Open reduction and internal fixation via two lateral approaches in treating Sanders type III intra-articular calcaneal fractures: a comparative analysis / 中华创伤杂志

Objective:To compare the post-operative outcomes between extended lateral approach and L-shaped lateral approach in surgical treatment of Sanders type III intra-articular calcaneal fractures.Methods:A retrospective case-control study was made on clinical data of 34 patients with fresh Sanders type III intra-articular calcaneal fractures hospitalized in Langfang Hospital of Traditional Chinese Medicine from October 2014 to October 2017. There were 33 males and 1 female, with the age of 18-56 years [(42.5±9.4)years]. All fractures were fresh. Seventeen patients were fixed by the extended lateral approach (extended approach group) and seventeen patients by L-shaped lateral approach (L-shaped approach group). Operation duration, intraoperative bleeding volume, length of hospital stay, one-stage wound healing rate and complication rate were observed. B?hler and Gissane angle were measured before operation, one week after operation and 12 months after operation. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was applied to evaluate function recovery.Results:There were no significant differences between groups in operative time and intraoperative bleeding volume ( P>0.05). There were significant differences between extended approach group and L-shaped approach group in length of hospital stay [(15.7±4.0)days vs.(22.4±9.6)days], one-stage wound healing rate [88%(15/17) vs. 47%(8/12)] and postoperative complication rate [12%(2/17) vs. 47%(8/17)] ( P<0.05). The B?hler and Gissane angles did not differ significantly between groups before operation and one week and 12 months after operation ( P>0.05). At postoperative 12 months, the B?hler and Gissane angles were improved from preoperative (8.2±6.0)°, (85.3±10.5)° to (23.9±6.1)° and (119.3±6.2)° respectively in extended approach group, and those from preoperative (9.4±3.9)°, (85.5±7.1)° to (25.8±3.7)° and (122.2±5.6)° respectively in L-shaped approach group (all P>0.05). At 12 months after operation, the AOFAS score was (86.9±7.5)points in extended approach group, with the excellent and good rate of 88%; and was (83.3±12.5)points in L-shaped approach group, with the excellent and good rate of 76% ( P>0.05). While the score of hindfoot joint activity in extended approach group was (5.8±0.7)points, significantly higher than (3.4±1.0)points in L-shaped approach group ( P<0.05). Conclusion:For Sanders III intraarticular calcaneal fractures, compared with L-shaped approach group, plate fixation via extended approach can promote fracture healing, shorten hospital stay, reduce incidence of complications and facilitate function recovery of subtalar joint.

The application of Critical Care Chest Ultrasonic Evaluation-plus Protocol in the etiological diagnosis of dyspnea and/or hemodynamic instability caused by abdominal abnormality / 中华内科杂志

Objective To investigate the application of Critical Care Chest Ultrasonic Examination (CCUE)-plus (CCUE-plus) in the etiological diagnosis in patieuts with dyspnea and/or hemodynamic instability caused by abdominal abnormalities.Methods Patients who suffered from dyspnea and/or hemodynamic instability in the Department of Critical Care Medicine,Xiangya Hospital,Central South University from September 2013 to September 2016 were recruited in this study.A total of 255 consecutive patients completed CCUE within 2hrs of admission.If the diaphragm could not be seen in the routine phrenic points according to Bedside Lung Ultrasound Evaluation (BLUE) protocol,it would be found along midaxillary line and defined m-point.The 59 patients with altered diaphragmatic position (m-point was more than 2 cm higher than phrenic point) received sequential abdominal ultrasonography.The latter ultrasonographic findings were compared with CT results.Results There were 42 (71.19％) cases with positive findings of abdominal ultrasonography,including 18 cases of seroperitoneum,16 cases of intestinal obstruction and 8 cases combined.Compared with 56 patients who applied with CT exam,the abdominal ultrasonography revealed a sensitivity of 76.7％ and a specificity of 100.0％ to diagnose seroperitoneum (AUCRoc 0.917);whereas the sensitivity was 75.0％ and the specificity was 90.9％ (AUCRoc 0.778) to diagnose intestinal obstruction.Moreover,there were 44 (74.58％) patients with normal left ventricular systolic function;more than three quarters (46/59,77.97％) patients had pulmonary consolidation.Conclusion In patients with dyspnea and/or hemodynamic instability caused by abdominal abnormalities and altered diaphragmatic position in BLUE protocol,CCUE-plus protocol has a high positive predictive value of more than 90％ in abdominal abnormality.The findings of abdominal ultrasonography may change therapeutic target from cardio-pulmonary optimization to relief of intestinal obstruction or drainage of seroperitoneum.

Development of practical and low-cost instrument for protein purification / 医疗卫生装备

To develop a low-cost, reliable, easy-to-maintain and practical instrument for protein purification. Some ultraviolet luminescent diode was used to provide 280 nm light source, and high-sensitivity S1336 photo-electric detector was employed for real-time monitoring of purified protein solution flowing through quartz cell to supervise the concentration of the protein. The instrument gave voice alarm and stopped working in case the protein concentration was less than the standard one. The lower SCM monitored the liquid level of the protein collecting cup and the position of loading arm through laser infrared distance sensor, so that a cup full of protein might be replaced by another empty cup. The instrument involved in Samsung S5PV210 embedded master computer, Wince6.0 operating system, Keil4.0 and VS2005. Trials proved that the instrument could perform real-time monitoring and curve display of dual-channel ultraviolet absorption, and could realize auto collection of 735 ml protein solution and up to 5-hour standby. The instrument developed has simple structure, high reliability and easy maintenance, and meets the desired require-ments.

Diagnostic value of serum procalcitonin for infection in the immunocompromised critically ill patients with ;suspected infection / 中华危重病急救医学

Objective To evaluate the diagnostic and prognostic value of the serum procalcitonin ( PCT ) level in the non-acquired immune deficiency syndrome ( AIDS ) immunocompromised critically ill patients suspected to have infection. Methods A retrospective study was conducted in the non-AIDS immunocompromised patients who were admitted to Department of Critical Care Medicine of Xiangya Hospital, Central South University during January 2011 to December 2014. Demographic characteristics, underlying disease, acute physiology and chronic health evaluationⅡ( APACHEⅡ) score at admission, and clinical records including baseline and peak levels of temperature, white blood count ( WBC ), PCT, and survival rate within 28 days, infection focus, infectious agents ( bacterial, fungi or mixed infection ), and the severity of infection ( sepsis, severe sepsis, or septic shock ) were recorded. Receiver operating characteristic ( ROC ) curve was plotted, and the diagnostic and protective value of above parameters was evaluated. Results A total of 98 patients ( 43 male and 55 female ) were enrolled in the study with a median age of 44 ( 28, 52 ) years old and a median APACHEⅡscore of 17 ( 11, 20 );47 with malignant hematological tumor, 45 with autoimmune diseases, and 6 post solid organ transplantation. Among them 53 patients ( 54.1%) died within 28 days. Twenty-seven patients were diagnosed as systemic inflammatory response syndrome ( SIRS ) without infection. Among 71 patients with infection, 45 were diagnosed as bacterial infection, 10 with fungal infection, and 16 with mixed infection. Sepsis was diagnosed in 7 patients, severe sepsis in 32 patients , and septic shock in 32 patients .①There was no statistical significance in the baseline and peak levels of PCT and WBC, or baseline level of temperature between the groups of SIRS patients without infection and infected patients. The peak level of temperature was significantly higher in the patients with infection as compared with that of the SIRS without infection patients [℃:39.4 ( 38.9, 40.0 ) vs. 38.8 ( 37.8, 39.2 ), Z=-3.268, P=0.001 ]. It was showed by subgroup analysis that in patients with hematological malignant disease or autoimmune diseases, higher level of body temperature was found in infection group compared with non-infection SIRS group [℃:39.5 ( 39.0, 40.0 ) vs. 39.0 ( 38.4, 39.4 ), Z=-2.349, P=0.019;39.0 ( 38.4, 39.5 ) vs. 38.2 ( 37.0, 38.9 ), Z=-2.221, P=0.026 ].②The baseline level of PCT (μg/L ) were 0.54 ( 0.20, 4.19 ), 2.78 ( 0.50, 9.54 ), 1.00 ( 0.45, 6.89 ), and 0.22 ( 0.07, 1.86 ) in non-infection SIRS patients or the patients with bacterial, fungal, and mixed infection, respectively. The peak level of PCT (μg/L ) were 4.19 ( 1.95, 13.42 ), 12.37 ( 3.82, 45.89 ), 1.82 ( 0.49, 17.86 ), and 5.14 ( 2.66, 12.62 ), respectively, in each subgroup. When the comparison was conducted among the patients with different infectious agent, the baseline level of PCT in patients with bacterial infection was significantly higher than that in SIRS patients without infection ( P=0.026 ) and mixed infection patients ( P=0.001 ), and the peak level of PCT was significantly higher than that in the SIRS patients without infection ( P=0.009 ) and the patients with fungal infection ( P=0.016 ). ROC curve showed that the higher value was found in the baseline and peak levels of PCT for diagnosis of septic shock in all patients [ area under ROC curve ( AUC ) of baseline level = 0.681±0.054, P = 0.001; AUC of peak level = 0.690±0.054, P=0.002 ], and the same value was also found in the baseline and peak levels of PCT for diagnosis of bacterial infection in the patients with malignant hematological tumor ( AUC of baseline level=0.687±0.080, P=0.008;AUC of peak level=0.697±0.079, P=0.021 ).③The peak level of PCT (μg/L ) were 4.05 ( 0.53, 31.22 ), 5.78 ( 2.14, 16.68 ), and 11.64 ( 2.94, 58.14 ) in subgroup of patients with sepsis, severe sepsis and septic shock, respectively, and they showed no statistical significance among subgroups ( P>0.05 ). A high serum level of peak PCT strongly indicated the presence of septic shock ( AUC=0.646±0.060, P=0.019 ), especially in the subgroup of patients with systemic autoimmune disease ( AUC=0.689±0.081, P=0.035 ).④The peak level of PCT (μg/L ) in the APACHEⅡ>18 group ( 38 cases ) was significantly higher than that of APACHEⅡ≤18 group [ 60 cases, PCT (μg/L ):11.64 ( 3.36, 39.39 ) vs. 4.42 ( 1.32, 14.70 ), P=0.016 ];there was a certain correlation between the peak level of PCT and the severity of the disease.⑤The peak level of PCT in death group was significantly higher than that of the survival group [μg/L:9.07 ( 3.05, 33.09 ) vs. 4.19 ( 1.26, 14.61 ), P=0.043 ]. ROC curve showed that the peak level of PCT might be valuable in predicting the prognosis in immunocompromised patients ( AUC=0.619±0.057, P=0.043 ). Conclusions The serum level of PCT is found to be a reliable marker for the diagnosis of bacterial infection in immunocompromised critical patients, especially in those with hematologic malignancy. Additionally, PCT provides a useful tool for evaluating the severity of infection and the prognosis of critically ill patients.

The impact of hyperthyroidism on erythrocyte indices and serum iron of rats / 重庆医学

Objective To study the change of erythrocyte indices and serum iron in hyperthyroidism rats .Methods SD female rats were randomly divided into hyperthyroidism group and control group .Hyperthyroidism rats were induced by intragastric ad‐ministration of Euthyrox (Levothyroxine) and their blood and serum were obtained after administration of 1-8 weeks ,respective‐ly .And the control rats were given normal saline .Levels of T3 ,T4 and TSH were determined by a radioimmunoassay .Erythrocyte index were measured by automatic blood cell analyzer .Serum iron concentration and total iron binding capacity were determined by chromatometry .Results The concentration of serum T3 and T4 increased in hyperthyroidism rats ,whereas the TSH decreased . RBC was higher in hyperthyroidism rats at 2-8 weeks compared with the control rats (P<0 .05) .HCT was higher in hyperthy‐roidism rats at 1-8 weeks compared with the control rats (P<0 .01) .MCV was lower in hyperthyroidism rats at 2-8 weeks com‐pared with the control rats (P<0 .05) .MCHC was lower in hyperthyroidism rats at 1 -8 weeks compared with the control rats (P<0 .01) .RDW SD and RDW CV was higher hyperthyroidism rats at 1-2 weeks compared with the control rats(P<0 .01) .Ser‐um iron concentration and total iron binding capacity increased in hyperthyroidism rats at 4 -8 weeks compared with the control rats(P<0 .01) .Conclusion The hyperthyroidism rats in the present study is absent significant manifestation of anemia ,whereas the hypochromic changes of erythrocyte is significant .Serum iron concentration and total iron binding capacity increase in hyperthy‐roidism rats ,which demonstrate the iron utilization disorder .

Detection of interleukin-10 and transforming growth factor-β1 in the culture supernatant of CD4+CD25+ T cells from patients with alopecia areata / 中华皮肤科杂志

Objective To evaluate the potential association of CD4+CD25+ T cells with alopecia areata.Methods Totally,this study enrolled 23 patients with progressive alopecia areata,25 patients with stable alopecia areata,and 25 healthy controls.Peripheral blood was isolated from these subjects followed by isolation of CD4+ CD25+ regulatory T cells,which were then cuhured with the presence of anti-CD3 and-CD28 monoclonal antibodies for four days.Subsequently,enzyme-linked immunosorbent assay was performed to measure the levels of interleukin (IL)-10 and transforming growth factor (TGF)-β1 in the culture supematant of these T cells.Results The levels of IL-10 and TGF-β1 were (31.68 ± 6.78) pg/ml and (32.29 ± 6.8) pg/ml respectively in the culture supernatant of CD4+CD25+ regulatory T cells from patients with progressive alopecia areata,significantly lower than those from the healthy controls ((57.34 ± 14.15) pg/ml and (57.43 ± 15.16) pg/ml,both P ＜ 0.05) and patients with stable alopecia areata ((52.56 ± 13.02) pg/ml and (61.75 ± 14.10) pg/ml,both P ＜ 0.05).However,no significant difference was observed in the supernatant levels of IL-10 or TGF-β1 between the healthy controls and patients with stable alopecia areata.Conclusions The secretion of IL-10 and TGF-β1 by CD4+CD25+ T cells is decreased in patients with progressive alopecia areata,which may contribute to the pathogenesis of alopecia areata.

Detection of interleukin-10 in sera and culture supernatants of CD4 +CD25 + T cells from children with atopic dermatitis / 中华皮肤科杂志

Objective To determine the level of interleukin (IL)-10 in sera and culture supernatants of CD4+CD25+T cells from children with atopic dermatitis (AD),and to evaluate its relationship with clinical course and severity of AD.Methods Totally,46 children with AD and 31 healthy controls were included in the study.All the patients were divided into 3 groups,i.e.,mild (n =10),moderate (n =16) and severe (n =20) group,according to severity scoring of atopic dermatitis (SCORAD) score.Venous blood samples were obtained from the patients and healthy controls.CD4+CD25+ regulatory T cells were separated from the blood samples by magnetic cell sorting (MACS) system in two steps and cultured in vitro.Enzyme linked immunosorbent assay (ELISA) was conducted to quantify the level of IL-10 in sera and culture supernatants of CD4+CD25 + T cells from these subjects.Analysis of variance was carried out to compare the level of supematant and serum IL-10 between the patients and controls,and Pearson correlation analysis to assess the relationship between the level of IL-10 and SCORAD score.Results The patients with mild,moderate and severe AD showed a similar serum IL-10 level compared with the healthy controls ((43.10 ± 25.07) pg/ml,(68.40 ± 36.65) pg/ml and (55.55 ± 41.97) pg/ml vs.(58.27 ± 36.84) pg/ml,all P ＞ 0.05).The level of supernatant IL-10 secreted by CD4+CD25+ T cells from the controls was significantly higher than that from the patients with severe AD ((55.15 ± 11.15) pg/ml vs.(27.25 ± 7.01) pg/ml,P ＜ 0.05),but similar to that from the patients with mild and moderate AD ((52.96 ± 11.69) pg/ml and (49.86 ± 9.18) pg/ml,respectively,both P ＞ 0.05).The level of secreted IL-10 was negatively correlated with SCORAD score (r =－0.757,P ＜ 0.01),whereas the serum level of IL-10 showed no statistical correlation with SCORAD score.Conclusion CD4+CD25+ T cells and IL-10 may be implicated in the development of AD.

Significance of central venous-to-arterial carbon dioxide difference for early goal-directed therapy in septic patients / 中南大学学报(医学版)

OBJECTIVE@#To determine whether central venous-to-arterial carbon dioxide tension difference (Pcv-aCO(2)) could still be used as a goal of fluid resuscitation in septic patients who already had ScvO2 greater than 70% after early resuscitation.@*METHODS@#A prospective observational study was performed on 56 septic patients admitted to the Intensive Care Unit (ICU) in a single University Hospital, who already had ScvO2 greater than 70% after early resuscitation. They were divided into two groups, based on whether the patients' initial Pcv-aCO2 was less than 6 mmHg (low gap group) or greater than or equal to 6 mmHg (high gap group). The following data were collected at 0, 12, and 24 hours (T(0), T(12), T(24)) after study inclusion: hemodynamic indices [mean blood pressure (MAP), heart rate (HR), cardiac output (CO), central venous pressure (CVP)], perfusion-related indexes [ScvO(2), Pcv-aCO2, serum lactate (Lac), Lac clearance rate], organ function- related indices [oxygenation index (PaO2/FiO(2)), serum creatinine (SCr), creatine kinase (CK-MB)], APACHE II score, SOFA score, and 24 hours amounts of fluid infusion.@*RESULTS@#Twenty patients (42.9%) with initial Pcv-aCO(2) ≥ 6 mmHg were included in the high gap group and another thirty-two patients were included in the low gap group. At T12 and T24, ScvO(2) and CO were significantly higher, and Lac and SCr were significantly lower in low gap patients than high gap patients (P 70% has achieved after early resuscitation, Pcv-aCO2 can still be used as a goal of fluid resuscitation in septic patients .

Imbalance between peripheral blood Th17 cells and CD4+CD25+ regulatory T cells in children with atopic dermatitis / 中华皮肤科杂志

ObjectiveTo evaluate the roles of imbalance between peripheral blood T helper 17 (Th17) cells and CD4+CD25+ regulatory T(Treg) cells in the pathogenesis of atopic dermatitis (AD).Methods Peripheral blood samples were obtained from 52 patients with AD aged 2-14 years and 30 age- and sex-matched healthy controls.Flow cytometry was performed to detect the percentage of Th17 cells and Treg cells in peripheral blood.Meanwhile,enzyme linked immunosorbent assay(ELISA) was carried out to detect the serumlevel of interleukin (IL)-6 and transforming growth factor (TGF)-β1.Results The children with AD showed a higher percentage of Th17 cells but a lower percentage of Treg cells in CD3+ T cells compared with the controls (( 1.20 ± 0.41 )％ vs.(0.54 ± 0.28)％,t =2.58,P ＜ 0.05; (2.29 ± 0.67)％ vs.(5.95 ± 0.45)％,t =15.23,P ＜ 0.01 ).Moreover,the serum level of IL-6 was significantly higher,while that of TGF-β1 was lower in patients with AD than in the controls ((5.12 ± 0.45) ng/L vs.(3.89 ± 0.38) ng/L,t =2.59,P＜ 0.05; (57.65 ± 10.78) ng/L vs. (81.18 ± 7.78) ng/L,t =5.41,P ＜ 0.01 ).ConclusionsChildren with AD experience a change in the percentage of Thl7 cells and Treg cells in peripheral blood as well as in the serum level of IL-6 and TGF-β1,and the imbalance between Th17 cells and Treg cells in peripheral blood may contribute to the development of AD.

meta-analysis of highly active anti-retroviral therapy for treatment of plasmablastic lymphoma

Plasmablastic lymphoma is a recently described B-cell derived lymphoma. The prognosis of plasmablastic lymphoma patients is usually poor. We performed a systematic review of the literature on the use of highly active anti-retroviral therapy [HAART] and the prognosis of plasmablastic lymphoma. A comprehensive search of relevant databases, including Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library, and the Science Citation Index yielded ten randomized controlled trials. Trials were divided into two groups according to therapy. The rates of plasmablastic lymphoma were analyzed using a fixed-effects model. Sensitivity analyses [on publication type, statistical model] were performed to further detect and evaluate clinically significant heterogeneity. Tests of survival for plasmablastic lymphoma were also performed by using Kaplan-Meier method. Meta-analysis result showed that the prognosis of plasmablastic lymphoma patients was statistically different in the patients receiving HAART in addition to chemotherapy and/or radiotherapy than in the patients receiving the chemotherapy and/or radiotherapy alone [pooled relative risk=3.04; P=.03]. Survival analyses also displayed a statistically significant difference [chi[2]=6.22, P=.013]. HAART in addition to chemotherapy and/or radiotherapy is effective in improving the prognosis of plasmablastic lymphoma. However, the small sample sizes increase the likelihood of bias in the studies in this meta-analysis, and therefore, the results should be taken cautiously

Detection and typing of human papillomavirus (HPV) as well as mutation analysis of HPV 6b L1 gene in lesions from patients with condyloma acuminatum / 中华皮肤科杂志

Objective To investigate the genotype of HPV and L1 gene polymorphism of HPV subtype 6b in patients with condyloma acuminatum (CA) from Wenzhou region. Methods Gene chips were used to profile the genotype of HPV in tissue samples from 73 patients with CA. PCR was performed to amplify the L1 gene in 11 samples positive for HPV type 6 followed by sequencing. Results Of the 73 patients, 61 (83.56%) were positive for HPV DNA. Among the 61 HPV-positive patients, 93.44% were infected with single type of HPV, and 6.56% with mixed type of HPV. In patients infected with single type of HPV, type 11 predominated with a prevalence of 29.51% followed by HPV 6 (18.03%); in those infected with mixed type of HPV, 6and 11 were the most common genotypes. Besides, sequencing analysis revealed single nucleotide polymorphism at 6 sites of HPV 6b type L1 gene, and an A/T polymorphism at position -810 was present in all samples, which was considered to be a local mutation of HPV from Wenzhou region. Conclusions In Wenzhou region, HPV types 11 and 6 prevail in patients with CA, and multiple mutations are present in L1 gene of HPV 6b type.

uPA,β-catenin expression status and microvessel density correlated to invasion and metastasis in thyroid carcinoma / 中国医师杂志

Objective To investigate the expression of urokinase-type plasminogen activator(uPA)and β-catenin proteins and their relationship with tumor angiogenesis,and explore their correlation with invasion and metastasis of thyroid carcinoma.Methods SP immunohistochemistry was performed to detect the expression of uPA,β-catenin and CD105 in 90 cases of thyroid carcinoma tissues.MVD counting was performed and analyzed in conjunction with the clinicopathological features of human thyroid carcinomas.Results The positive rate of uPA expression and abnormal expression rate of β-catenin and the MVD value was positively correlated with histological typing of thymid carcinoma.There was significant difference in thyroid carcinoma with lymph node metastasis,which was significantly higher than those cases without lymph node metastasis(P＜0.05),as well as between clinical stage Ⅲ～Ⅳ and Ⅰ～Ⅱ.The MVD value was significantly correlated with the positive expression of uPA and abnormal expression of β-catenin in thyroid.There was statistically significant correlation between the expression of uPA and β-catenin.Conclusion The expression of uPA protein in thyroid carcinoma was higher than those in normal.A reduced membranous expression rate and abnormal nuclear/cytoplasmic expression of β-catenin was observed in thyroid carcinoma cells,which was positively correlated with histological typing and clinical staging,invasion and metastasis in thyroid carcinoma.uPA and β-catenin were cooperated in angiogenesis of thyroid carcinoma.MVD was positively correlated with invasion and metastasis in thyroid carcinoma.They were hopeful to be an important prognostic indicator of thyroid carcinoma.

The exploration and practice of guarantee system of practical teaching quality in medical vo- cational colleges / 中华医学教育探索杂志

Practical teaching is an important component of higher medical education. The article introduced a number of exploration and experience of Shaoyang Medical College in building a practical teaching quality guarantee system,such as revising personnel training programs, optimizing practice teaching environment,enhancing teaching quality construction projects, strengthening teachers troop construction reinforcing teaching practice management and the teaching quality monitoring,etc.

To explore educational reform of the Academy of Medicine under building a new socialist countryside / 中华医学教育探索杂志

With the development of the socialist new rural reconstruction,the contradiction between the demand for medical health care and the insufficiency in hygienic resources in the countryside is increasingly prominent. Training the practical medicine talented person who are willing to go to the countryside and are able to stay there and be used for the countryside community has already become the important mission for the medicine higher professional training school. Taking my school’s actual situation as the example,we make exploration on orientting accurately,deepen medical education reform,establish and raise practical talented persons with skills.

On the Continuing Training of Nursing Ethics for Clinical Nurses / 中国医学伦理学

In this paper,the importance and the necessity of the continuing training of nursing ethics for clinical nurses were analyzed.Then,based on the needs and characteristics of current clinical nursing work in China,a preliminary study on the implementation of the continuing training was conducted in terms of the training objectives,process,content,form,and the evaluation approaches.