Objective To measure and compare the expression profdes of plasma miRNA between Tibetan and Han nationality.Methods Plasma samples were taken from 246 healthy Tibetans and 128 Han individuals.The randomly selected 50 Tibetan and Han plasma samples were pooled respectively and the levels of 754 miRNAs were examined using a TaqMan Low Density Array.Two markedly differentially expressed miRNAs,miR-130a-3p and miR-629-5p,were verified in all the plasma samples by individual qRT-PCR.Results The Low Density Array results showed that the correlation coefficient of expression profiles of plasma miRNA for the Tibetan and Han population was 0.592.Compared with Han population,the expression levels of 139 miRNAs were distinctly different,in Tibetan (62 up-regulated and 77 down-regulated).The levels of miR-130a-3p and miR-629-5p were further verified to be significantly higher in the plasma from Tibetans than those in the plasma from Han population [(467 ± 27.30) × 10-5 vs (236 ± 9.69) × 10-5,p ＜ 0.01;(14.67 ±0.94) × 10-5 vs(7.58 ± 0.52) × 10-5,P ＜ 0.01] by qRT-PCR assay.Conclusion There may be marked difference of plasma miRNA expression profile between Tibetan and Han nationality.The influence of the nationality factors on miRNA profiles should be taken into account in the application of miRNAs in clinical detection in the future.

Objective:To explore the application effect of segmented teaching combined with Kirkpatrick model evaluation in the teaching of specialized nurses of peripherally implanted central venous catheter (PICC).Methods:A total of 60 trainees in the PICC specialized nurse training class in PICC Clinic of Cancer Hospital Affiliated to Nantong University from June 2020 to September 2020 were selected in the study, and they were randomly divided into a control group and a study group, with 30 nurses in each group. The control group conducted traditional training for PICC specialized nurses, and the research group used segmented teaching. After training, the Kirkpatrick model was used to evaluate the response level, learning level, behavior level and result level of the training effect of the two groups of PICC specialized nurses. SPSS 22.0 was used for t test and chi-square test. Results:Through the segmented teaching training, the evaluation results of the Kirkpatrick model showed that the effect of the PICC specialized nurse training was significantly better in the study group than that in the control group in terms of response level, learning level, behavior level and result level. The study group's satisfaction with the training program and teaching content scored higher than that of the control group, with statistically significance ( P<0.001). The research group nurses' mastery of theoretical knowledge and practical skills and humanistic care scores were higher than those of the control group, with significant differences ( P<0.001). After the training, the self-behavior assessment scores of the two groups increased, and the improvement of the research group was more obvious. When the nurses of the research group returned to the hospital clinical work after training, their professional identity, PICC teaching and guidance ability, treatment, nursing service quality, the recognition of patient and family members and the effectiveness of the department were improved to varying degrees, the corresponding measures could be carried out in the hospital, and the development of PICC technology was promoted. Conclusion:The combination of segmented teaching and Kirkpatrick model evaluation can effectively meet the training needs of PICC specialized nurses and make a full range of effect evaluations to improve the quality of PICC specialized nursing services.

Objective To analyze the effects of different therapies on patient survival,to explore the related prognostic factors in elderly patients with advanced gastric cancer,and to provide recommendations for the treatment of such patients.Methods Retrospective analysis was conducted on 146 elderly patients with advanced gastric cancer hospitalized from January 2009 to October 2013 in Yixing People's Hospital of Jiangsu Province.Detailed clinical data were recorded,and patients were followed up during the total survival time.Univariate analysis with the Log rank test and multivariate analysis with the COX proportional hazard model were utilized to examine the related prognostic factors in elderly patients with advanced gastric cancer.Results The 1-,2,3-year survival rates of t46 elderly patients with advanced gastric cancer were 33.6 ％,11.0 ％,and 2.1 ％,respectively,and the median survival time was 10.3 months.The Log-rank test showed that Karnofsky (KPS) score,differentiation degree,number of metastatic sites,malignant serous effusion,chemotherapy,and traditional Chinese medicine (TCM) were associated with the prognosis of elderly patients with advanced GC (all P＜0.05).Multivariate analysis by the COX proportional hazard model showed that KPS score (HR=1.575,95％ CI:1.094 2.267,P=0.015),differentiation degree (HR=0.499,95％CI:0.340-0.732,P＜0.001),malignant serous effusion (HR=0.516,95％ CI:0.356-0.748,P＜ 0.001),chemotherapy (HR=1.669,95％ CI:1.185 2.351,P=0.003),and TCM (HR=1.793,95％ CI:1.237-2.600,P=0.002) were independent factors related to the prognosis of elderly patients with advanced GC.Conclusions The prognosis of elderly patients with advanced gastric cancer is poor,especially for patients with a low KPS score,a poor differentiation degree,or malignant serous effusion.Chemotherapy and TCM can improve the prognosis.

Blended teaching can promote the learning engagement of students and enhance their experience by combining online independent learning and offline class learning. We applied blended teaching in the course of Histology and Embryology in the large class of 147 nursing undergraduates in Chongqing Medical University. First, the teaching method was designed by a pre-course survey, and online resources were constructed. Second, students' online learning activities and group discussions were guided by a learning map. Then, flipped classes were carried out in offline class hours. Finally, an end-of-course survey and final exam scores were used evaluate the effectiveness of blended teaching. A total of 142 valid questionnaires were returned; 123 students (86.6%) approved of the effectiveness of blended teaching, 133 students (93.7%) showed improved abilities in various aspects, and 79 students (55.6%) were able to complete their online learning tasks in fewer hours than required for face-to-face lectures. The final exam results showed that the average score of blended teaching class increased by 3.5 points compared with that of the traditional face-to-face lecture class. In conclusion, blended teaching in Histology and Embryology in the large class can achieve good learning and teaching effects and thus holds promise for application.

AIM: To assess the association between the Dem, axial length/corneal radius ratio(AL/CR ratio), and the refractive status of children aged 3 to 14, compare the efficiency of Dem with AL/CR ratio in predicting myopia, and to explore a more effective method for quantitatively predicting the refractive state of children.METHODS: This cross-sectional study involved 519 children aged 3 to 14, including 519 eyes(data from the right eyes were used). All participants were out-patients at the ophthalmic clinic of Xi'an No.1 Hospital from March 2021 to December 2022. The axial length(AL), keratometry(K), Dem, and spherical equivalent refraction(SER)were recorded before ciliary paralysis, and myopia was defined when the SER ≤-0.50 D.RESULTS: There was a positive correlation between SER and Dem(r=0.88, P<0.01), and a negative correlation between SER and the AL/CR ratio(r=-0.87, P<0.01)in children aged 3-14. The optimal cutoff points for the Dem and AL/CR ratio were 20.40 D, and 3.02, respectively. Myopia could be diagnosed when the Dem ≤20.40 D or the AL/CR ratio ≥3.02. SER decreased by 0.57 D for every 1 D decrease in Dem and by 1.00 D for every 0.06 increase in the AL/CR ratio. The area under the ROC curve(AUC)for Dem(0.958)was significantly greater than that for the AL/CR ratio(0.940).CONCLUSION: There is a positive correlation between SER and Dem, and a negative correlation between SER and the AL/CR ratio in children aged 3-14. Dem is more efficient than the AL/CR ratio in myopia assessment. The eye biometrics directly provide Dem values, which is more convenient for calculating the dose-effect relationship with SER, thus making it more efficient for predicting SER in children.