Objective To observe the effects of a-eating stroke constipation with ZengYeChengQi Decoction (ZYCQD) and BuYangHuanWu Decoction(BYHWD). Methods 86 cases of stroke constipation were recruited to receive ZengYeChengQi Decoction (ZYCQD) and BuYangHuanWu Decoction (BYHWD) orally for one therapeutic course, and observe the therapeutic effects. Results Among 86 cases, 65 cases were totally recovery, 16 cases had obvious improvement, and 5 cases were inefficacy. The total effective rate was 94.19%. Conclusion Oral ZengYeChengQi Decoction (ZYCQD) and BuYangHuanWu Decoction (BYHWD) can improve constipation symptom score and improve the clinical therapeutic effect.

Objective To investigate the optimal scan time of MRI using the imaging probe alphamethyl-L-tryptophan(α-MTrp)-superparamagnetic iron oxide nanoparticles (SPIONs) for localizing temporal lobe epilepsy (TLE) foci.Methods α-MTrp-SPIONs were injected into rat models of TLE through the tail vein during the acute and chronic stages (72 h and 8 weeks after status epilepticus,respectively).MRI was performed before and 1,2,4,8,24 h after the injection in all animals,and the T2 values of the epileptogenic regions were measured.One-way repeated measures analysis of variance was used for data analysis.Results Compared with the T2 values before the injection of α-MTrp-SPIONs,the T2 signal of epileptogenic regions after the injection had a negative increased change.The T2 values before and 1,2,4,8,24 h after the injection in acute stage were 112.08±5.85,107.83±6.59,105.08±6.79,95.58±5.14,100.92± 5.81,105.17±6.31 respectively,and those in chronic stage were 112.08±7.53,107.75±7.10,102.75± 5.50,96.17±5.01,97.75±4.37,102.92±4.74.The T2 values after the injection were significantly different from those before the injection (both P＜0.01).The T2 value at 4 h after the injection decreased mostly.Conclusions α-MTrp-SPIONs can precisely localize epileptogenic regions of TLE on MRI.The optimal scan time is 4 h after the injection.

In order to promote our country's research on transitional care for patients with chronic kidney disease (CKD),the article summarized research progress on transitional care for patients with CKD,analysed the problems existed including lack of evidence-based basis,insugiciency of Intervention staff,one-sided intervention content and effect evaluation,etc,and put forward the corresponding countermeasures.

Objective:To construct the core competence evaluation indicators for clinical teaching nurses,provide quantifiable indicators for the core competency of clinical teaching nurses.Methods:Using literature review, survey of nursing students, interview of clinical teaching nurses, and two-round Delphi expert consultation for 18 clinical teaching nurses, the core competence evaluation indicators was constructed.Results:The response rates for two rounds of expert consultation were 18/18 and 16/18, authority coefficients were 0.83 and 0.85, and coordination coefficients at all levels ranged from 0.096-0.503( P<0.05). The core competence evaluation indicators for clinical teaching nurses consisted of 7 first-class indicators, 25 second-class indicators and 43 third-class indicators. Conclusions:The enthusiasm, authority, concentration degree and coordination degree of experts are comparatively high. It can provide references for standardized evaluation, training and management of clinical teaching nurses.

Objective:To extract the common factors for evaluating the teaching effect of the integrated curriculum of basic medicine in China, and to analyze and explain the practical significance of these common factors.Methods:A questionnaire survey was conducted among undergraduates of 15 medical colleges in China to evaluate the teaching effect of integrated curriculum of basic medicine, and exploratory factor analysis was conducted for screening and classification. SPSS 22.0 was used to conduct factor analysis.Results:The four major common factors evaluating the teaching effect of integrated curriculum were the effectiveness of teaching process, the rationality of teaching organization, the education of teaching content, and the innovation of teaching methods.Conclusion:The integrated curriculum reform of basic medicine should pay great attention to the simultaneous development of basic theory learning and practical ability training, the effective connection between theoretical teaching and experimental teaching, the educational role in comprehensive quality cultivation of students, and the flexible application of various teaching means and methods.

Objective:To investigate the effect of virtual reality (VR) video-based pre-discharge psychological intervention on the post-discharge emotions of patients with deep facial burn.Methods:Enrolled in the prospective randomized controlled study were 84 patients with deep facial burn that were hospitalized from October 2017 to September 2019 in the First Hospital of Jilin University and met the inclusion criteria. According to the random number table, the patients were divided into two groups, with some losing touch in follow-up, there were 40 cases (21 males and 19 females) left in VR video group, aged 18~53 years, while there were 41 cases (22 males and 19 females) left in general video group, aged 19~55 years. Seven patients who had been treated in the First Hospital of Jilin University from January 2014 to December 2016 and returned to work and life after recovering from the deep facial burn were selected, and then a video was made for each of them based on the pictures taken before and after they got burned and at each stage of treatment with the relevant oral explanations, the problems they faced after discharge and the solutions adopted for those problems, and the image data about their living conditions. Seven days before discharge, the patients in VR video group began to watch videos by wearing VR glasses, while the patients in general video group began to watch videos on a tablet computer. On the 7th day before discharge (before watching the videos) and 1 month after discharge, the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Social Avoidance and Distress (SAD) Scale were used to evaluate the level of anxiety, depression, social avoidance and distress of patients in both groups. Data were statistically analyzed with t test, chi-square test, or Fisher's exact probability test.Results:On the 7th day before discharge, the scores of anxiety, depression, and social avoidance and distress of patients in general video group were (34±7), (34±6), and (11.5±3.9) points, respectively, close to (35±7), (35±5), and (10.5±3.9) points in VR video group, and the scores of both groups were higher than the national norms. One month after discharge, the scores of anxiety, depression, and social avoidance and distress of patients in VR video group were (31±5), (31±5), and (7.2±2.5) points, respectively, significantly lower than the scores on the 7th day before discharge (t=6.609, 7.492, 7.622, P<0.01); the scores of anxiety, depression, social avoidance and distress of patients in general video group were (37±7), (38±8), and (13.9±7.4) points, respectively, significantly higher than the scores on the 7th day before discharge (t=2.802, 3.599, 2.739, P<0.01). One month after discharge, the scores of anxiety, depression, and social avoidance and distress of patients in VR video group were significantly lower than those in general video group (t=4.722, 5.043, 5.490, P<0.01).Conclusions:The unhealthy emotions of patients with deep facial burn, such as anxiety, depression, and social avoidance and distress, can be alleviated after discharge if they undergo psychological intervention by watching VR videos before discharge.

With the further development of education informatization,the popularity of computer simulation technology and multimedia network technology were increasing.The teaching center of school of stomatology in the fourth military medical university combined stomatology teaching with information technology and gradually applied diversified teaching mode in the dental clinical experiment teaching,which not only saved the input of faculty and consumables items,but also improved the stomatology experimental teaching quality and achieve the teaching modernization.

AIM:To explore the effect of Delta-like ligand 4 (Dll4)-Notch signaling pathway blockade on the development of Thelper 17(Th17) cells in the asthmatic mice.METHODS:Male BALB/c mice were randomly divided into 5 groups:control group, asthma group, normal saline group, anti-Dll4 antibody group, and immunoglobulin G group.The protein expression of Dll4 was detected by immunohistochemical staining.The proportion of Th17 cells in mouse spleen isolated CD4+ T cells was measured by flow cytometry.The protein expression of Th17 transcription factor retinoid-related orphan receptor γt (RORγt) was determined by Western blot.The serum level of interleukin (IL)-17 was measured by enzyme-linked immunosorbent assay (ELISA).RESULTS:The expression of Dll4 in the lung tissues from asthma group significantly increased as compared with anti-Dll4 antibody group.The proportion of Th17 cells in CD4+ T cells was significantly down-regulated, and the protein expression of RORγt in the lung tissues was significantly reduced in anti-Dll4 antibody group compared with asthma group (P<0.05).Moreover, the serum level of IL-17 in anti-Dll4 antibody group was significantly reduced compared with asthma group (P<0.01).CONCLUSION:The blockade of Dll4-Notch signaling pathway inhibits the differentiation of Th17 cells in asthmatic mice.

Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.

Objective To explore the risk factors,the distribution of etiology and drug resistance status of patients with early infection (3 months) after liver transplantation,and to provide reference for clinical diagnosis and treatment.Methods The clinical data of 112 recipients from February 2014 to December 2015 were collected,and logistic regression analysis was performed on the risk factors of early postoperative infection in liver transplant patients.The independent risk factors of infection after liver transplantation were screened out.At the same time,the results of pathogen culture and drug sensitivity test were statistically described.Results The independent risk factors for infection at 3th month after liver transplantation included the operative time ≥600 min [P =0.003,odds ratio (OR) =9.996,95 ％ confidence interval (95 ％ CI),2.221-44.981],intensive care unit (ICU) ≥6 days (P =0.010,OR =6.306,95％ CI =1.563-25.437),Child-Pugh grade of C (P =0.023,OR =6.298,95％ CI =1.294-30.659).Of the 112 liver transplant recipients,59 had an infection (52.68％),and 168 stains of pathogens were isolated.The positive rate of the specimens was highest in sputum,followed by bile,ascites,drainage and catheter end,blood,deep vein catheter,middle urinary,pleural effusion and peripherally inserted central catheter (PICC).The detectable rate of gram-negative bacteria,gram-positive bacteria,fungi and viruses was 46.43％ (78 strains),29.76％ (50 strains),18.45％ (31 strains),and 5.36％ (9 strains) respectively.Infection occurred mainly within 1 month after surgery,accounting for about 80.36％ (135 strains),especially at 1st week after surgery,accounting for about 34.52％ (58 strains).Gram-positive bacteria had a higher drug resistance rate,including penicillins,macrolides,aminoglycosides,quinolones,linamides,etc.especially in the highest rate of Enterococcus faeciurr.Gram-negative bacteria were individualized based on the different strains of the bacteria,and they were relatively low in the resistance of the carbapene.Conclusion Infection is one of the most common complications after liver transplantation.To reduce the incidence of infection after liver transplantation,efforts should be made to shorten the duration of operation and ICU stay time,improve the basic nutritional status of recipients,and enhance monitoring of the recipient's infection after liver transplantation,to further increase the survival rate of postoperative liver transplantation recipients and improve the quality of life.