Objective A meta-analysis was conducted to figure out the effects of anesthetic methods on postoperative myocardial infarction in noncardiac surgery patients.Methods We searched PubMed, Embase, Ovid, Cochrane Library, Google scholar, CNKI, Wang-fang data and VIP Database (by September 2016) to identify relevant studies that focused on the effect of intrathecal blockade on postoperative myocardial infarction and mortality in non-cardiac surgery.Meta-analysis was performed using software of RevMan 5.3.Results A total of 21 859 patients from 10 RCTs were enrolled.The meta-analysis showed that there were no differences in myocardial infarction within 7 postoperative days (OR=0.44, 95%CI 0.13-1.46, P=0.18) or 30 days (OR=1.49, 95%CI 0.89-2.49, P=0.13) and all-cause mortality (OR=1.26, 95%CI 0.84-1.88, P=0.26) between epidural anesthesia combined with general anesthesia and general anesthesia.Furthermore, there were no differences in myocardial infarction within postoperative 7 days (OR=1.14, 95%CI 0.31-4.17, P=0.84) and all-cause mortality within postoperative 30 days (OR=0.88, 95%CI 0.43-1.79, P=0.73) between spinal anesthesia alone and general anesthesia alone.Conclusion Intrathecal blockade cannot affect the incidence of myocardial infarction and mortality in high-risk cardiac patients undergoing intermediate or high-risk non-cardiac surgery.

Objective Through analyzing nursing course-teaching plans of 10 representative higher vocational colleges,to realize advantages of the curriculum implementation and contents to be improved from the practical teaching perspective,to review the application of China's educational objectives as well as to provide the reasonable choice and practical support for deepened teaching reforms.Methods Statistical models were employed in analyzing 10 colleges' class hours and course composition.The results were compared with relative guidance documents in national scope.Results All 10 colleges' practical teaching relevant indicators exceeded the national criteria in running higher vocational colleges,but deviations were appeared in response of the national guidance of the nursing education,especially in clinical clerkship.Conclusions The quality guarantee of nursing course-teaching should be improved.A national policy should be implemented to combine the professional education accreditation with the nursing practitioner admittance,apply the minimum professional education standards to achieve the educational quality guarantee and guidance in each level.

0.05);the body weight of 170 and 357 mg/kg 3,4-DCA exposure groups decreased significantly(P

Objective To evaluate the clinical pathway (CP) for treatment of hepatic cystic echinococcosis.Methods Data were retrospectively obtained from hospitalized patients with hepatic cystic echinococcosis (CE) who were treated surgically between April 2011 to December 2012.Patient treated with the clinical pathway (the CP group) were compared with patients who were treated with conventional treatment (the non-CP group).The following outcomes were compared:the average length of in-hospital stay,the hospital charges,patient's satisfaction,patient's knowledge about his/ her own health and postoperative complications.Results For the CP groups,the length of in-hospital stay,the hospital charges,the patient's satisfaction and the health knowledge for the patients were (10.25±1.26)d,(19600.25±1520.73) yuan,(46.4 5±2.14),(83.50±8.02),respectively.The corresponding figures for the non-CP group were (14.25 ± 1.50) d,(23931.25 ± 1629.17) yuan,(42.65 ± 1.93),(74.50 ± 12.60),respectively.There were significant differences between the 2 groups (t=-4.086,-4.074,8.351,3.811 ; P＜0.05).The postoperative complications,including bile leakage,bleeding,ascites and pleural effusion,were 2,0,2 cases in the CP group,and 0,4,5 cases in the non-CP group.There were no significant difference between the 2 groups (x2 =0.17,0,0.6; P＞0.05).Conclusion Our initial clinical experience showed that the clinical pathway decreased the length of in-hospital stay and hospital charges,and provided quality and efficient clinical services to patients with hepatic cystic echinococcosis.

Objective To compare the efficacy of radical and quasi-radical hepatectomy for the treatment of end-stage hepatic alveolar echinococcosis(HAE)with involvement of major blood vessels and viscera.Methods The clinical data of 41 patients with end-stage HAE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2002 to January 2010.All patients were divided into radical hepatectomy group (13 patients)and quasi-radical hepatectomy group(28 patients)according to whether blood vessels were reconstructed and repaired.The operation time,blood loss,length of hospital stay,recurrence and metastasis of HAE,pleural effusion,ascites,biliary complications and death between the 2 groups were compared.All data were analyzed by using the t test or chi-square test.Results The volume of blood loss,length of hospital stay,number of patients with recurrence and metastasis of HAE,obstructive jaundice and number of dead patients were(326 ±115)ml,(22 ± 18)days,0,0,and 0 in the radical hepatectomy group,and were(24 ± 20)ml,(15 ± 12)days,10,10 and 10 in the quasi-radical hepatectomy group,there were significant differences between the 2 groups(t =13.41,1.47;x2 = 4.36,4.36,4.36,P ＜ 0.05).The operation time,number of patients with pleural effusion and ascites,bile leakage,cholangitis and number of patients died perioperatively were(407 ± 146)minutes,4,0,1 and 1 in the radical hepatectomy group,and(263 ± 93)minutes,2,2,2 and 1 in the quasi-radical hepatectomy group,there were no significant differences between the 2 groups(t = 3.81;x2 = 2.30,0.04,0.34,0.04,P ＞ 0.05).Conclusions Radical hepatectomy should be the first choice when construction of infringed vessels can be achieved.Quasi-radical hepatectomy has lower operation risks for avoiding important vessels injury.

Objective To explore the application of reading education in cultivating nursing students' humanities in vocational college.Methods Nursing students were selected at random and divided into two groups,35 students in the experimental group and 50 in the control group.The students in the experimental group were given the 2-year related instruction through reading activities in the light of the principle enhance general humanities foundation in the first grade and strengthen humanistic features in the second grade.Nursing skill assessment and questionnaire oriented to humanities were used to test the educational effect.Results The result of nursing skill assessment in the experimental group was significantly better than that of the control group.The score of humanities' moral,law,culture and aesthetic dimension and the total score of the experimental group were significantly better than those of the control group.Conclusions Well targeted reading is effective in the cultivation of nursing students' humanities.Meanwhile reading education can serve as an important and beneficial way to improve the cultivation mode of vocational college's nursing humanities.

Objective To observe the recent clinical efficacy of the sequential therapy hormone in the treatment of active rheumatoid arthritis.Methods In accordance with the principle of digital sheet,160 patients with active rheumatoid arthritis were randomly divided into the observation group and the control group,80 cases in each group.On the basis of methotrexate and leflunomide in both groups,the hormone sequential therapy was given in the observation group,but prednisone was given in the control group.The clinical efficacy of treatment after 1 week and 3 months were compared in two groups.Results In the observation group,the indicators in 7 d after treatment were significantly reduced,compared with untreated(t =19.90,7.63,14.73,7.58,6.84,14.09,all P ＜0.01),In the control group,three indicators of the duration of morning stiffness,joint tenderness index and joint swelling index in 7d after treatment were significantly reduced,compared with untreated (t =13.42,3.34,7.24,all P ＜ 0.01),Compared the indicators in the two groups in 7 d after treatment,there were statistically significant differences (t =13.07,4.92,10.51,5.23,5.74,15.03,all P ＜ 0.01).The indicators in the 3 months after treatment in both groups were signifi cantly decreased,buttherewasnosignificantdifferencebetweenthetwogroups (t =1.80,1.73,1.59,1.22,1.21,1.35,all P ＞ 0.05).The total effective rate was 80% in the observation group; but the rate was 75 % in the control group;there was no statistically significant difference in the two groups(x2 =0.57,P ＞ 0.05).Conclusion The sequential hormone therapy is an effective means for the treatment of active rheumatoid arthritis,by controlled the symptoms of rheumatoid arthritis effectively and alleviated the patient's condition.

Objective By the reform of vocational nursing Maternal and Child Care course teaching methods,to solve the problems existing in higher vocational curriculum in five-year nursing specialty such as too much repetition in teaching content,low learning interest and enthusiasm in students,and not being able to reach target level of personnel training effectively.Methods Higher vocational nursing class 2 (51students) were extracted as the experimental group,class 3 (50 students) were extracted as as the control group from grade 2009.The experimental group adopted the project teaching method,the control group used the traditional teaching method.At the end of the course,the results of knowledge and operating skills between the two groups were compared.Results The total scores of the experimental group were better than the control group in memorizing theoretical knowledge examination,interpretation,application.There were no differences in individual skill examination skills assessment between the two groups,comprehensive skills assessment and total scores of the experimental group was better than the control group.Conclusions Application of project teaching method in higher vocational nursing specialty maternal and child care course teaching in higher vocational cohesion.It can effectively avoid the repetition of teaching content which may lead to the low utilization rate in class,stimulate students' interest in learning,and develop students' comprehensive occupation ability,and make vocational course objectives to achieve high stage.

The family Gentianaceae are found mostly on the Qinghai-Tibet Plateau in China, which have important medicinal properties. Based on 27 published complete chloroplast genome sequences from Gentiana, Swertia, Halenia, Menyanthes, and Nymphoides of Gentianaceae, the chloroplast genome structure was analyzed. The cp genome sizes of 27 taxa range from 137 to 154 kb, and they contain 101-114 unique genes, including 67-80 protein-coding genes, 30 tRNA genes and four rRNA genes. Also, a Bayesian phylogenetic tree was constructed based on the 27 cp genome sequences with Pentalinon luteum (Apocynaceae) as the outgroup. The tree was topologically consistent with the treatments of traditional taxonomy, and the cp genome sequences have genus- or section-level resolution. In addition, we reviewed the significance of species identification within the family. These cp genome sequences could provide basic data for the endangered species conservation, the genetic analysis and pharmacognostic researches of herbs from Gentianaceae.

BACKGROUND: Studies are very few regarding the specific reaction of bone marrow mesenchymal stem cells (BMSCs) to activated microglia. Moreover, it remains unclear how MSCs maintain dopaminergic neuronal survival under specific microenvironment.OBJECTIVE: To explore the effect of BMSCs stimulated by activated microglia on dopaminergic neuron survival.METHODS: BMSCs were isolated from Wistar rats by attachment method, and in vitro cultured; microglia was activated, and dopaminergic neurons were cultured by enzyme digestion method. The experiment included 5 groups: BMSCs, microglia, lipopolysaccharide (LPS)+microglia; BMSCs+LPS+microglia groups, in which the dopaminergic neurons were cultured with corresponding culture medium; the dopaminergic neurons alone group was cultured with 10% fetal bovine serum+ DMEM/F12. The effect of different microenvironment on dopaminergic neuron survival and gliocyte-derived neurotrophic factor released from BMSCs were detected by immunofluorescence technique.RESULTS AND CONCLUSION: The release of gliocyte-derived neurotrophic factor in groups involving BMSCs was greater than corresponding control group. Tyrosine hydroxylase immunofluorescence showed that neuronal survival of dopaminergic neurons alone group was 15%, microglia group was 10%, LPS+microglia was 5%, but BMSCs+LPS+microglia group was 28%, significantly greater than the other groups (P < 0.05). In addition, survival of in vitro cultured dopaminergic neurons was decreased with increasing culture duration, but the survival of dopaminergic neurons in group involving BMSCs was significantly greater than corresponding control group. This indicates that microglia activation stimulated BMSCs to upregulate gliocyte-derived neurotrophic factor to prevent dopaminergic neurons from toxic injury, and inhibit delayed death of dopaminergic neurons.