Objective To investigate the effect of applying scenario simulation practice in the professional ICU nursing students' emergency and intensive care intensified skill training before internship.Methods Totally 120 professional ICU nursing students from grade 2010 and 2011 were enrolled.Control group included 60 students from grade 2010 and experimental group included 60 students from grade 2011.Studnets in control group accepted standardized routine training while those in experimental group accepted scenario simulation practice.All students participated in skill examination after training.Two questionnaires were designed to survey nursing students and clinical teachers respectively at one month after internship.One questionnaire was to evaluate students' attitude to the training and the other one was to survey clinical teachers' evaluation of students' abilities.T test was used to statistically analyze skill examination performance and questionnaire scores between two groups.Results Skill examination performance of experimental group was better than that of control group (P＜0.01).Effects of intensified training were better in experimental group than in control group (P＜0.05,P＜0.01) including the aspects of combining theory and practice,shortening internship role transition time,enhancing selfconfidence of clinical practice and relieving tension anxiety before practice,etc.Clinical teachers thought that the experimental group's analysis ability,strain capacity,operation ability,communication ability,team cooperation ability and actively acquiring knowledge ability were stronger than those of control group (P ＜ 0.01).Conclusions Scenario simulation practice is helpful to improve operation ability and comprehensive ability.Nursing students can adapt to the clinical work better.Findings may be beneficial to the improve-ment of teachers' professional level.

In order to perfect teaching method,strengthen the teaching effect,we apply the multimedia teaching mold.We will give some positive suggestions for the optimization of the field and track teaching process for improving teaching quality.The multi-media aided-teaching should be better utilized for the requirements of teaching and learning to improve the teaching quantity.

Objective:To evaluate the effects of different denture cleaners on the discoloration of heat-cured denture base resin and artificial teeth.Methods:40 same specifications of the heat-curing denture base resin and 40 artificial central incisors were immerced in an acombination stain of coffee,tea and soy sauce for 4 weeks.Then specimens and artificial teeth were randomly distributed into 4 groups and soaked in Polident,Steradent,0.5％ sodium hypochlorite solution and distilled water for 4 hours respectivelly(n =10).Color differences(△E) were measured by using a colorimeter and a denture spectrophotometer before and after staining,and after cleaning.Results:Before or after staining there was no difference of △E among the groups of denture base risn or artificial teeth(P ＞ 0.05).After cleaning the denture base resin and the artificial teeth in the group of 0.5％ sodium hypochlorite solution presented higher △E than the other groups(P ＜ 0.05),in group of distilled water presented lower △E than the other groups(P ＜ 0.05).No significant difference was found between Polident group and Steradent group(P ＞0.05).The △E of the denture base resin and artificial teeth.in distilled water group before staining and after cleaning were the highest among the groups(P ＜0.05).Conclusion:0.5％ sodium hypochlorite solution,Polident and Steradent are effective in removing the discoloration from the heat-cured acrylic resin and artificial teeth.0.5％ sodium hypochlorite solution is the most effective,Polident and Steradent are the similar.

Objective To evaluate the hemodynamic changes in patients with middle cerebral artery (MCA) stenosis pre- and post-stenting by transcranial color-coded and pulsed-Doppler sonography.Methods Thirty patients with middle cerebral artery stenosis were included.Two-dimensional,color-coded and pulsed-Doppler sonography were used to monitor the morphologic and hemodynamic changes of the MCA before,in the middle of,and after the endovascular stenting operation.All patients were verified by digital substract angiography.Results The hyper-echoic stent grafts and also the size and location of the stent were clearly shown by two-dimensional ultrasonography in 28 patients.The systolic,diastolic and the timeaveraged maximal flow velocities significantly decreased both instantly and 3 - 7 d after the stenting.Specifically,the systolic peak flow velocity of the MCA dramatically decreased immediately after the stenting [(151.43 ± 25.14) cm/s vs (286.13 ± 57.38)cm/s,P ＜0.05],and showed a further decrease after 3 - 7 d [(108.80 ± 9.95) cm/s vs (151.43 ± 25.14) cm/s,P ＜0.05].Conclusions Transcranial color-coded and pulsed-Doppler sonography could be used to evaluate the hemodynamic changes after MCA stenting,and could be considered as the first choice of method for evaluating the therapeutic outcome of stenting.

Objective:To determine the content of six main flavonoids in herba epimedii by self contrast with correction factor. Methods:HPLC was carried out with reversed-phase technique on an Agilent ZORBAX Eclipse XDB-C18 (150 mm × 4. 6 mm, 5 μm) column with the mobile phase consisting of acetonitrile-water with gradient elution. The detection wavelength was 268nm and the col-umn temperature was 30℃. The correction factor was established through the increase value of chromatographic peak area for the self internal standard. The relative retention time and spectrum reference method were used to determine the position of impurities. Re-sults:The relative retention time of epimedin A1 , epimedin A, epimedin B, epimedin C and baohuoside I was 0. 750,0. 810,0. 865, 0. 939 and 1. 651, respectively. The correction factor of them was 0. 998 6, 0. 998 7, 0. 998 8, 0. 989 4 and 0. 985 6, respectively. Conclusion:The self contrast with correction factor can be use to quantitatively determine the components with the same kind of chem-istry environment. The method is simple, efficient and accurate in the quantitative analysis of multi components in Chinese medicines.

Objective:To establish a comprehensive quality evaluation pattern for epimedium pieces to provide reference for the quality control. Methods:The overall quality of Epimedium brevicornu Maxim was evaluated through the establishment of a fingerprint identification mode to perform the bifunctional feedback to the fingerprint peaks. The chromatographic separation was carried out on an Agilent ZORBAX Eclipse XDB-C18 (150 mm × 4. 6 mm,5 μm) column with the mobile phase of acetonitrile and water with gradient e-lution. The flow rate was 1. 0 ml·min1 , and the column temperature was maintained at 30℃. Results:The HPLC fingerprint of Epi-medium brevicornu Maxim decoction pieces containing 16 common peaks was obtained. The marketed Epimedium brevicornu Maxim de-coction pieces were divided into two categories and the quality between them showed significant differences. Conclusion:The similarity of 11 batches of epimedium herbs used to establish the fingerprints shows notable different, and the different habitats and sampling time exhibit significant influence on the overall quality. The fingerprint pattern can effectively reflect the overall trend of quality of Chinese herbal pieces, which is suitable for comprehensive quality evaluation of traditional Chinese medicines with multiple components and their relative preparations.

To introduce professor Gao Yuchun's clinical experience and treating characteristics of facial paralysis treated with acupuncture and moxibustion. Professor Gao pays attention to yangming when he selects acupoints for clinical syndrome, and directs acupoints selection based on syndrome differentiation in different levels of jingjin, meridians and zangfu; he praises opposing needling technique and reinforcing the deficiency and reducing the excess highly; the acupuncture manipulation is gentle,shallow and slow for reducing the healthy side and reinforcing the affected side, and through losing its excess to complement its deficiency; besides, he stresses needle retaining time and distinguishes reinforcing and reducing. Facial paralysis is treated with key factors such as acupoints selecting based on yangming, acupuncture manipulation, needle retaining time, etc. And the spleen and stomach is fine and good at transportation and transformation; the meridians is harmonious; the qi and blood is smooth. The clinical efficacy is enhanced finally.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; Aged, 80 and over ; China ; Facial Paralysis ; history ; therapy ; History, 20th Century ; History, 21st Century ; Humans

Objective To assess the efficacy and feasibility of Wingspan stents for symptomatic atherosclerotic stenosis of the bas-ilar artery.Methods Clinical data of 40 patients with symptomatic atherosclerotic stenoses in the basilar artery were analyzed retro-spectively.The operative successful rate,the degree of stenosis,perioperative complications and the results of clinical and imaging follow-up were analyzed.Results The technical success rate was 95.35%.The rate of procedure-related complications during the perioperative period (30 days)was 20.0% (eight of 40 patients).There were two patients with no permanent neurological sequelae. Ipsilateral stroke or death occurred in six patients(1 5%).Thirty-six patients(92.3%)were available for a clinical follow up.The mean follow-up period was 36.3 months (range 12-75 months).Seventeen patients (47.2%)were available for follow-up imaging with DSA or CTA.The mean imaging follow-up period was 9.4 months (range 4-41 months).Symptomatic in-stent restenosis (ISR)was documented in two (1 1.76%)of these patients.Three ischemic events occurred during the follow-up period in 12 months.The adverse event rate was 8.33% at 1 year.Conclusion Wingspan stents for symptomatic atherosclerotic stenosis of the basilar artery was an effective and feasible technique,but we should carefully grasp the operation indications.

Objective To analyze the image,treatment methods and results of 13 patients with dural arteriovenous fistula (DAVF) in the anterior cranial fossa to investigate the treatment strategy.Methods Radiographic examinations (digital subtraction angiography,CT and MRI),surgical methods,and follow-up data of 13 symptomatic patients with DAVFs in the anterior cranial fossa,admitted to our hospital from January 2006 to May 2011,were retrospectively analyzed.Results Catheterization was performed via transarterial approach in six patients; embolization was performed using a liquid embolic system (Onyx-18,MTI).Craniotomy to block the arteriovenous fistula was performed in 7 patients.All patients were followed up for 6-12 months; Glasgow outcome scale (GOS) scores were 5 in all cases.Angiographic follow-up showed complete occlusion of the DAVFs in all patients,without observed fistula.No post-treatment complications were observed.Conclusion Direct surgical management can get good result for DAVFs of anterior cranial fossa; for lesions fed by anterior branch of middle meningeal artery,transarterial embolization of anterior cranial fossa DAVFs is feasible.

Objective To investigate the pattern of nodal recurrence after curative resection in adenocarcinoma of the gastroesophageal junction ( AGE ) , and to provide a basis for delineation of the radiation range in the high-risk lymphatic drainage area.Methods A retrospective analysis was performed in 78 patients with locally advanced AGE who were newly treated in our hospital from January 2009 to December 2013 and had complete clinical data.All patients received curative resection and were pathologically diagnosed with stage T3/T4 or N (+) AGE.Those patients were also diagnosed with SiewertⅡor Ⅲ AGE by endoscopy, upper gastroenterography, macroscopic examination during operation, and pathological specimens.None of the patients received preoperative or postoperative radiotherapy.All patients were diagnosed by imaging with postoperative nodal recurrence.The computed tomography images of those
patients were accessible and had all the recurrence sites clearly and fully displayed.Results The median time to recurrence was 10 months ( 1-48 months) , and 90%of the recurrence occurred within 2 years after surgery.The lymph nodes with the highest risk of recurrence were No.16b1( 39%) , No.16a2( 37%) , No.9 (30%), and No.11p (26%), respectively.There was no significant difference in the recurrence rate within each lymphatic drainage area between patients with SiewertⅡandⅢAGE ( P=0.090-1.000) .The lymph nodes with the most frequent recurrence were No.16b1, No.16a2, No.9, No.16b2, No.11p, and No.7 in patients with stage N3 AGE and No.11p, No.16b1, No.16a2, No.9, No.8, and No.7 in patients with stage non-N3 AGE.Patients with stage N3 AGE had a significantly higher recurrence rate in the para-aortic regions (No.16a2-b2) than those with stage non-N3 AGE (67%vs.33%, P=0.004, OR=4.00, 95% CI=1.54-10.37) .Conclusions The lymph nodes with the highest risk of recurrence are located in the celiac artery, proximal splenic artery, and retroperitoneal areas ( No.16a2 and No.16b1) in patients with SiewertⅡorⅢlocally advanced AEG.Moreover, patients with stage N3 AGE have a higher risk of retroperitoneal recurrence.The above areas should be involved in target volume delineation for postoperative radiotherapy.