Nursing students in junior college have less class time and weaker foundation com-pared with nursing undergraduates, therefore it is more difficult for them to learn pathphysiology. In order to improve the teaching effect, we adopt the following strategies in pathophysiology teaching:①Guiding clinical nursing practice combining with specific situation in order to give students a deep understanding of pathophysiology knowledge and its significance. ②Urging students to review relevant basic knowledge before class and teacher to briefly introduce the basic knowledge before initiating class in order to reinforce the knowledge. ③Examples of daily life should be combined to make the abstract theory knowledge vivid. Teaching should revolve around the main line and key points should be highlighted. ④Dividing pathophysiology course into three units, and summary must be executed at the end of each unit.

OBJECTIVE To investigate the distribution and drug resistance of the bacteria encountered from the(clinical) infection,and provide reference for the rational use of agents in clinics.METHODS To culture the(specimens) from inpatient and outpatient clinic from Dec 2004 to Mar 2005,and perform the drug (sensitivity) test.RESULTS In 1584 isolated strains,the first four were coagulase negative Staphylococcus((15.6%),) Klebsiella(13.0%),Escherichia coli(10.0%),and Candida albicans(9.9%).The highest resistance of Gram(-negative) bacilli was to ampicillin(86.7%),then to cephalothin(79.5%),and mezlocillin(75.7%);G~-bacilli were(sensitive) to meropenem(2.3%),piperacillin/tazobactam(19.0%),and fosfomycin(29.1%).Gram~+ cocci had drug(resistance) to 18 antibacterials except vancomycin,MRSA was higher than MSSA;(Enterococcus) faecium showed poor sensitive rate to penicillin and erythromycin.CONCLUSIONS We should give more attantion to the Rules on Antibacterials in Clinical Application and use drugs reasonably.

Objective The purpose of this study was to examine the relationship between acute mountain sickness ( AMS) and AMS susceptibility indices before ascent to high altitude and to evaluate their predictive value for AMS. Methods A total of 314 healthy male a-dults were voluntarily enrolled. Their 22 physiological and mental indices of AMS susceptibility were obtained before exposure high altitude. The diagnoses of AMS were based on the Lake Louise score ( LLS) ,an international standard scoring system for AMS. According to the char-acteristics of selected AMS susceptibility indices and the strong fault tolerance of neural network theory, the learning vector quantization ( LVQ) neural network method was adopted to build the prediction model of susceptibility to AMS. Results The results showed the sensitiv-ity of the LVQ model which distinguishes subjects with no-AMS reached 95. 00%,the average correct-prediction precision ultimately reached 72. 22%. The result of prediction is believable. Conclusion The builded LVQ model provide a scientific method for screening crowd who quickly ascend to high altitude,and also can lead to an effective preliminary screening of susceptibility to AMS.

Objective:To explore the effect of targeted nursing with evidence-based support in the treatment of craniopharyngioma via the transsphenoidal approach.Methods:A total of 70 patients with craniopharyngiomas who were admitted to the Department of Oncology of Beijing Tiantan Hospital, Capital Medical University from June 2018 to June 2019 were selected and all received transsphenoidal surgery in the hospital. The patients were divided into 2 groups according to the lottery method, 35 cases in the control group, using conventional nursing; 35 cases in the observation group, using targeted care with evidence-based support; comparing the two groups of patients before and after care, the incidence of complications, and the length of hospital stay.Results:The scores of anxiety and depression (6.05±1.24 and 5.78±1.48) in the observation group 2 weeks after nursing were lower than those in the control group (9.95±1.73 and 10.52±1.87). The difference was statistically significant ( t value was 10.036, 10.886, P<0.05). The postoperative high fever, electrolyte imbalance, diabetes insipidus, epilepsy remission time and hospital stay in the observation group were (5.49±0.84)h, (5.46±0.39)d, (1.03±0.21)h, (6.24±2.78)d, (12.51±1.48)d, which were shorter than those in the control group (8.78±1.05)h, (8.51±0.47)d, (2.49±0.35)h, (8.97±2.80)d, (15.26±1.52)d. The difference was statistically significant ( t value were 4.093-29.545, P<0.05). The incidence of postoperative complications in the observation group was 17.14% (6/35), which was lower than 37.14% (13/35) in the control group, and the difference was statistically significant ( χ2 value was 4.786, P=0.029). Conclusion:Targeted nursing with evidence-based support can reduce the incidence of postoperative complications in patients with craniopharyngioma through the transsphenoidal approach, shorten the length of hospital stay, and achieve significant application results.

Objective To evaluate the accuracy and value of ventricular function in conotruncal defects(CTD)by three-dimensional echocardiography(3DE).Methods Fifty-two children with CTD and forty-three children with normal hearts were examined by 3DE.The measurements of left ventricular volume and wall mass were outlined and calculated.The measurements of left ventricular volume and wall mass of 3DE in preoperative CTD were compared with those of 2D biplane Simpson-method in preoperative CTD,3DE in control group and 2D biplane Simpson-method in control group.The results of 3DE and 2DE preoperative measurements were also compared with their postoperative clinical cardiac conditions.Results From the findings of analysis of variance and Student-Newman-Keuls(SNK)test,there was no significant difference between 3DE and 2DE measurements of left ventricular function in normal children,but there was significant difference between 3DE and 2DE measurements of left ventricular function in children with CTD.2DE measurements of left ventricular volume and wall mass in the CTD group were significant underestimated and less correlated with their postoperative clinical cardiac conditions(r=0.20,P=0.2086)than 3DE measurements(r=0.39,P=0.0090).Furthermore,left ventricular function in the CTD group was poorer than that in the control group.Stroke volume and effective function were reduced due to increasing end-systolic volume.while left ventricular wall mass was increased due to the possible compensation of its ventricular muscle.With the lower end-diastolic volume,stroke volume and effective function,patients were more likely to have the occurrence of postoperative low cardiac output.Conclusions By making a precise quantitative assessment,3DE is very useful in providing more information for preoperative diagnosis in CTD and predicting such postoperative prognoses as the occurrence of postoperative low cardiac output.

AIM: To study the protective effects of HIF-1α gene transfection on hypoxic injury in human HepG2 cells. METHODS: After gene transfection, HepG2 cells were randomly divided into 4 groups: normoxia with Ad-GFP transfected group, normoxia with Ad-HIF-1 transfected group, hypoxia with Ad-GFP transfected group and hypoxia with Ad-HIF-1 transfected group. LDH leaking rate, cell viability, contents of NO and ROS, the iNOS activity were measured. RESULTS: High levels of HIF-1α mRNA and protein were detected in Ad-HIF transfected HepG2 cells. Cell viability was significantly lower in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05). No marked difference of cell viability was found between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. ROS was significantly higher in Ad-GFP transfected-hypoxia group than that in Ad-GFP transfected-normoxia group (P<0.05), while no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group or between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group. The content of NO and iNOS activity were significantly higher in Ad-HIF transfected-normoxia group and Ad-GFP transfected-hypoxia group than those in Ad-GFP transfected-normoxia group (P<0.05), no marked difference was found either between Ad-HIF transfected-hypoxia group and Ad-GFP transfected-hypoxia group or between Ad-HIF transfected-hypoxia group and Ad-HIF transfected-normoxia group. CONCLUSION: Higher HIF-1α expression is contributed to protective effects against hypoxic injury in HepG2 cells, the mechanisms of which may be correlated with promoting expression of gene regulated by HIF-1 and restraining over-expression of injure factors.

Objective To provide a quantitative summary estimate on the efficacy and safety measures of the combination therapy.Methods We searched databases(Medline and Embase)from January 1997 to December 2009 using‘ Fluticasone and salmerterol' or‘ Seretide' or‘ Advair' or‘ budesonide/formoterol' or‘ Symbicort Turbuhaler' in combination with ‘ Randomised controlled trial'.The databases of GlaxoSmithKline Clinical Trial Register and Cochrane Controlled Trials Register,or relevant original studies and review articles were approached for additional studies or details of all relevant studies.Results Morning peak expiratory flow(PEF),evening PEF and clinic FEV1 were 17.59L/min,14.95L/min and 0.08L/min higher with combination therpy than with increasing ICSs by two fold or more at endpoint,respectively.The risk of asthmatic exacerbation was reduced in the combination therpy group compared with the increased doses of ICS groups,with OR being 0.61(95 ％ CI 0.53 ～ 0.70,P ＜ 0.01).Significantly increases in the percent of symptom-free days 6.30(95％ CI 3.52 ～9.10),asthma-control days 9.49(95％ CI 4.74 ～14.25)and relieve-free days 6.59(95％ CI 6.10 ～ 7.08)were observed in patients treated with ICS/LABA compared with increased doses of ICSs at endpoint.Reduction in reliever medication use(inhalations/day)0.22(95 ％ CI 0.11 ～0.33)with significant difference was also observed at endpoint.Conclusion Combination products of ICS/LABA were more effective than a high dose of ICSs in improving lung function,reducing asthmatic exacerbation and use of reliever medication and improving control of asthma.

AIM: This study was designed to investigate the protective role of hypobaric hypoxic pretreatment (HHPT) on hippocampal neurons in Babl/c inbred mice. METHODS: HHPT was produced by simulating a 7 000 m high altitude 2.5 h/d for 3 d. At 36 h after last time decompression, three subgroups consisted of both the control and pretreatment mice were subjected to the 12 000 m high altitude hypobaric hypoxia for 4 h, the severe ischemia produced by bilateral common carotid artery occlusion for 18 min, and the severe ischemia/hypoxia produced by permanently ligation of right lateral common carotid artery followed by a 8 000 m high altitude hypobaric hypoxia for 4 h, respectively. The extents of protection to hippocampal CA1 neurons by HHPT were evaluated by accounting the number of intact neurons between HHPT and control group. RESULTS: The results indicated that HHPT protected hippocampal neurons against severe hypobaric hypoxia, severe ischemia, and ischemia combined with hypobaric hypoxia. CONCLUSION: Hypobaric hypoxic pretreatment induces a delayed protection to hippocampal neurons against hypoxic and ischemic injuries.

AIM: This study was designed to explore the differentially expressed genes between hypobaric hypoxic delayed preconditioning (HHDP) and normal mouse hippocampus. METHODS: HHDP was produced by treating the animals at a 7 000 m high altitude for 2.5 h/d for 3 d. At 36 h after last time decompression, total RNA was isolated from hippocampus. cDNA was synthesized and amplified by SMART PCR. cDNA libraries of differentially expressed gene between HHDP and control hippocampus were constructed. 452 clones from forward (subtracted control from preconditioning) cDNA library and 74 clones from backward (subtracted preconditioning from control) one were screened by reverse Northern hybridization. RESULTS: Screening with subtracted probes, hybridization signal of 85 gene fractions decreased and that of 217 gene fractions increased by more than 2 times in HHDP hippocampus compared with control. Screening with unsubtracted probe, hybridization signal of 44 gene fractions decreased and that of 135 gene fractions increased by more than 2 times in HHDP hippocampus compared with control. Some of the clones had been sequenced. Analysis and comparison with the data of GenBank were performed. The results showed that mouse cytochrome C oxidase subunit 1, NADH dehydrogenase subunit 1 and 6, deleted in split-hand/split-foot 1 region (DSS1) and cDNA corresponding to clone IMAGE: 5251089 of mice cDNA library were increased in hippocampus of HHDP mice. cDNA corresponding to clone IMAGE: 3593193, mus musculus adult male olfactory brain cDNA and mus musculus bladder RCB-0544 MBT-2 cDAN were decreased in hippocampus of HHDP mice. CONCLUSION: Many genes expresses differentially in hippocampus of mice during HHDP. This may be one of the molecular mechanisms of HHDP.

BACKGROUND:Scholars have carried out a lot of research on the main cariogenic microorganisms, but there is stil no comprehensive and systematic evaluation. OBJECTIVE:To perform an evidence-based medicine analysis on the six main cariogenic microorganisms. METHODS:Literature about microbial factors and age factors of caries disease etiology were retrieved, which were published from 2011 to 2014 in the Cochrane Library, EMBASE, PubMed, Wanfang, China Biology Medicine disc (CBMdisc), Chinese Journal Ful-text Database (CJFD) and VIP. Eligible studies were divided into two groups according to absorbance values: observation group (higher absorbance value) and control group (lower absorbance value). The probability of dental caries under the impact ofStreptococcus mutans, Lactobacilus microbe,Prevotela,Selenomonas,Capnocytophaga,Veilonelawere statisticaly analyzed using Meta-analysis. RESULTS AND CONCLUSION:Eight articles were included in result analysis. Odds ratio (OR) values refer to the statistical difference in the probability of dental caries under same pathogenic factors between two groups:OR > 1 indicates the incidence of dental caries is higher in the observation group than the control group, andOR < 1 suggests the incidence of dental caries is lower in the observation group than the control group. Meta-analysis results showStreptococcus mutans (OR=2.41),Lactobacilus microbe (OR=1.68),Prevotela (OR=2.75),Capnocytophaga (OR=1.98),Selenomonas(OR=2.38), indicating that the probability of dental caries is higher in the observation group than the control group, and these microorganisms are greatly correlated with the occurrence and development of dental caries;Veilonela (OR=0.45), indicating the probability of dental caries is lower in the observation group than the control group, andVeilonela has smal correlation with dental caries and only plays an important role in a certain development stage of dental caries.