In nursing teaching,it is necessary to adopt the idea of developmental teaching,innovate the traditional teaching method,make the students be active and learn autonomously and in the meantime make the exploration of developmental evaluation,in order to improve the students' integrative quality and promote their individual development and strengthen their competence of autonomous learning.

Objective: To study the chemical constituents of Polygala crotalarioides. Methods: The compounds were isolated by silica gel, RP-18, Sephadex LH-20 column chromatography, and semi-pre HPLC. Their structures were elucidated on the basis of spectral analysis and chemical evidence. Results: Four oleanane-type saponins were isolated from the roots of P. crotalarioides. Their structures were elucidated as 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[β-D-glucopyranosyl-(1→3)]-β-D-fucopyranoside (1), 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[6-O-acetyl-β-D-glucopyranosyl-(1→3)]-[4-O-(E/Z)-4″-mehoxycinnamoyl]-β-D-fucopyranoside (2), 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[6-O-acetyl-β-D-glucopyranosyl-(1→3)]-[4-O-(E/Z)-3″, 4″-dimethoxycinnamoyl]-β-D-fucopyranoside (3), and 3-O-β-D-glucopyranosyl presenegenin 28-O-β-D-xylopyranosyl-(1→4)-α-L-rhamnopyranosyl-(1→2)-[6-O-acetyl-β-D-glucopyranosyl-(1→3)]-[4-O-(E/Z)-3″, 4″, 5″-trimethoxy-cinnamoyl]-β-D-fucopyranoside (4), respectively. Conclusion: Compounds 1-4 are new compounds named crotalarioside C, (E/Z)-crotalariosides D, E, and F, respectively. Among them, compounds 2-4 are cis-trans-isomers, which can not be separated by the experimental technique because of the configuration.

Objective :To explore the curative effect of endoscopic sinus surgery (ESS) and the factors associ-ated with surgery effect for treating children with chronic sinusitis. Method :Thirty-one children with a medianage of 10 years (range 5～14 years) who suffered from chronic sinusitis or/and nasal polyps and were operatedvia ESS from May 1996 to January 1999 were retrospectively analyzed. Result:According to the therapeutic evalu-ation standard (ESS-199 7, Haikou ), twelve cases (38.7 ％ ) were completely cured, fifteen cases (48.4 ％0 ) wereinproved and four children (12.9 ％ ) showed no change with a general effective rate of 87.1 ％00 without any severeoperative complication. Conclusion:The results suggested ESS is a safe and effective method in the treatment ofchildren with chronic sinusitis or/and nasal polyps. Furthermore, meticulous postoperative endoscopic care andmedication are also important for securing optimal long-term results.

Objective: To clarify the contribution of the fingerprint peaks from different parts of prepared Ershen Pill to the effect of warming spleen to relieve diarrhea, and to reflect the material basis. Methods: The HPLC fingerprints of different parts of Ershen Pill (composed of Psoraleae Fructus stir-baked with saltwater and Myristica Fragrans simmered with bran) were established. The diarrhea index of acute diarrhea in mice caused by senna leaf was researched to compare the effect of warming spleen to relieve diarrhea. Results: The fingerprints of different parts of Ershen Pill were established, and all of the similarity degrees were over 0.90. The effect of warming spleen to relieve diarrhea of Ershen Pill was obtained from many constituents collaboratively. The contribution of different peaks to relieve diarrhea with astringents was ranked as 6 > 18 > 7 > 20 > 14 > 21 > 1 > 25 > 24 > 23 > 4 > 3 > 8 > 11. Conclusion: The method for establishing HPLC fingerprints of different parts of Ershen Pill is simple and repeatable. The relationship between the fingerprints and the effect of warming spleen to relieve diarrhea is paralleled to some extent. And this will lay a foundation for the research of processing mechanism of Ershen Pill.

Objective To compare sequence analysis of the yeast-like fungal isolates with traditional methods and analyze the feasibility of identification of common yeast-like fungal by sequence analysis of gene. Methods 115 yeast-like fungal isolates were collected in the clinical laboratory of Beijing Tongren Hospital. DNA of yeast-like fungal was extracted and then amplified with universal primers of part of 18S rRNA genes followed by sequencing directly. The sequences obtained were submitted to the GenBank (NCBI) to identify the fungi. At the same time, the CHROMagar Candida and Vitek 32 YBC were used to identify the fungi. The identification accuracy with three methods was compared to explore the feasibility of the identification of sequence analysis. Results 18S rRNA gene sequence analysis was compared with traditional method. There were some differences in the identification results of 13 strains. The coincidence rate between CHROMagar Candida and sequence analysis was 89. 2% (91/102) and the coincidence rate between Vitek 32 YBC and sequence analysis was 91.3% (105/115). The positivity rate of species-level identification by CHROMagar Candida , Vitek 32 YBC and the 18S rRNA gene sequence analysis were 88. 7 % ( 102/115 ), 100% ( 115/115 ), 100% ( 115/115 ). Conclusion Identification of medically important yeast-like fungal by sequence analysis of the 18S rRNA gene is reliability.

Objective To deeply understand the postoperative real experience of colostomy patients on ostomy management, and try to explore the difficulties and needs after discharge in order to provide theoretical basis for postoperative nursing intervention. Methods By using phenomenological research method, 10 colostomy patients were interviewed face- to- face, and the content was analyzed by Colaizzi method. Results Three themes were concluded: self- care obstacle related to ostomy; self- growth brought by ostomy; expectations for social support and family care. Conclusions Colostomy patients have to face so many problems after operation on ostomy management, and hospital, society and family have responsibility to help patients adapt to ostomy as soon as possible and improve their quality of life.

Objective The aim of this study was to evaluate the diagnostic value of thyroglobulin(Tg)mRNA in peripheral blood samples of patients with differentiated thyroid carcinoma(DTC)after remnant ablation.Methods Tg mRNA Was detected by reverse transcription-polymerase chain reaction(RT-PCR)in peripheral blood of 162 patients.SPSS 13.0 was used for date analysis.Results The Tg mRNA assay had higher sensitivity than the conventional serum Tg measurement[86.61%(97/112)vs 53.57%(60/112),X2=29.153,P＜0.001]which Was the"gold standard"for the identification of recurrence or metastases.In the anti-Tg antibodies(TgAb)positive DTC patients,the sensitivity of Tg mRNA was higher than that of serum Tg[86.54%(45/52)vs 0]in identifying recurrent or metastatic thyroid disease(X2=79.322,P＜0.001).There was a significantly positive correlation between Tg mRNA expression and the clinical stages(Kendall correlation coefficient=0.515,P＜0.001).There was no difference of Tg mRNA expression in peripheral blood among ages,sex,pathological types and location of metastases,respectively(Kendall correlation coefficient=0.020,0.069,0.050 and 0.028;all P＞0.05).Conclusions Circulating Tg mRNA is a more sensitive marker than serum Tg in identifying recurrent or metastatic DTC,particulady in patients during levo-thyroxine(l-T4)therapy and with TgAb-positive.The DTC patients who have positive expression of Tg mRNA indicates poor prognosis.

ObjectiveTo study the changes of iodine uptake of the follicular thyroid carcinoma cell line (FTC-133) and nude mice bearing human follicular thyroid carcinoma after the induction with alltrans retinoic acid (ATRA),trichostatin A (TSA) or ATRA combined with TSA.MethodsAfter the induction with ATRA,TSA,or ATRA combined with TSA in different concentrations for 96 h,the iodine uptake of FTC-133 cells was observed.The concentrations for different groups were as follows:ATRA 1.0 ×10-6 mol/L(Alow group),ATRA 1.0 × 10-4 mol/L(Ahigh group),TSA 1.65 ×10-7 mol/L(T group),Alow +T group,Ahigh +T group and ethanol (control group).Cell quantities and morphology were observed by HE staining.FTC-133 cells were subcutaneously injected into nude mice.Twelve nude mice were randomly divided into 4 groups after tumor formation:ATRA group (2 mg/kg,intragastric administration),TSA group (10 mg/kg,intraperitoneal injection),combined therapy group (ATRA + TSA,the same doses as above) and saline control group (10 ml/kg,intragastric and intraperitoneal administration,respectively).Drugs were administered to the tumor-bearing mice according to the mouse body mass daily.At the 22nd day,the tumor-bearing mice were injected with 37 MBq 131I intraperitoneally.The biodistribution of 131I and gamma imaging were performed at 4,6,12 and 24 h after the injection respectively.Histopathological examinations of the tumor samples were taken after imaging completion.The results were analyzed by analysis of variance (ANOVA) with SPSS 13.0.ResultsThe cellular iodine uptake were (23 885 ± 616.0 ) and ( 13 849 ±728.2) counts · min-1 · 10-6 cells in the Alow + T group and Ahigh + T group respectively,and the data were (985 ± 84.2) - ( 17 600 ± 782.7 ) counts · min-1 · 10-6 in the other groups ( F =600.879,P ＜0.001 ).The ％ ID/g of tumor at 6 h was 6.17 ±0.46 in the combined group and it increased to 9.34 ±0.61 at 12 h and 11.19 ± 0.98 at 24 h.The ％ ID/g of tumor in the other groups were from ( 1.97 ± 0.34)to (5.14 ± 0.65 ).The tumor qualities of the 4 groups were significantly different ( F =3.723,P ＜ 0.05 ).ConclusionThe iodine uptake of the tumor could be enhanced in the tumor-bearing mice administered with ATRA combined with TSA,a potential way for treating follicular thyroid carcinoma.

Objective To evaluate the clinical significance of serum thyroglobulin autoantibody(TGAb) in thyroglobulin(TG)-negative and TGAb-positive patients with differentiated thyroid carcinoma(DTC)after thyroid ablation and ascertain the optimal operating point(OOP)of TGAb.Methods A total of 169 patients with histologically confirmed DTC and thyroid remnant ablation showed TG-negative and TGAb-positive results which were assessed by electrochemiluminescence immunoassay(ECLIA).The cases were divided into group A(59 cases)and group B(110 cases)with or without evidence of recurrence or metastasis,respectively.The receiver operating characteristic(ROC)curve and positive likelihood ratio of different threshold values were analysed according to their serum TGAb level.Results Serum TGAb level(1368?1343)IU/ml in group A was significantly higher than that(154?539)IU/ml in group B(P1000 IU/ml was 1.12 times that of 204 IU/ml≤TGAb≤1000 IU/ml,4.03 times that of 100 IU/ml≤TGAb

Objective:To evaluate the possible role of cytokines in pathophysiology and treatment of nasal polyps.Method:The expressions of Th1-typed cytokines IFN-γ、IL-2 、IL-12 and Th2-typed cytokines IL-4、IL-5、IL-8、IL-10、IL-13 were investigated with enzyme-linked immune sorbent assay(ELISA) in 25 patients with nasal polyps.Result:There was a significant upregulation of Th2-typed cytokines IL-4、IL-5、IL-8、IL-10、IL-13 in nasal polyps compared with normal nasal mucosa, especially　IL-4 and IL-5 (3.9 times and 8.8 times higher than normal mucous respectively) while the expression of Th1-typed cytokines IFN-γ、IL-2、IL-12 drcreased after treated with local glucocorticoid. The levels of Th2-typed cytokines decreased significantly and Th1-typed cytokines had no obvious change.Conclusion:The upregulation of Th2-typed cytokines such as IL-4、IL-5、IL-8、IL-10、IL-12 may play an important role in the pathophysiology of nasal polyps and Th2-typed cytokines can be viewed as a target of treatment to nasal polyps.