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The rapid expansion of China's influence on the world stage underscores the significance of nursing education and practice development. From collaborative models with other universities, nursing leaders in China are moving towards development of their own models that merge the uniqueness of Eastern philosophy with elements of Western models. Qualified nurse leaders are increasingly replacing physicians as faculty while nursing comes of age in a time of change and advancing knowledge. This article describes the outcomes of 2 projects to develop graduate nursing education in China, launched by the China Medical Board within the context of early Chinese nursing education history. The 2 programs produced a total of 88 new Masters of Science in Nursing, signaling a new generation of Chinese nursing leadership and posing a model for international partnership.

There is little evidence to suggest that T lymphocytes are involved in the leukemic process in chronic myeloid leukemia (CML). A case of CML in blast phase is described in which T-cell surface antigens were detected by immunofluorescence on the patient's blasts using monoclonal antibodies. In order to determine that the T-cell blasts were derived from the original CML clone, cells bearing the T3 antigen were isolated by fluorescence-activated cell sorting and chromosome analysis was performed. All metaphases examined had the Philadelphia chromosome, confirming their origin from CML.

Twelve rhesus monkeys were delivered prematurely at 129, 130, or 131 days. The first breath was inhibited while tracheotomy was performed and a catheter introduced into the umbilical artery. Into the tracheal tubes of six of the newborn monkeys was instilled 0.20 to 0.27 ml. of a natural surfactant (SA) suspension, obtained from lung wash of adult rabbits. Nothing was given to six control monkeys. Breathing was then supported with a ventilator. Although its settings were adjusted in attempts to maintain normal blood gases, the control monkeys developed severe hypercapnia and acidosis, and two died after 4½ and 5½ hours. The remaining four control monkeys and the six treated monkeys were killed after six hours. Pulmonary pressure-volume characteristics were conspicuously better following SA treatment. It was concluded that instillation of SA in the upper airways of premature primates prior to their first breath holds promise as an effective way of preventing respiratory distress.

1. The pathways of disposition of waste nitrogen were studied in a male infant with neonatal citrullinaemia during 3 months of normal growth on a protein-restricted diet supplemented by a mixture of amino acids and nitrogen-free analogues of amino acids. 2. The rate of excretion of urea averaged one-sixteenth, and the rate of excretion of total urinary nitrogen one quarter, of that reported in normal infants retaining the same amount of nitrogen per kg. Thus the efficiency of retention of dietary nitrogen for growth in this infant was very high. Plasma urea varied from 0·35 to 1·30 mmol/l. 3. The small amount of urea formed was apparently derived entirely from dietary arginine via arginase, as indicated by the observation that urea excretion and plasma urea were linear functions of arginine intake with intercepts of zero or less. These relationships imply that urea synthesis would cease at zero arginine intake. This hypothesis could not be verified because arginine intakes below 2·2 mmol day-1 kg-1 led to hyperammonaemia. 4. The high intake of arginine was required chiefly to replenish ornithine skeletons lost as citrulline in the urine (0·7 mmol day-1 kg-1). Smaller amounts of arginine were estimated to be required for protein synthesis and for creatine synthesis. The rate at which ornithine was utilized in reactions other than citrulline synthesis appeared to be excessively high. 5. Citrulline was the principal end-product of nitrogen metabolism, accounting for 51% of urinary nitrogen. 6. The results suggest that normal growth can be obtained in the virtual absence of the ability to dispose of waste nitrogen as urea.

Subtotal (95%) pancreatectomy has been advocated for hyperinsulinemic hypoglycemia unresponsive to medical therapy. We studied pancreatic exocrine function in infants with ICD before surgery, 1-2 mths after 95% resection of the pancreas (early po), and 1-2 yrs later (late po). We used a quantitative perfusion technique to collect duodenal secretions during pancreatic stimulation with IV secretin and CCK.Results are expressed as mean units/kg/hr, mean mEq/kg/hr(HCO3) and % of mean age-matched control values.Pre-op mean trypsin and HCO3secretion was depressed in ICD during medical therapy. Despite 95% resection, all pts had sufficient pancreatic function to absorb fat normally. By 2 mths po, considerable residual secretory capacity was present. Further functional improvement had occurred 1-2 yrs later. One pt operated on for recurrent hypoglycemia had definite evidence of pancreatic regeneration 3 yrs after initial resection.These pts demonstrate that infants may have significant potential to increase pancreatic exocrine secretory capacity after major resection, independent of developmental changes, presumably due to regenerative hyperplasia and/or hypertrophy.