Nursing skill competitions are the wind vane for clinical nursing development, and the teaching concepts, proposition forms, and evaluation systems demonstrated by competitions have a strong reference value for nursing teaching. This article introduces the knowledge selection and integration from nursing-related courses according to the problems and objectives to be solved by drawing on the STEM education concept in comprehensive nursing practical training in the context of integration of competition and education. Realistic problem scenarios can be created with clinical cases as the carrier or main line, and then the Tanner clinical judgment model is used to guide students to conduct a comprehensive analysis of cases, thereby helping students to develop clinical thinking ability and comprehensive practical skills, so as to bridge the gap between the contents learned at school and nursing work in clinical practice and help nursing students adapt to clinical practice as soon as possible.

Abstract OBJECTIVE To explore the material basis and mechanism of Crataegi Fructus in improving metabolic hypertension(MH) by using network pharmacology and molecular docking technique.METHODS The components of Crataegi Fructus were collected by HERB, ETCM database and literature survey; screening all ingredients of Crataegi Fructus to improve MH targets through databases such as SwissTargetPrediction and GeneCards; build "active ingredient-target-disease" network of Crataegi Fructus with Cytoscape software; DAVID was used to analyze GO enrichment and KEGG pathway. The core components and core targets were verified by molecular docking with Autodock software. RESULTS The total of 89 active components were screened from Crataegi Fructus and acted on 84 targets. Among them, the core active components of Crataegi Fructus to improve MH were maslinic acid, fomefficinic acid B, linolenic acid, linoleic acid, methyl-n-nonylketone, apigenin, ursolic acid, etc. The core targets were CYP19A1, PPARA, ESR1, PTGS2, PPARG, NR3C1, MMP9, TNF, etc. The mechanism of action mainly involved multiple signaling pathways such as inflammation, glycolipid metabolism, and vascular endothelial function. Molecular docking showed that the core active ingredients of Crataegi Fructus had high affinity with core targets. CONCLUSION Crataegi Fructus may regulate multiple signaling pathways such as TNF, IL-17, AGE-RAGE, HIF-1, cGMP-PKG through multi-component regulation, thereby inhibiting inflammatory response, improving glucose and lipid metabolism abnormalities, and improving vascular endothelial function, so as to comprehensively exert the role of improving MH in various aspects.

Background In recent years, the incidence of metabolic syndrome (MS) is increasing significantly in China. Some studies have found that temperature is related to single metabolic index, but there is a lack of research on associated mechanism and identifying path of the influence of temperature on MS. Objective Based on the data of Guangdong Province, to investigate the effect of temperature on MS and its pathway. Methods A total of 8524 residents were enrolled by multi-stage random sampling from October 2015 to January 2016 in Guangdong. Basic characteristics, behavioral characteristics, health status, and physical activity level were obtained through questionnaires and physical examinations, and meteorological data were obtained from meteorological monitoring sites. We matched individual data both with the temperature data of the physical examination day and of a lag of 14 d. A generalized additive model was used to explore the exposure-effect relationship between temperature and MS and its indexes, calculate effect values, and explore the effects of single-day lag temperature. Based on the literature and the results of generalized additive model analysis, a path analysis was conducted to explore the pathways of temperature influencing MS. Results The association between daily average temperature on the current day or lag 14 day and MS risk was not statistically significant. When daily average temperature increased by 1 ℃, the change values of fasting blood-glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high density lipoprotein cholesterol (HDL-C) were −0.033 (95%CI: −0.040-−0.026) mmol·L⁻¹, −0.662 (95%CI: −0.741-−0.583) mmHg, −0.277 (95%CI: −0.323-−0.230) mmHg, and −0.005 (95%CI: −0.007-−0.004) mmol·L⁻¹ respectively. The effects of average daily temperature on FBG, blood pressure, HDL-C, and waist circumference lasted until lag 14 day. The effects of daily average temperature on SBP and DBP were the largest on the current day. Daily average temperature of current day had direct and indirect effects on FBG and SBP. Temperature had an indirect effect on TG, and the intermediate variables were waist circumference and FBG, with an indirect effect value of −0.011 (95%CI: −0.020-−0.002). The indirect effects of daily average temperature on SBP, FBG, and TG were weak. Conclusion There is no significant correlation between temperature and risk of MS, and daily average temperature of current day could significantly affected blood pressure and FBG with a lag effect. Daily average temperature of current day has indirect effects on FBG and TG.

Objective:To study the application effect of objective structured clinical examination (OSCE)-based situational simulation case teaching on Nursing Fundamentals practical training. Methods:Using convenient sampling method, two undergraduate nursing classes of Batch 2018 in Hubei University of Chinese Medicine were chosen as the study objects. They were divided into observation group with 45 students and control group with 43 students through ball touching method. The control group used traditional teaching method, on this basis, the observation group used OSCE-based situational simulation case teaching. At the end of the semester, the results of theoretical assessment, operational skills assessment, humanistic care, health education achievements of the two groups of nursing students and students’ evaluation of the new teaching method in the observation group. SPSS 22.0 was used for t test. Results:The sores of theoretical assessment, operational skills and humanistic care assessment in the observation group were (81.01±8.53), (92.69±3.87) and (11.73±1.59), and the corresponding sores in control group were (76.94±9.74), (91.21±2.70) and (10.79±1.36). The nursing students in the observation group had significantly higher scores than the control group in above mentioned aspects ( P<0.05). In the observation group, 45 students (100.0%) believed that this teaching method could stimulate learning interest and comprehensively deal with clinical problems, 43 students (95.6%) thought that this teaching method could improve team cooperation ability, only one person (2.2%) did not agree that this teaching method could help to form critical thinking, and 42 students (93.3%) said that the teaching hours of this teaching method could be appropriately increased. Conclusion:The OSCE-based situational simulation case teaching may effectively improve the teaching quality of the nursing students and mobilize their learning activities.

Objective:To determine the seroprevalence of celiac disease in susceptible population, and to analyze the relationship between demographic characteristics, dietary habits, lifestyle and serological positivity so as to provide guidance for the prevention and treatment of celiac disease in Southern China.Methods:A total of 1 273 individuals who participated in Guangdong Province Health Screening Program in 2015, were selected as serologically positive subjects of celiac disease, including people with irritable bowel syndrome, colitis, diarrhea, anemia, low BMI, short stature, type 1 diabetes mellitus (T1DM), rheumatoid arthritis (RA), ankylosing spondylitis, psoriasis and bristol grade=6 or 7. All subjects were tested for serum IgA anti-tissue transglutaminase antibodies (TTGA), IgA antibodies against deamidated gliadin peptides(DGPA) and IgG against deamidated gliadin peptides (DGPG). Dietary habits, lifestyle and demographic characteristics were compared in subgroups.Results:The seroprevalence of celiac disease in susceptible population was 0.94% (95% CI 0.54%-1.64%) including 0.08% (1/1 273) for TTGA, 0.47% (6/1 273) for DGPA, and 0.39% (5/1 273) for DGPG. The seropositive rate was 3.6% (1/28) in patients with psoriasis, 2.1% (2/95) in the low BMI group, 1.9% (1/53) in T1DM group, 1.8% (3/169) in diarrhea group and 1.1% (5/463) in RA group. No significant difference was found in age, gender, high carbohydrate diet or lifestyle between the negative and the positive subjects. Conclusions:In Southern China, the seropositive rate of celiac disease is 0.94% in susceptible population, which prompts an urgent need of serological screening for early diagnosis.

Objective To explore the effect of the modular teaching for nursing students based on WeChat in the comprehensive training before the practice.Methods The undergraduate students of nursing were randomly divided into 5 classes,among which class 1,2,3 as the control group,and class 4,5 as the experimental group.The control group used the traditional ‘Case Teaching Method',taking the group as a unit to practice the clinical nursing skills individually;while the experimental group took the method which integrated individual nursing skills and practical materials with humanistic qualities in clinical cases.They conducted practical training by dividing the learning module with the ‘representative patients',using WeChat as the learning and exchange platform andbuilding modular training model.After the training,the results were evaluated by the score sheet for integrated skills,a critical-thinking scale and the learning model questionnaire.The data was analyzed by T-Test and Chi-Square inspection.Results All of the nursing students were willing to use WeChat for autonomous learning.The scores of the nursing students in the experimental group were higher than those in control group in the abilities of judgement,communication,operation and introspection.The difference was statistically significant (P＜0.05).In addition to the cognitive maturity,the scores of experimental group were higher than those in control group in the searching for truth,opening mind,abilities of analysis and integration and self-confidence in critical thinking and desire for knowledge,The difference was statistically significant (P＜0.05);Also the proportion of experimental group was higher than the control group in students' attitude to study,knowledge acquisition and practical training mode.The difference was statistically significant (P＜0.05).Conclusion The implementation of nodular teaching mode based on WeChat is beneficial to improve the clinical comprehensive ability of nursing students,and help to train the high quality nursing talents who meet the needs of clinical practice.

OBJECTIVETo explore the effects of acupuncture on improving the peripheral skeletal muscle exercise ability in patients with chronic obstructive pulmonary disease (COPD) at stable phase.

METHODSForty-four patients were randomly divided into an observation group (24 cases) and a control group (20 cases). Based on regular western medication treatment and aerobic training, acupuncture was used in the observation group and placebo acupuncture was used in the control group. The acupoints selected were Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25), etc., 2-3 times per week, and totally 14 treatments were given. The body mass index (BMI), average distance and average maximum heart rate recorded during bicycle exercise, six-min walking distance (6-MWD), maximum power (Wmax) and maximum heart rate (HRmax) recorded during exercise cardiopulmonary function test, and pulmonary function index including forced expiratory volume in one second/estimate value (FEV1%), forced vital capacity/estimate value (FVC%), FEV1/FVC and maximal voluntary ventilation (MVV) were observed in both groups before and after treatment.

RESULTSThe BMI before and after treatment in the observation group was not significantly changed (>0.05), while that in the control group was significantly reduced (<0.05). Compared before treatment, the average distance of bicycle exercise, 6-MWD, Wmax, FEV1%, FVC% and MVV were significantly improved after treatment in the observation group (<0.01,<0.05), which were all superior to those in the control group (<0.01,<0.05). The treatment outcomes in the control group were not significantly changed after treatment (all>0.05).

CONCLUSIONSAcupuncture combined with aerobic training of bicycle and conventional western medication could prevent the reducing of BMI in patients with COPD at stable phase, improve pulmonary ventilation function, and increase the function of peripheral skeletal muscle to improve its performance.

Objective To observe the effect of acupuncture in promoting the lung recovery in chronic obstructive pulmonary disease (COPD), and to discuss its advantage and safety in lung recovery. Method Forty-four patients were randomized into two groups, 22 cases in the treatment group and 19 in the control group finally (with 3 dropouts). In addition to the required aerobic exercises, the treatment group received active acupuncture treatment and the control group received placebo acupuncture treatment, with acupoints from the Spleen and Stomach Meridians and Conception Vessel as the major points, 2-3 sessions a week, for 14 sessions in total. The body mass index (BMI), athletic ability, COPD Assessment Test (CAT), pulmonary function and inflammation indexes [interleukin (IL)-6 and tumor necrosis factor (TNF)-α] were observed before and after the treatment. Result After the treatment, the improvements in the six-minute walking distance, CAT and pulmonary function scores were statistically more significant in the treatment group than those in the control group (P<0.05,P<0.01); the serum content of TNF-α was increased more significantly in the control group than in the treatment group (P<0.05); there was no significant change in BMI in the treatment group, while a significant decrease of BMI was found in the control group (P<0.05). Conclusion Acupuncture plus exercises can boost the lung recovery in remission-stage COPD and reduce the adverse reactions brought by sports fatigue.

Objective To explore the solution for regional population health information platform based on the involvement of internet plus and big data.MethodsThe objective and contents of the platform were discussed,and its logic structure and deployment architecture were designed.The functions of a platform-based application system and two information integration platforms were described.The key technical links of the system were demonstrated.Results The solution for regional population health information platform based on internet plus completed population health information service system,and laid a foundation for the application of medical big data.Conclusion The solution contributes to the inter-connection and communication between medical fields in some region,promotes healthcare informatizatoin platform and is thus worthy applying practically.

BACKGROUND:Maxil ofacial malformation limits the function of the mandible, produces the overload of the temporalmandibular joint leading to oral diseases. OBJECTIVE:To measure the characteristics of mandibular movement in populations with various types of dental occlusion. METHODS:Thirty-three volunteers (1 male and 32 females, mean age 21.71 years) meeting the inclusion criteria were enrol ed from Dalian Medical University, China and divided into four groups:normal control (n=10), Angle’s class I, II, III malocclusion (n=10, 8, 5). The protrusion, lateral, opening motion trace of mandibular central incisor and the right mandibular first molar, and the trace from mandibular postural position to intercuspal position were measured using the mandibular kinesiograph. The features of different occlusal patterns were analyzed using SPSS 17.0 software. RESULTS AND CONCLUSION:In the trace of protrusion, lateral, opening and closing motion, there were significant differences in the trace of the right mandibular first molar’s Max.Slant between Angle’s class II malocclusion group and the other three groups (P<0.05). In the trace of open wide and close fast, there were significant differences in the trace of mandibular central incisor in vertical distances between normal control group and Angle’s class I, III malocclusion groups (P<0.05);there were significant differences in the trace of mandibular central incisor in Max.Slant between normal control group and Angle’s class I malocclusion group (P<0.05);there were significant differences in the trace of the right mandibular first molar in vertical distances between Angle’s class II malocclusion group and the other three groups (P<0.05);there were significant differences in the trace of the right mandibular first molar in Max.Opening velocity between normal control group and Angle’s class II, III malocclusion groups (P<0.05). There were no significant differences in free space between the four groups (P>0.05). These results indicate that there are differences in the trace of mandibular central incisor and the trace of the right mandibular first molar in range and speed between different occlusal patterns. We can draw a conclusion that malocclusion has effects on the direction, range and speed of mandibular movement.