The changes in left ventricular function and hemorrheology were investigated serially before and after treatment with thyroid tablets in 32 cases of primary hypothyroidism. It was found that cardiac function was impaired and hemorrheology was disturbed in all of these patients before treatment, but they recovered to normal range when hypothyroid state was corrected. It was found that there was a good correlation between cardiac function and blood level of thyroid hormone, presence of thyroid auto-antibodies, as well as disturbance of hemorrheology. These facts suggested that blood level of thyroid hormone and hemorrheology might act as two indirect indicators in the prediction of left ventricular function in patients with primary hypothyroidism.

The change in pancreatic A- and B-cells in Chinese hamsters with spontaneous hereditary diabetes mellitus were investigated with specific immunohistochemical and image analyzing methods. A variety of pathological changes of the islets and change in number and distribution of the pancreatic A- and B-cells were found in diabetic Chinese hamsters. Microscopic examination revealed that the intensity of staining reaction of pancreatic B-cells varied greatly and the number of A-cells increased in this model. The results of image analysis showed that the range of the average optical density of B-cell staining was 54.4% wider than that in the control and the percentage of the glucagon positive immunoreactive area in the islet was significantly higher in diabetic Chinese hamsters(31.6?13.2%)than in the controls(21. 8?7.5%). These findings suggest that the islet cytology of this diabetic model changes significantly.

The expression, amplification and rearrangement of c-myc and c-erbB-2 genes in thyroid tumor were studied. 32P-dATP-labelled probes of c-myc, c-erbB-2 and v-sis DNA fragments were used to hybridise with the cellular total RNA. We found that c-myc and c-erbB-2 oncogenes were expressed in all samples. The levels of c-myc RNA were three-to eleven-fold higher in 9 out of 15 cancer samples when compared with that in normal tissues. In 7 of 15 cancer samples, c-erbB-2 gene was overexpressed 10~50 times higher than normal. No v-sis RNA was detected in all the samples. Southern blot hybridisation showed that rearrangement of c-myc oncogene were observed in 4 cancer samples, of which one showed a 150-fold amplification of c-myc gene. No amplification or rearrangement of c-erbB-2 gene was detected. These data indicate that the activat.:on of c-myc and c-erbB-2 oncogenes may contribute to the development and/or maintenance of the malignant phenotype of the thyroid carcinomas.

Objective To evaluate the value and significance of bedside ultrasound in diagnosis of lung atelectasis/consolidation in multiple trauma patients with mechanical ventilation.Methods Bedside thoracic ultrasound and chest computed tomography(CT)were performed in 81 multiple trauma patients with mechanical ventilation admitted to the emergency intensive care unit(EICU).CT result was regarded as the "golden standard" to evaluate the value of ultrasound in diagnose lung atelectasis/consolidation.At the same time,the ultrasound was used to dynamically monitor the lung recruitment effect of the therapeutic measures.Results CT detected 154 regions of lung atelectasis/consolidation of 324 lung regions in 81 patients,while ultrasound detected 126 regions that were divided into 87 complete regions and 39 incomplete regions according to different sonogram in the breathing cycle.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of ultrasound were 81.8%,100%,100%,85.9% and 91.4% respectively.A concordance test showed a very high concordance between ultrasound and CT,with a Kappa coefficient of 0.825(P=0.031).Ultrasound found that 39 regions with incomplete lung atelectasis/consolidation were completely recruited and 62 out of 87 regions with complete lung atelectnsis/eonsolidatian gained visible recruitment within three days after different therapeutic measures,with total effective rate of 80.2%.Conclusion Bedside ultrasound can continuously monitor and guide the therapeutic measure to recruit the lung and is a convenient,safe,direct-viewing and accurate method for diagnosis of lung atelectasis/cansolidation in multiple trauma patients with mechanical ventilation.

Objective To investigate the role of large-diameter magnetic resonance imaging (MRI) simulation in target volume delineation in radiotherapy for nasopharyngeal carcinoma (NPC).Methods Eighteen patients with NPC underwent computed tomography (CT) simulation and MRI simulation scans and localization in the same body position,with SOMATOM Sensation Open 40-row 82-cm large-diameter CT simulator and Siemens 3T MRI MAGNETOM Skyra 70-cm large-diameter simulator,respectively.The gross tumor volume (GTV) and parotid glands were delineated on all images according to the ICRU Report 50/62,and MRI was applied to observe the changes in GTV and parotid volume during radiotherapy.Paired t-test was applied to analyze the differences between GTVCT and GTVMRI and between GTVnx-CT and GTVnx-MRI.Results GTVMRI decreased significantly compared with GTVCT,and the average volume decreased from (213.64±84.59) cm3 to (199.68±84.69) cm3(p=0.006).As for the volume of primary lesions in the nasopharynx,GTVnx-MRI was significantly smaller than GTVnx-CT,and the volume decreased from (95.75± 24.76) cm3 to (88.12±26.25) cm3 (P =0.001);as for the volume of cervical lymph nodes,GTVnd-MRI was significantly smaller than GTVnd-CT,and the volume decreased from (117.89± 72.69) cm3 to (111.56± 70.69) cm3 (P=0.018).The targets delineated by CT and MRI did not overlap completely,with major differences in skull base bone and cervical soft tissue.The volume of both parotid glands delineated on MRI image was higher than that delineated on CT image,with a major difference in the deep lobe.MRI showed that GTV was reduced by 82.64± 16.87％ during radiotherapy,and the volumes of the left and right parotid glands were reduced by (32.7± 23.95) ％ and (34.7± 21.72) ％,respectively.Conclusions The delineation of target volume based on MRI simulation is more accurate than that based on CT simulation and can achieve a smaller volume range,which helps to guide target volume delineation in radiotherapy for NPC accurately.

This article mainly expounded the actuality,the importance and the improving way of enhancing the western rural education.

Objective? To understand the psychological experience of nursing interns who underwent bedside rescue events. Methods? From September to December of 2018, 12 nursing interns who underwent bedside rescue events in Rescue Room of Emergency Department were interviewed and data was processed by Colaizzi 7-step analysis method. Results? Totally five themes were extracted: novelty and overwhelming, orderly rescue work caused the nursing interns to think about their own value, the sense of value due to professional identity, solid basic skills and reasonable teaching is the cornerstone of the rescue room internship, and the perception of sense of mission. Conclusions? Schools and hospitals should pay attention to the cultivation of soft skills of nursing interns, improve the familiarity of nursing interns with first-aid equipment, consolidate their basic skills, and establish a standardized first-aid process to improve the teaching work to foster first-aid awareness of nursing interns and promote nursing students to integrate into the rescue environment.

Objective? To investigate the current status and influencing factors on career decision-making self-efficacy among near-employment internship nursing students. Methods? By convenience sampling, the near-employment internship nursing students who voluntarily participant in this research were selected from April to May of 2018 from a ClassⅢ Grade A hospital in Beijing. The Career Decision-Making Self-Efficacy Scale (CDMSE) was used in the study to investigate the participants. A total of 178 questionnaires were distributed with 170 valid ones retrieved. Results? The total score of CDMSE of 170 near employment internship nursing students was (137.62±2.240). The linear-regression analysis showed that gender and satisfaction on hospitals were the influencing factors of their career decision-making self-efficacy. Conclusions? The career decision-making self-efficacy of internship nursing students is at an intermediate level. Hospitals and schools can develop individualized training methods for them in order to improve their career decision-making self-efficacy.

Objective:To understand the cognition and attitudes of Emergency Department nurses towards palliative care, and to explore the factors that hinder or promote the development of palliative care in the Emergency Department, so as to provide basic data for emergency palliative care.Methods:From March to June 2021, semi-structured interviews were conducted with 11 nurses in the Emergency Department of Peking Union Medical College Hospital using the purposeful sampling. The interview data were organized and analyzed using Colaizzi's 7-step analysis method.Results:A total of three themes were induced. The themes were that Emergency Department patients and their families were often caught in decision-making dilemmas, and Emergency Department nurses had a high degree of acceptance of palliative care, but there were barriers to implementation in the Emergency Department, and the implementation methods of emergency palliative care needed to be further explored, and Emergency Department nurses were willing to participate in palliative care training.Conclusions:Emergency palliative care needs to consider the characteristics of the Emergency Department work environment and explore appropriate implementation methods. Training related to palliative care can be increased, the palliative care literacy of Emergency Department nurses can be improved, so as to provide effective support for life-limited patients and their families.

Objective:To understand the cognition and attitudes of Emergency Department nurses towards palliative care, and to explore the factors that hinder or promote the development of palliative care in the Emergency Department, so as to provide basic data for emergency palliative care.Methods:From March to June 2021, semi-structured interviews were conducted with 11 nurses in the Emergency Department of Peking Union Medical College Hospital using the purposeful sampling. The interview data were organized and analyzed using Colaizzi's 7-step analysis method.Results:A total of three themes were induced. The themes were that Emergency Department patients and their families were often caught in decision-making dilemmas, and Emergency Department nurses had a high degree of acceptance of palliative care, but there were barriers to implementation in the Emergency Department, and the implementation methods of emergency palliative care needed to be further explored, and Emergency Department nurses were willing to participate in palliative care training.Conclusions:Emergency palliative care needs to consider the characteristics of the Emergency Department work environment and explore appropriate implementation methods. Training related to palliative care can be increased, the palliative care literacy of Emergency Department nurses can be improved, so as to provide effective support for life-limited patients and their families.