Objective To discuss the technique and result of arthroscopic suprascapular nerve release.Methods From February 2008 to February 2011, nine cases of suprascapular nerve compression were treated.Four of them were transverse scapular ligament compression,and 5 cases with cyst compression around spinoglenoid notch,one case was double nerve compression.The patients were manifested nerve compressive symptoms, and MRI, EMG can be a useful tool to identify the locations of compressions. All the patients were treament with arthroscopic nerve release, by transverse scapular ligament releasing or cyst removing. Results The average follow up time was 10 months,the symptoms disappeared,the atrophy or weakness of supraspinatus and infraspinatus muscles were significantly improved after operation. Conclusion The Arthroscopic suprascapular nerve release is an effective,miniinvasive,and fast recovery technique.

Objective To investigate the team-based learning(TBL) combined with microteaching method in the teaching of undergraduate first aid courses. Methods Totally72 undergraduate nursing students randomly divided into the observation group and control group each including 36 cases by lottery. Nursing students in the observation group received TBL combined with microteaching, while nursing students in the control group received conventional teaching. Results The average score of objective structured clinical examination (OSCE) in observation group was (86.66±5.09) points and the control group was (84.47 ± 5.78) points, the difference was statistically significant (t=3.38, P<0.05). After training,the total score of Critical Thinking Disposition Inventory Chinese Version (CTDI-CV) and 5 dimensions′were (329.39 ± 25.56), (49.33 ± 4.42), (45.11 ± 6.08), (48.17 ± 6.14), (51.08 ± 6.55), (45.06 ± 5.19) points in observation group, and (325.17±27.26), (48.19±4.97),(44.42±6.30), (47.47±6.27), (50.36±7.12), (44.56± 5.13) points before training, the differences were statistically significant (t=2.11- 4.95, P<0.05). Conclusions TBL combined with microteaching method in first aid training course can improve the undergraduate nursing students′first aid ability, critical thinking ability.

Objective To explore the effect of training course based on the model of practical performance which was designed to improve the humanistic caring ability of nursing postgraduates. Methods After conceived, designed and trained the nursing postgraduates, we combined quantitative research method and qualitative research method to understand the effect and the true feelings of the students after taking the training. Results “Humanistic Caring Ability of Nursing Undergraduates Assessment scale (HCANU)“was used before and after 22 nursing postgraduates accepted the training. After training, their total score (86.06±5.16) was higher than before (67.70±5.00) (t=2.665, P<0.01) and 8 dimensions scores were respectively higher than before(P<0.01 or 0.05). The course has improved the humanistic caring ability of nursing postgraduates, enhanced their empathy of nursing objects and promote self-reflection. Conclusions This training course based on the model of practical performance helps to improve the humanistic caring ability of nursing postgraduates and cultivate their humantistic quality.

Objective:To study the predictive value of combining alpha-feto protein (AFP) with contrast-enhanced MRI imaging features in predicting incidence of microvascular invasion (MVI) in patients with hepatocellular carcinoma.Methods:The data of 206 patients with hepatocellular carcinoma treated at Tianjin Medical University Cancer Institute and Hospital from January 2017 to April 2019 were retrospectively analyzed. There were 179 males and 27 females, with an average age of 58.7 years. The roles of preoperative MRI imaging features and clinical data on predicting the incidence of MVI in patients with hepatocellular carcinoma were evaluated by univariate and multivariate logistic regression analyses. Multivariable regression analysis was then used to plot a nomogram.Results:There were 86 patients (41.7%) with MVI positivity and 120 patients (58.3%) with MVI negativity. Multivariate logistic regression analysis showed that AFP >400 μg/L ( OR=3.318, 95% CI: 1.243-8.855, P=0.017), two-trait predictor of venous invasion (TTPVI) ( OR=13.111, 95% CI: 6.797-28.119, P<0.001), diffusion weighted imaging/T 2 weighted imaging (DWI/T 2WI) mismatch ( OR=17.233, 95% CI: 4.731-44.490, P<0.001), and rim enhancement( OR=5.665, 95% CI: 2.579-18.152, P=0.013) predicted increased risks of MVI in patients with hepatocellular carcinoma. The constructed nomogram directly predicted the risk of MVI in these patients. Conclusions:AFP>400 μg/L, TTPVI, DWI/T 2WI mismatch and rim enhancement were independent risk factors in predicting MVI in patients with hepatocellular carcinoma. This predictive model of MVI which was based on multivariate logistic regression analysis was helpful to clinicians in making individualized treatment plans for patients with hepatocellular carcinoma.

Objective To observe the dynamic changes of endothelial progenitor cells (EPC)and vascular endothelial growth factor (VEGF) in the patients with acute myocardial infarction (AMI)after percutaneous transluminal coronary intervention (PCI). Methods The level of VEGF before and after PCI in 50 cases with AMI were determined by fluorescence immunoassay and enzyme-linked immunosorbnent assay (ELISA),and the ratio of EPC in flood was checked by flow cytometry.Results The level of EPC was higher after PCI than before PCI [(4.15 ± 0.22)％ vs.(0.59 ±0.02) ％,P＜0.01],and there were positive correlations between EPC and number of coronary artery disease (r=0.45,P ＜ 0.05 ),coronary artery lesions ( r =0.76,P ＜ 0.01 ),left ventricular enddiastolic diameter (r=0.68,P＜0.01),ejection fraction (r=0.75,P＜0.01).The VEGF levels after PCI was increased [(506± 120)μg/L vs.(204±98)μg/L,P＜0.01],and its level was positively related with coronary lesions (r=0.66,P＜0.01),left ventricular ejection fraction(r=0.90,P＜0.01).There was association between rising rates of EPC and VEGF in a short time after PCI within 24 h period (r=0.56,P＜0.01). Conclusions The clinical efficacy and prognosis can be assessed by the changes of VEGF level and EPC ratio before and after PCI operation in AM1 patients.

Objective To discuss the nursing care for patients with advanced hepatocellular carcinoma (HCC) who are receiving transcatheter arterial chemoembolization (TACE) combined with sorafenib. Methods A total of 23 consecutive patients with advanced HCC who met the inclusion criteria were enrolled in this study. TACE was carried out in all patients. Three-five days after TACE the patients started to orally take sorafenib. During the treatment course, the patients were kept under close observation for adverse reactions and complications. After leaving the hospital the patients were followed up by the extended care team members, and health education as well as appropriate nursing intervention was carried out. Results All patients with advanced HCC took sorafenib orally after TACE. The major adverse events and complications were gastrointestinal adverse reactions (n = 22) and transient liver dysfunction (n = 23). After leaving the hospital all the patients received regular follow- up examination and extended nursing care. Conclusion Usually, the incidence of adverse reactions is higher in patients with advanced HCC after TACE combined with sorafenib treatment. Careful in-hospital observation and extended out-hospital nursing can reduce the incidence of adverse reactions and thus improve the patient’s quality of life.

Objective To investigate influence of cisplatin (DDP) on the tumor inhibition rate,transcriptional levels of CyclinB1 and CyclinD1 of CNE-1 xenograft in nude mice.Methods Tumor mode of nude mice CNE-1 xenograft was established.Then mice were divided into control arm,DDP arm,high speed irradiation arm,simulated intensity modulated radiation therapy (IMRT) arm and simulated IMRT + DDP arm,with 12 mice in each arm.Irradiation dose was 20 Gy with a single fraction.DDP was 15 μg/g weight.The maximum diameter of tumor base was measured every other day.The growth curve was drawn and tumor inhibition rate werevcalculated after 40 days.The transcriptional level of CyclinB1 and CyclinD1 of xenograft was measured by RT-PCR.The results of different groups were compared with one-factor analysis of variance.Results Tumor inhibition rates of the control arm,DDP arm,high speed irradiation arm,simulated IMRT arm and simulated IMRT + DDP arm were-129.1％,-71.2％,42.5％,35.3％ and 47.1％,respectively.There was significant difference between the high speed irradiation arm and simulated IMRT arm (P =0.034),but not between the high speed irradiation arm and simulated IMRT + DDP arm (P =0.222).The transcriptional levels of CyclinB1 in the arms were 0.429,0.386,0.322,0.354 and 0.268.There were significant differences between the high speed irradiation arm and the simulated IMRT arm or the simulated IMRT + DDP arm (P =0.007 and 0.000).The transcriptional levels of CyclinD1 in the arms were 0.716,0.583,0.348,0.495 and 0.296,respectively.There was significant difference between the acute irradiation arm and the simulated IMRT arm (P =0.000),but there was no significant difference between the high speed irradiation arm and the simulated IMRT + DDP arm (P =0.072).Conclusions Irradiation of 20 Gy single fraction,or combined with DDP are effective on the CNE-1 xenograft in nude mice,but DDP alone can only lower the tumor growth speed.Irradiation of 20 Gy single fraction,or combined with DDP,or DDP alone can reduce the transcriptional levels of CyclinB1 and CyclinD1.As the single therapeutic time is prolonged in IMRT mode,the tumor inhibition rate is reduce,and the reduce of the transcriptional levels of CyclinB1 and CyclinD1 is depressed,while combined DDP can compensate the decline of the biological effect.

BACKGROUND:Human hypoxia-inducible factor-1 alpha can regulate the expression of osteogenic and angiogenic genes, and promote osteogenic activity. OBJECTIVE:To observe the expression of osteogenic genes in rat bone marrow mesenchymal stem cells carrying human hypoxia-inducible factor-1 alpha slow virus infection. METHODS:Hypoxia-inducible factor-1 alpha was obtained from Hela cells using RT-PCR. Lentivirus expression vector plasmid carrying hypoxia-inducible factor-1 alpha (Lenti-HIF-1α-eGFP) was constructed. 293Ta cells with LentiPac HIV mixed packaging plasmid was packaged, and then lentivirus was obtained. Rat bone marrow mesenchymal stem cells were isolated and cultured using direct whole bone marrow adherent method. Bone marrow mesenchymal stem cells were identified using flow cytometry. Bone marrow mesenchymal stem cells were infected with slow virus for 1, 4, 7 and 14 days. Bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase expression levels were detected in bone marrow mesenchymal stem cells using real-time fluorescent quantitative PCR. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells were effectively infected with Lenti-HIF-1α-eGFP. Real-time fluorescent quantitative PCR results revealed that bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase began to obviously overexpress from 4 days after infection with Lenti-HIF-1α-eGFP until 14 days. Results suggested that hypoxia-inducible factor-1 alpha could elevate the osteogenic activity of bone marrow mesenchymal stem cells.

Objective: To evaluate the effects L-apigenin A on Alzheimer＇s disease(AD), and analyze the correlation between MMSE and ADAS-cog scores. Methods: From January 2009 to December 2014, 34 patients with AD were selected in Qinhuangdao Military Industry Hospital.They were treated with celery seed extract L-apigenin.The MMSE scores and ADAS-cog scores were evaluated before treatment and 18, 36 and 72 d after treatment.The correlation between MMSE scores and ADAS-cog scores was analyzed. Results: There were statistically significant differences in the MMSE scores between 72d after treatment[(22.59±1.13)points]and before treatment[(20.53±1.42)points], 18d after treatment[(20.44±1.24)points]and 36d after treatment[(20.97±1.17)points](t=6.619, 7.473, 5.807, all P<0.05). There were statistically significant differences in ADAS-Cog scores between 72d after treatment[(17.09±1.53)points]and before treatment[(20.47±2.85)points], 18d after treatment[(20.18±2.34)points]and 36d after treatment[(20.18±2.49)points](t=6.093, 6.445, 6.165, all P<0.05). The MMSE score and ADAS-Cog score had negative correlation by Pearson analysis (r=-0.259, P=0.000). Conclusion L-apigenin A can significantly improve the cognitive function of patients with AD.There is significant negative correlation between the MMSE scores and ADAS-cog scores.

Objective: To investigate the contamination, antimicrobial resistance and virulence genes of S. aureus from toilets of primary schools in Guangzhou. Methods: The surface samples of toilets were collected from eight primary schools in Guangzhou from May to July 2016. The standard microbiological assays, disk diffusion methods and PCR technique were used for the isolation and identification, antimicrobial resistance and virulence genes of S. aureus . Results: The contamination rate of S. aureus and MRSA was 6.25% and 3.13%, respectively. There was significant difference in the contamination rate of S. aureus among different sampling sites ( χ 2=15.15, P <0.01) and the highest contamination rate was on the ground (15.00%).The most predominant antibiotic for S. aureus was penicillin (100.00%) and the proportions of resistant to teicoplanin, erythromycin,rifampicin, clindamycin and linezolid were more than 75.00%.The multidrug resistant rate of S. aureus was 85.00%.The detection rate of virulence genes of S. aureus was sea (50.00%), tst (30.00%), etb (15.00%), eta (10.00%), seb (10.00%) and pvl (5.00%), respectively. Conclusion The contamination rate of S. aureus from toilets of primary schools in Guangzhou is in a lower level among similar researches. However, the contamination of MRSA is serious, which accounts for half of S. aureus . In addition, S. aureus isolates show high multi-drug resistant rate and high detection rate of virulence genes.