The construction of a network resource data base for clinical skill teaching aiming at sharing excellent teaching resources was completed by integrating all kinds of teaching resource including characters,eourseware,pictures,cartoons,videos and examination questions,etc.In view of the generally weak situation of the current domestic education resource data base construction,the contents,guiding ideology,principle,object,orientation,function and the management mechanism of the network resource data base construction were devised for clinical skills teaching.Suggestions for specific ideas and construction problems were proposed to promote the construction and optimization of the network resource database for clinical skills teaching.

Objective To investigate the methods how to improve condition of procreative health of childbearing disabled women for planned parenthood and good procreation and good education.Methods The method of whole flock sampling of many stages and many layers were taken and the questionnaire and group interview were performed to collect the data of quantity and analyze the affect factors of disabled women about their marriage,procreation,procreative health,and knowledge about procreative health.Results There were 4 380 cases of validity questionnaire.62.33% of them married.In 3 005 procreated women,45.49% had one baby,45.49% had two babies and 8.95% had three babies or more.46.54% of them denied that they had infection of reproductive system.63.19% of them had been examined in department of gynecology.63.17% of them took birth control measure.29.70% of them were lost in taking birth control measure.50.24% of them could say three methods of birth control.37.39% of them could say three ways about AIDS infection.Conclusion Childbearing disabled women have some troubles in birth control,procreative health,and their knowledge about procreative health.

Objective To explore the optimum flow shear stress and mass transport for the construction of tissue-engineered bone.Methods The β-tricalcium phosphate (β-TCP) scaffolds seeded with human bone marrow-derived mesenchymal stem cells (HBMMSCs) were cultured in perfusion bioreactor.When the same flow rate was applied,the flow shear stress was separately 1×,2× and 3×.When the same flow shear stress was applied,the flow rates were separately 3 ml/min,6 ml/min and 9 ml/min.Cell proliferation was measured by MTT method.The construction of tissue-engineered bone was evaluated by measuring alkaline phosphatase (AKP) activity,secretion of osteopontin (OP) and osteocalcin (OC),and the mineralization of extracellular matrix (ECM).The flow shear stress and the mass transport were obtained using computational fluid dynamics.Results When the flow rate was same,the most cell proliferation was found in 2× group.The AKP activity and secretion of OC was higher in 2× and 3× groups than in those in 1× group.After 28days,the highest amount of mineralization of ECM was found in 3× group.When the flow shear stress was same,the AKP activity was highest in 6 ml/min group.After 28 days,secretion of OC and formation of mineralized ECM was highest in 3 ml/min group.When the flow rate was same,the flow shear stress was separately 0.004-0.007 Pa,0.009-0.013 Pa and 0.013-0.018 Pa.When the flow shear stress was same,the flow rate was separately 0.267-0.384 mm/s,0.521-0.765 mm/s and 0.765-1.177 mm/s.Conclusion When the tissue-engineered bone was constructed,0.013-0.018 Pa flow shear stress and 0.267-0.384 mm/s mass transport velocity could improve the construction of the tissue-engineered bone in vitro.

Objective:To evaluate the practicability and effectiveness of nursing plan for elderly patients with urinary incontinence after operation.Methods:The patients admitted to the Department of Urology and Gynecology in a Grade 3A general hospital from September to October 2019 were selected as the control group, and the patients admitted from December 2019 to January 2020 as the intervention group. In the quasi-experimental study, the control group was given routine discharge guidance, and the intervention group was given a nursing plan for elderly patients with urinary incontinence to observe the preliminary effect of the nursing program for a period of 2 months.Results:Two months after implementation, the total scores of discharge preparation, quality of life and satisfaction of urinary incontinence in the intervention group was (125.08 ±17.64), (58.79 ±5.52) and (96.09 ±2.53) respectively, which were significantly different from those in the control group ( P<0.05). Conclusion:The preliminary verification of the scheme has a certain feasibility, has a certain guiding significance for nurses, and is helpful to improve the discharge preparation of elderly surgical patients with urinary incontinence and improve their satisfaction and quality of life when they are discharged.

Objective To establish a conventional intraocular lens (IOL) calculation formula which is applicable to eyeballs with abnormal data and laser in situ keratomileusis (LASIK) postoperative eyes.Methods A case-series study was adopted.According to the classical optical theory,a normal IOL implanted eye has the following characteristics:when light is refracted by cornea and arrives on the IOL plane,the value of refractive power (F1) + IOL refractive power (F2) =the value of refractive power which is suitable for vitreous body depth (F3).Thereafter,a mathematical model was built on the basis of theory,experience,and regression analysis data after IOL implantation surgeries.Furthermore,based on the new LASIK postoperative cornea curvature modified formula,the two kinds of IOL calculation programs of conventional and LASIK postoperative eyes were established.The test data was collected from 644 patients who had undergone the cataract extractions and IOL implantation surgeries (600 physiological cornea eyes,7 radial keratotomy [RK] eyes and 37 LASIK postoperative eyes) at the Affiliated Drum Tower Hospital of Nanjing University Medical School.Through the analysis of these data,the new formulas were examined.Results With IOL refractive power of 607 eyes (including 7 RK postoperative eyes),the average error of XLQ formula (the tentative name of the established formula in this study)was 0.1 D,and the 95％ limits of agreement range was-1.1 to + 1.2 D.The error range of IOL refractive power predicted by XLQ,SRK-T and Haigis formulas was-2.21 to +2.25 D,-5.10 to +5.63 D and-3.00 to +3.18 D,respectively,the absolute average error of IOL refractive power predicted by the three formulas was (0.43 ± 0.28),(0.74 ± 0.53) and (0.79 ± 0.49) D,respectively.Compared with SRK-T and Haigis formulas,the average error of IOL refractive power predicted by XLQ formula was Lower,with significant differences between them (both at P =0.000).The error value of IOL refractive power predicted by XLQ formula had no statistical correlations with axial length (AL),keratometry (K) and A constant respectively (all at P＞0.05),while the error value predicted by SRK-T and Haigis formulas had statistical correlations with AL,K and A constant,respectively (all at P＜0.05).Thirty-seven patients who had conducted LASIK for myopia (and whose IOL refractive power value were predicted by XLQ formula) had been undergone the postoperative examination.Comparing the predicted and actual value,the error range of IOL refractive power was-0.52 to +1.18 D,and the absolute average error was (0.49±0.26)D.Conclusions The conventional mode of the XLQ formula established in this study can be used in the cases with broad values of axial length,corneal curvature and A constant,as well as various types of physiological cornea and RK postoperative eyes;the dedicated mode is suitable for LASIK postoperative eyes of myopia.

Objective: To investigate risk perception, emergency preparedness and emergency literacy among medical students under COVID-19 epidemic. Methods: An online survey was conducted by using the self designed COVID-19 questionnaire on risk perception, emergency preparedness and emergency literacy from March 27 to March 30, 2020. The convenience sampling method was used to investigate 4 864 medical students from 2 colleges and technical secondary schools in Sichuan Province. Results: The scores of risk perception, emergency preparedness and emergency literacy associated with COVID-19 were(35.18±4.33)(28.30±4.16) and(25.23±2.97) respectively. Risk perception of medical students was positively correlated with emergency preparedness and emergency literacy(r=0.35, 0.40), emergency preparedness was positively correlated with emergency literacy(r=0.51)(P<0.05). Conclusion Considering interrelationships among risk perception, emergency preparedness and emergency literacy associated with COVID-19, medical students should be given targeted prevention and control training.

Objective: To analyze the effect of breakfast nutrition quality on the satiety among young white-collar workers. Methods: A total of 278 subjects were recruited from two cities, Shenyang and Chongqing, in June 2015. The inclusion criteria: white-collar workers aged 25-45 years involved mainly in office work, who did not experience major changes, and individuals who should follow the study protocol and sign the informed consent form. The study employed a three-phase crossover design trial. Each participant received nutritional-adequate breakfast, nutritional-inadequate breakfast, and no breakfast treatment on the basis of assignment to one of three sequences. The breakfast time was once a week and then changed, all participants underwent the tests for three successive weeks. At last, we compared the effect of participants to consume different nutritional quality on satiety sense and hunger sense. Results: A total of 232 participants completed three successive breakfast intervention studies, the age of participants was (35.2 ± 7.9) years, comprised of 48.7% male (n=113). The numbers of participants of aged 25-35 year-old and aged 36-45 were 118 and 114, respectively. Satiety scores of nutrition-adequate breakfast group, nutrition-inadequate breakfast group and no breakfast group were 63.5±14.7, 53.1±10.2 and 36.4±7.2, respectively (P<0.05). In nutrition-inadequate breakfast group and no breakfast group, male subjects scored significantly higher than female subjects (50.9±10.5 vs 46.6±9.4, 35.2±8.3 vs 31.8±5.4) (P<0.05). And, participants aged 25-35 year-old. got satiety score significantly higher than aged 36-45 (51.3±11.0 vs 45.6±12.1, 34.1±6.8 vs 32.5±7.9), the difference was statistically significant (P<0.05). The scores of hunger in the group of nutrition-adequate breakfast, nutrition-inadequate breakfast and no breakfast were 26.3 ± 8.0, 35.1 ± 11.2 and 57.3 ± 17.0, respectively (P<0.05). Conclusion The nutrition quality of breakfast affects the satiety of young white-collar workers. The better the nutrition quality of breakfast is, the higher the satiety score and the lower the hunger score become. Compared with women and participants aged 36-45 year-old, men and those aged 25-35 year-old get satiety sense more easily.

Objective:To search, evaluate and integrate the best evidence of exercise rehabilitation intervention after PCI in patients with acute myocardial infarction, so as to provide evidence-based basis for clinical doctors and nurses to intervene in exercise rehabilitation of patients.Methods:We searched PubMed, China National Knowledge Infrastructure, Wanfang Data and other domestic and foreign databases, guide websites and professional association websites about the evidence of exercise rehabilitation intervention in patients with acute myocardial infarction after PCI. The search period is from January 2010 to June 2021. The quality of the included literature was evaluated by two researchers, and the literature evidence in accordance with the quality standard was extracted.Results:A total of 20 articles were included, and 39 pieces of evidence were summarized from 11 aspects, such as the establishment of multidisciplinary team, evaluation, exercise prescription, exercise monitoring and so on.Conclusions:This study summarized the best evidence of exercise rehabilitation intervention in patients with acute myocardial infarction after PCI, and provided theoretical support for clinical practice. It is suggested to combine the clinical situation and patients' wishes to promote the transformation of the best evidence to clinical practice.

Objective:To explore the phenotypic and genotypic characteristics of 3 Chinese families with dystrophinopathy, so as to provide the data for earlier diagnosis and therapy.Methods:The clinical, muscle pathology and electrophysiological data from the 3 families with dystrophinopathy were analyzed.The perpheral venous blood of 15 members from the 3 families was collected.Meanwhile, the known genes that were related to neuromyopathy were detected.Results:There were 8 patients in the 3 families.All the patients presented progressive weakness of extremities as the main manifestation, with elevated creatine kinase (CK) and myogenic changes in electrophysiological examination.The proband of family 1 was a 15 years old boy with 1 year history.He displayed limb weakness and accompanied with muscle pain after exercise.Muscle pathology only revealed denatured and atrophy muscle fibers, without necrosis and hyperplastic muscle fibers.The proband of family 2 was a 9 years old boy with 1 year history.His muscle pathology illustrated degeneration, necrosis, proliferation and lipid deposition muscle fibers.The proband of family 3 was a 16 years old boy with 10 years history.He exhibited generalized muscle atrophy, spine and chest deformity.His muscle pathology demonstrated classical muscular dystrophy changes.Gene detection gave information that deletion mutation in exons 45 to 47 of DMD gene in family 1 proband.c.2636 T> G mutation in exons 18 of DMD gene in family 2 proband, repeat mutation in exons 61 to 76 of DMD gene in family 3 proband; c.2636T>G was classified as pathogenic variation according to the guidelines for the interpretation of sequence variants of the American college of medical genetics and genomics guidelines. Conclusions:The phenotype of dystrophinopathy is related to genotype.A new mutation of DMD gene c. 2636T>G is discovered.Early patient with dystrophinopathy can only display pained weakness of muscle after exercise.Muscle pathology and gene detection should be performed as soon as possible.

Objective: To explore the lipid-lowering effect and potential mechanism of the couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris on hyperlipidemia rats. Methods: Forty-eight Sprague-Dawley rats were randomly divided into 6 groups, normal control group, high-fat model group, simvastatin group, Tribulus terrestris group, Flastem Milkvetch Seed group, and couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group, with 8 rats in each group. The normal control group was fed with basal diet, and the other groups were fed with high-fat diet to establish a hyperlipidemia rat model. At the same time, different group rats were treated with different drug respectively. 6 weeks later, the body weight and visceral index of the rats were measured. Levels of serum cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were detected by automatic biochemical analyzer. The mRNA and protein expression of HMG coenzyme A reductase (HMGCR), cholesterol 7-alpha hydroxy-lase (CYP7A1) and low density lipoprotein receptor (LDL-R) were detected by RT-PCR and western blot. Results: Compared with model group, the serum levels of TC, TG, and LDL-C were significantly decreased in all Chinese medicine groups, and the serum level of HDL-C was significantly increased in Flastem Milkvetch Seed group and couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group. Moreover, the mRNA and protein expression of HMGCR, CYP7A1, and LDL-R in rat liver also significantly increased in all Chinese medicine treatment groups. And couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris group shows more significantly effect. Conclusion: Couplet medicines of Flastem Milkvetch Seed and Tribulus terrestris significantly regulate the serum lipid levels on hyperlipidemia rat model, and its mechanism may be related to the regulating expressions of HMGCR, CYP7A1, LDL-R gene.