the NMDA subtype of glutamate receptors in the spinal dorsal horn (L4-5) before and after EA was investigated by RT-PCR analysis in IBS rats.Results:The results demonstrated that EA could significantly decreased both AWR scores from behavioral test and AEMG discharges from electrophysiological recording in IBS model rats elicited by colorectal distension (CRD) stimuli with strengths of 20,40,60 and 80 mmHg,respectively (P＜0.05).Meanwhile there was a significant decrease in mRNA expression of NMDA receptor-1 in the spinal dorsal horn of IBS rats treated by EA (P＜0.05),but no such effect was observed in IBS rats treated by sham EA (inserting needles without electrical stimulation).Conclusion:These results indicate that EA can relieve chronic visceral hyperalgesia in IBS rats and this effect might be correlated with the down-regulation of NMDA receptor-1 in the dorsal hom of the spinal cord.

Adult albino rats were exposed to simulated high altitude of 5000 m for 72 hours. Mild degree of interstitial pulmonary edema was observed under light microscope. Rats with the left lung excised were subjected to hypoxice of the same degree for 48 hours. On histologic examinations interstitial edema of the right lung was more obvious than that of the previous group. In isolated alveolus or in small groups of alveoli, edematous fluid could he seen.There were perivascular and peribronchial "Cuffs". The former were supposedto be accumulation of edema fluid leaking from the capillaries at the level of alveoli. The latter might be the result of extension of perivascular fluid to the peribrochial space.Excision of the left lung may result in a rise in pulmonary arterial pressure and over perfusion in certain areas remaining lung. Hypoxia may intensify the above changes. Pulmonary hypertension and overperfusion may in force promote the genesis of pulmonary edema.

Objective To explore the effects of intensity modulated radiation therapy (IMRT) on lung function in patients with non small cell lung cancer (NSCLC) ,analyze relationship between lung function indexes and radiation pneumonitis (RP) incidence rate ,dose volume histogram (DVH) parameters and incidence degree of RP .Methods 52 patients without operation first radiother‐apy patients were included ,all with Karnofsky score (KPS) ≥ 80 points .Detection of IMRT ,before the end of the end ,first months ,third months of forced vital capacity (FVC) ,forced expiratory volume in one second (FEV1 .0) and diffusion capacity of carbon monoxide (DLCO) change were conducted .The incidence and degree of RP were measured ,and got the V20 and V30 value in DVH .By Spearman correlation analysis ,the relationship between pulmonary function index and the incidence of RP ,V20 ,V30 and RP was analyzed .Results Among the 52 patients ,49 patients were followed up ,the follow -up rate was 94 .2% .In the 49 pa‐tients ,two cases were excluded in the lung recurrence or lung metastasis patients ,thus a total of 47 patients were included in the fi‐nal study .There were 18 cases of RP ,the incidence of RP was 38 .30% .In the third month ,FEV1 .0 and DLCO were significantly decreased than that before radiotherapy (P<0 .05) ,FVC had no significant change (P>0 .05) .Correlation analysis showed that FVC ,FEV1 .0 and DLCO and RP were positively correlated (r=0 .451 ,0 .405 ,0 .635 ,P<0 .05);and V20 ,V30 and RP was posi‐tively correlated (r=0 .689 ,0 .725 ,P<0 .05) .Conclusion the larger the NSCLCV20 ,V30 value ,the more serious the RP would be ,thus they could be predictor of RP degree .