Objective:To investigate the therapeutic effect and possible mechanism of low intensity pulsed ultrasound（LIPUS）on painful gait in mice with Achilles tendon injury.Methods:Male C57BL/6 mice were selected to establish the Achilles tendon injury model by surgically full-thinkness tear of the right Achilles tendon. The mice were divided into Achilles tendon injury group and Achilles tendon injury+LIPUS group according to the random number table method，with 7 mice per group. The Catwalk gait analysis system was used to evaluate the gait function of the mice by measuring the following five parameters 14 days after operation，including print area，standing time，step cycle，max intensity and stride length. Morphological changes of the Achilles tendon were observed by HE staining. Immunofluorescence staining was used to detect the expression level of nitric oxide synthase（iNOS）in the Achilles tendon tissues. At the same time，Achilles tendon cells were isolated and cultured in vitro. The cells were induced by 100 ng/ml lipopolysaccharide（LPS）for 12 hours to establish in vitro model（LPS group），and treated with LIPUS（LPS+LIPUS group）. The control group was set as well（without any treatment）. The nuclear translocation of nuclear transcription factor-κB（NF-κB）P65 was detected by immunofluorescence staining，and the expression of iNOS and phosphorylation（p）-NF-κB p65 protein was detected by Western blotting. Results:Compared with Achilles tendon injury group［（0.14±0.10）cm 2］，the print area of the affected limb in Achilles tendon injury+LIPUS group［（0.28±0.13）cm 2］was increased（ P<0.05）. Compared with Achilles tendon injury group［（0.11±0.04）seconds］，the standing time of the affected limb in Achilles tendon injury+LIPUS group［（0.21±0.03）seconds］was increased（ P<0.05）. Compared with Achilles tendon injury group［（0.25±0.05）seconds］，the step cycle of the affected limb in Achilles tendon injury+LIPUS group［（0.40±0.05）seconds］was increased（ P<0.05）. There was no significant difference in the max intensity and stride length between Achilles tendon injury group and Achilles tendon injury+LIPUS group（ P>0.05）. HE staining showed obvious hyperplasia of Achilles tendon tissues in Achilles tendon injury group，with loosely and randomly arranged fibers，accompanied by neovascularization and inflammatory cell infiltration. Achilles tendon injury+LIPUS group showed more orderly arranged fibers in Achilles tendon tissues，and the degree of neovascularization and inflammatory cell infiltration were reduced. Compared with Achilles tendon injury group［（5.70±0.81）%］，the expression level of iNOS in Achilles tendon injury+LIPUS group［（2.84±0.94）%］was decreased 14 days after operation（ P<0.05）. Immunofluorescence results of Achilles tendon cells showed that NF-κB p65 protein entered the nucleus in LPS group compared with control group，and that LIPUS treatment inhibited nuclear translocation. In control group，Western blotting showed that iNOS was not expressed，and that the expression of phosphorylated NF-κB p65 was 0.63±0.16. Compared with control group，the expression levels of iNOS（0.99±0.22）and p-NF-κB P65（1.02±0.19）in LPS group were significantly increased（ P<0.05）. Compared with LPS group，the expression levels of iNOS（0.62±0.10）and p-NF-κB P65（0.65±0.21）in LPS+LIPUS group were decreased（ P<0.05）. Conclusion:LIPUS treatment can alleviate pain gait in mice with Achilles tendon injury and inhibit iNOS expression in vivo and in vitro，which may be related to inhibition of NF-κB signaling pathway.

? This paper introduces the connotation and theoretical development of adaptive leadership framework and its current application in different fields, and analyzes the applicability and possibility of introducing the theory into the intervention and management of frailty in the elderly so as to provide a possible path for medical and nursing workers to intervene frailty in the elderly effectively.

This article reviews different screening and assessment tools for frailty in the elderly, including tool makers, assessment contents, scoring methods, results determination and applicability of tools, in order to provide reference for the broad medical staff in screening and evaluating frailty in elderly people.

At the historical moment of 100th anniversary of Peking Union Medical College (PUMC), the nursing personnel of PUMC reviewed the history of nursing education in the past and summarize the excellent education and scientific research experience. This paper is to dedicate thankfulness to the pioneers of PUMC nursing education and wish to collaborate with fraternal colleges in China to create a brighter future for Chinese nursing education.

In view of the current environment and background of nursing education in China, this paper is to analyze the strengths, weaknesses, opportunities and threats of nursing education in China and to discuss the development trend of nursing education in the future under the new situation.

Objective To analyze the research hotspots and future trend of nursing safety. Methods Biclustering analysis was adopted to analyze the nursing safety literature in PubMed and Wanfang databases from 2012 to 2016 through the bibliographic contribution system BICOMB and graph clustering toolkit gCLUTO 1.0. Results Domestic nursing safety research fronts from 2012 to 2016 focused on adverse events,quality care services, quality evaluation indicators, work errors and safety culture. On the other hand,overseas nursing safety researches focused on system analysis, nursing quality sensitive indicators, teamwork and nursing safety, and the impacts of nursing work environment on quality and safety. Conclusions Comprehensive means of multi-disciplinary teamwork can be called into play for in-depth study of deloping adverse events assessment tools, establishing a unified nursing sensitive indicator system and continuous improvement. The future research trends are establishing a national standardized nursing adverse events reporting system, using information technology to build a big data platform for information sharing and exploring nursing safety from the security environment and organization management.

Medication error is one of the most incidental nursing adverse events, which not only brings additional pain and financial burden, but also creates tense nurse-patient relationship. Zero defects management focuses on the control of prevention system and procedure. The aim is to greatly prevent the mistake and provide satisfied product or service by the standard of zero defects. This prevention theory is fit in the medicine. The study reviews the basic content and principle of zero defects, and proposes improving measures for the management of nurses' medication safety according to the theory.

Objective To explore the effects of referral and rehabilitation status of patients with total knee arthroplasty (TKA) under the mode of medical alliance.Methods One hundred and ninety cases with total knee arthroplasty in the secondary rehabilitation hospitals after referral from a tertiary hospital from January 2016 to January 2017 were analyzed, including general demographic data, disease and surgical data, rehabilitation data after referral, hospital day and change of medical expenses of the tertiary hospital and rehabilitation hospitals before and after the promotion of the medical alliance mode.Results After receiving the rehabilitation treatment in secondary rehabilitation hospitals, the range of motion, muscle strength and some other indices of the patients' surgical legs were significantly improved (P<0.05). And the hospital day of the surgical hospital was shorten from (15.05±6.59) d to (12.97±5.24) d, and medical expenses were decreased by 2.18% in total, 4.76% per knee and 14.01% in rehabilitation costs.Conclusions Under the mode of medical alliance, transferring patients with TKA from a tertiary hospital to secondary rehabilitation hospitals in their early postoperative phase can facilitate recovery of the patients, and it can also help to reduce hospital day and medical expenses, thus to optimize the allocation of medical resources.

Objective To provide supporting data for the quality control and evaluation of Nitraria Spp .from Xinjiang region by analyzing the content of isorhamnetin-3-rutinoside in its leaves .Methods HPLC method was used for the determina-tion of isorhamnetin-3-rutinoside in leaves of Nitraria Spp .Results There is a good linear relationship in the range of 0 .007813~1 mg/ml .The average recovery rate is 100 .13% (RSD=3 .02% ) .Conclusion There were large interspecific and intraspecific differences of isorhamnetin-3-rutinoside content in leaves of Nitraria Spp from Xinjiang region .A simple method was identified to give accurate and reproducible results .This method can be used for quantitative analysis of isorhamnetin-3-ru-tinoside content in leaves of N itraria Spp .

ObjectiveTo study the effect of ginsenoside Rg1 on the pathological changes of rat optic nerve injury. MethodsThe model of rat optic nerve injury was established, the rats were divided into the experimental group and control group,intraperitonealiy injected ginsenosides Rgl (10mg/kg) to experimental group of rats for 20days ,meanwhile intraperitonealiy injected the same volume of saline to the control group,took eyeball and optic nerve from the optic nerve injury eye and the normal eye in both groups ,HE staining,SABC immunohistochemical staining of Bcl-2, neurocan were analyzed. ResultsHE staining results showed the morphological difference on optic nerve cells from control group and the optic nerve injury group. Immunohistochemistry showed the neuronal cell apoptosis was significantly increased after optic nerve injury. The intraperitoneal injection of ginsenoside Rg1 could significantly improve the situation of cell apoptosis. The significant increment of fiber protein may be partly related to the improvement of cell apoptosis, but the principle was not clear. ConclusionGinsenoside Rg1 had protective effect on rat optic nerve injury.