Since participating in the clinical skills competition, the hospital has made consid-erable progress in the clinical practice teaching equipment, teachers, atmosphere and standards. This paper aims to explore the significance of competition to promote clinical practice teaching and sug-gests that under the existing conditions, we should improve the clinical skills curriculum and assess-ment, establish training standards, improve the level of clinical practice teaching, to give comprehen-sive support for cultivating excellent medical talents.

Objective To analyze the clinical effects of sevoflurane and propofol anesthesia on hemorrheology in elderly patients with colorectal cancer undergoing radical mastectomy.Methods 86 patients with colorectal cancer undergoing radical surgery in our hospital from March 2014 to December 2016 were selected and randomly divided into sevoflurane group and propofol group group with 43 cases in each group.Two groups of elderly patients were anesthetized before, 40 minutes after induction, 80 minutes after induction, 140 minutes after induction and 30 minutes after entering the anesthesia monitoring room 30 minutes to draw the neck 4 mL venous blood.Analysised of two groups of patients with hemorheology ( low cut blood viscosity, blood viscosity in the cut, high shear whole blood viscosity, plasma viscosity, erythrocyte deformation index, erythrocyte aggregation index) index.Results There was no significant difference in the difference of detection indexes between sevoflurane group and propofol group at each time point Comparison of sevoflurane group and propofol group in elderly patients, 40 min, 80 min after induction and 140 min after induction compared with those of pre-anesthesia low-cut whole blood viscosity, middle whole blood viscosity, high shear whole blood viscosity and plasma viscosity, the difference was statistically significant(P<0.05), erythrocyte deformation index and erythrocyte agglutination index were not significantly different between the two groups.The blood viscosity in the propofol group was significantly lower than that in the anesthesia group at 80 minutes after induction and 140 minutes after induction, the difference between the two groups was statistically significant (P<0.05).The whole blood viscosity of the sevoflurane group was significantly lower than that before anesthesia at 140 min, and the difference between the two groups was statistically significant (P<0.05).Conclusion From the point of view of hemorheology, sevoflurane and propofol anesthesia can be used in elderly patients with colorectal cancer radical operation.

Objective: To develop adriamycin liposome (AL) , adriamycin long circulating liposome (ALCL) and adriamycin long circulating temprerature-sensitive liposome ( ALTSL) and to study their anti-tumor effects on tumor-bearing mice. Methods: The antitumor activity was observed using the tumor weight as index. The life prolongation rate of mice was calculated according to the tumor-bearing mice survival time. The tissue distribution of adriamycin was determined by HPLC method. Tumor, heart, liver and kidney tissue of the tumor-bearing mice, were sliced and prepared to observe the tissue pathology differences. Results: Compared with free adriamycin, the anti-tumor effects of ALCL and ALTSL were remarkably increased. Their tumor growth inhibitory rates were 57. 8% and 67. 0% respectively. The study of pharmacoki-netics indicated that the adriamycin concentrations were remarkably higher in tumor tissue and blood,lower in heart and lung tissue of ALCL and ALTSL groups when compared with the free ADM group; The pathology slices indicated that tumor cells in the ALTSL group with hyperthermia were mostly destroyed; the cardiac muscle cells in the ALTSL group were similar to the normal cardiac muscle. Conclusion: ALCL and ALTSL remarkably increased the adriamycin concentration on the tumor site, significantly enhanced the anti-tumor effects, decreased the side-effects (such as cytotoxicity) when compared with free ADM, they also significantly prolonged the survival time of the tumor-bearing mice.

Objective To establish the HPLC determination method of chlorogenic acid for developing the quality standard of Yinqiao Jiedu Oral Liquid.Methods HPLC method was performed on an E.Merck LiChrospher 100RP-18 column(250 mm? 4 mm,5 ? m).The mobile phase consisted of acetonitrle and o.4 % phosphoric acid(10:100).The flow rate was 1.0 mL/min,column temperature was 30 ℃,and the detection wavelength was 327 nm.Results Chlorogenic acid was linear at the range of 0.12～ 0.63 ? g(r=0.999 6),the average recovery was 96.68 %,and RSD was 1.56 % .Conclusion This method is accurate,reliable,reproducible,and can provide evidence for the quality control of Yinqiao Jiedu Oral Liquid.

Objective To make a summary of the clinical application and cooperation of piezosurgery in jaw bone tumour operation. Methods 64 patients with jaw bone tumour were selected since 2007 and were divided into the piezosurgery group and the routine group, they used piezosurgery and routine osteotome respectively. Feelings during operation, operation time, hemorrhage, postoperative reaction and complication were observed and compared. Results Discomfort and hemorrhage during operation was lighter, but operation was longer in the piezosurgery group compared with the routine group. Complications such as postoperative infection, hemorrhage and nerve damage did not occurred. Conclusions Application of piezosurgery in jaw bone tumor operation can increase comfort degree and reduce hemorrhage, it requires proficiency in operation procedures and master key aspects of nursing, so that can cooperate well.

BACKGROUND:Cigarette smoking can seriously damage the periodontal tissues and root, and the nicotine in tobacco accelerates the progression of periodontal diseases. OBJECTIVE: To investigate the effect of different doses of nicotine on the expression of cyclooxygenase-2 mRNA in the periodontal tissue during orthodontic tooth movement. METHODS: Totaly 110 Sprague-Dawley rats were randomly divided into blank control group (n=10), normal saline group (n=25), 0.5 mg/kg nicotine group (n=25), 0.75 mg/kg nicotine group (n=25), 1 mg/kg nicotine group (n=25). Rats in the normal saline groups were injected intraperitonealy with 0.1 mL normal saline, and those in the three nicotine groups were respectively injected with 0.5, 0.75, 1 mg/kg nicotine tartrate solution. Except the blank control group, the unilateral maxilary first molars of rats in the other four groups were exposed to 50 g force. At 1, 3, 5, 7, 14 days under force, the rats were sacrificed to take the maxilary tissues. Hematoxylin-eosin staining was used to observe the changes of periodontal tissues, immunohistochemical staining was employed to count positive cels, andin situ hybridization staining was adopted to detect the mean absorbance value of cyclooxygenase-2 in the periodontal tissues. RESULTTS AND CONCLUSION:The number of odontoclasts and the expression of cyclooxygenase-2 in the nicotine groups were higher than those in the non-nicotine groups. With the increasing dose of nicotine, the number of odontoclasts gradualy increased, and the difference was statisticaly significant (P < 0.05). At 7 days under force, the number of odontoclasts reached the peak. With the increasing dose of nicotine, the positive expression intensity of cyclooxygenase-2 was also increased, and the difference was statisticaly significant (P < 0.05). The expression of cyclooxygenase-2 reached peak at 5 days under force. These findings indicate that with the increasing dose of nicotine, the number of odontoclasts and the expression intensity of cyclooxygenase-2 are both increased at the same time point under force. During the orthodontic tooth movement, the intake of nicotine can damage the periodontal tissue, and the dose of nicotine can directly influence the severity of damage to the periodontal tissue.

Pre-S2 protein in 78 samples of liver from patients with various types of hepatitis B was determined by immunohistochemical method.45 out of 78 samples (57.69%) were positive for pre-S2.The location and expression patterns of pre-S2 were similar to those of HBsAg,i.e.,pre-S2 was found in cytoplasm of hepatocytes,epithelial cells of bile ducts,and hepatocellular carcinoma cells,etc,Four different patterns diffuse,inclusion,submembranous,and membranous type were demonstrated.The membranous expression of pre-S2 was often associated with activity of liver diseases.The positive rate of pre-S2 was significantly higher in HBcAg positive group than HBcAg negative group.It seems that pre-S2 protein of HBV may be a replicative marker of HBV.

Medical education should combine clinical professional skills with humanities skills,integrate humanities knowledge into vocational education.Taking 2008 grade seven-year program clinical medicine students in the 2nd affiliated hospital of Harbin Medical University as fostering object,we made researches into students' understanding of doctor-patient relationship before practice and their mastering of skills.Through conducting questionnaire,we got to know the effect of humanities practice skill training for seven-year program clinical medicine students.Meanwhile,we compared students' self evaluation results before and after training,discussed on how to improve medical students' communication skills,cultural skills and the reform direction in an aim to guide students to transit from students to clinical doctor.

Objective:To explore the status of quality of sexual life, self-acceptance and self-disclosure in patients with breast cancer undergoing chemotherapy after surgery, and analyze the mediating effect of self-disclosure between self-acceptance and quality of sexual life.Methods:Using convenience sampling, 209 female patients with breast cancer undergoing postoperative chemotherapy in a Class Ⅲ Grade A hospital in Zhuhai from January to October 2022 were selected for investigation by using the General Information Questionnaire, Sexual Quality of Life Questionnaire for Breast Cancer Survivors, Self-Acceptance Questionnaire (SAQ) and Distress Disclosure Index (DDI). Pearson correlation was used to analyze the correlation between quality of sexual life, self-acceptance and self-disclosure in breast cancer patients undergoing chemotherapy after surgery. Bootstrap mediating effect method was used to analyze the mediating effect of self-disclosure between self-acceptance and quality of sexual life in breast cancer patients undergoing chemotherapy after surgery.Results:The scores of the quality of sexual life (average score of items), self-acceptance and self-disclosure of breast cancer patients undergoing chemotherapy after surgery were (2.69±0.59), (38.61±5.32) and (35.90±5.73) respectively. The quality of sexual life of patients was positively correlated with self-acceptance and self-disclosure, and self-acceptance had a mediating effect on the quality of sexual life through self-disclosure ( P<0.05) . Conclusions:The quality of sexual life of breast cancer patients undergoing chemotherapy after surgery needs to be improved. Helping patients increase their self-acceptance and self-disclosure level will help them improve their quality of sexual life.

Objective:To explore the posttraumatic growth of first stroke patients and analyze its dynamic development trajectory.Methods:From January to December 2022, 180 stroke patients admitted to Xinxiang Central Hospital were selected as research subjects by convenience sampling. The Posttraumatic Growth Inventory (PTGI) score was dynamically evaluated at the end of the first month (M 1), second month (M 2), third month (M 3), fourth month (M 4), fifth month (M 5), and sixth month (M 6) of onset. The latent class growth model (LCGM) was used to analyze the developmental trajectory categories, and multiple Logistic regression was used to analyze the influencing factors of posttraumatic growth trajectory categories. Results:A total of 180 questionnaires were distributed, and 177 valid questionnaires were collected, with a valid response rate of 98.33% (177/180). Within six months, the patient's PTGI score gradually increased, with the lowest PTGI score (29.11±5.65) at M 1 and the highest proportion of low-level growth, accounting for 85.31% (151/177). At M 6, the PTGI score was (42.14±13.04), and the proportion of low-level growth was 40.68% (72/177). Two latent categories of posttraumatic growth, namely sustained low growth type and growth improvement type, were identified, with 72 cases of sustained low growth type and 105 cases of growth improvement type. Gender ( OR=2.648, P=0.008), age ( OR=1.055, P=0.002), education level ( OR=6.403, P<0.001), and stroke type ( OR=2.863, P=0.014) were the influencing factors for posttraumatic growth trajectories among stroke patients. Conclusions:Post traumatic growth in stroke patients is a dynamic state of change, with low overall levels and a common type of sustained low growth. There may be differences in the sociodemographic and disease characteristics of patients with different types of posttraumatic growth trajectories, providing reference for the development of clinical nursing strategies, but further research is still needed.