Objective To investigate the status of undergraduate nursing faculty's structural empowerment and job satisfaction and to analyze the correlation between themn.Methods Totally 246 nursing teachers were investigated with Conditions for Work Effectiveness Questionnaire Ⅱ and Minnesota Satisfaction Questionnaire.The correlation between structural empowerment and job satisfaction were analyzed by Pearson correlation analysis.Results Undergraduate nursing faculty's total score was (3.04±0.57) points,and score of job satisfaction was (2.93±0.59) points,both of which were at moderate level.Structural empowerment was positively correlated with job satisfaction (r=0.450-0.714,P＜0.01),the higher structural empowerment level,the higher job satisfaction.Conclusions Undergraduate nursing managers can improve nursing teachers' job satisfaction by strengthening the empowerment to nursing teachers,in order to enhance the teaching quality.

Objective To explore the psychological experience and the needs of parents who had children with leukemia in order to provide the theoretical and practice reference for clinical nursing work.Methods A qualitative phenomenological methodology was used in this study.10 parents of children with leukemia were interviewed with semi-open-ended questions.The NVivo10.0 software was used to supervise,excavate and seek data.The Colaizzi phenomenological methodology was used to analyze the data.Results Through careful analysis,four themes were identified:leukemia news was like crowning calamity; psychological changes generally varied in different stages; pressure had pluralism as well as the diversity of coping.The demand had multipolarity.Conclusions Attention should be paid closely to parents with leukemia children.The individualized measures should be taken by medical workers in order to provide them with mental nursing and holistic nursing and make them stay in a best health state,so that they can supply better social support for these children.

With the development of the population aging and the shifting of medical paradigm,as well as the deeply expansion of community health services,the importance of general medicine has become more and more evident.This paper describes the development history of general medicine and general medical education at home and abroad,analyzes the main problems of general medical education in China.By studying the characteristics of different models,we provided the basis of literature for the related policies.

Objective To develop an ultrasonic frostbite treatment instrument to enhance the efficiency of its treatment.Methods The instrument was designed with thermal effect of ultrasound,which used LPC1788 controller as the core of the hardware circuit.Corresponding software was developed based on KEIL uvision4.0 platform.The instrument was composed of the circuits for square wave generation,boosting,transduction,LCD and power source.Results Five-to-seven-day treatment by the instrument gained high efficacy,and no adverse response occurred.Conclusion The instrument has the characteristics of high reliability,strong controllability,wide adaptation and no side effects,and thus is worthy promoting practically for the clinical treatment of frostbite.

Objective To examine the expression of heparin binding-epidermal growth factor-like growth factor (HB-EGF) in paclitaxel-resistant ovarian cancer and elucidate the relationship between HB-EGF and the resistance of ovarian cancer to paclitaxel. Methods The human ovarian carcinoma cell line A2780 and the paclitaxel-resistant human ovarian carcinoma cell line A2780/Taxol were cultured in vitro. Western blot was used to dectect the expression of HB-EGF protein in A2780 and A2780/Taxol groups. The A2780 cells were treated with cross-reacting material 197 (CRM197 and A2780 + CRM197 group) or dimethyl sulphoxide (DMSO;A2780 group), while the A2780/Taxol cells were treated with CRM197 (A2780/Taxol+CRM197 group) or DMSO (A2780/Taxol group). The effects of CRM197 on growth and proliferation was tested by methyl thiazolyl tetrazolium( MTT) and the results were showed as absorbance (A).The effects of CRM197 on cell cycles was tested by flow cytometry, while the effects of CRM197 on apoptosis was examined by caspase-3 activity assay and the results were showed as p-nitroaniline(pNa). In animal experiment, four groups of cells were inoculated to BALB/c nude mouse subcutaneously to observe tumor formation ability following CRM197 treatment. Immunohistochemistry was used to determine the expression of HB-EGF protein in A2780 and A2780/Taxol group. Results The expression level of HB-EGF protein in A2780/Taxol group (2.11±0.41) was significantly higher than that of A2780 group (0.75±0.20;P<0.01). The inhibition effect of CRM197 on the cell growth of A2780+CRM197 and A2780/Taxol+CRM197 group was accompanied by the acceleration of CRM197 concentration(P<0.01). When CRM197≥1 μg/ml, the inhibition effect of CRM197 on the cell growth of A2780/Taxol+CRM197 group was significantly higher than that in A2780/Taxol group(P<0.05). In cell cycle experiment, CRM197 induced the cell-cycle arrest at the G0/G1 phase in A2780+CRM197 cells[(67 ± 4)%] compared with A2780 cells[(54 ± 6)%;P<0.01], while CRM197 significantly induced the cell-cycle arrest at the G0/G1 phase in A2780/Taxol+CRM197 cells [(72± 4)%] compared with A2780/Taxol cells [(24±8)%;P<0.01]. CRM197 treatment in A2780+CRM197 group [(40 ± 6)μmol/L] led to the acceleration of the caspase-3 activity when compared to A2780 group [(6 ± 6)μmol/L;P<0.01], while CRM197 treatment in A2780/Taxol+CRM197 group [(66 ± 12)μmol/L] led to significant acceleration of the caspase-3 activity when compared to A2780 group [(9 ± 6)μmol/L;P<0.01]. In experiments in vivo, the expression scores of HB-EGF protein in A2780/Taxol tumors(10.8 ± 3.3) were higher than that in A2780 tumors (5.0±2.2;P<0.01). The tumor size and tumor weight of the A2780/Taxol+CRM197 group were both higher than those of the A2780+CRM197 group [(546 ± 85) mm3 vs (1 355 ± 119) mm3,(0.56 ± 0.09) g vs (1.31 ± 0.27) g; all P<0.01]. The CRM197 inhibition rate of the A2780+CRM197 and A2780/Taxol + CRM197 group were 43% and 68% respectively, showed that CRM197 significantly suppressed the growth of A2780/Taxol xenografts in vivo(P<0.01). Conclusions HB-EGF is over-expressed in paclitaxel-resistant ovarian cancer and may be contributes to drug resistance. Inhibition of HB-EGF expression potently enhances apoptosis and inhibit the growth of paclitaxel-resistant ovarian cancer, shedding light on the HB-EGF-targeted therapy options for chemoresistant ovarian cancer patients.

Objective To analyze the language structure of nursing records and the application of defined vocabulary in nursing records of community child care,and to explore the possibility of structuralization and standardization of community nursing records by researchers' consulting International Classification of Nursing Practice (ICNP(R)2.0).Methods Convenient sampling method was used.A total of 432 handbooks about child health care were extracted from three community health service centers in Liaoning province.By analyzing the nursing records,the vocabulary was selected,and a coding book was built.Then researchers compared them with ICNP(R)2.0 Chinese version.Results Totally 567 terms were extracted.All phrases in nursing records about community child health care can be classified into three categories and seven shafts,which were nursing phenomenon,nursing action and nursing outcome.Our community nursing records about child health care could not fully meet shaft level of nursing record writing requirements from the International Council of nurses.Only 146 records were labeled as perfect fit with ICNP(R)2.0 terminology,223 records as not fit at all.The difference of different levels of suitability distribution about nursing phenomenon,nursing action and nursing outcome had statistically significant difference.Words of able to adapt and can't adapt about nursing action had larger proportion.Words that can't adapt about nursing phenomenon and nursing outcome had larger proportion.Conclusions There is still certain gap between domestic nursing records and ICNP(R)2.0 terminology.The list of terms from comparison nursing records about community child health care with ICNP(R)2.0 can lay the foundation for nursing language system structure and perfect community nursing record language in our country.

Objective To investigate the influence of producing areas and sexual reproduction on the genetic features of Citrus grandis‘Tomentosa’. Methods The genetic distance in different species was counted,and the DNA fingerprint of germplasm resources of Citrus grandis ‘Tomentosa’ was established after random amplified polymorphic DNA analysis of Citrus grandis ‘Tomentosa’ and Citrus grandis (L.) Osbeck of various species from different producing areas. Results The genetic distance index D of Citrus grandis ‘Tomentosa’ and Citrus grandis (L.) Osbeck of various species from different producing areas was in the range of 0.01~0.64. Conclusion Sexual reproduction and the changes of producing areas can result in the genetic diversity of Citrus grandis ‘Tomentosa’.

This paper mainly introduces a rare special subtype of gastric cancer , the stomach hepatoid adenocarcinoma .This kind of adenocarcinoma in pathogenesis ,pathology ,treatment and prognosis has great differ-ence from traditional stomach cancer .Because it has both characteristics of gastric carcinoma and hepatocellular carcinoma,and is easily to result in missed diagnosis and misdiagnosis in clinic .It is necessary for us to distin-guish hepatoid adenocarcinoma of the stomach and gastric carcinoma .We may further improve the diagnosis rate of hepatoid adenocarcinoma of the stomach ,and reduce its mortality rate ,prolong the survival period .

Objective To investigate the effect and mechanism of CRM197, the heparin binding-epidermal growth factor-like growth factor (HB-EGF) inhibitor, on the reverse of the resistance ofovarian cancer to paclitaxel. Methods (1)The effect of CRM197 on the 50% inhibitory concentrations (IC50) of human ovarian carcinoma cell line A2780 and paclitaxel-resistant ovarian carcinoma cell line A2780/Taxol was tested by methyl thiazolyl tetrazolium (MTT) assay. Western blot was used to detect the effect of CRM197 on the expression of HB-EGF,epidermal growth factor receptor (EGFR) and plasma membrane glycoprotein (P-gp) protein in A2780 and A2780/Taxol cells. Real-time PCR was used to examine the MDR1 mRNA expression in these cells. (2) A2780/Taxol cells were divided into 4 groups, including the cells transfected with empty vector and saline treatment (empty vector group), MDR1 small interference RNA (siRNA)vector and saline treatment (MDR1 siRNA group),empty vector and CRM197 treatment (empty vector+CRM197 group) and MDR1 siRNA vector and CRM197 treatment (MDR1 siRNA+CRM197 group), respectively. Flow cytometry was used to detecte the effect of intracellular rhodomine 123 (Rh123) accumulation, and caspase-3 activity assay was used to test the effect of apoptosis in four groups of A2780/Taxol cells. (3) In experiments in vivo, A2780/Taxol cells were inoculated to nude mouse subcutaneously to determine the EGFR and P-gp protein expression following CRM197 treatment by immunohistochemistry. Results (1)In vitro,MTT examination showed that the IC50 of A2780/Taxol cells to paclitaxel in A2780/Taxol+CRM197 group [(6.4±0.3)μmol/L] was significantly lower than the IC50 in A2780/Taxol group [(34.1± 0.5)μmol/L,P<0.01], and the reveral fold of CRM197 was 5.3. The expression level of HB-EGF protein in A2780/Taxol+CRM197 group (1.44 ± 0.29) was significantly lower than HB-EGF protein in A2780/Taxol group (2.72 ± 0.32),respectively (P<0.05). The expression level of EGFR protein (0.71 ± 0.25) and P-gp protein (0.82±0.19) in A2780/Taxol+CRM197 group was significantly lower than EGFR protein (1.87±0.31) and P-gp protein (1.84 ± 0.27) of A2780/Taxol group (P<0.05). Compared with A2780/Taxol group(1.78 ± 0.27), MDR1 mRNA was significantly down-regulated in A2780/Taxol+CRM197 group (0.79 ± 0.13,P<0.05). (2) The fluorescence intensity of Rh123 of the A2780/Taxol cells in empty vector group, MDR1 siRNA group,empty vector+CRM197 group, MDR1 siRNA+CRM197 group was 33.4±1.6, 56.3±3.3, 43.5± 3.1,100.4 ± 7.4, and the pNA of the A2780/Taxol cells was(11.4 ± 1.2),(52.8 ± 0.9),(71.2 ± 3.6),(82.7 ± 3.8)μmol/L. The expression levels in MDR1 siRNA+CRM197 group were both higher than the expression levels in empty vector+CRM197 group, and the expression levels in empty vector+CRM197 group, MDR1 siRNA group were both higher than the expression levels in empty vector group (P<0.05). (3) In vivo, the expression scores of EGFR protein in A2780/Taxol+CRM197 tumors (4.4 ± 1.4) were lower than that in A2780/Taxol tumors (10.2 ± 3.1,P<0.05). The expression scores of P-gp protein in A2780/Taxol+CRM197 tumors (3.8 ± 1.1) were lower than that in A2780/Taxol tumors (8.8 ± 2.7,P<0.05). Conclusion CRM197 reverses the resistance of ovarian cancer to paclitaxel by increasing caspase-3 activity to advance apoptosis via EGFR/MDR1/P-gp pathway.

Objective:To survey the practice of hospice care and influencing factors among health providers in Shanghai.Methods:From November to December in 2019, a sampling survey on the practice of hospice care was conducted among 2 982 health providers from 217 institutions in 16 districts of Shanghai by using the self-designed scale.Results:The overall behavior frequency of hospice care in health providers was between "occasionally" (3 points) and "often" (4 points). The item score was (3.7±0.9), and the total score was (52.1±10.0). In the aspect of building a good relationship with patients and family(77.7%, 2 317/2 982), the participants had the highest work-practice(46.4%, 1 383/2 982). However, they practiced less in recommending the hospice care institutions to terminal patients. In terms of work-practice, the average score in male providers, those with education of undergraduate and above, those being married (including divorced or widowed), medical staff, those with associated senior titles, with witness of dying, or those currently working in the hospice care service department was higher.Conclusions:The hospice care work-practice of health providers in Shanghai is generally satisfactory, however, there is still some discrepancy among health providers with various characteristics. To further improve quality of hospice care, it is necessary to strengthen policy implementation, to encourage multidisciplinary team cooperation and carry out various forms of professional training for health providers.