Pathology is the bridge of medicine between basic course and clinic course.The building and development of the subject is inseparable from the surgical pathology.Teachers should enrich and enhance professional knowledge,pay attention to the concepts and key points,and handle properly the relationship of the general pathology and the systematic pathology.Multimedia tools for teaching pathology are suitable but still need improvement.

The dental clinical internship is the critical stage of combining theory and practice and changing the knowledge into ability for medical smdents through clinical practice.It should be based on the characteristics of oral medicine such as integrating the teaching content firstly,promoting the discussion teaching;then carrying the seminar teaching,including three steps,question-making,question-suspecting and question-solving Meanwhile,the training of scientific research and cultivate the innovative ability should be strengthened to cultivate students'creative ability by guiding studetents to refer to data.fill in the proposal of medical students and process an opening report,make medical records discussion and write professional summary and thesis.

Objective:To evaluate the clinical value of activated carbon nanoparticles for guiding lymphadenectomy in advanc-ing rectal cancer. Methods:Eighty rectal cancer patients who underwent laparoscopic curative resection for rectal cancer were divided into two groups:control group (40 cases) and experiment group (40 cases). The experiment group received carbon nanoparticle-labeled lymph nodes in surgery. The number of lymph nodes, lymph nodes≤5 mm in size, and positive lymph nodes, as well as the side effect of the procedure, were analyzed. Results:No complications were observed in the experiment group. The experiment group showed sig-nificantly higher values (P<0.05) than the control group for average number of lymph nodes (25.5 ± 8.78 vs. 16.05 ± 4.84), lymph nodes≤5mm in size (22.6 ± 8.25 vs. 13.65 ± 4.62), and positive lymph nodes (3.13 ± 4.14 vs. 1.35 ± 2.06). During operation, two dyed lymph nodes in two cases were found at the roof of the inferior mesenteric artery and along the side of the internal iliac artery. Dissec-tion was extended for these patients and the dyed lymph nodes were confirmed to be positive. Conclusion:Local injection of activated carbon nanoparticles around the tumor during surgical exploration was an effective, secure, and easy approach for guiding lymphade-nectomy in rectal cancer patients.

BACKGROUND: Strontium-doped calcium polyphosphate (SCPP) is a new type of bone repair materials with good biocompatibility and controlled degradation. The preliminary studies of our group indicate their role in promoting angiogenesis,but its mechanism is unclear.OBJECTIVE: By co-culturing osteoblasts ROS17/2.8 with SCPP in vitro to observe cell proliferation and the secretion of vascular endothelial growth factor (VEGF).DESIGN, TIME AND SETTING: A contrast study was performed at the Laboratory of Tissue Engineering of Sichuan University from October 2008 to June 2009.MATERIALS: A series of calcium polyphosphate (CPP) respectively containing 0%, 1 %, 2%, 5%, 8%, and 10% Sr~(2+) were prepared. ROS17/2.8 osteoblastic cell strain was provided by Laboratory of Transplantation Immunity and Transplantation Engineering, West China Hospital, Sichuan University.METHODS: ①Preparation of cell scaffold complexes: The materials were placed in 24-well plates, then 300 μL cell suspension with a concentration of 2×10~7 cells/Lwas inoculated into each hole. These complexes were cultured for 14 days and the liquid was changed every two days. ②These complexes were measured by MTT assay to observe the proliferation of osteoblasts on the 1~(st), 3~(rd), 5~(th), 7~(th), 10~(th) and 14~(th) days, respectively. ③ The centrifugal supernatant of the complex cultured for seven days was measured by ELISA assay to check the secretion of VEGF.MAIN OUTCOME MEASURES: The proliferation of osteoblastic cells on SCPP and CPP was observed. The amount of VEGF protein secreting from osteoblastic cells was detected.RESULTS: The results of MTT showed that, compared with the CPP group, SCPP groups could promote the proliferation of osteoblasts, and 8% SCPP group was the best; ELISA results showed that, compared with the CPP group, SCPP groups could increase the amount of VEGF protein secretion, of which the promoting role of 8% SCPP was the most obvious (P < 0.05).CONCLUSION: When cultured with osteoblasts, SCPP can promote cell proliferation, and can significantly increase the secretion of VEGF; moreover, 8% SCPP is the best, which reveals a certain mechanism of its promoting angiogenesis.

BACKGROUND:Bone marrow mesenchymal stem cels can secrete a variety of factors in the local lesion, and these factors can promote cel proliferation and inhibit cel apoptosis. OBJECTIVE: To observe the curative effect of bone marrow mesenchymal stem cel transplantation on the aging heart of rats and to explore the possible mechanism of action. METHODS:Thirty Sprague-Dawley rats were randomized into three groups: normal blank group, model group and treatment group. Aging models were made in the latter two groups by injection of D-galactose. Rats in the treatment group were given alogeneic bone marrow mesenchymal stem cel injection, once a week, totaly four times. At 1 week after final injection, the heart tissues were sliced into sections to observe the pathological changes using hematoxylin-eosin staining. Western blot assay was used to detect the expression of basic fibroblast growth factor in the heart tissues. Real-time PCR was used to measure the expression of p53 mRNA in the heart tissues. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel transplantation could improve the pathological morphology of the aging heart. Compared with the model group, the expression of basic fibroblast growth factor in the heart tissues was significantly higher in the treatment group (P < 0.05), but the mRNA expression of p53 was lower (P < 0.05). It is speculated that bone marrow mesenchymal stem cels can interact with heart cels to secrete basic fibroblast growth factor and reduce p53 mRNA expression, thereby playing a curative effect on the aging heart.

Objective:To construct an objective and scientific core competence training system for intensive care unit (ICU) specialized nurses in Yunnan Province, and to provide references for formulating a homogeneous and standardized ICU specialized nurse training strategy and assessment.Methods:Based on the theoretical basis of the nurse-patient safety competency framework, the relevant literature of nursing job competence was consulted, the core competency training system of ICU specialized nurses in Yunnan Province was constructed, and the expert letter questionnaire was designed through theoretical analysis. From January to May 2020, 15 experts of critical care medicine from Yunnan Province were consulted by Delphi method to establish a core competency training system for ICU specialized nurses in Yunnan Province. SPSS 21.0 was used to input and analyze the data.Results:A total of 2 rounds of Delphi expert consultation were carried out. The final core competency indicators for ICU specialized nurses included effective communication, teamwork, safety risk management, nursing quality improvement and professionalism, including 5 first-level indicators, 14 second-level indicators and 59 third-level indicators. The effective recovery rates of the two rounds of Delphi expert consultation questionnaires were 100.00% (15/15) and 86.67% (13/15), the expert authority coefficient values were 0.863 and 0.881 respectively, the Kendall harmony coefficients of the first-level index, the second-level index and the third-level index were 0.381, 0.299 and 0.250, and χ2 value was 22.86, 58.22 and 217.30, with statistically significant differences ( P<0.001). The 5 first-level indicators were safety risk management (0.360), professionalism (0.280), teamwork (0.200), nursing quality improvement (0.120), and effective communication (0.040) in descending order. Conclusions:The established core competence training system for ICU specialized nurses in Yunnan Province based on patient safety is reliable and scientific, which can provide objective basis for the on-the-job training, evaluation and development of patient safety education courses for ICU specialized nurses in Yunnan Province.

Self-efficacy can affect the confidence of adolescent patients with chronic diseases in coping with disease and management, and then affect their disease management and health behavior. This paper introduced the concept of self-efficacy of adolescent patients with chronic diseases, and summarized self-efficacy scale for adolescent patients with chronic diseases from aspects of development, application scope and the reliability and validity, to provide reference for clinical evaluation of self-efficacy level of adolescent patients with chronic diseases during treatment and formulation of targeted intervention plan.

Objective:To explore the prevalence of hepatitis C virus (HCV) infection, influence factors and interaction on HCV infection in patients receiving methadone maintenance treatment (MMT) in Taiyuan.Methods:Between April-June 2019, three MMT clinics in Taiyuan were selected to conduct a face-to-face questionnaire survey among MMT patients to collect the information about their socio-demographic characteristics, drug use, MMT, sexual behavior and health status. Software EpiData 3.1 was used for real-time double entry to establish the database. Software SAS 9.4 was used to analyze the data, and χ 2 test was used for univariate analysis and logistic regression model was used for multivariate and interaction analyses. Results:A total of 903 subjects were surveyed among MMT patients, the male to female ratio of was 7.21∶1(743∶103), and the rate of HCV infection was 12.53% (106/846). After adjusting for the confounding factors, being women ( OR=1.936, 95% CI: 1.023-3.662), having sex with drug users ( OR=2.073, 95% CI: 1.110-3.871) and injection drug use ( OR=7.737, 95% CI: 4.614-12.973) might be the risk factors for HCV infection in patients receiving MMT. The results showed that there were multiplicative interactions among women, having sex with drug user and injection drug use on HCV infection. Conclusions:Being women, having sex with drug user and injection drug use were associated with higher risk for HCV infection in patients receiving MMT in Taiyuan. There were multiplication interactions between being women and having sex with drug user, being female and injection drug use, and having sex with drug use and injection drug use on HCV infection.

Objective:To compare the anti-HBs level in maintained hemodialysis patients one year after receiving 20 μg and 60 μg hepatitis B vaccination at 0, 1 and 6 months, and explore the influence factors for the immunity persistence and their interactions.Methods:Based on a randomized controlled trial of 20 μg and 60 μg hepatitis B vaccine immunization in maintained hemodialysis patients at 0, 1, and 6 months, follow up was conducted for the patients for one year after the completion of the vaccination for the quantitative detection of anti-HBs, and χ 2 test, t test, unconditional logistic regression and interaction analyses were used for statistical analysis. Results:One year after the vaccination, 125 and 124 patients in the 20 μg and 60 μg groups were tested for anti-HBs, respectively. The positive rate of anti-HBs in the 60 μg group (77.42%, 96/124) was significantly higher than that in the 20 μg group (65.60%, 82/125) ( P<0.05). After adjusting for the confounding factors, the positive probability of anti-HBs in the 60 μg group was 1.925 times higher than that in the 20 μg group (95% CI: 1.068-3.468). Patients with hemodialysis duration ≥5 years ( OR=0.523, 95% CI: 0.293-0.935) and diabetes mellitus ( OR=0.376, 95% CI: 0.173-0.818) had lower positive probability of anti-HBs. Moreover, there were additive and multiplicative interactions between hemodialysis duration ≥5 years and diabetes mellitus. Conclusions:The immunity persistence after one year in 60 μg hepatitis B vaccination group was longer than that in 20 μg hepatitis B vaccination group in maintained hemodialysis patients, vaccine dose, hemodialysis duration and diabetes mellitus were the influencing factors for the immunity persistence, there were additive and multiplicative interactions between hemodialysis duration ≥5 years and diabetes mellitus.

Objective To investigate the effect and mechanism of galactose on the expression of sialic-acid-binding immunoglobulin-like lectin 9(Siglec-9)glycan ligand on human primarily cultured pulmonary artery endothelial cells.Methods The expression of Siglec-9 glycan ligand on the endothelial cell surface and the type of glycosidic bonds at the end of this ligand were identified by flow cytometry.Endothelial cells were treated with L-glucose,glucose,N-acetylglucose,mannose,N-acetylmannose,galactose,sialic acid and sucrose for 48 h,and the expression of Siglec-9 glycan ligand in endothelial cells was detected by flow cytometry.The endothelial cells were divided into the control group and the galactose group(n=3).Western blotting,flow cytometry,and immunofluorescence assay were employed to investigate the impact of galactose on the Siglec-9 glycan ligand in endothelial cells.After α2-3,6,8 sialidase treatment for endothelial cells,Western blotting was used to detected the effect of galactose on the recovery time of Siglec-9 glycan ligand in endothelial cells.Endothelial cells were treated with galactose,Western blotting was used to detect and analyze the expression levels of intracellular sialic acid synthetases(GNE,NANS,NANP,CMAS,NPL and ST3Gals),and the mRNA expression levels of the relevant proteins were verified by RT-qPCR.Western blotting was used to detect the changes of Siglec-9 glycan ligand level in endothelial cells after siRNA knockdown in NANP,CMAS and ST3Gal-Ⅲ.The effect of the increase of Siglec-9 ligand on apoptosis and phagocytosis of macrophages was analyzed by macrophage co-culture experiments.Results Endothelial cells showed the expression of Siglec-9 ligand and the ligand was a sialic acid glycoprotein linked to α 2-3 sialic acid at the end.Compared with the control group,the expression level of this ligand on endothelial cells in the galactose group was increased significantly(P＜0.01),but the addition of galactose had no effect on the self-recovery time of the ligand.Compared with the control group,the expression levels of NANP,CMAS and ST3Gal-Ⅲ in endothelial cells treated with galactose were increased(P＜0.05,P＜0.01),respectively.The results of RT-qPCR verification were consistent with those results.After the expression of NANP,CMAS or ST3Gal-Ⅲ was inhibited,the level of Siglec-9 glycan ligand in endothelial cells was decreased(P＜0.01).In the co-culture experiment,compared with the untreated group,galactose-treated endothelial cells promoted the apoptosis of macrophages(P＜0.01)and reduced their phagocytosis(P＜0.05).Conclusion Galactose up-regulates the level of Siglec-9 glycan ligand on endothelial cells through the NANP-CMAS-ST3Gal-Ⅲ pathway,thereby inhibiting the activity of macrophages.