To keep vocational schools distinctive and vigorous,top priority should be placed in teachers'training and teaching,making practice skill training systematic,embodying practical open professional principle based on vocational education in the process of practice teaching,by the teachers'guidance and stimulating students to actively participate in practice,reforming teaching ways and means.

Urban and periurban agriculture (UPA) is the important part of modern agriculture. It can resolve the food supply to city residents, increase employments and improve the urban ecosystem. But without proper management and reasonable programming, UPA also can carry heavy burden to urban environment and impact people's health. This paper specifically analyzed the potential risks of urban agriculture and suggested preventive and control measures.

Objective To improve the treatment of abnormal calcium-phosphorus metabolism in hemodialysis patients, and observe its influence on the quality of life. Methods Implemented the kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in hemodialysis patients, improved the treatment of abnormal calcium-phesphoms metabolism in hemodialysis patients. After 1 year, the values were compared between before and after application of K/DOQI guidelines, including albumin-adjusted serum calcium, phosphorus, calcium × phosphorus (Ca × P) product, and intact parathyroid hormone (iPTH) and their achieved target range rates. The quality of life were evaluated by using the kidney disease questionnaire (KDQ). Results One year later, the levels of serum calcium, phosphorus, Ca × P product, and iPTH were all decreased (P<0.01 or <0.05) compared with before the application of K/DOQI guidelines. The percentage of patients fell within the guideline range were as follows: 74.42% (32/43), calcium; 62.79%(27/43), phosphorus; 55.81%(24/43), Ca × P product; 60.47%(26/43), iPTH; 25.58%(11/43), all four criteria, higher than before (P<0.01 or <0.05). The scores of KDQ in global indices and symptom scores of physical symptoms, fatigue, depression, relationships with others and frustration dimension were also all increased (P<0.01). Conclusion The state of calcium-phospberns metabolism in hemodialysis patients is improved, the quality of life is also enhanced.

Objective: To explore the effect of persistent atrial ifbrillation (AF) on circadian rhythm of blood pressure (BP) in patients with essential hypertension (EH).
Methods: A total of 173 EH patients treated in Gansu Provincial Hospital from 2013-02 to 2014-01were studied. The patients were divided into 2 groups: EH group,n=88 and Persistent AF combining EH group,n=85. The baseline information was studied and the risk factors of persistent AF combining EH were investigated by multivariate logistic regression analysis.
Results: Compared with EH group, the Persistent AF combining EH group showed decreased average daytime DBP, minimum daytime SBP, minimum daytime DBP and the average 24-hour DBP, while increased maximum nighttime SBP and the percentage of reverse dipper in DBP, allP<0.05. There were no significant differences for the average of daytime SBP, maximum daytime SBP, maximum daytime DBP, the average 24-hour SBP, average nighttime SBP, average nighttime DBP, maximum nighttime DBP, minimum nighttime SBP, minimum nighttime DBP and the percentage of reverse dipper in SBP between 2 groups, allP>0.05. Multivariate logistic regression analysis indicated that the maximum nighttime SBP was obviously related to persistent AF combining EH (OR=1.038, 95 CI 1.014-1.062,P=0.001).
Conclusion: Persistent AF may incur daytime BP dropping, such change was not obviously observed for nighttime BP in EH patients.

Objective To investigate the effect of Goserelin in protection of the ovarian function of pre-menopausal breast cancer patients. Methods Eighty premenopausal patients with breast cancer randomly divided equally into study group and control group. The two groups were compared in terms of the menstrual status and the levels of E2,FSH,LH before and after chemotherapy. Results The menstrual recovery rates of the study group and the control group were 90% and 57.5%,respectively ,with statistically significant difference between them (P = 0.018). In the study group,the serum E2 decreased gradually to the postmenopausal level,and the serum levels of FSH and LH were also significantly decreased during the treatment. While in the control group ,the E2 levels gradually decreased ,but the levels of FSH and LH significantly increased during the chemotherapy. Conclusions Goserelin can effectively prevent the injury of ovarian function caused by chemotherapy.

Objective:To compare 5-year overall survival (OS) and disease free survival (DFS) between preoperative three dimensional conformal radiotherapy (3DCRT) and volumetric medulated arc therapy (VMAT) concurrently combined with chemotherapy for locally advanced rectum cancer (LARC), and analyze the value of induction and/or consolidation chemotherapy in these circumstances.Methods:334 patients with LARC treated with preoperative 3DCRT (172 cases) and VMAT (162 cases) concurrently combined with chemotherapy, main protocol XELOX (capecitabine plus oxaplatin), and subsequent surgery in Sun Yat-sen University from May 2007 to April 2013 were retrospectively analyzed. The radiation prescription dose for VMAT group was 50 Gy 25 fractions for planning target volume1(PTV 1), and 46 Gy 25 fractions for PTV 2. The radiation prescription dose for 3DCRT group was 46 Gy 23 fractions for PTV 2. One hundred and eighty-five cases of all received preoperative concurrent chemoradiotherapy (namely, CCRT group), 149 cases received preoperative concurrent chemoradiotherapy plus median 2 courses (1-7 courses) induction and/or consolidation chemotherapy (namely, CCRT±induction chemotherapy±consolidation chemotherapy group), whose main chemotherapy protocol was XELOX. Difference of 5-year OS and DFS between 3DCRT and VMAT group was compared. The rate differences of acute toxicity during chemoradiotherapy, postoperative complications, ypCR, and survival between CCRT group and CCRT±induction chemotherapy±consolidation chemotherapy group were analyzed. Results:After a median follow-up of 62.3 months (2.4-119months) for the 334 patients, no any significant difference for 5-year OS (79.0% vs. 83.2%, P=0.442) and 5-year DFS (77.0% vs. 82.1%, P=0.231) between 3DCRT and VMAT group was observed. There was no any significant difference for the Grade 3 hematological toxicity (7.0% vs. 12.1%, P=0.114) and non-hematological toxicity (14.1% vs. 16.8%, P=0.491) during chemoradiotherapy, postoperative complications (17.3% vs. 17.4%, P=0.971), ypCR rate (25.4% vs. 30.2%, P=0.329), 5-year OS (80.5% vs. 82.0%, P=0.714) and 5-year DFS (78.8% vs. 81%, P=0.479) between CCRT group and CCRT±induction chemotherapy±consolidation chemotherapy group. Conclusions:Compared with 3DCRT, the physics advantage of VMAT technique does not significantly convert into clinical benefits and improve 5-year OS and DFS, even further boosting radiation dose to the gross tumor volume. It is safe for median 2 courses of induction and/or consolidation chemotherapy before and or after preoperative concurrent chemoradiotherapy in the treatment of LARC, though it does not significantly improve ypCR rate and survival.

Objective: To observe blood levels of cystetine C (Cys C) and superoxide dismutase (SOD) in patients with obstructive sleep apnea syndromes (OSAS) related hypertension (HP). Methods: A total of 102 HP patients received polysomgography (PSG) in our hospital from 2013-01 to 2013-12 were studied. According to apnea hypopnea index (AHI), the patients were divided into 2 groups: OSAS with HP (OH) group, n=55 patients with AHI≥5 and HP group,n=47 patients with AHI<5; in addition, there was a Control group,n=45 normal subjects with PSG examination at the same period. The general conditions, biochemical and sleep parameters were studied, the differences among 3 groups were analyzed by SPSS 17.0 software. Results: In OH group, HP group and Control group, blood levels of Cys C were (1.06 ± 0.27) mg/L, (0.91 ± 0.19) mg/L and (0.79 ± 0.32) mg/L respectively; SOD were (127.63 ± 63.19) U/mL, (149.14 ± 60.12) U/mL and (181.54 ± 59.37) U/mL respectively, allP<0.05. Based on clinical conditions, OH group was further divided into Mild, Moderate and Severe sub-groups, blood levels of Cys C and SOD were similar among different sub-groups,P>0.05. Conclusion: Blood levels of Cys C in OH and HP groups were higher than Control group, Cys C in OH group was higher than HP group; SOD levels in OH and HP groups were lower than Control group, SOD in OH group was lower than HP group. The relationships between Cys C, SOD and OH severity were unclear.

Objective To observe the effects of autophagy on the expression of synaptic plasticity related protein, growth-associated pro-tein-43 (GAP-43) and microtubule associated protein-2 (MAP-2), in CA1 area of hippocampus of vascular dementia rats. Methods Nine-ty-six healthy male Sprague-Dawley rats were randomly divided into sham group, vascular dementia model group (VD group), autophagy in-hibitor 3-methyl adenine preconditioning group (3-MA group) and autophagy agonist rapamycin preconditioning group (Rap group). Each group was divided randomly into subgroups of one week, two weeks, four weeks and eight weeks after modeling, six rats in each group. The vascular dementia rat model was established with modified Pulsineli's four-vessel occlusion. The expression of GAP-43 and MAP-2 in CA1 area of hippocampus were detected with immunohistochemistry. Results Compared with the sham group, the expression of GAP-43 protein increased, and the expression of MAP-2 protein decreased at every time point in VD group (P<0.01). Compared with VD group, the expres-sion of both GAP-43 and MAP-2 increased in 3-MA group (P<0.05), and decreased in Rap group (P<0.05). Conclusion Autophagy may in-hibit the expression of synaptic plasticity related protein, GAP-43 and MAP-2, in CA1 area of hippocampus in vascular dementia rats, indi-cating inhibition of autophagy may promote synaptic remodeling.

Objective To evaluate the effects on catheter related blood stream infection by different dressing frequency of peripherally inserted central catheter(PICC)with neonates. Methods A systematic review of randomized controlled trials (RCTs) from databases, Data were searched about the transparent dressing replacement frequency for neonatal PICC catheterization. The meta-analysis was performed by using RevMan 5.2 software. Results Nine RCTs were included in a total of 1 730 patients. Meta analysis showed that there was no significant difference in the incidence of PICC puncture dressing, catheter-related infections (including puncture port infection, catheter-related blood flow infection, catheter bacterial colonization) at every 3, 5, and 7 days (P> 0.05). Conclusion the dressing of PICC catheter are replaced will not increase the incidence of catheter-related infections within 7 days, throughout the more appropriate frequency of dressing replacement is once every 7 days.

Objective To explore the protective effect of extracorporeal membrane oxygenation (ECMO) on donor kidneys from non-controllable donation after cardiac death (DCD). Methods A total of 60 non-controllable DCD donors were selected and divided into 3 groups randomly based on the in vivo perfusion time of ECMO: test group 1 received EMCO perfusion for 2 h, test group 2 for 4 h and test group 3 for 6 h, with 20 cases in each group. Corresponding recipients were also divided into 3 groups, with 20 cases in each group. Meanwhile, 20 recipients from donation after brain death (DBD) with stable circulatory function were randomly selected as control group. Incidence of delayed graft function (DGF), primary graft nonfunction (PNF) and acute rejection of the recipients in different groups was compared. The indexes including graft function recovery time, urine volume on day 1 and graft function within 1 year after renal transplantation were compared for the recipients in different groups. And 1-year survival rate of the recipients and grafts after renal transplantation was compared. Results Compared with the control group, various test groups presented no significant differences in the incidence of PNF, DGF and acute rejection (all P>0.05). Compared with the control group, graft function recovery time prolonged significantly in each test group, which presented statistically significant differences (all P<0.05), while the urine volume on day 1 and graft function within 1 year after renal transplantation presented no statistically significant difference in each test group (all P>0.05). The 1-year survival rate of the recipients and grafts after renal transplantation was 100％ in various test groups and control group, which presented no statistically significant difference (all P>0.05). Conclusions ECMO can protect donor kidneys effectively through assisting the circulatory or respiratory function of non-controllable DCD, and improve their utilization rate.