Objective To explore the effect classroom teaching quality evaluation on the improve-ment of teaching quality. Methods In-service teachers offering classes to undergraduates majoring in clinical medicine during the period of 2010 to 2011 in Tangshan Clinical Hospital of Hebei Medical University were enrolled as research objectives. Totally 128 teachers(majored in 16 disciplines), screened out from the enrolled teachers, met the criteria and passed through the evaluation in terms of class quality of lessons. They were arranged in descending order and the top 15%were grouped as the preeminent group while the 15%at the bottom were classified as standard group and the rest 70%as good group. Descriptive analysis was made to appraise results from four respects:major and discipline, records of formal school-ing, professional ranks and titles and length of teaching experience. Results Based on the analysis of teaching situation in major disciplines, the top 3 disciplines possessing the largest proportion of preemi-nent teachers were neurology ( 50%) , otolaryngology-head and neck surgery ( 40%) and surgery (20.6%). When it comes to the analysis of formal schooling records of teachers , there is no distinct dis-crepancy in rate of standard reaching between teachers with postgraduate degree and teachers with gradu-ate degree. However, rate of standard reaching was slightly higher in teachers with other degrees than teaching with undergraduate degree or above. In the analysis of professional ranks and titles, the proportion was 94.6%in teachers with senior professional title(associated senior professional title and senior profes-sional title) and the teachers with medium grade professional title only occupied a proportion of 5.4%. In the dimension of teaching years, rate of outstanding and good teachers was relatively high in teachers with 8 teaching years and teacher with less than 3 teaching years, whereas the outstanding rate was low and rate of standard reaching was high in teachers with the 3-4 teaching years. Conclusions Measures to enhance the quality of teaching can be found out according to the analysis of influencing factors of teaching quality evaluation.

We analyzed the cost effectiveness of four different surgical methods (A,B,C and D) in treatment of hepatic echinococcosis.Totally 757 cases of hepatic echinococcosis surgery clinical data and cost information of hospitalized cases were collected from nine hospitals in Xinjiang during 2005-2013.The clinical effects,cost effectiveness ratio and incremental costeffectiveness ratio were analyzed and compared.The total complication rates were 15.8％,9.2％,0％ and 2.9％;the recurrence rates were 7.3％,6.2％,0％ and 0％;the cure rates were 77.8％,84.6％,100.0％ and 97.1％;the cost (RMB) were 11 947.3,18 543.6,25 510.7 and 18 877.4,cost-effectiveness ratio were 153.6,219.1,255.1 and 194.3,incremental cost-effectiveness ratio /C//E were 964.4,610.4 and 358.0 respectively for group A,B,C and D.The results after adjusting of price factor were consistent with original cost effectiveness analysis.The complete resection of inner and outer capsule (D) is the most effective and economical way of clinical operation and may worthy be promoted in treatment of hepatic echinococcosis.

Objective In embryology, the pancreas is formed by fusion of the ventral pancreas(VP) and the dorsal pancreas(DP) during the seventh week of gestation. The aim of this study was to clarify whether there were differences in the clinicopathological characteristics of the carcinoma of pancreatic head(PhCa) arising from the VP and DP. MethodsResected specimens from 43 cases with PhCa were studied histologically and immunohistochemically. The VP and DP were distinguished by islet shape and amount of cells producing pancreatic polypeptide(PP) in normal pancreatic parenchyma adjacent to the main tumor. ResultsThere were 20 cases of PhCa from VP(VP-group) and 23 cases of DP (DP-group) in this study. The prognosis of the 20 patients in VP-group was significantly better than that of the 23 in DP-group ( P

Objective To explore the effect of gestational hypertension on multiple organ system in neonates. Methods A total of 100 newborns whose mother had pregnancy complicating primary hypertension admitted to our hospital from December 2011 to December 2012 were selected and divided into preeclampsia group (n=53), gestational hypertension group (n=47) according to the blood pressure during pregnancy. Meanwhile, 100 newborns with healthy mother were selected as control group including 12 term infants and 88 premature infants. Data including birth weight, length and head circumference, Apgar score, the percentage of amniotic lfuid pollution, placental abruption and fetal distress, Neonatal Behavioral Neurological Assessment (NABA) score, serum level of creatine kinase, pulmonary arterial pressure, thyroid function, blood glucose, blood routine, cranial MRI parameters were collected and compared among three groups. Results In preeclampsia group, the gestational age, birth weight and head circumference, 1-min and 5-min Apgar scores were lowest while the ratio of low birth weight infants was highest among three groups, and the differences were signiifcant (P<0.05). In preeclampsia group, the rates of antenatal abnormalities (amniotic lfuid meconium III degree pollution, placental abruption and fetal distress) and complications (severe infection, myocardial damage, neonatal polycythemia, liver and kidney damage, hypoglycemia, hypothyroidism and respiratory failure) were highest among three groups, and the differences were signiifcant (P<0.01). In preeclampsia group, the red blood cell count, the levels of hemoglobin, hematocrit and thyroid stimulating hormone were signiifcantly higher than those in the other two groups ( P<0.05 ), and the white blood cell and platelet count was signiifcantly lower than that in the control group (P<0.05). The passive muscle tension scores in preeclampsia group were signiifcantly lower than those in the other two groups (P<0.05).The abnormity rate of cranial MRI in preeclampsia group was highest among three groups, and the difference was signiifcant (P<0.01). Conclusions Gestational hypertension may cause multisystem disorders in newborns, such as fetal intrauterine growth restriction, endocrine system disorders, heart dysfunction, increased blood viscosity, delayed neurodevelopment. The severity of gestational hypertension is associated with the adverse impact on the multiple systems in neonates.

Objective To explore the roles of serum TLR-4, TNF-αand IL-6 in neonates with preterm birth. Methods A total of 120 neonates from neonatology department in the Xingtai People's Hospital were selected and divided into full-term group (n=40), premature rupture of fetal membranes (n=40) and idiopathic preterm group (n=40) based on the gestational age. The peripheral venous blood was collected within 30 minutes when the infants were born, and the supernatant was reserved after centrifuged. The levels of serum TLR-4, TNF-αand IL-6 were detected by enzyme-linked immunosorbent assay. Results The levels of TLR-4, TNF-αand IL-6 in idiopathic preterm and premature rupture of fetal membranes were signiifcantly higher than that in full-term group and showed positive correlation. Conclusion Cytokines TLR-4, TNF-αand IL-6 maybe closely related to the preterm birth.

Objective To study the dose-effect relationship and time-effect relationship of T cell receptor (TCR) gene mutation induced by γ-rays in lymphocytes of human peripheral blood.Methods Samples of peripheral blood were collected from 10 healthy adults and lymphocytes were separated.Four samples from males used to fit time-effect curve were exposed to γ-rays at the doses of 0,0.5,1.0,1.5,2.0,2.5,3.0,3.5,4.0,and 5.0 Gy,respectively,and 6 samples from 3 males and 3 females used to fit dose-effect curves were exposed to γ-rays of the dose of 2 Gy.Flow cytometry was used to detect the mutation frequency of TCR gene (TCR MF).Radiation dose-effect curves and time-effect curves were fitted and optimal mathematical models were selected respectively.Results The optimal mathematical model for radiation dose-effect was quadratic equation model:TCR MF = 92.14 + 22.61D2 (R2adj = 0.65).The optimal mathematical model for radiation time-effect was quadratic polynomial equation model:TCR MF = 3.74 + 743.66T + 308.64T2 (R2adj = 0.79).Conclusions TCR MF is increased as the γ-rayirradiation dose increases within the range of 0-5 Gy,and TCR MF is increased with the lapse of time within the range of 4 days after γ-ray radiation.

Objective To explore the clinical efficacy and indications of kyphoplasty with movement and secondary en?largement of balloon for the compression fracture of vertebral body with ruptured posterior wall. Methods A retrospective analy?sis was carried out on the data of 29 patients (10 males, 19 females;age range:55-86 years old;mean age:71 years old;29 verte?bral bodies in total) who suffered from compression fracture of the thoracolumbar spine and below, and underwent kyphoplasty through the movement and secondary enlargement of balloon within the vertebral body and were followed up from January 2011 to November 2014. These patients had backache, accompanied by lowered support, limitation of movement, no symptom of nervous lesion on both lower extremities and no past history of balloon kyphoplasty. All fractured vertebral bodies were at T 11 or below, in?cluding 1 case at T11, 4 cases T12, 11 cases L1, 9 cases L2 and 4 cases L3. The causes of injury included fall (19 cases), car accident (8 cases) and unknown reasons (2 cases). All patients underwent kyphoplasty with the movement and secondary enlargement of bal?loon within the vertebral body. Photos were taken immediately after the surgery, at 1 month, 3 months, 6 months and 12 months, and these patients were assessed and analyzed in terms of vertebral height, Cobb angle, visual analogue score (VAS) and Oswestry disability index (ODI). Results The operation time (including the formation and solidification of bone cement) of 29 patients was 40 to 65 min and the mean time was 55 ± 7 min;the blood loss during operation was 2 to 15 ml and the mean blood loss was 5 ± 2 ml;the injected volume of bone cement was 2.5-7.5 ml and the mean volume was 5.5±0.5 ml. Post?operative pain was relieved and ambulation was performed under the protection of lumbar orthosis brace. Statstical analysis was conducted on VAS, ODI, vertebral height and Cobb angle before operation and at 1 month, 3 months, 6 months and 12 months after operation, showing statistically significant differences. X ray examination found that there was no alternation or displacement of bone cement location, and no change in vertebral morphology, the vertebral height and cobb angle remained the post?operative status, and posterior wall rupture of the vertebral body was recovered well. CT revealed that the morphology of bone cement was irregular and closely integrated with bone substance, and no cavity or fissure was seen. Conclusion Kyphoplasty with movement and secondary enlargement of bal?loon within the vertebral body has a good, definite clinical efficacy in treating compression vertebral fracture with incomplete pos?terior wall of the vertebral body without obvious displacement of fractured bone and symptom of nervous lesion on both lower ex?tremities. This surgery is easy to operate, and has an immediate analgesic effect, which could recover vertebral height as well as re?duce kyphosis deformity and improve patient’s prognosis.

OBJECTIVETo investigate the role of apoptosis in radiation-induced mouse thymus lymphocyte damage and repair and provide the basis for understanding the molecular mechanism of radiation-induced lymphocyte damage and repair as well as the prevention and treatment of acute radiation sickness.

METHODSWe studied the dynamic changes of apoptosis of mouse thymus lymphocytes and the expression of bax and bcl-2 gene products after 2, 4, 6 and 8 Gy of whole body gamma-irradiation using in situ terminal labeling, DNA electrophoresis and immunohistochemical techniques.

RESULTSAt the early stage after irradiation, the percentage of apoptotic lymphocytes increased rapidly in accordance with the increasing of radiation doses, while the counts of the thymus and peripheral lymphocytes decreased sharply, showing an opposite change to lymphocyte apoptosis. After 6 Gy gamma-irradiation, typical morphological characteristics of thymus apoptotic lymphocytes in early, middle and late stages were found by transmission electron microscopy. The thymus lymphocytes displayed characteristic DNA ladders 4 hr and 8 hr after 2-6 Gy gamma-irradiation,using DNA gel electrophoresis techniques. Abnormal expression of bcl-2 and bax gene products were shown in irradiated lymphocytes.

CONCLUSIONSApoptosis plays an important role in the process of radiation-induced mouse thymus lymphocyte damage and repair. Bcl-2 and Bax proteins may regulate the process of lymphocyte apoptosis.

Animals ; Apoptosis ; radiation effects ; Dose-Response Relationship, Radiation ; Gamma Rays ; Lymphocytes ; physiology ; radiation effects ; Male ; Mice ; Proto-Oncogene Proteins ; analysis ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Thymus Gland ; pathology ; radiation effects ; Time Factors ; bcl-2-Associated X Protein

Objective:To understand the research hotspots of external fixation nursing in the past 5 years and analyze the research status and development trend of this field, so as to provide a reference for external fixation nursing practice and research development in China.Methods:PubMed, Web of Science, China National Knowledge Internet (CNKI), Wanfang Database and VIP database were used to retrieve external fixation nursing related literature published from August 2015 to July 2020. Bibliographic information data mining system software and graph clustering toolkit software were used to perform bibliometric and cluster analysis.Results:A total of 720 literatures were included, including 318 English literatures and 402 Chinese literatures. A total of 25 English high-frequency words were extracted with frequency greater than or equal to 23 times, and 17 Chinese high-frequency words were extracted with frequency greater than or equal to 25 times. After cluster analysis, two English research hotspots were obtained, namely, information acquisition and application in nursing research, functional recovery after external fixation. Five Chinese research hotspots were obtained, including the prevention of needle-path infection, the nursing effect of systematic nursing on patients with external fixation, application of negative pressure sealing drainage technology in open fractures, perioperative nursing of patients with bone defects and rehabilitation nursing of fractures at different locations.Conclusions:It is possible to use information management and big data to analyze the risk factors of external fixation care for prevention, and to standardize the external fixation care process through standardized procedures and the introduction of nursing guidelines for different parts of the external fixation. At the same time, attention should be paid to the functional recovery of patients with external fixation in order to improve the nursing quality of external fixation.

Objective:To explore the risk factors of pinhole infection in patients with external fixators, and build a risk prediction model.Methods:From January 2018 to June 2019, the data of patients ( n=300) with external fixators in the Department of Trauma and Orthopedics, South Hospital, South Medical University, were selected by retrospective survey, and were divided into infection group and non-infection group according to whether pinhole infection occurred in the postoperative case records. Single factor analysis and Logistic regression analysis were used to establish the risk factors of pinhole infection and its prediction model. The grade of risk prediction was constructed by the assignment method. Results:Among 300 patients with external fixators, 103 (34.33%) had pinhole infection and 197 (65.67%) had no infection. Logistic regression analysis showed that basic disease [ OR=4.726 (one of diabetes, pulmonary infection), 17.053 (two of diabetes, pulmonary infection, cardiovascular diseases) ], postoperative albumin [ OR=0.082 (<25 g/L) ], postoperative hemoglobin [ OR=3.715 (>90-120 g/L), 9.720 (>60-90 g/L), 7.338 (30~60 g/L) ], intraoperative bleeding volume [ OR=2.196 (200-400 ml), OR=3.256 (>400 ml) ] and the type of disinfectant [ OR=3.897 (chlorhexidine), 3.625 (iodophor + chlorhexidine) ] were risk factors for pinhole infection in patients with external fixators ( P<0.05). The constructed model was divided into high-risk group (≥ 7 points), higher-risk group (5-6 points), medium-risk group (4 points), low-risk group (3 points) and lower-risk group (0-2 points) . Conclusions:The model can well predict the risk of pinhole infection of orthopedic external fixator, provide reference for medical and nursing staff to identify the risk of external fixation infection in time, and prevent the occurrence of infection as soon as possible.