Objective To investigate the relationship between p53,COX-2,Bax,c-myc genes and colorectal carcinoma complicated with chronic schistosomiasis. Methods One hundred and sixty patients with colorectal carcinoma were selected and divided into two groups;a schistosomiasis group(colorectal carcinoma complicated with chronic schistosomiasis,n=80)and a non-schistosomiasis group(colorectal carcinoma uncomplicated with chronic schistosomiasis,n=80). The tissue microarray tech-niques and immunohistochemistry method were used in all the patients to detect the expressions of p53,COX-2,Bax and c-myc proteins. Results The positive rate and level of p53 protein expression in the schistosomiasis group were lower than those in the non-schistosomiasis group,but there were no significant differences between the two groups(both P>0.05). The COX-2 protein in both groups was positive,but the positive expression level of COX-2 in the schistosomiasis group was higher than that in the non-schistosomiasis group,and there was a significant difference between the two groups(P<0.01). The positive rate and level of Bax protein expression were not significantly different between the two groups(both P>0.05). The positive rate of c-myc expression in the schistosomiasis group was higher than that in the non-schistosomiasis group,with a significant difference(P<0.01),but the positive expression level was lower than that in the non-schistosomiasis group,and there was a significant difference between the two groups(P<0.01). Conclusions Schistosome infection may impact on the deficiency of p53 of human colorectal cancer cells. It may promote the excessive expression of COX-2 protein,which is an indirect carcinogenic factor. The expression of Bax gene has no correlation with schistosome infection. The schistosome chronic infection may cause a persistent low level expression of c-myc gene.

Objective To study the feasibility and clinical significance of internal tourniquet (temporary arterial lumen blood flow occlusion by balloon catheter) for controlling the hemorrhage from traumatic neck and adjacent trunk arteries by temporarily occluding the arterial lumen blood flow.Methods The study involved 35 patients with traumatic neck and near trunk arteries who were firstly managed by internal tourniquet during operation to temporarily occlude the proximal aorta blood flow from May 1987 to February 2009.Each blocking time ranged from 30 to 70 minutes and the blocking was performed at an interval of 15 to 20 minutes.Then,surgical therapy was taken.Results After temporary proximal aorta blood flow occlusion with internal tourniquet,the operation presented few bleeding,with a clean operating field and clear anatomic structures.The total intraoperative blood loss was 100-400 ml.All patients were healed without ischemia of brains and limbs or relapse during the 3-14 years of followup.Conclusion Internal tourniquet,which can effectively reduce intraoperative blood loss and improve operation safety by temporarily occluding the proximal aorta blood flow,is an auxiliary approach for treating hemorrhage from traumatic neck and adjacent trunk arteries.

Objective To explore the methods and strategies of nursing training promotion after integration of two hospital, so as to improve the effects of nursing training and promote the rapid integration of the class Ⅱ hospital to class Ⅲ hospitals.Methods In February 2015, Zhongda Hospital Southeast University hosted district level class Ⅱ Nanjing Dachang Public Hospital. Nursing department-area-department, a hierarchical management of three level of training management architecture has been formed by analyzing the difficulties in nursing training after the integration of the two hospitals. Hierarchical training and assessment has been applied in N0 to N4 nursing staff, combining scene simulation, video teaching and other diversity training and assessment methods. A self-designed satisfaction questionnaire was adopted, and quality control data was extracted and statistically analyzed by nursing management information system, so as to compare the nursing training effect of earlier integration (August 2015 to January 2016) and after integration (February to July 2016).Results The median score of nursing training satisfaction after integration was 96, which was higher than 92 before integration , and the difference was statistically significant (Z=-10.876,P<0.01). The qualification rate of special grade Ⅰ nursing, ward management, nursing technique, emergency medicine equipment, disinfection and sterilization was 98.38％, 95.00％, 93.38％, 95.70％ and 96.27％ respectively after integration, which were all higher than those before integration (92.88％, 92.85％, 91.01％, 93.04％, 93.48％), and the differences were statistically significant (χ2=28.923, 6.410, 8.446, 10.502, 12.596;P<0.01). The satisfaction of clinical ward, outpatient and operation theatre improved significantly after integration (97.36％ vs. 91.26％, 93.42％ vs. 90.35％, 97.68％ vs. 94.14％; χ2=94.373, 4.419, 4.131;P<0.05).Conclusions After the two hospitals' integration, diversified training helps to improve nurses' satisfaction with nursing training, nursing quality and patient satisfaction, which is worthy of further application in clinical nursing training.