In term of innovating in teaching,the text proposes some rectification and improvement measures according to the weak point existing in the chemical experiment in the past.We have improved the teaching quality of the chemical experiment through improving teacher's innovative quality,adjusting the experiment content rationally,changing the teaching mode of the experiment and examining method,and optimizing the experiment means,etc.

Objective To investigate the posttraumatic stress disorder(PTSD) and ethical decision-making in nurses suffered workplace violence, and analyze the relmionship between them. Methods Totally 340 nurses suffered workplace violence were questionnaired by the PTSD Scale and the Ethical Decision- making Scale. Results The incidence rate of PTSD was 17.06%(58/340), the total score of PTSD was (38.77± 13.57).The scores of ideal ethical practice, actual ethical practice and ethical decision- making in the PTSD group were 121.36±8.33, 105.56±7.76, 226.92±15.52, and were significantly lower than that in the non-PTSD group (140.60±9.01, 117.65±8.41, 258.27±16.73) (t=-14.996, -10.015, -13.153, P < 0.01). The score of PTSD was negtively correlated with the scores of ideal ethical practice, actual ethical practice and ethical decision- making (r=-0.415, -0.431,-0.420, P < 0.05). Conclusions The PTSD probably occurred after workplace violence, nursing administrators should pay close attention to the PTSD and therefore improve nurses′ethical decision-making.

OBJECTIVE:To investigate the effect of arsenic trioxide(As2O3)on human hepatoma cells SMMC-7721 viability and the expression of urokinase plasminogen activator receptor(uPAR).METHODS:SMMC-7721 cells were cultured and treated with As2O3 at different concentrations for different time with untreated SMMC-7721 cells(without As2O3 treatment)served as control.The proliferation rate of the SMMC-7721 cells was measured by MTT assay;the change of cell cycle was detected by flow cytometry analysis;the effect of As2O3 on uPAR mRNA levels was analyzed by real-time fluorescent quantitative polymerase chain reaction.RESULTS:As2O3 had significant inhibitory effect on SMMC-7721 proliferation in time-dependent and concentration-dependent manner.As compared with control group,As2O3 significantly decreased the proportion of cells in G0/G1 phase but increased the cell proportion in G2/M phase,and it markedly down-regulated the level of uPAR mRNA expression(P

Objective: To observe the efifcacy and safety of bivalirudin on primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI).
Methods: A total of 159 patients with acute STEMI treated by emergent PCI in our hospital from 2011-09 to 2014-01 were retrospectively studied. The patients were divided into 2 groups according to procedural bivalirudin application as Bivalirudin group and Heparin group, and the application of GPI (glycoprotein IIb/IIIa inhibitor) was decided by the operator. The baseline condition, coronary artery imaging condition, peri-operative and 30-day post-operative bleeding, the occurrence rate of MACE were compared between 2 groups.
Results: There were 153 patients completed the follow-up study including 72 in Bivalirudin group and 81 in Heparin group. The peri-operative bleeding rates in Bivalirudin group and Heparin group were 6.5% vs 11.0%, the in-stent thrombosis rates were 0% vs 1.2%, 30-day post-operative bleeding rates were 9.7% vs 13.5% and the occurrence of MACE were 1.4% vs 7.4% allP>0.05.
Conclusion: THE application of bivalirudin in emergent PCI is safe and effective in patients with acute STEMI, it has certain trend to reduce bleeding in relevant patients.

Objective To provide the scientific evidence for studying Alzheimer's disease (AD) and decision-making for its management by analyzing the strategic information of hotspots in studies on AD.Methods Citation strategic coordinate diagram was plotted by describing the history of studies on AD with co-citation clustering for further understanding the novelty and concern of hotspots in studies on AD.The current hotspots in studies on AD were discovered by co-words clustering and their strategic coordinates were analyzed to reveal their development periods.Results The current hotspots in studies on AD were substance metabolism in AD patients, etiology of AD and therapies for AD.The diagnosis of AD according to its clinical characteristics and hypothesis on amyloid cascade in AD patients were greatly concerned.Conclusion Citation strategic coordinate analysis and co-words strategic coordinate analysis can display the hotspots in studies on AD and their development history.

Objective To investigate the expressions, clinical pathological features and prognostic significance of HIF-1?, JNK1 and multidrug resistance proteins: P-gp, MRP1 and LRP in human gastric carcinoma. Methods The tissue microarray technique and immunohistochemical EnVision method were used to detect HIF-1?, JNK1, P-gp, MRP1 and LRP proteins in 135 specimens of gastric carcinoma and 27 gastric mucosa tissues. Results In gastric carcinoma, the positive expression rate of HIF-1?, JNK1, P-gp, MRP1and LRP was higher than that in gastric mucosa tissues (P

Objective To explore the quality of randomization of RCT in medical periodicals of China.Methods We designed a table of quality evaluation of RCT.and then randomly chose 137 articles entitled with "random control",which were published in 1995,2000,and 2005.Results Of the 137 articles,103 meet the requirement of this research.Of the 103 articles,99 didn't include the details of randomization (96.1%),100 didn't present the sampling methods(97.1%).Articles published in 1995 totally didnt include the introduction of randomized sampling And grouping methods, but the situation got beuer in 2000 and 2005.There was 63.1% included clear description of diagnostic criteria.Of remaining of 36.9%, 23.3% included either in drawing or excluding criteria,50.5% included both, and 26.2%included none,For grouping,69.9% included the introduction of the baseline of each group, and 30.1%didn't.Conclusions There were some problems in the RCT,such as lack of rigorous in randomization, incomplete in diagnostic,in drawing,and excluding criteria,and lack of clear introduction of the baseline.which revealed there were still much work needed to be done to improve the clinical research level in our country.

BACKGROUND: Growth factors and other biological methods have become very popular in the repair of degenerative interevrtebral disc. Insulin-like growth factor-1 (IGF-1) can promote the proliferation of nucleus pulposus cells, and synthesis of functional extracellular matrix, but the mechanisms remain unclear.OBJECTIVE: To investigate the effect of IGF-Ⅰ on the expressions of aggrecan and collagen type Ⅱ in nucleus pulposus cells, and to explore its signal transduction mechanism.METHODS: The human nucleus pulposus cells were isolated and cultured. Passage 3 nucleus pulposus cells were induced in different concentrations of IGF-1 (0, 20, 50, 100 and 200 μg/L), respectively. The expressions of aggrecan and collagen type Ⅱ were detected by reverse transcription PCR and western blot assay. Western blot assay was adopted to observe the effect of 100 μg/L IGF-1 on the activation of PI3K/Akt signaling pathway in nucleus pulposus cells,and the expression of aggrecan and collagen type Ⅱ was detected after the inhibition of PI3K/Akt pathway by LY294002.RESULTS AND CONCLUSION: With the increase of IGF concentration, the expression levels of aggrecan and collagen type Ⅱ were increased gradually. 100 μg/L IGF-1 could significantly promote the expressions of p-PI3K and p-Akt (P <0.01), while LY294002 reversed this effcet (P < 0.01). 100 μg/L IGF-1 significantly upregulated the expression levels of aggrecan and collagen type Ⅱ in nucleus pulposus cells (P < 0.01); in contrast, LY294002 significantly downregulated the expression levels of aggrecan and collagen type Ⅱ promoted by IGF-1(P < 0.01). These results indicate that IGF-1 can promote the expression levels of aggrecan and collagen type Ⅱ in nucleus pulposus cells via the PI3K/Akt signaling pathway.

Objective To evaluate the value of tissue Doppler imaging (TDI) in diagnosing pulmonary arterial hypertension(PAH) with common simple congenital heart disease(CHD).Methods 104 patients of CHD approved by operation or intervention were retrospectively analyzed.Both TDI and right cardiac catheterization were performed in all patients,whose were divided into PAH and non-PAH groups according to mean pulmonary arterial pressure (mPAP) on diagnostic right cardiac catheterization:60 PAH patients[mPAP ≥25 mmHg(1 mmHg =0.133 kPa) and pulmonary arterial capillary wedge pressure ≤15 mmHg],44 non-PAH patients (mPAP ＜25 mmHg).The PAH group was divided into mild (25 mmHg≤ mPAP≤35 mmHg),moderate (36 mmHg≤mPAP≤50 mmHg) and severe (mPAP＞50 mmHg) subgroups.The tricuspid annular systolic peak velocity (TS'),early diastolic peak velocity (TE'),late diastolic peak velocity (TA') were measured by TDI and TE'/TA' and Tei index were calculated.The correlation between TDI parameters and the cardiac catheterization findings (sPAP,mPAP and dPAP) were assessed.Results ①TS' and TE' in PAH group were significantly lower than those in non-PAH(P ＜ 0.05),but Tei in PAH group were significantly higher than that in non-PAH (P ＜0.001),however,there were no significant difference in TA' and TE'/TA' between two groups (P ＞ 0.05).②Tei correlated positively with pulmonary arterial pressure (P ＜0.001),TS' was found to be negatively correlated with pulmonary arterial pressure(P ＜0.05),but no correlation between TE',TA',TE'/TA' and pulmonary arterial pressure(P ＞0.05).③ROC analysis showed the area under curves for Tei index and TS' diagnosis for PAH was 0.893 and 0.699,respectively.At the cutoff of Tei＞0.49 and TS'＜16 cm/s for indicating PAH,the sensitivity were 86.67 ％ and 80.00％,respectively and the specificity were 79.55 ％ and 45.45 ％,respectively.④Tei in the moderate and severe PAH were significantly higher than that in mild PAH (P ＜ 0.05),TS' and TE' in severe PAH were significantly lower than those in mild and moderate PAH (P ＜ 0.05),At the cutoff of Tei＞0.55 for indicating moderate or severe PAH,the sensitivity and specificity were 95.24％ and 72.22％.Conclusions Tei index and TS' have high application value in assessing PAH and classification of PAH.Tei＞0.49 indicates PAH,while Tei＞0.55 suggests moderate or severe PAH.

Objective To investigate the ultrasound imaging findings of anatomical relationship between femoral artery and vein in children of different ages.Methods Sixty-five children aged 4 months-7 years were enrolled in this study.The children were divided into 3 age groups: group Ⅰ＜ 1 yr;group Ⅱ 1-3 yr and group Ⅲ＞ 3,≤ 7 yr.A protable ultrasound machine was used.The probe was placed at the level of inguinal ligament and 2 and 4 cm below inguinal ligament.The children were placed in supine position.The legs were placed in 2 positions:(1)extended and in standard anatomical position and(2)flexed and 45° abducted and 45° laterally rotated.Results The examination showed that at the level of inguinal ligament,the femoral vein lay behind and lateral to femoral artery in 91% of children.At the level of 4 cm below inguinal ligament,the femoral vein lay posterior and lateral to the femoral artery in all children.When the leg was placed in abducted and laterally rotated,the depth of femoral vein was reduced and the vein was less overlapped by artery in all children,especially in preschool children.Conclusion At the level of 4 cm below inguinal ligament,the femoral vein lies posterior and lateral to the femoral artery in children.When the leg is placed in abducted and laterally rotated,the depth of femoral vein is reduced and the vein is less overlapped by artery.It is indicated that femoral vein puncture should be performed at the level of 4 cm below inguinal ligament with the leg flexed and abducted in all children,especially in preschool children.