Clinical skills training center of Dongyang People's hospital introduced lean man-agement conception into the resident clinical skills training. The recruited residents were grouped by degree, the training contents were detailed, and teaching plans were normalized, and small class teach-ing and real-time feedback were implemented, which improved the normalization and standardization of resident training. The implementation of lean management leads to great progress in resident train-ing, but still needs further efforts. Only in the long-term management of standardization, can lean man-agement conception be embedded in daily work, making clinical skills training center play its role in cultivating medical talents effectively.

Objective To explore the application value of Roy adaptation mode in self-image disorder and reformation of patients suffered from breast cancer after operation.Methods 178 cases of postoperative patients suffered from breast cancer were separately divided into the experimental group (90 cases)and the control group(88 cases) at random according to the order of hospital admission.The experimental group adopted nursing of the Roy adaptation mode based upon operation and normal treatment,while the control group received general nursing besides operation and routine treatment.The investigation was carried out using the form of questionnaires.The occurrence rate of self-image disorder,life quality by using GQOLI-74 questionnaire,psychological quality by using emotion scale were compared between the two groups.Results The occurrence rate of the self-image disorder of the patients of the experimental group was evidently lower than that of the control group after the nursing measure was taken.Scores of all items of life quality and emotional scale of the experimental group were evidently higher than those of the control group.Conclusions Applying Roy adaptation mode to nurse post-operative patients suffered from breast cancer is a very good nursing mode,it can facilitate psychological suitability,improve psychological quality and promote their effective adaptability.It has pivotal significance to lower the occurrence rate of the self-image disorder of the patients,reform the self-image and make them return to society early.

OBJECTIVE:To investigate the effects and mechanism of total flavonoids from Armeniaca mume on depression in chronic stress depression model rats. METHODS:60 rats were randomly divided into normal saline group,model group,fluox-etine group(positive control,20 mg/kg)and total flavonoids from A. mume low-dose,medium-dose,high-dose groups(80,160, 240 mg/kg), 10 in each group. Except for normal saline group, the other groups adopted chronic unpredictable mild stress (CUMS)+solitary feeding condition to induce depression model. These groups were intragastrically administered,once a day,for 28 d. Changes of body mass and food intake,degree of preference for sugar were observed;forced swimming test and tail suspen-sion test were used to determine the time that rats did not move;open field test was used to determine the changes of residence time in central square,horizontal crossing lattice,standing times,modification times;tumor necrosis factor α(TNF-α),cortisol, interleukin 6 (IL-6),serotonin (5-HT) levels in serum after 24 h of last administration were determined. RESULTS:Compared with normal saline group,growth of body mass,food intake and sugar preference percentage in model group were decreased;the time that rats did not move was prolonged in forced swimming test and tail suspension test;residence time in central square was prolonged,while horizontal crossing lattice,standing times and modification times were decreased in open field test;serum levels of TNF-α,cortisol were increased,while IL-6,5-HT were decreased,with statistical significances (P<0.05 or P<0.01). Com-pared with model group,except that there were no obvious improvement in sugar preference percentage,the time that rats did not move in forced swimming test,modification times in open field test in total flavonoids from A. mume low-dose group and IL-6, 5-HT levels in serum in total flavonoids from A. mume low-dose,medium-dose groups,the above-mentioned indexes were obvious-ly improved in other groups (P<0.05 or P<0.01). CONCLUSIONS:Total flavonoids from A. mume can obviously improve the CUMS-induced depression in rats,and the mechanism may be related to inhibiting inflammation response,adjusting the hypothala-mus-pituitary-adrenal axis functions.

The aim of this study was to investigate the functional characteristics and in vitro specific killing effect of EGFRvIII CAR-T cells co-expressing interleukin-15 and chemokine CCL19, in order to optimize the multiple functions of CAR-T cells and improve the therapeutic effect of CAR-T cells targeting EGFRvIII on glioblastoma (GBM). The recombinant lentivirus plasmid was obtained by genetic engineering, transfected into 293T cells to obtain lentivirus and infected T cells to obtain the fourth generation CAR-T cells targeting EGFRvIII (EGFRvIII-IL-15-CCL19 CAR-T). The expression rate of CAR molecules, proliferation, chemotactic ability, in vitro specific killing ability and anti-apoptotic ability of the fourth and second generation CAR-T cells (EGFRvIII CAR-T) were detected by flow cytometry, cell counter, chemotaxis chamber and apoptosis kit. The results showed that compared with EGFRvIII CAR-T cells, EGFRvIII-IL-15-CCL19 CAR-T cells successfully secreted IL-15 and CCL19, and had stronger proliferation, chemotactic ability and anti-apoptosis ability in vitro (all P < 0.05), while there was no significant difference in killing ability in vitro. Therefore, CAR-T cells targeting EGFRvIII and secreting IL-15 and CCL19 are expected to improve the therapeutic effect of glioblastoma and provide an experimental basis for clinical trials.
Humans ; Receptors, Chimeric Antigen/metabolism* ; Glioblastoma/metabolism* ; Interleukin-15/metabolism* ; Chemokine CCL19/metabolism* ; Cell Line, Tumor ; T-Lymphocytes/metabolism*