BACKGROUND:Total knee arthroplasty solves a great pain for patients with severe knee joint disease, and its clinical curative effects have been general y accepted. In the clinic, the formulation of clinical analgesic program of the two surgeries in patients undergoing double knee prosthesis lacks of the support of evidence-based medicine.
OBJECTIVE:To compare the differences in pain during early stage of primary and secondary surgeries in bilateral total knee arthroplasty, and to provide evidence for clinical analgesic programs.
METHODS:A total of 87 patients receiving staged bilateral total knee arthroplasty from January 2009 to January 2013 were retrospectively analyzed. Visual analogue scale was compared at 24, 48 and 72 hours after first and second staged total knee arthroplasty, including seating and maximum flexion position. In addition, the difference in early pain score was compared between second and first total knee arthroplasty in different intervals (less than 6 months, 6-12 months, more than 12 months).
RESULTS AND CONCLUSION:The visual analogue scale scores at seating and maximum flexion position at 24 and 48 hours after second total knee arthroplasty were significantly higher than the first surgery. No significant difference in visual analogue scale scores was detected between 72-hour seating and maximum flexion position. Visual analogue scale scores were significantly higher in the interval of less than 6 months than in the 6-12 month group and more than 12 month group in the 24-hour seating and maximum flexion position after second total knee arthroplasty. No significant difference in visual analogue scale scores was detected between the 6-12 month group and more than 12 month group at seating and maximum flexion position. Results suggested that the pain of second surgery was obviously higher than the first surgery within 48 hours after staged bilateral total knee arthroplasty, and this can provide a clinical evidence to enhance the analgesic strategy in the second staged bilateral total knee arthroplasty. The interval between two surgeries also affected the early pain after second surgery. Considered the aspect of postoperative pain, it is better to suggest the interval between first and second surgeries in staged total knee arthroplasty should be more than 6 months. This can reduce pain after second surgery, elevate patient’s satisfaction and accelerate the speed of recovery.

Objective To investigate the influence factors work on the willingness of nursing students to participate in Mobile Learning. Methods A cross-sectional survey was conducted with 400 undergraduate nursing students. The instruments used was the influencing factors of the nursing students' willingness in Mobile Learning questionnaire. Results The resource of study about source, formation and contents, the characteristic, these scores are (12.20 ± 2.66), (14.74 ± 2.95), (11.33 ± 2.63), (11.57 ± 2.34) respectively. In addition, the score of perceived ease of use, the score of perceived usefulness and the score of study attitude, the school of preference, which are (15.02 ± 3.12), (14.81 ± 2.91), (11.43 ± 2.07), (15.18 ± 2.94) respectively. Model fit index which have these factors reached acceptable ranges. Conclusion In order to promote nursing students independent, efficient and convenient study on Mobile Learning, the designing of Mobile Learning should consider the resources characteristics and optimize techniques used.

Under the background of international medical market surging in the demand for caregivers and aging of the population in Finland,in order to solve the problem of nursing personnel missing,Finland has attached importance to nursing education.By means of approving creation of international courses,increasing practical courses,raising the degree of convergence settings with the international labor market structure,adopting the Credit Transfer System to facilitate students broad flow,implementing encouraging and innovative curriculum evaluation,training academic awareness,and so on,to broaden students'career horizons and help them to achieve the career orientation as soon as possible.In this regard,our nursing education should actively learn to take reform measures to improve education quality assurance mechanisms; pay attention to the guiding role of the evaluation; enrich extensive practical course content;focus on academic awareness.

Objective In order to grasp the status quo of the internship nursing students' evidence awareness in our province, to improve the teaching measures, and to promote nursing safety. Methods We delivered questionnaires to 480 nursing students who were exercising practice in some major hospitals in our province about their contemporary consciousness of evidence, the results underwent analysis. Results The results showed that the awareness of nursing evidence was very poor in the new period. Conclusions It's imperative to enhance the normative education about evidence awareness among the nursing students.

BACKGROUND: A simple use of antibiotic drugs as anti-infection therapy after joint replacement is not enough for subsequent debridement and secondary revision surgeries. Therefore, our team intended to confirm the feasible use of controlled-release microspheres in the local anti-infection treatment.OBJECTIVE: To prepare the Human beta defense 3 (HBD-3)/poly(lactic-co-glycolic acid) (PLGA) micro-spheres and to investigate the microsphere physicochemical properties and drug release profile in vitro.METHODS: With PLGA as a carrier,HBD-3/PLGA controlled-release microspheres were prepared by using double emulsion-solvent evaporation method. Scanning electron microscopy was used to observe its surface morphology.The size of each microsphere was accurately determined using scaleplate. Drug loading capacity and encapsulation efficiency of HBD-3/PLGA controlled-release microspheres were calculated using spectrophotometer. HBD-3/PLGA microsphere controlled-release time was determined in order to analyze the drug release profile of the microsphere. RESULTS AND CONCLUSION: The HBD-3/PLGA controlled-release microsphere possessed smooth surface, uniform distribution and good liquidity.The average particle size was 219.49 nm, the drug loading capacity of HBD-3 was (20.67±0.17)% and the encapsulation efficiency was (54.52±1.31)%. The cumulative release percentage of HBD-3 was(74.12±0.43)%. The HBD-3/PLGA controlled-release microsphere has well controlled-release performance in vitro. In theory, the purpose of antibacterial controlled-release can be achieved,laying a foundation for subsequent animal antibacterial experiments.

To explore the changes in metabolites in the greasy tongue coating in patients with chronic gastritis.

AIM: To explore the effect of pyrrolidine dithiocarbamate (PDTC), the specific inhibitor of NF-?B, on anti-thymocyte serum nephritis (ATSN) in rats. METHODS: The rat model of ATSN was reproduced with rabbit anti-thymocyte serum (ATS). The rats were divided into ATSN group, ATSN+PDTC group and control group. The expression of NF-?B p65 and the apoptosis, lysis as well as proliferation of mesangial cells (MC) were examined by immunohistochemical staining, Tdt-mediated X-dUTP nick end labeling (TUNEL), light microscope and electron microscope at 40 minutes, 24 hours and 7 days after injection of ATS or normal serum. RESULTS: The expression of glomerular NF-?B p65 in the ATSN group was observed with significant difference compared to controls at 40 min (P

Objective To explore the relationship between posttraumatic stress disorder and nurses′ psychological capital. Methods By convenient sampling, totally 550 nurses in 5 first-class upper level general hospitals in Zhejiang province were investigated by the posttraumatic stress disorder (PTSD)Cheeklist-Civilan Version (PCL-C) and Nurses Psychological Capital Questionnaire Revision (NPCQR), and the results were analyzed. Results 18.35%investigated nurses showed a certain degree of PTSD symptoms and 13.71% showed obvious PTSD symptoms. The positive rate was 32.06%.The overall score of nurses′psychological capital was 78.81 ± 16.54, which was in the middle level, and the dimension scores from high to low were self-efficacy (23.80±5.35), hope (23.36±5.24), resilience (19.66 ±4.29), and optimism (11.99 ± 3.21). The nurses′psychological capital had a negative effect on posttraumatic stress disorder (P<0.01). Conclusions Psychological capital of nurses is a negative predictor of PTSD symptoms, which suggested that managers should pay more attention to the development of nurses′psychological capital to reduce and prevent the occurrence of posttraumatic stress disorder,then to improve nursing service quality.

Objective To explore the effect of the clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for undergraduate nursing students.Methods Totally 87 undergraduate nursing students were enrolled and divided into the experimental group (n=44) and the control group (n=43).The experimental group received clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for communication.The control group received traditional class-based education for communication.The chnical communication skills questionnaire and Communication Observing Questionnaire were administered before and after the training.The testing results of both groups were compared.Results After participating in the education project,six dimensions of clinical communication competence and the total score were significantly improved after training compared with those before training in the experimental group.After training,the experimental group was better than the control group in establishment of harmonious relationship,confirming patients' problems,efficient information transfer,validation experience and communication competence,t values were 2.64,2.32,2.19,2.20 and 4.36,P＜ 0.05.In testing of integrated cases,scores of six aspects such as case design,information collection,explaining behavior,relationship development,conflict coordination and service behavior in the experimental group were significantly higher than those of the control group,t values were 2.15,2.10,3.26,2.84,2.14 and 2.61,P＜0.05.Conclusions The clinical scenario-based simulation education based on the Calgary-Cambridge Guide can improve communication competence of nursing students.

Various teaching methods were used in occupational health and occupational medicine teaching,including problem based learning,multimedia teaching,bilingual teaching,case based learning and practice teaching methods when being confronted with new situation of occupational health and occupational safety.These methods are mean to encourage students' enthusiasm,cultivate students' comprehensive ability and enhance their sense of social responsibility and mission.Results showed that these methods improved the quality of teaching and achieved good teaching results.