Objective To analyze the factors that influence the learning effectiveness of students in higher vocational medical school and to explore the ways to improve the teaching effect of higher medical vocational education.Methods Self-designed questionnaire survey was conducted to investigate the basic condition,study status,teaching satisfaction degree and socre influencing factors of 639 students before internships.Teaching efficacy was assessed by scores (taking full score 100 as the standard,≥ 85 are the first class,≤70 are the second class and the rest are the third class).SPSS 14.0 was employed to do statically analysis and an orderly regression analysis was made by taking the factors affecting student learning outcomes as independent variable and the level of learning outcomes as dependent variable.Results There were statically differences in learning efficacy between nurse group and medical student group (Z=-4.817,P=0.000).Students' interests in discipline,family rearing patterns,secondary education means,whether doing preview and study style satisfaction were factors that influence the learning effectiveness.Conclusions Strengthening ideological education and learning atmosphere improvement as well as encouraging students to adopt appropriate learning methods can help students improve their learn-ing effectiveness.

Objective To investigate and analyze the influencing factors of community nursing cognition and employment intention of higher vocational nursing students,and provide reference for higher vocational colleges to carry out community nursing education and employment guidance.Methods Using the stratified cluster sampling method,nursing students from different grades and different education levels were selected as the object of study and participate in the questionnaire survey.Results The nursing students from different grades,education levels and areas showed significant difference in community nursing and employment intention.Conclusions Higher vocational nursing colleges should strengthen the community nursing practice education and community employment guidance; improve the community nursing cognition and community employment intention of nursing students.

Objective To further investigate clinical manifestations and management for thallium poisoning. Methods Clinical data of 6 patients who were hospitalized in Union Hospital of Tongji Medical College in May 2008 with diagnosis of acute or chronic thallium poisoning,were retrospectively analyzed.Results Six patients (4 male and 2 female) ,aged from 12 to 50,came from one family (two sisters with their husbands and sons). Five of them (3 acute and 2 chronic,for the second time in half a year,thallium poisoning) initiated with peripheral neuritis,represented with severe burning pain,numbness,paresthesia in the lower limbs,accompanied with or without gastrointestinal symptoms. A 12 year-old boy with obviously elevated urinary thallium concentration was asymptomatic. Blood and urinary thallium concentrations of the patients were determined by atomic absorption spectrophotometry and were all significantly elevated.Treatment was initiated using potassium supplementation,diuresis,oral laxatives,Prussian blue and intramuscular injection of dimercaptopropansulfonate sodium.Meanwhile two of them were treated with hemoperfusion. Finally,two of them recovered,another two were transferred to a specialized hospital for continuous treatment,and the rest two deteriorated rapidly with occurrence of unconsciousness and died of multiple organ failure. Conclusions The main clinical manifestations of thallium poisoning are multiple peripheral neuritis,gastrointestinal symptoms and dermatological changes. In order to avoid missed diagnosis and misdiagnosis,a high suspicion should be arose for thallium poisoning when a patient suffering from the above symptoms.Prussian blue was considered traditionally as an effective therapeutic strategy for the condition,and hemoperfusion may be a more effective treatment for acute thallium poisoning.

Objective To discuss the effect and application value of applying the master teacher responsibility system in neurology teaching. Methods 100 five-year medical students were randomly di-vided into the experimental group and the control group with computer. Master teacher and teaching team were set in the experimental group to use a variety of teaching methods for course-teaching. At the same time, the traditional teaching method was used in the control group. After the course, theory test was arranged for the two groups blindly. Statistic tool SPSS 13.0 of t test was used to evaluate the teaching effect of these two groups. And capability-oriented questionnaire survey for experimental group was conducted to survey students' subjective assessment of their own learning. Results The experimental group students' average score of the theory examination was (73.87±7.12), while control group students' average score was (73.18± 9.94), and the difference was not statistically significant (t=0.265, P=0.792). Besides, there was no signifi- cant difference in the scores of male and female students in the experimental group either (t=0.068, P=0.947). Teaching satisfaction survey results showed that 100% (16/16) of the experimental group students believed that their ability of autonomous learning, problem analysis and team cooperation was improved significantly. Conclusion Setting up master teacher responsibility system is beneficial to strengthening teacher team and cultivating students' autonomous learning ability, and it also ensures the fairness of the exam. But it still need to be improved in the quality of teachers, quantity of students, process supervision and so on to ensure the teaching effect.

Objective To investigate the change of peripheral blood lymphocyte immunophenotype in the patients with malignant carcinoma and its clinical significance .Methods The flow cytometry was adopted to detect the expression levels of peripheral blood T lymphocyte subpopulations ,CD19+ cells ,CD3-CD56+ cells ,CD3+CD56+ cells in 167 patients with malignant carcinoma (inclu‐ding respiratory tract cancers ,gastrointestinal cancers and reproductive system cancer) and 170 normal controls as the healthy con‐trol group .The contrastive analysis was performed .Furthermore the analysis was conducted according to whether having tumor me‐tastasis and chemotherapeutic cycles .Results The total absolute value of the lymphocytes and the proportion of CD3+CD4+ cells in the patients with malignant carcinoma were significantly lower than those in the healthy control group (P<0 .05) ,but the propor‐tions of CD3+CD8+ ,CD3+CD56+ and CD3-CD56+ cells were significantly higher than those in the healthy control group (P<0 .05) .The proportion of CD3+CD4+ cells in the patients with tumor metastasis were significantly lower than those in the ones without tumor metastasis ;but the proportions of CD3+ CD8+ ,CD3-CD56+ and CD3+ CD56+ cells were significantly higher than those in the ones without tumor metastasis ,the differences were statistically significant(P<0 .05) .In the chemotherapy treatment , the proportions of CD3+CD4+ ,CD3+CD56+ and CD3-CD56+ cells were gradually increased with the increase of chemotherapeutic cycles ,but the proportion of CD3+CD8+ cells was gradually reduced .Conclusion In the process of development ,progression and treatment of tumor ,the cellular immunity function plays a dominant role ,which could be used as one of indexes for clinically moni‐toring the cellular immune function in the patients with tumor .

Objective To determine the expression levels of serum miR-25 in the patients with non-small cell lung cancer (NSCLC),and evaluate its clinical significance in the screening of NSCLC.Methods Serum samples from 82 untreated NSCLC patients,including 4 with TNM satge Ⅰ,10 with TNM stage Ⅱ,11 with TNM stage Ⅲ,53 with TNM stage Ⅳ and 4 with unknown stage,and 82 healthy controls with matched age and gender were collected,and the levels of miR-25 in these samples were determined by quantitative reverse transcription PCR (qRT-PCR).The diagnostic value of miR-25 in NSCLC was evaluated by the receiver operating characteristic (ROC) curve.Results Serum miR-25 levels in NSCLC patients were significantly higher than that in healthy controls (0.017 ± 0.028 vs 0.004 ±0.004,t =4.098,P ＜0.01).The area under the ROC curve (AUGROC),sensitivity and specificity of miR-25 for the diagnosis of NSCLC were 0.818 (95％ CI:0.753-0.882),70.7％ and 80.7％,respectively.In addition,the AUCROC,sensitivity and specificity of serum miR-25 for the screening of stage Ⅰ/Ⅱ NSCLC were 0.852 (95％ CI:0.728-0.976),78.6％ and 87.8％,respectively.Logistic regression analysis showed that miR-25 was an independent risk factor of NSCLC (OR =10.84,95％ CI:5.07-23.19,P ＜ 0.01).Conclusion Serum miR-25 levels in NSCLC patients increase significantly,indicating that it may be a novel molecular biomarker for the screening of NSCLC.

AIM:To investigate the effect of gastrodin(GAS)on microglia-mediated inflammatory response after hypoxic-ischemic brain damage(HIBD)neonatal mice by regulating the expression of JAK1/STAT1 pathway through C-C chemokine recepeor 5(CCR5).METHODS:Forty-eight C57BL/6J mice at about 10 days after birth were randomly divided into sham group,HIBD model group and HIBD+GAS group.BV-2 microglia were divided into control(Con)group,oxygen glucose deprivation(OGD)group,oxygen glucose deprivation with gastrodin intervention(OGD+GAS)group,GAS group,Maraviroc(MVC)group,OGD+MVC group,and OGD+MVC+GAS group.The mRNA expression of CCL4 and CCR5 were detected by RT-qPCR.The protein expression of CCR5,p-JAK1,p-STAT1,tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were detected by Western blot.The expression of CCR5,p-JAK1 and p-STAT1 in cells were observed by immunofluorescence staining.RESULTS:(1)Compared with sham group,the expression levels of CCL4 and CCR5 mRNA,and CCR5,p-JAK1 and p-STAT1 proteins were significantly higher in the ischemic side of the corpus callosum in HIBD group(P＜0.05).(2)Compared with Con group,the protein levels of CCR5,p-JAK1 and p-STAT1 significantly increased in BV-2 cells of OGD group(P＜0.05).The protein levels of CCR5,p-JAK1 and p-STAT1 in BV-2 cells of OGD+GAS group were significantly lower than those of OGD group(P＜0.05).(3)Maraviroc did not cause significant BV-2 cell death in the 0～80 μmol/L range.The p-JAK1 and p-STAT1 protein levels in MVC+OGD group were significantly lowered compared with OGD group(P＜0.05),but no significant difference was found between MVC+ OGD and OGD+MVC+GAS groups.CONCLUSION:Gastrodin can exert neuroprotective effects via CCR5/JAK1/STAT1 signaling pathway.

Objective To investigate the mechanism behind the protective effects of gastrodin against microglia-mediated inflammatory responses following hypoxic-ischemic brain damage(HIBD)in neonatal mice.Methods Thirty-six 10-day-old C57BL/6J mice were randomized into sham-operated group,HIBD(induced by ligation of the left common carotid artery followed by hypoxia for 40 min)group,and HIBD with gastrodin treatment groups(n=12).In gastrodin treatment group,100 mg/kg gastrodin was injected intraperitoneally 1 h before and at 2 and 12 h after hypoxia.After the treatments,the expressions of CCR5,AKT,p-AKT,and TNF-α and the co-expression of IBA1 and CCR5 in the corpus callosum of the mice were detected with Western blotting and immunofluorescence double staining.In a BV2 microglial cell model of oxygen-glucose deprivation(OGD),the effects of pretreatment with gastrodin and Maraviroc(an CCR5 antagonist)on protein expressions of CCR5,AKT,p-AKT,TNF-α and IL-1β were evaluated using Western blotting and immunofluorescence double staining.Results The neonatal mice with HIBD showed significantly increased expressions of CCR5 and TNF-α with lowered p-AKT expression in the brain tissues,and GAS treatment obviously reversed these changes.HIBD also significantly increased the co-expression of IBA1 and CCR5 in the corpus callosum of the mice,which was obviously lowered by gastrodin treatment.In BV2 cells,OGD significantly increased the expressions of CCR5,TNF-α,and IL-1β and decreased the expression of p-AKT,and these changes were inhibited by treatment with gastrodin,Maraviroc or their combination;the inhibitory effect of the combined treatment did not differ significantly from that of gastrodin or Maraviroc alone.Conclusion Gastrodin can produce neuroprotective effects in neonatal mice with HIBD by inhibiting inflammatory cytokine production and activate AKT phosphorylation via inhibiting CCR5.

Objective To investigate the mechanism behind the protective effects of gastrodin against microglia-mediated inflammatory responses following hypoxic-ischemic brain damage(HIBD)in neonatal mice.Methods Thirty-six 10-day-old C57BL/6J mice were randomized into sham-operated group,HIBD(induced by ligation of the left common carotid artery followed by hypoxia for 40 min)group,and HIBD with gastrodin treatment groups(n=12).In gastrodin treatment group,100 mg/kg gastrodin was injected intraperitoneally 1 h before and at 2 and 12 h after hypoxia.After the treatments,the expressions of CCR5,AKT,p-AKT,and TNF-α and the co-expression of IBA1 and CCR5 in the corpus callosum of the mice were detected with Western blotting and immunofluorescence double staining.In a BV2 microglial cell model of oxygen-glucose deprivation(OGD),the effects of pretreatment with gastrodin and Maraviroc(an CCR5 antagonist)on protein expressions of CCR5,AKT,p-AKT,TNF-α and IL-1β were evaluated using Western blotting and immunofluorescence double staining.Results The neonatal mice with HIBD showed significantly increased expressions of CCR5 and TNF-α with lowered p-AKT expression in the brain tissues,and GAS treatment obviously reversed these changes.HIBD also significantly increased the co-expression of IBA1 and CCR5 in the corpus callosum of the mice,which was obviously lowered by gastrodin treatment.In BV2 cells,OGD significantly increased the expressions of CCR5,TNF-α,and IL-1β and decreased the expression of p-AKT,and these changes were inhibited by treatment with gastrodin,Maraviroc or their combination;the inhibitory effect of the combined treatment did not differ significantly from that of gastrodin or Maraviroc alone.Conclusion Gastrodin can produce neuroprotective effects in neonatal mice with HIBD by inhibiting inflammatory cytokine production and activate AKT phosphorylation via inhibiting CCR5.

Objective:To investigate the effect of gastrodin(GAS)on the sex-determining region Y-box2(SOX2)/β-catenin pathway in microglia induced by lipopolysaccharide(LPS).Methods:BV2 microglia was cultured in vitro and divided into the following groups:Control group(Control),LPS group(LPS),LPS+0.17 mmol/L gastrodin treatment group(LPS+GAS-L),LPS+0.34 mmol/L gastrodin treatment group(LPS+GAS-H),SOX2 inhibitor pronethalolgroup(PR),LPS+PR group(LPS+PR),and LPS+PR+GAS group(LPS+PR+GAS).Effect of PR on BV2 microglia viability was detected by CCK-8.The expression of SOX2,β-catenin,mannose receptor(CD206)and tumor necrosis factor-α(TNF-α)was assessed using Western Blot and immunofluorescence double staining.Results:PR did not induce significant BV2 cell death in the 0～40 μmol/L range.After LPS treatment,the expression levels of SOX2,β-catenin,and TNF-α significantly increased in the LPS group,while CD206 decreased(P＜0.05).Following GAS treatment,the expression levels of SOX2,β-catenin,and TNF-α significantly decreased,while CD206 increased(P＜0.05).Compared to the LPS group,the expression levels of β-catenin and TNF-α significantly de-creased in the PR group(P＜0.05),but no significant difference was observed between the LPS+GAS and LPS+PR+GAS group.Conclusion:GAS significantly inhibits LPS-induced microglia activation potentially through the inhibi-tion of the SOX2/β-catenin signaling pathway,and exerts anti-inflammatory effects.