In order to meet the needs of increased requirement of nurse especially in the region with limited resources for education and training, PUMC Nursing School initiated a program of Day School Student since 2002. This paper reviews the enrollment, education and training of these students and to share our experience with other schools in China in terms of strategy development and program implementation.

Objective To investigate the anatomical mark of attachment edge in mesorectal tail and the effect of its morphologic distribution in performing total mesorectal excision (TME). Methods The gross specimens of 220 consecutive patients with the middle lower rectal cancer were collected by a group of surgeons.Patients were divided into two groups.①Group in saving sphincter. Ⅰa group, low anterior resection (LAR): 81 patients with lesions between 5 and 6 cm from the anal verge underwent LAR ; Ⅰb group, anterior resection (AR): 68 patients with lesions between 7 and 8 cm from the anal verge underwent AR.②Group in resecting sphincter. Abdominoperineal resection (APR): 71 patients with lesions between anal verge and 5 cm from the anal verge underwent APR. Results ①The circular edge of mesorectal tail is attached on rectal wall of 1 cm above anal hiatus of levators,which level parallels the lower margin of lower rectal cancer.In order to reset distal rectal wall of 2 and 3 cm,undergoing LAR must avoid injuring rectal wall when dissecting muscular vessel of rectum continue along the levators fascia to the anal hiatus.②The attachment morphology of mesorectal tail is a circular flake and not circular linear in shape. There are a little of fat tissue between posterior rectal wall and mesorectal tail,the length of its longitudinal attachment is (1.269?0.171) cm (81 cases in LAR group and 71 cases in APR gourp).Because the distal resective margin of rectum undergoing AR just locate in area of flake attachment of mesorectum, removing mesorectum around rectal wall must avoid injuring the rectal wall. Conclusion The mesorectal tail is a circular flake and attaches on rectal wall of 1.0 cm above anal hiatus of levatorani.Undergoing LAR or AR must avoid to injure rectal wall,which may result in leakage of anastomosis when removing mesorectal tissuce around distal rectal wall.

This article was aimed to study the pharmacokinetics of mussaenoside in rats. Gardenoside was used as the internal standard in the content determination of mussaenoside in rat plasma with HPLC. The chromatographic conditions were Diamonsil C18 (2) column (150 mm í 4.6 mm, 5 μm), mobile phase of methanol:0.5% glacial acetic acid (30:70), flow amount of 1.0 ml/min, detection wavelength at 238 nm, column temperature at 30℃. Compartment model fitting of average plasma concentration in rats - time data had been conducted after mussaenoside was given to mice through single intravenous injection with the help of DAS 2.0 pharmacokinetics intelligence analysis software. The results showed that the plasma concentration using 2-comparment model intravenous injection calculation method, which corresponded well to that of actually measured (weighting of 1), was proved superior to other models. The distribution half-life time (t1/2α) was 9.892 min and the elimination half-life time (t1/2β) was 55.384 min. It was concluded that the established method was convenient, accurate and stable, which can be used for the study on phar-macokinetics of mussaenoside. Mussaenoside was distributed rapidly in the body of rats. The main process of mus-saenoside in the body of rats was elimination. The metabolic rate was at moderate speed.

Recurrence and peritoneal metastases are the major factors for the survival of colorectal cancer. With the development in the theory and technique of intraperitoneal chemotherapy,it has become a indispensable adjuvant chemotherapy of the advanced colorectal cancer.

Objective To investigate the indications and clinical values of percutaneous transthoracic biopsy guided by different locating means respectively on pulmonary lesions. Methods Patients were divided into different groups according the locating methods,which included X -ray, type -B ultrasonography, and CT. Pathologic diagnosis and complications were retrospectively analysed between groups. Conclusion Each locating method has its own advantages and disadvantages. Results we should choose the optimistic one according the patients′ condition.

In order to meet the needs of increased requirement of nurse especially in the region with limited resources for education and training,PUMC Nursing School initiated a program of Day School Student since 2002. This paper reviews the enrollment,education and training of these students and to share our experience with other schools in China in terms of strategy development and program implementation.

Interleukin-12 can induce the production of INF-?, up-regulate the inhibitive factor of angiogenesis such as IP-10, MIG, TIMP, TNF-?, down-regulate the induced factor of angiogenesis such as VEGF, bFGF, MMP, inhibit the angiogenesis of tumor together and accelerate the regression of tumor. Interleukin-12 can inhibit the angiogenesis of tumor, which is independent of the immune system.

Post-traumatic brain syndrome is a common disease in neurosurgery department, referring to a variety of neurological symptoms after brain traumas. Currently, research shows that this disease involves the fields of neurologic anatomy, pathology, trauma mechanics, neurobiochemistry, cerebral hemodynamics, etc, and the treatment majorly includes medication, hyperbaric oxygen, and psychotherapy, but they don't work so well. In primary hospitals, the convenient, low-cost and safe acupuncture-moxibustion therapy should be paid more attention. By retrieving literatures during the latest 10 years, this article has concluded that the acupuncture-moxibustion treatments for this disease covered acupuncture, auricular acupoint therapy, bloodletting therapy, and moxibustion, and the action mechanisms were mostly the improvement of cerebral circulation and cerebral metabolism, and the change of neurotransmitters and cytokines. The improvement of cerebral circulation and increase of cerebral blood flow can be taken as the future direction in the research on acupuncture-moxibustion for this disease. However, in the treatment of post-traumatic brain syndrome with acupuncture-moxibustion, it still requires the standardization of acupuncture and the objectification of evaluation indexes.

Objeaive To investigate the impact of serum uric acid concentration on short-term outcome in patients with acute ischemic stroke.Methods The patients with acute ischemic stroke were collected.According to the modified Rankin scale (mRS) scores at discharge,the patients were divided into either a good outcome group (mRS score 0 to 2) or a poor outcome group (mRS score 3 to 6).The baseline National Institutes of Health Stroke Scale (NIHSS) scores,serum uric acid (SUA) levels and other demographic and clinical data in both groups were compared.Results A total of 311 patients with acute ischemic stroke were enrolled in the study.There were 185 patients in the good outcome group and 126 in the poor outcome group.The patients' constituent ratios of the baseline NIHSS scores (median [interquartile range]) (7 [4-11] vs.3[2-4] ; Z =9.858,P =0.001),previous type 2 diabetes mellitus (29.4％ vs.14.1％ ;x2 =10.877,P =0.001) and history of TIA (27.8％ vs.17.8％ ;x2 =4.335,P =0.037) were significantly higher than those in the poor outcome group,while the patients' constituent ratio of the SUA levels (331.984±118.995 mmol/Lvs.363.276±100.743 mmol/L;t =2.497,P=0.013) and the NIHSS score ＜9 (63.5％ vs.96.8％ ;x2 =59.562,P =0.000) were significantly lower than those in the good outcome group.The baseline NIHSS and mRS scores at discharge were higher in the SUA lower quartile group (all P ＜0.01).Multivariate logistic regression analysis showed that the increased SUA was an independent protective factor for short-term outcome in patients with acute ischemic stroke (odds ratio 0.997,95％ confidence interval 0.995-0.999; P =0.016).Conclusions The increased SUA is an independent protective factor for short-term outcome in patients with acute ischemic stroke.

Objective:To investigate the anti-inflammatory effect and safety of tranexamic acid in the perioperative period of total knee arthroplasty.Methods:Eighty patients who underwent primary unilateral total knee arthroplasty because of knee osteoarthritis in Anqing Hospital of Anhui Medical University from October 2018 to March 2020 were included in this study. They were divided into an observation group and a control group ( n = 40/group) according to whether they received tranexamic acid treatment. In the observation group, 1 g tranexamic acid was intravenously administered at 10 minutes before releasing tourniquet and once every 3 hours starting at 24 hours after surgery. In the control group, 100 mL 0.9% sodium chloride injection was identically administered. Before surgery, immediately after surgery, and 1, 2 and 3 days after surgery, interleukin-6 level, erythrocyte sedimentation rate and C-reactive protein level in the venous blood were compared between the observation and control groups. Coagulation function and lower extremity deep venous thrombosis in the two groups were monitored. Postoperative pain, nausea, vomiting and muscle strength were compared between the two groups. Results:There were no significant differences in age, gender, body mass index and Hospital for Special Surgery knee score between the two groups (all P > 0.05). Univariate analysis of variance revealed that there were significant differences in interleukin-6 level ( t1 = 9.364, t2 = 11.027, t3 = 11.068), erythrocyte sedimentation rate ( t1 = 20.94, t2 = 18.898, t3 = 22.797) and C-reactive protein level ( t1 = 14.079, t2 = 12.099, t3 = 23.416) between the two groups at 1, 2 and 3 days after surgery (all P < 0.05). Regression analysis revealed that the maximum differences in erythrocyte sedimentation rate ( β = 0.217, P = 0.038), interleukin-6 ( β = 0.143, P = 0.025) and C-reactive protein ( β = 0.032, P = 0.010) between before and after total knee arthroplasty in the observation group were significantly lower compared with the control group ( β > 0, P < 0.10). Moreover, the differences in erythrocyte sedimentation rate, interleukin-6 and C-reactive protein at 3 days after surgery were significantly lower compared with at the other time points studied. Before and after surgery, there was no significant difference in coagulation function between the two groups (both P > 0.05). Lower extremity deep venous thrombosis occurred in neither groups. The recovery of postoperative pain, nausea, vomiting, and muscle strength in the observation group was significantly superior to that in the control group (all P < 0.05). Conclusion:Application of tranexamic acid in primary unilateral total knee arthroplasty can effectively attenuate perioperative inflammatory reaction, reduce postoperative adverse reactions and promote functional recovery, which deserves clinical application.