Objective To explore the feasibility and effect of the multivariate integration teaching in clinical nursing teaching, improve the shortcomings of the traditional single teaching, and enhance the quality of clinical teaching and nursing students' satisfaction. Methods 117 clinical nursing students of the Department of Rheumatoid Immune Kidney of the Nanjing Hospital Affiliated to Nanjing Medical Uni-versity were chosen as the subjects and were divided into two groups, and 57 nursing students who practiced in the Department of Rheumatoid Immune Kidney from 2013 to 2014 were recruited to the experimental group to receive multivariate integration teaching method, with another 60 students who practiced in the Department of Rheumatoid Immune Kidney from 2012 to 2013 as control group to receive the traditional single model teaching method. Two groups of nursing students were given the unified theory test and clinical skills exam-ination as well as the evaluation of comprehensive quality and satisfaction survey. SPSS 20.0 software was used to give the general statistical description of the theoretical results, operating results, comprehensive quality, satisfaction and other measurement data. Examination results were expressed by x±s. t test, rank sum test was used for statistical analysis and the test level was α=0.05. Results Theoretical result of the experimental group was (96.283±2.330), operating result was (93.883±3.173), the compre-hensive quality evaluation result was (46.133±2.111), and satisfaction degree was (45.033 ± 5.966). Theo-retical result of the control group was (87.850 ± 4.953), operating result was (84.333±5.011), the com-prehensive quality evaluation result was (35.650 ±3.804), and satisfaction degree was (33.683 ±7.101). Conclusion Multi-variate integration teaching method is conducive to the cultivation of nursing students' clinical thinking and comprehensive quality, and can improve their ability to communicate with patients and enhance their self-confidence. Therefore it is an effective teaching method, worthy of popularization and application in all departments.

Objective To observe the morphology, quantity and migration of Langerhans cells in normal or HPV-infected skin treated with localized hyperthermia. Methods Tissue specimens obtained from 16 patients with condyloma accuminatum (CA) and 15 normal controls were divided into three equal parts, and irradiated by a self-made hyperthermia equipment at 37℃, 42℃ and 45℃ respectively for 30 minutes. Immunohistochemistry and flow cytometry were applied to detect the morphology, quantity and migration of Langerhans cells (LCs), respectively, in these treated specimens. Results With a rise in temperature, the number of LCs in epidermis decreased, the dendrites shortened, decreased in number or even disappeared. After exposure to hyperthermia at 37℃, 42℃ and 45℃, the number of LCs was 782.40±114.8, 649.44±119.40 and 510.88±118.64 per square millimeter respectively, in normal tissue, 646.04±135.67, 489.38±118.19 and 387.93±110.15 per square millimeter respectively in HPV-infected skin tissue.The percentage of migratory LCs expressing CD1a was 0.19%±0.18%, 0.89%±0.19% and 1.59%±0.28% in normal skin tissue treated with hyperthermia at 37℃, 42℃ and 45℃ respectively, 0.62%±0.31%,2.31%±0.54% and 6.33%±0.98%, respectively, in HPV-infected skin tissue; the differences were significant among these different temperatures. Furthermore, the migration of LCs from tissue into culture was enhanced by the treatment with hyperthermia. Conclusions Hyperthermia can promote the migration of LCs, and accordingly enhance the antigen presenting effect of these cells in immune response.

Objective To investigate the effect of hyperthermia on the expression of E6 and E7 genes of human papillomavirus (HPV) type 6 and 11 in HPV-infected human skin. Methods Tissue samples were obtained from the lesions of condyloma accuminatum (CA) in 6 patients after informed consent. Each sample was divided into 4 parts: one was embedded and directly stored at -80 ℃; the other 3 parts were placed in culture medium and the surface of the samples was irradiated for 30 minutes with a thermotherapy apparatus at 37℃, 42 ℃, 45 ℃, respectively, then the samples were taken out and stored at -80 ℃. RNA was extracted from the specimens, real time quantitative PCR (qPCR) was performed to detect the expression of E6 and E7 genes of HPV-6 and -11. Results Of the 6 patients, 2 were infected with HPV-6 and -11 respectively, 4 with both HPV-6 and HPV-11. The expression of E6 and E7 mRNA decreased with the increase in irradiation temperature. The relative mRNA expression levels at 37 ℃, 42 ℃ and 45 ℃ were 1.00 ± 0.00, 0.61 ± 0.17, 0.27 ± 0.15, respectively, for HPV-6 E6 gene, 1.00 ± 0.00, 0.56 ± 0.21, 0.16 ± 0.11 respectively, for HPV-6 E7 gene, 1.00 ± 0.00, 0.60 ± 0.22, 0.16 ± 0.08, respectively, for HPV-I1 E6 gene, 1.00 ± 0.00, 0.55 ± 0.15, 0.24 ± 0.06, respectively, for HPV-11 E7 gene; statistical difference was noted among them between the specimens irradiated at different temperature (all P < 0.01). Conclusion Hyperthermia can remarkably suppress the expression of HPV-6/I 1 E6 and E7 genes, which may be a possible mechanism under the regression of warts induced by local hyperthermia.

Objective To investigate the expression of complement split product C4d and its significance in renal allograf tissue of chronic rejection in rats.Methods The healthy closed population Wister rats and SD rats were used as donator and acceptor in renal transplantation.The chronic rejection model of renal transplant in rats was established and the rats were divided into 2 groups.The rats in experimental group were given Mycophenolate mofetil(MMF)(10 mg/kg) and those of the control group were given nothing except CsA(5 mg?kg~(-1)?d~(-1)) for 10 days.At the 12th week of renal transplantation,the allograft was tested by light microscope,and the pathological changes of renal grafts and the expression of C4d in peritubular capillaries were observed.Results On the 12th week of renal transplantation,the morphology changes of chronic rejection was observed in the experimental group and obvious C4d deposition was detected in peritubular capillaries of renal allograft tissue,with significant difference compared with those of the control group(all P

Objective To study the role of tumor necrosis factor(TNF)?receptor75000(p75)in psoriasis vulgaris.Methods Expression of p75was detected by immunohistochemistry and enzyme-linked immunosorbent assay(ELISA)in skin and sera of patients with psoriasis vulgaris.Results Expression of p75was not found in skin of normal controls.p75expression was noted in epidermis of lesional and non-le-sional psoriatic skin,and in dermal infiltrating mononuclear cells(MNCs)of psoriatic skin.The staining in-tensity of p75on epidermal keratinocytes(EKCs)was significantly correlated(r' s =0.732,P

Objective To investigate the distributions of haptoglobin (Hp) phenotypes and their clinical significance in five skin diseases. Methods Haptoglobin phenotypes were determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) in a discontinuous buffer system, and then confirmed by staining with silver nitrate. Results The distribution of Hp1-1, Hp2-1, Hp 2-2 of Han ethnic group was 9.9 percent, 46.9 percent, 43.2 percent, respectively. Compared with normal controls, the frequency of Hp2-2 in SLE group (59.3%) was markedly high, especially in those with kidney damage, that of Hp2-1 in psoriasis(30.9%) was low, and that of Hp1-1 in eczema was high, especially in those without exudation (27.4%). There was no statistical significance for the distributions of Hp phenotypes in secondary syphilis and condyloma acuminatum. Conclusion Hp phenotypes might be associated with the pathogensis and some clinical manifestations in SLE, psoriasis of eczema.

Objective Repetitive transcranial magnetic stimulation (rTMS) has gradually been used in the treatment of generalized anxiety disorder (GAD).The efficacy and adverse reactions of repetitive transcranial magnetic stimulation on general anxiety disorder are assessed in the review.Methods Searched databases such as Pubmed,Cochrane library,OVID,CNKI,VIP by computer,and researched published randomized controlled trials (RCTs) focused on repetitive transcranial magnetic stimulation on general anxiety disorder.Meta-analysis was conducted by RevMan 5.3 software.Results A total of 10 RCTs were included,involving 732 general anxiety disorder patients.The were divided into two subgroups,one group is effect observation,the other group is the improvement of curative effect in the treatment process.The effectiveness of intervention of rTMS follow up is better than that of the control group (WMD =-5.02,95％ CI=-6.84--3.20,P＜0.01).The intervention of rTMS group can early ameliorate the symptom of anxiety.The results of low frequency and high frequency rTMS intervention is (WMD =-1.34,95％ CI=-1.97--0.71,P＜0.01;WMD =-2.65,95％ CI=-3.51--1.79,P＜0.01).The adverse reactious of the intervention of rTMS group is less than that of the control group(WMD =-7.04,95％ CI=-11.64--2.43,P＜0.01).Conclusion rTMS intervention in the treatment of GAD patients at the end of the treatment and short-term follow-up efficacy is better,rTMS intervention after the onset of rapid intervention,the intervention group adverse reactions are rare.

Objective To investigate the expression of haptoglobin(Hp)mRNA and protein in nor-mal human epidermal cells and human keratinocyte cell line-HaCaT cells.Methods In situ hybridization and RT-PCR were used to detect the expression of Hp mRNA in normal human epidermal cells and HaCaT cells.Immunohistochemistry was used to detect the expression of Hp on normal human epidermal cells.Im-munohistochemistry and Western blot were used to detect Hp expression on HaCaT cells.Results There was Hp mRNA expression in normal human keratinocytes and HaCaT cells.There was no Hp mRNA expres-sion in normal human epidermal Langerhans cells.There were some Hp positive dendritic cells in normal human epidermis.There was no obvious Hp protein staining in the HaCaT cells by immunohistochemistry.There was Hp protein band from HaCaT cells by Western blot.Conclusions There is Hp mRNA expression in normal human keratinocytes and HaCaT cells which suggests that normal human keratinocytes and HaCaT cells have the ability to synthesize Hp protein.Normal human epidermal Langerhans cells have no ability to synthesize Hp protein.There is small amount of Hp protein in HaCaT cells.

Objective To investigate the effect of local hyperthermia on the morphology and quantity of Langerhans cells (LCs)at challenged skin sites of a mouse model of contact hypersensitivity.Methods Sixty mice were equally divided into 3 groups to be treated with local hyperthermia (37℃,39℃,41℃and 43℃)for 20 minutes at sensitization sites on the back of mice 3 days before (pre-heat group),concurrently with (concurrent-heat group)or 2 days after(post-heat group)sensitization respectively.Five mice which remained unsensitized and untreated served as the controls.Five days after the sensitization,the mice were challenged on the dorsal surface of right ears.Two days after the elicitation,the right ears were resected and immunohistochemistry was performed to observe the morphology and determine the quantity of LCs at challenged sites.Results With the rise in temperature,the number of LCs in the epidermis of ear skin decreased in pre-heat group(321.83±41.81,251.12±16.29,191.41±28.7,128.33±77.61 per square millimeter at 37 ℃,39 ℃,41℃and 43℃,respectively,P<0.05),but increased gradually in the concurrent-heat group(309.08±84.69,355.33±11.38,405.5±55.25,438.16±99.56 per square millimeter at 37℃,39℃,41℃ and 43℃,respectively,P>0.05)and in the post-heat group(320.83±113.6,398.33±31.91,437.83±29.78,477.25±86.79 per square millimeter at 37℃,39 ℃,41℃and 43℃,respectively,P<0.01).The dendrites of LCs increased in number and length when the temperature lose from 37 ℃ to 41℃,but slightly declined at 43℃.Conclusions Local hyperthermia at sensitization sites could affect the morphology and density of LCs at challenged sites,and the effect is likely associated with the severity of contact hypersensitivity.

Objective To investigate the effect of local hyperthermia on the mRNA expression of phosphatidylinositol 3-kinase(P13-K)in Langerhans cells(LCs)transmigrating from HPV-infected skin.Methods Tissue samples were collected from 5 female patients with condyloma acuminatum(CA)and 5 normal human controls.then equally divided into three parts to receive local hyoerthermia treatment at 37℃,42 ℃ and 45℃,respectively,for 30 minutes.After another 12-hour incubation in RPMI 1640 culture medium,transmigrating cells were collected and LCs were purified.Real-time quantitative reverse transcription-PCR was performed to detect the mRNA expressions of P13-K p85a and p110α in purified CD1a~+ LCs from these tissue samples.Results In CD1a~+ LCs transmigrating from normal skin and lesions of CA.the expressions of P13-K p85a and P110α mRNA decreased with the increase of temperature.Atier local hyperthermia treatment of normal skin at 37℃,42℃,45℃,the relative mRNA expression level was 1.00±0.00,0.78±0.13,0.54±0.17,respectively.for P13-K p85α in transmigrating LCs,1.00±0.00,0.80±0.11,0.61±0.12,respectively.for P13-K P110α;there was a significant difierence among the three temperatures in bOth parameters(both P＜0.01).In the case of lesions of CA.the relative mRNA expression level of P13-K p85αand p110α was 1.00±0.00 and 1.00±0.00 under treatment at 37℃,0.20±0.11 and 0.49±0.21 at 42℃.0.1±0.08 and 0.09±0.03 at 45℃.respectively;significant difierence was also noted among the three treatment temperatures(both P＜0.01).The decrease in P13-K P110α mRNA expressions under hyperthermia treatment at 42 ℃ and 45℃ compared with those at 37℃was greater in LCs from CA lesions than that from normal skin.Conclusions Local hyoerthermia could remarkably inhibit the expression of P13-K genes.which may enhance immunity and favor elimination of HPV.