With furthering of the education reform of high degree nursing profession, to explore the reform of the high degree nursing education is an inexorable trend of adapting to the development of modern society. The "BASIC of NURSING" is the basis of each of clinical nursing course; it provides the basic demand of nursing activity to meet patients and health people. To fit the nursing education demand of the new century, it is necessary to run the principle of holistic nursing through the teaching process, to improve the teaching methods, to add the new content of cultivating the nurses' quality and general ability in teaching, and to make students understand the value of their profession at all aspects, and raise the integral quality of the nursing team so as to meet the request of the new century.

MiRNA is a small non-coding single stranded RNA(ssRNA)which is made up by 21~23 nucleotide.This ssRNA has a double effect as tumor suppressor genes and oncogenes , and plays an important role in cell proliferation , differentiation and apop-tosis.Pancreatic carcinoma is a highly malignant tumor with poor prognosis and high mortality rate , and the early diagnosis is difficult . In the last decades , growing studies highlighted the interactions between miRNAs and pancreatic carcinoma .This review provides a re-search overview between miRNAs and pancreatic carcinoma .Meanwhile , the significance of Expression Profile in pancreatic carcinoma′s diagnosis ,treatment and prognosis is also discussed .

Objective To invetigate the clinical effect of Guyouling Liniment in the treatment of soft tissue contusion.Methods Sixty-three cases of soft tissue contusion in our hospital from October 2012 to January 2014 were selected and divided into the treatment group (n=32)and control group(n=31).The treatment group were treated with Guyouling Liniment and the control group adopted Indomethacin Liniment.The effects were compared between the two groups.Results Twenty-six cases(81.13％) in the treatment group were cured and 30 cases (93.75％) were effective;23 cases(74.19％) in the control group were cured and 27 cases (87.10％) were effective.The clinical effect of the treatment group was better than that of the control group with statistical difference(P＜0.05).Compared with the control group,the pain degree and stasis purple area in the treatment group were significantly alleviated,the difference was statistically significant(P＜0.05).Conclusion Guyouling Liniment has significant effect in the treatment of soft tissue contusion and is worthy of clinical promotion.

Objective To study the impact of therapy strategy on outcomes of patients suffering from severe sepsis and/or septic shock. Method A total of 195 patients diagnosed as severe sepsis or septic shock were enrolled for prospective study from June 2008 to December 2009. Patient's clinical manifestation,treatments and outcomes were studied by using SSC database. Patients were divided into control group and treatment group. In control group, patients enrolled from June 2008 to December 2008, were treated with conventional medical care In treatment group, patients enrolled from January 2009 to December 2009 were treated with a novel algorithm of mandatory treatment for sepsis In-hospital mortality of two groups was compared. SPSS15.0 software was used for analysis of data. Chi-square test and unpaired t-test were used for comparisons between groups. Results Compared to the control group The need for blood lactate test was significantly grown in treatment group [98.2% (115/117) versus 2.56% (2/78), P ＜ 0.001]. Antibiotics was administered to 69.2% (81/117) patients of treatment group within 3 hours after their arrival at the emergency department compared to 35.8% (28/78) in the control group (P ＜ 0. 001). Blood cultures made before antibiotics given were 47.9% (56/117) in the treatment group compared to the control group 25.6%(20/78), P = 0. 003. The rate of fluid resuscitation was 80.3% (53/66) in the treatment group and 27%(10/37) in the control group, P ＜0.001. The rate of CVP (8 mmHg was 27.3% (18/66) in the treatment group and 8.1% (3/37) in the control group, P = 0. 023. In-hospital mortality was 29.1% (34/117) in the treatment group and 44.8% (35/78) in the control group, P =0. 032. Conclusions The algorithm of mandatory treatment for sepsis improved the therapeutic efficacy of the treatment for severe sepsis and septic shock, decreasing in-hospital mortality.

To observe the changes in L Arginine /NO pathway of platelet in elderly patients with essential hypertension 20 elderly patients with essential hypertension and 15 healthy volunteers were entered for the study. The changes in L Arg transport, the activity of NOS and the production of NO - 2 were measured. Results showed that the activity of NOS and the production of NO - 2 were decreased, compared with those of healthy volunteers. The maximum transport velocity (Vmax) of L Arg transport in elderly patients with essential hypertension was 70% of healthy volunteers. No changes in Michaelis constant (Km) were found. This results suggested that function of L Arginine/NO pathway of platelet in patients with hypertersion is decreased. L Arginine/NO pathway of platelet played an important role in antithrombosis. Not only drugs to lower blood pressure should be given but also antiplatelet drugs to prevent thrombosis.

Objective To investigate the relationship between biomarkers of renal function and cerebral microbleeds (CMBs) in cerebral hemorrhage patients.Methods This is a cross-sectional study including a total of 129 patients with cerebral hemorrhage.All patients underwent susceptibility weighted 3.0 T MRI.The presence and number of CMBs on susceptibility weighted MRI were independently interpreted.We calculated the urinary albumin/creatinine ratio (UACR) from morning spot urine and the estimated glomerular filtration rate (eGFR) in serum samples.Serum cystatin C (CysC) was measured using the automated particle-enhanced turbidimetric immunoassay.Results Among 129 patients with cerebral hemorrhage,86 (66.7％) had CMBs on susceptibility-weighted imaging.UACR (mg/g;20.47 ± 9.03 vs 35.24±14.83,t=3.823,P＜0.01)andCysC (mg/L;0.98±0.09vs 1.31 ±0.13,t=4.739,P＜0.01) levels were higher in the patients with CMBs than those without,and the eGFR (ml · min-1 · 1.73 m 2) was lower in the patients with CMBs than those without (78.07 ± 18.69 vs 61.59 ± 17.08,t =3.672,P ＜0.01).A Logistic regression analysis indicated that the levels of kidney impairment biomarkers were significantly associated with the prevalence of CMBs in cerebral hemorrhage patients after an adjustment for age,sex and other risk factors.The odds ratio (OR) and 95％ CI of each kidney biomarkers (eGFR,UACR,and CysC) for the CMBs status were 2.573 (1.172-5.315),2.735 (1.247-6.246)and 2.976 (1.764-6.968),respectively.CysC exhibited fair diagnostic value for CMBs,with an area under the curve of 0.835 (95％ CI 0.791-0.878).Furthermore,there were negative correlations between eGFR and the the number of CMBs (P =0.038,R2 total =0.216).There was a positive correlation between UACR,CysC and number of CMBs (P =0.024,R2 total =0.312;P =0.013,R2 total =0.375).Conclusions Elevated levels of kidney biomarkers are associated with the presence of CMBs in cerebral hemorrhage patients,independent of conventional risk factors.CysC may be a potential diagnostic biomarker for CMBs in cerebral hemorrhage patients.

Objective To investigate the anti-fibrotic effect of Kudancao tablets on bleomycin-induced pulmonary fibrosis in rats . Methods Forty healthy adult SD rats(200±20g)were randomly divided into 4 groups: normal control group(without any treatment),normal saline group(intratracheal instillation of normal saline), model group(intratracheal instillation of 5mg/kg of Bleomycin)and kudancao tablets group(intragastric administration of kudancao tablets suspended in normal saline,0.705g/(100 g.d),2 times/day and for 5 times, then intratracheal instillation of 5 mg/kg of Bleomycin 1h later). Rats in all groups were scraficed 14d and 28d after intratracheal instillation. Alkali hydrolysis method was used to detect the HYP content in lung tissues. The pathological changes were observed with HE staining and silver staining. ResultsCompared with the normal control group and normal saline group,the HYP content in the lung tissues of rats in model group increased significantly (P<0.01). Compared with the model group,the HYP content in the lung tissues of rats in kudancao tablets group decreased significantly(P<0.01). Pathological examination showed that significant fibrotic changes were found in lungs of rats in model group,while the fibrotic changes were ameliorated in lungs of rats in kudancao tablets group. ConclusionKudancao tablets may decrease the hydroxyproline content in lung tissues,and ameliorate the fibrotic degree of lungs of rats with bleomycin-induced pulmonary fibrosis.

Objective To construct the adenovirus vector containing mice CD40- IgG2aFc-IRS-GFP fusion gene and detect the expression of the fusion protein in transfeete 293cells.Methods The fragments of CD40, IgG2aFc were obtained and inserted into plasmid PDC316-IgG2aFc-GFP.After being verified by sequencing, Ad5-PDC316-CD40-IgG2aFc-GFP was contransfored with the bckbone vector into 293 cells.The virus titer was detected after replicating and purifing and the expression of the fusion protein was analyzed.Results A virus and plasmid were constructed successfully.The vitro infection showed that the virus can infect cells of which the fusion protein was confirmed by fluo-rescence.The expression of the fusion protein increased with the increased time and virus concentra-tion.The protein expression stopped increasing after the virus concentration came to a certain level.Conclusion CD40, IgG2aFc fragments are correctly ligated with plasmid PDC316-IgG2aFc-GFP, and the fusion protein can be expressed in 293cells.This might lay a foundation for further studies of the expresstion of virus, immune tolerance and mechanism of liver transplantation model in rats.

Objective To evaluate and compare the applicability and accuracy of POSSUM , P-POSSUM and Thora-coscore in predicting the postoperative mortality of thoracic surgery patients .Methods We collected the clinical data of 1 450 thoracic surgery patients during March 2012 to August 2013 in the Second Xiangya Hospital.We used the 3 kinds of risk sco-ring system to calculate the predicted postoperative mortality in these patients .Then we used H-L test and the area under the ROC curve to evaluate and compare their degrees of compliance and validities of identification independently .Results Within 1 450 cases,20 patients (1.4%) died in 30 days after surgery, POSSUM overestimated the mortality (3.84%,P<0.001), while the P-POSSUM (1.05%/1.10%) and Thoracoscore (0.90%) underestimated the mortality, P>0.05.The area under the ROC curve of POSSUM, P-POSSUM ( two kinds of death prediction formula ) and Thoracoscore to predict postoperative mortality in all thoracic surgery patients was 0.774,0.777,0.777 and 0.831 independently, P <0.05; the area under the ROC curve to predict postoperative mortality in patients after lung surgery was 0.755,0.771,0.771,0.849 independently, P<0.05; the area under the ROC curve to predict postoperative mortality of patients with esophageal surgery was 0.640,0.650,0. 650,0.764 independently, only Thoracoscore P<0.05;the area under the ROC curve to predict postoperative mortality of pa-tients with mediastinal and other surgical was 1.000,1.000,1.000,0.854 independently, only Thoracoscore P<0.05.Con-clusion Thoracoscore scoring system is the most suitable risk scoring system to predict postoperative mortality in thoracic sur-gery patients with high predictive accuracy and good identification validity .

Objective:To study the correlation of leucocyte level of peripheral blood with degree of pyretic pulmonary syndrome in different bacterial pneumonia patients and to provide evidence in clinical practice.Methods:To observe pneumonia patients that had been healed in our respiration department of The Jiangxi Province Chinese Medicine Hospital from January,2006 to December,2007 years,incorporating the non-foundation disease or the chronic obstuctive pulmonary disease or chronic cor corpulmonale,We were to summarize relation degree of pyretic pulnonary syndrome to the white blood cell countingthe neutral granular cell percentage relevance.Results:From the non-foundation disease's pneumonia patients group,degree of pyretic pulnonary syndrome and the peripheral blood white blood cell counting and the neutral granular cell level had obvious relevance(P