In order to improve the quality of nursing dissertations,we combined the teaching of nursing research with clinical internship to teach nursing dissertation writing,following the process of program input-situation experience-clinical internship-problem study-dissertation writing.Taking problem study as the leading role,students as subject,self experience as the main access and tutors as whole-process instructors,we taught and evaluated nursing dissertations at different stages.Students'interests in scientific research,enthusiasm for participation and quality of dissertations were improved effectively.95.78％ of the students showed positive attitude to this teaching method.

The thyroid allografts in rats were cultured for 48h in the conditions of hyperbaric oxygen (a mixture of 95% O2,5% CO2 pressurized at 2 atmospheres)and low pH(5.5 and 6.9).Uncultured and air cultured allografts were taken as control groups.The thyroid slices were transplanted under the kidney eapsulse of thyroidectomized recipients.By examining histological changes,detecting the serum T3 and T4 levels and five weeks body weight gain,the graft survival was cvaluated.Though the thyroids cultured in hyperbaric O2 were contaminated with the passenger leukocytes,the grafts had prolonged survival,suggesting this method might effectively diminish MHC immunogenicity to thyroid grafts.

Objective To explore the effects of glargine combined metformin and repaglinide combined metformin treatment on metabolism of free radicals in elderly patients with type 2 diabetes(T2DM ) .Methods Selected 90 cases of elderly T2DM pa‐tients were divided into 2 groups:group A (glargine combined metformin treatment group) ,group B (repaglinide combined met‐formin treatment group) .Each group had 45 patients ,they were all treated for four weeks in antidiabetic therapy ,select 40 healthy people in physical examination center of hospital as controls .They were measured in patients with fasting plasma glucose (FPG) ,2h postprandial blood glucose(2hPG) ,malondialdehyde (MDA) ,glutathione peroxidase (GSH‐PX) ,8‐iso‐prostane (8‐iso‐PGF2a) , Hcy and so on ,before and after treatment .Results (1)Before treatment ,the FPG ,2hPG ,HbA1c ,MDA ,8‐iso‐PGF2a ,Hcy of group A and B were higher than the control group ,while the level of GSH‐PX was lower than the control group ,the difference was statis‐tically significant(P<0 .05);(2)After treatment ,the levels of FPG ,2hPG ,MDA ,8‐iso‐PGF2a ,Hcy were significantly reduced and the levels of GSH‐PX was significantly elevated in group A ,the differences were statistically significant (P<0 .05);(3)There were no obvious difference in reduce the levels of FPG ,2hPG and HbA1c between group A than group B(P>0 .05) ,While 8‐iso‐PGF2a , MDA ,Hcy of group A had a bigger decline rate than group B ,the GSH‐PX in group A increased more compared with group B ,the difference was statistically significant (P<0 .05) .Conclusion (1)There is a high oxidative stress state in elderly patients with T2DM ;(2)Both treatments could improve diabetics oxidative stress levels ,but glarginecombined metformin to reduce diabetics oxi‐dative stress is superior to repaglinide combined metformin .

Shenzhen Eye Hospital took the lead to launch the time interval outpatient clinic appointment registration,for easing the difficulty of seeing doctors and shortening outpatient waiting time.With 30min as a registration interval,the hospital calls into play a variety of means to provide this service to outpatients.This service benefits the outpatients with comfortable hospital environment and promotes hospital efficiency.On this basis,the paper probed into existing problems in the appointment system and proposed improvement suggestions.

ObjectiveTo summarize the diagnosis,treatment and prognosis of testicular tumor.MethodsThe clinical and followed data of 91 cases of testicular tumor were retrospectively studied. Results In 91 patients, was in 18-40 years old 70.3 ％ (64/91) and 91.2 ％ (83/91) cases were germ cell tumor. 18-40years old germ cell tumor was 75.6 ％ (28/37), there was no case below 17 years old, the older than 60 years was 2.7 ％(1/37). The percentage of below 5 years and 18-40 years was 16.1％ (5/31) and 67.7 ％ (21/31),respectively.The interstitial tissue tumor developed in each age section,the number was least.The mixed tumor cases of 18-40 years percent was 93.3 ％(14/15).The early symptom of testicular tumor was indolent swelling in one side testis or testis nodus.Combined therapy,including radical orchiectomy,retroperitoneal lymph node dissection, chemotherapy and radiotherapy, were taken. The one year, three years and five years survival rate were 97.3 ％, 91.8 ％, 91.8 ％, respectively. The percentage of Ⅰ, Ⅱ, Ⅲ stage survived 5 years was 83.6 ％, 52.3 ％, 33.3 ％. ConclusionThe peak age of testicular tumor patients was 18-40 years old.The different pathological type is distributed in different ages,and the prognosis is related to pathology and stage. The survival time of germ cell tumor or early stage tumor is longer.

Objective The aim of the study was to assess the human neural stem cells (NSCs) induced by mitogens in vitro and investigate effects of TH(T 3) on differentiation. Methods The cerebral hemispheres of human fetal at 10-12 weeks of gestation were minced and mechanically dissociated. Cells were seeded at a concentration of 10 5 per ml into defined medium that consisted of DMEM/F12 Epidermal growth factor (EGF,20??g/L) and basic fibroblast growth factor (bFGF,20??g/L) were added respectively as mitogens for 7 days. In some cases, triiodothyronine (T 3, 30??g/L) was added through the culture period. Upon differentiation, the cell cultures were exposured to a substrate and treated with or without T 3 after removing the mitogens. To detect the phenotypes of differentiated cells, immunochemistry staining was performed with the antibody to NF 200, GFAP, MBP and Gal C. To recognize the different stages of oligodendrocytes development, the antibodies O4 and A2B5 were used. The proportion of each neural cell type was determined by counting positive cells in standardized fields at 40? magnifications. Results NSCs induced by EGF and/or bFGF grew in culture as free floating spheres(neurospheres) and were immunoreactive for the intermediate filament nestin. After removing EGF and bFGF, the cells cease mitosis and can be induced to differentiate into neurons, astrocytes, and oligodendrocytes regardless of whether T 3 was presented. T 3 favored an neuroglia cell fate especially when combining EGF with T 3 and differentiated cells appeared more early when added of T 3.MBP positive cell is over 80%. The O4 and A2B5 positive cells can be observed at early stage of differentiation only after process grew from neurospheres after adhesion to certain substrate, which indicated that the neuronal network could promote the maturity of oligodendrocyte.Discussion The timing of NSCs differentiation depends on both intracellular mechanisms and extracellular signals. TH is such a signal to activate the effector component of a “clock” mechanism that induces oligodendrocyte differentiation after a limited number of cell divisions.[

Objective To investigate the diagnostic value of a new tumor marker CK19-2G2 for lung cancer.Methods The serum levels of CK19-2G2 in 150 lung cancer patients,50 pulmonitis patients and 50 healthy controls were detected with chemoluminescence.The diagnostic efficacy between the serum levels of CK19-2G2 and CYFRA21-1 were compared.Results The sensitivity and accuracy of CK19-2G2 were 55.3 ％ (83/150) and 80.3 ％ (281/350),respectively,while the sensitivity and accuracy of CYFRA21-1 were 28.0 ％ (42/150) and 67.4 ％ (236/350),respectively.The differences were significant (P ＜ 0.001).Conclusion The detection of CK19-2G2 may be a new diagnostic tumor marker for lung cancer.

Objective To introduce our experience of performing posterior or anterior renal lip incision for partial nephrectomy in the treatment of renal hilum endophytic renal cell carcinoma.Methods From Jan.2010 to Jan.2014,five female patients with renal hilum tumors were treated in our institute.The median age was 54 (51-72) years.The median tumor diameter was 4.0 (2.8-4.8) cm.The median preoperative creatinine was 53.9 (52.6-75.4) μmol/L.One of them was solitary kidney with absolute indication; three cases had basic disease with relative indication; one was with selective indication.The patients were put in supine or lateral position.After general anesthesia,we preformed partial nephrectomy by cutting posterior renal lip in 3 cases and the anterior lip in 2 cases.We clamped the renal artery,opened the renal posterior or anterior lip,then dissected the tumor beside the pseudo-capsule.After removing the tumor,we used 3-0 absorption suture to control bleeding and repair the opened collecting system.Finally,we used 2-0 absorption suture to close the renal defect.Results The median operation time was 195 (155-215) min; the median renal warm ischemia time was 35 (15-70) min; the median postoperative hospital stay was 8 (7-9) d.There was no secondary bleeding and urine leakage happened.The pathological results showed that 3 cases with clear cell carcinoma,1 with papillary carcinoma and 1 with renal medullary interstitial cell tumor.All patients showed normal kidney shape.The median postoperative creatinine was 63.0 (59.4-75.4) μmol/L.After a median follow up of 24.2 mon,all patients survive without tumor recurrence.Conclusions The short-term result of posterior or anterior renal lip incision partial nephrectomy in treating endophytic renal hilum endophytic renal cell carcinoma is safe and feasible.

BACKGROUND: The bone marrow stem cell (MSC) transplant treatment have the obvious superiority to tradition graft treatment for bone nonunion, but how to obtain the concentrated and highly effective bone marrow mesenchymal stem cell, as well as the dose-effect relations to fracture healing need further discussions. OBJECTIVE: To observe the curative effect of bone nonunion by using autologous MSC transplant treatment, and to compare with autologous iliac bone graft.DESIGN, TIME AND SETTING: Randomized controlled analysis was performed from January 1999 to June 2005 in the Affiliated Second Hospital of Hebei Northern College.PARTICIPANTS: The admitting 140 patients with humerus and tibia fracture were divided into 2 groups at random, autologous iliac bone graft group and autologous MSC transplant group, with 70 patients in each group. METHODS: Under aseptic condition, autologous MSC transplant group received puncture through posterior superior iliac spine, extracting bone marrow 10-20 mL from different spots, separating MSC using the density gradient centrifugation method, and counting as 4×10~9 nucleated cells/mL under the microscope for later use. In the autologous iliac bone graft group, bone fracture end was implanted with the suitable amount of iliac bone, while autologous MSC transplant group with the mixture of decalcified bone matrix and MSC, followed by suture. After the transplantation, external fixation may assist for 4-6 weeks according to the fixed degree of internal fixation.MAIN OUTCOME MEASURES: ① Bone callus formation and pain conditions in 2 groups at different time points after transplantation. ② Comparison of bone healing time between 2 groups. ③ Adverse events and side effects.RESULTS: According to intention-treatment analysis, experimental adopted 140 patients of humerus and tibia fractures, who all entered the final analysis. ① Bone callus formation and pain at different time points post-surgery: At 1 month after transplantation, bone callus formation in the fracture end was not obvious in autogenous iliac bone graft group, and could be seen in autologous MSC transplant group, both groups of fractures exhibited tenderness. At 2 months after transplantation, bone callus formation was observed in autogenous iliac bone graft group, fracture tenderness was relieved compared with the previous condition; in autologous MSC transplant group, a large number of bone callus formed, fracture tenderness was not obvious. At 3 months after transplantation, there were a large number of bone callus formations in autogenous iliac bone graft group, with slight fracture tenderness; in the autologous MSC transplant group, continuous bone callus formation appeared, without fracture tenderness. ② Bone healing time: The average healing time of autologous MSC transplant group was significantly shorter than autogenous iliac bone graft group [(5.5±1.5), (8.0±2.0) months, P < 0.05]. ③ Adverse events and side effects: Except 4 patients had iliac bone pain, all patients during the treatment had no infection and other complications, there were no re-fracture occurred at the follow-up of 8 months.CONCLUSION: The autologous MSC transplant treatment of exhibits a short duration and good effect for bone non-union, has obvious advantages over traditional bone graft.