Objective To establish a new scientific and rational training method based on the competency for newly recruited nurses and evaluate its training effect. Methods According to the requirements of "Syllabus Standardized Training for Newly Recruited Nurses (Trial)", a new method of standardized training for newly recruited nurses was established with competency as the guide. The teaching model of internet combined with traditional education was adopted to 24 new nurses recruited in September 2015 (observation group). The theory, operation, clinical practice ability and competency of nurses were assessed before and after the training, which were compared with another 24 new nurses recruited in September 2014 (control group). Results There was no significant difference in the theory, operation, clinical comprehensive ability and competency score of nurses in the two groups before the training (P>0.05). After the training, scores of theory, operation, clinical comprehensive ability and competency of nurses in the observation group were higher than those of the control group. The differences were statistically significant (P< 0.05). Conclusions The competency-oriented standardized training for newly recruited nurses is more suitable for clinical practice. Internet teaching has expanded the learning time and space for new nurses, which can effectively improve the competency and clinical practice ability of newly recruited nurses.

Cerebral venous thrombosis (CVT) refers to thrombosis of the intracranial veins and sinuses, which is a rare type of cerebrovascular disease.Due to this highly variable and nonspecific clinical presentations, CVT can be difficult to diagnose.Understanding the pathophysiology and etiology of CVT helps to understand its clinical symptoms and imaging findings and guide the treatment.This article reviews the related advances in the pathophysiology and etiology of CVT.

Objective To formulate a comprehensive and reasonable admission nursing assessment sheet with specialty features, so as to improve quality of nursing assessment for patients at admission to Department of Hepatobiliary Surgery. Methods According to characteristics of patients newly admitted to Department of Hepatobiliary Surgery and need of medical service,a nursing assessment sheet suitable for inpatients to Department of Hepatobiliary Surgery was designed,with main contents including basic information, physical examinations for nursing,conditions of daily life,social and psychological conditions,specialty examinations,risk of falling down from bed,and risk of pressure sores. Incidence rate of adverse nursing events like patients' falling down from bed or pressure sores,and the patients' satisfaction were compared before (June 2014 to May 2015) and after (June 2015 to May 2016) application of this sheet. Results After application of this new version of admission nursing assessment sheet,incidence of adverse nursing events happened to inpatients dropped from 2.95% to 0.91% (χ2=4.386,P< 0.05);patients' satisfaction increased from (83.16±10.62) to (90.41±8.66) (t=14.103,P<0.05). Conclusions By using this new version of admission nursing assessment sheet,status of the patients can be assessed in a diversified and multi-dimensional way,so that incidence of falling down from the bed can be lowered,medical risks be decreases,patients' satisfaction be increased,and nursing efficiency be improved,which make it worth promoting in Department of Hepatobiliary Surgery.

Collateral circulation actively enables or generates new blood vessels in order to ensure blood supply to the tissues of body when the normal feeding arteries are stenosis or occlusion.This article mainly reviews the assessment methods of collateral circuhtion in ischemic stroke.

Objective To investigate the impact of internal carotid artery stenosis on cognitive function of patients and the improvement of cognitive function after internal carotid artery stenting. Methods The clinical data of 92 patients with asymptomatic internal carotid artery stenosis on segment C1 segment diagnosed by cerebral angiography at the Department of Neurology,Urumqi General Hospital of Lanzhou Military Hospital from May 2007 to June 2013 were analyzed retrospectively,including 49 with moderate stenosis and 43 with severe stenosis. Thirty-one patients had stenting. The enrolled patients were evaluated with the Montreal Cognitive Scale (MoCA)score and the National Institutes of Health Stroke Scale (NIHSS) score,and the improvement of the MoCA score at 3 month after stenting was evaluated. Results (1)The MoCA score of the severe stenosis group was lower than that of the moderate stenosis group(22. 6 ± 2. 9 vs. 27. 4 ± 2. 3,P<0. 01). The patients with the MoCA score <26 was 83. 7%(36/43). It was significantly higher than 22. 4% in the moderate stenosis group (11/49). There was significant difference between the 2 groups (P<0. 01). (2)In the severe stenosis group,there was no significant difference in the preoperative MoCA score between the stenting group (22. 9 ± 3. 0)and the non-stenting group (21. 9 ± 2. 4)(P>0.05);3 months after stenting,the MoCA score (25. 4 ± 2. 7)of the stenting group was significantly better than that of the non-stenting group (22. 2 ± 2. 8). There was significant difference (P<0. 01);and after stenting,the proportion of patients with the MoCA score <26 (48. 4%,15/31)was significantly lower than those of the non-stenting (83. 3%,10/12,P=0. 037). Conclusion Severe stenosis of internal carotid artery may cause cognitive dysfunction. Carotid artery stenting is conducive to improve cognitive function in patients with severe stenosis.

ObjectiveTo explore the best treatment method of cerebral artery dissection.Methods This study included eight patients who were definitely diagnosed as cerebral artery dissection by the cerebral angiography in our department of neurology during Oct.2009 and Nov.2011.They were all treated by the anticoagulation or anti-platelet methods.Some patients received the stent therapy.All patients' were followed for at least three months. The treatment effect was assessed by NIHSS,mRS and by the cerebral angiography.ResultsSix patients had carotid artery dissection,2 had vertebral artery dissection.Four patients were given anticoagulant therapy and the other 4 were given anti-platelet therapy. The reexamination by angiography 10-14 days after admission showed that in 3 patients,the stenosis was aggravated or the infarction occurred.They were diagnosed as having repeated transient ischemic attack (TIA) during pharmacotherapy and received stents for treatment.There was no TIA and cerebral infarction in the follow-up period after individualized therapy.Mean NIHSS scores of 8 patients between pre and post treatment were 5.9,1.6 respectively. Mean mRS scores pre and post treatment were 2.5,0.9respectively.Conclusion The treatment for patients with cerebral artery dissection should be individuated.The patients in acute stage should get anticoagulation,anti-platelet therapy and angiography re-examination.According to the clinical manifestation and cerebral angiography,the next step for the treatment should be done.

Objective To observe the effect of tetrahydroxy stilbene glucoside (TSG) on the behavior on rat model and the expressions of autophagy-associated protein Beclin-1 and LC3- Ⅱ induced by Aβ1-42 Methods Eighty rats were equally randomized into 4 groups (n =20):The control group,the sham operated group,the model group and the TSG group.The behavior of rats was measured by using Y-maze and Morris water maze.The expression of Beclin-1 and LC3- Ⅱ in rats hippocampus was detected by Western blot and RT-PCR at the time points.Results The number of electric-stimulus in hippocampus significantly increased and the Morris water maze test showed that the escape latency prolonged,swimming distance increased and the times of crossing the exact former platform location decreased both in the model and TSG groups after 21 days compared with those in control group.The mRNAs and protein expressions of Beclin-1 (0.51 ±0.03)and LC3-Ⅱ (0.68 ± 0.04) in model group were higher than that in control group (0.31 ± 0.01,0.31 ± 0.02) at that time point ( Beclin-1:t =28.2843,P ＜ 0.05 ; LC3- Ⅱ :t =37.0000,P ＜0.05).Compared to model group,the expression of the Beclin-1 and LC3- Ⅱ was decreased at 21 d in TSG group (Beclin-1:t =9.8387,P ＜ 0.05 ; LC3- Ⅱ :t =16.2698,P ＜ 0.05 ).Conclusions Autophagy self-regulated system is started through the increased expressions of Beclin-1 and LC3- Ⅱ after Aβ deposition in rats,so as to attenuate cerebral injury caused by Aβ neurotoxicity.Autophagy pathway is possible one of the mechanisms in Aβ neurotoxic injury. Tetrahydroxy stilbene glucoside from polygonum multiflorum has protective effect on it.

Objective:To observe the effect of ginsenoside Rd pretreatment on the expressions of N-methyl-D-aspartate(NMDA)receptor subunit NR2 B protein and endonuclease G(EndoG)in basal ganglia region after cerebral focal ischemia-reperfusion in rats and to investigate possible mechanism of ginsenoside Rd in the treatment of ischemic stroke.Methods:A rat model of middle cerebral artery occlusion(MCAO)was induced by intraluminal filament method.The expressions of NR2B and EndoG in basal ganglia region for focal cerebral iSChemia 1 hour,and 1,6,24 and 72 hours reperfusion were detected by immunohistochemical staining and image analysis method.The effects of ginsenoside Rd on the expressions of FaxioG and NR2B and the volume of cerebral infarction were evaluated.Results:The positive expression of NR2B in basal ganglia region on the ischemic side in ischemia-reperfusion group was increased significantly.The expression of EndoG in the nucleus was notable;the positive expressions of NR2B and EndoG at different reperfusion time points in ginsenoside Rd pretreatment group were decreased significantly(P<0.05 or P<0.01),and the volume of cerebral infarction was reduced significantly(P<0.01).Conclusions:The expressions of NMDA receptor subunit NR2B protein and apoptosis-inducing factor EndoG were increased significantly after cerebral focal ischemia reperfusion;ginsenoside Rd pretreatment may significantly reduce the expressions of NR2B and EndoG.It reduces the volume of cerebral infarction by inhibiting excitatory neurotoxicity and blocking neuronal apoptosis,and thus plays a role in neuroprotection.

OBJECTIVE:To determine the content of plumbm(Pb) and cadmium(Cd) in the roots of Arachniodes exilis.ME-THODS:The samples were treated with microwave digestion.Graphite furnace atomic absorption spectrometry was adopted for the content determination of Pb and Cd in samples.RESULTS:The contents of Pb and Cd were 2.209 mg?kg-1 and 0.215 mg?kg-1 in the roots of A.exilis.CONCLUSION:Harmful heavy metals have been detected in the roots of A.exilis,which is in line with the limitation stated in the Green Trade Standard for Medicinal Plant and Preparations.This method is simple,accurate and reliable for the content determination of practical samples.

OBJECTIVE To explore the risk factors in aged patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies. METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed. RESULTS Totally 155 VAP of elderly patients had serious underlying diseases,and treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were mutiple-resistant. CONCLUSIONS The prevention of VAP was in priority for control of VAP patients.In order to control the occurrence and spread of VAP,clinicians should cut the time of ventilator,pay more attention to sterilization and isolation,and strengthen the tend of the patients.