It is advocated on clinical medical education to let students contact clinical diagnosis and treatment earlier, visiting more patients and promoting the ratio of visitation and course. But as more and more students flood into university, clinical visitation has turned into a difficulty to improve students' ability. To resolve this problem, we have made some efficient practice and exploration.

Some factors may induce accidents during physiotherapy for stroke patients. This article would summarize the general risk factors and discuss the management.

ObjectiveTo assess a simple apparatus measuring displacement of pelvis in clinical application.MethodsTwo testers measured the displacement of pelvis of 20 healthy young subjects moving their body forward, backward, leftward and rightward in standing position. The reliability of inter- and intra-tester was tested with intraclass correlation co-efficiency (ICC). And the validity between this method and Functional Reach Test (FRT) was tested.ResultsThe ICC of inter- and intra-tester were 0.91～0.97 and 0.94～0.98 respectively, and correlated with FRT (r=0.88, P<0.01).ConclusionThis simple apparatus can be used in a balance test.

The deficiency theories of dyslexia are quite contradictory and the cross-cultural studies in recent years mainly focused on whether the dyslexics among cultures shared the same cognitive profile or just based on the language. This study used Near-Infrared Spectroscopy (NIRS) imaging to measure the regional cerebral blood volume (BV) and the changes of cerebral activation in the left prefrontal cortex of 12 Chinese dyslexic children and their 12 age-matched normal controls during the Paced Visual Serial Addition Test (PVSAT). Results showed that the scores of PVSAT of dyslexic children were significantly lower than those of the normal children (t=3.33, P<0.01). The activations of the left prefrontal cortex in the normal group were significantly greater than those of dyslexic children (all P<0.01). Our results indicated that Chinese dyslexia had a general deficiency in working memory and this may be caused by the abnormal metabolic activity of brain blood volume in the left prefrontal cortex and the deficits in brain function might be the basis of neuropathology of Chinese dyslexia. Present study supports the difference on brain activation of dyslexics from different languages may be caused by the same cognitive system related to reading.

Objective To study the anti-tumor effect of the proteoglycan extracted from abalone viscera (AVPF-I). Methods Hepatic carcinoma cell H22-bearing mice were randomized to negative control (physiological saline), positive control (cyclophosphamide) and three doses of AVPF-I groups. The tumor growth, cell mediated immune function including lymphocyte proliferation, phagocytosis of peritoneal macrophage, NK cell activity, and the level of serum TNF-?,IL-1and IFN-?were detected. Results A significant inhibition of the tumor growth was observed in the AVPF-I group(P

Objective:To investigate the expression of microRNA (miR)-938, its effect on cell proliferation and its regulatory mechanism in hepatocellular carcinoma (HCC).Methods:HCC and paracancerous tissues were collected from 40 patients with HCC who underwent surgical resection in the Second Affiliated Hospital of Nantong University from January 2015 to June 2019, including 25 males and 15 females, with an average age of 61.4 years. HepG2 cells in the miR-938 overexpression group were transfected with miR-938 mimics, and the negative control group was transfected with the negative control sequence. Cell proliferation was detected by kit, the expression of miR-938 and the succinate dehydrogenase complex subunit D (SDHD) was detected by fluorescence quantitative polymerase chain reaction, and SDHD protein expression was detected by Western blot. The target genes of miR-938 were verified by dual luciferase reporting.Results:The relative expression of miR-938 in HCC tissues was (0.060±0.002), which was higher than that in adjacent tissues (0.030±0.002), and the difference was statistically significant ( P<0.05). The mRNA relative expression of SDHD in HCC tissues was (0.028±0.002), lower than that in adjacent tissues (0.062±0.002), and the protein expression of SDHD in HCC tissues was (0.963±0.008), lower than that in adjacent tissues (1.083±0.037), with statistical significance (both P<0.05). The proliferation activity of miR-938 overexpression group was significantly higher than that of negative control group, and the difference was statistically significant ( P<0.05). MiR-938 significantly inhibited the luciferase activity of SDHD wild-type 3’-untranslated regions. In the overexpression miR-938 cells, SDHD mRNA and protein levels were significantly lower than those in the negative control group ( P<0.05). Conclusion:MiR-938 was highly expressed in HCC tissues. MiR-938 promoted the proliferation of HCC cells by inhibiting the expression of SDHD.

Objective To investigate the serum concentration and the lung tissue expression level of hypoxia-inducible factor-1α (HIF-1α) in neonatal rats with hypoxia-induced pulmonary hypertension (HPH),and the role of HIF-1α in pathogenesis of HPH and pulmonary vascular remodeling.Methods Eighty neonatal Wistar rats were randomly assigned into normoxia and hypoxic group,forty in each group.HPH models were established on rats in hypoxic group.On the 3rd,7th,14th and 21st day after modeling,ten rats in each group were taken to measure the mean pulmonary arterial pressure (mPAP).Meanwhile,serum HIF-1α concentration were determined by enzyme-linked immunosorbent assay,while expression of HIF-1α in lung tissue were detected by immunohistochemistry and real time polymerase chain reaction.After hematoxylineosin and Van Gieson staining,morphological changes of pulmonary arterioles of rats in both groups were observed by optical microscope.Intima-media thickness/external diameter ratio (MT) and medial wall cross sectional area/vessel total cross-sectional area ratio (MA) were determined.Wilcoxon rank sum test,t-test,Ridit analysis,Pearson correlation and Spearman rank correlation test were applied for statistical analysis.Results mPAP in both groups kept increasing as the time went on.mPAP in hypoxic group were higher than that innormoxiagroup[(8.59±1.57) mmHgvs (6.14±1.02) mmHg,(11.63±2.56) mmHgvs (8.33±0.76) mmHg,(15.29±2.88) mmHgvs (10.92±2.74) mmHgand (18.04±2.69) mmHgvs (12.17±1.64) mmHg on the 3rd,7th,14th and 21st day after hypoxia modeling (t=4.14,3.91,3.48 and 5.89,all P＜0.05).Serum concentration,expressions of mRNA and immune response intensity of HIF-1α in hypoxic group were higher than those in normoxia group on the 3rd,7th and 14th day after hypoxia [serum concentration:(805.67±19.52) μg/molvs (204.34±83.21) μg/mol,(906.29±24.24) μg/molvs (548.93±11.78) μg/mol and (939.25±28.57) μg/mol vs (674.44± 17.41) μg/mol,t=6.43,4.11 and 2.34,respectively,all P＜0.05; relative expressions of HIF-1α mRNA:0.98±0.35 vs 0.23±0.16,1.30±0.49 vs 0.69±0.13 and 1.45±0.76 vs 0.64±0.21,respectively,t=4.56,2.72 and 4.63,all P＜0.05; immune response intensity of HIF-1α (average Ridit value):0.318 vs 0.183,0.303 vs 0.198 and 0.374 vs 0.176,respectively,u=3.26,2.73 and 3.91,all P＜0.05].MT and MA in hypoxic group were higher than those in normoxia group [MT:52.71％ (45.91％-63.23％) vs 47.42％ (41.14％ 56.17％),61.28％ (52.25％-68.63％) vs 50.22％(43.79％ 58.40％) and 65.24％ (56.02％-71.28％) vs 53.78％ (48.02％-64.58％) at 7,14 and 21st day respectively,u=2.08,4.54 and 4.37; MA:60.89％ (54.04％ 66.21％) vs 55.19％ (50.32％-63.59％),66.09％ (58.52％-72.58％) vs 59.77％ (53.55％-67.09％) and 68.25％(62.02％-74.51％)vs 61.40％(50.74％-70.55％),respectively,u=2.16,2.27 and 3.18,all P＜0.05].There were positive relations between HIF-1α and mPAP (r=0.294),as well as MT and MA (r=0.548 and 0.265,all P＜0.05).Conclusions HIF-1α may play a role in the pathogenesis of HPH.Pulmonary vascular remodeling occurred after seven days of hypoxia induction and may be exacerbated as the hypoxic time is prolonged,which might be prevented with early interventions.

Objective To explore the curative effect of modified closed negative pressure drainage on abnormal abdominal incision. Methods Sity-three patients with abnormal healing of abdominal incision in our hospital from January 2012 to June 2013 were selected as the observation group. Another 50 patients from January to December 2011 were assigned to the control group. The former was treated after debridement with human recombinant surface growth factor and modified closed negative pressure drainage,while the latter after debridement with anti-infection and dressings of ethacridine or gentamicinsolution as well as with infrared therapy. The two groups were compared in terms of the frequency,time and cost of changed dressings,and the healing time of the incisions.Results There was insignificant difference in the cost of changed dressings between the two groups(P>0.05). However,the differences were statistically significant in terms of the frequency and time of changed dressings and the healing time of the incisions(P<0.05). The observation group was significantly superior to the control group.Conclusions Modified closed negative pressure drainage is effective in accelerating the healing in abnormal abdominal incisions,reducing the frequency and the time of changed dressings,and easing the economic burdens of the patients,which is suggested to be popularized and applicable in the pimary hospitals.

ObjectiveTo explore influence of emergency nursing process reengineering on the satisfac-tion degree of patients, quality of rescue, rescue time and success rate of rescue. MethodsEvidence-based nursing method was used for emergency nursing process reengineering. The first 30 types of acute and sever diseases and the first 6 large emergency events in 2008 were chosen as the rescue objectves, and they received new emergency nursing process. Influence of classic emergency nursing process in 2007 was retrieved and revalued. The satisfaction degree of patients, quality of emergency nursing and success rate of emergency before and after process reengineering were compared and analyzed. ResultsCompared with that before process reengineering, the satisfaction degree of experts, doctors and nurses, and patients was higher, the quality of emergency nursing greatly improved, the rescue time was less, and the success rate of rescue was higher after process reengineering. ConclusionsEmergency nursing process reengineering was more hu-man oriented. It can rescue patients with acute and severe diseases with lest time, reduce disputes between nurses and patients. It is worthy of application in clinic and the process should be reengineered and im-proved constantly in the future.

ObjectiveTo investigate the expression of heme oxygenase-1 (HO-1) in lung tissue of mice with acute paraquat poisoning, and discuss its pathological mechanism.Methods Fifty-eight healthy male mice were randomly divided into control group (n = 8) and poisoned group (n = 50). The mice in poisoned group were lavaged with 20% paraquat (50 mg/kg), and those in control group with equal amount of normal saline. The mice were sacrificed on the day of experiment in control group, and those in poisoned group at 6 hours and 1, 3, 7, 14 days after poisoning. The lung tissue was harvested to observe the changes in pathology of lung with hematoxylin and eosin (HE) staining. The positive expression of HO-1 was determined with immunohistochemistry, and the protein expression of HO-1 was determined with Western Blot. The contents of superoxide dismutase (SOD) and malonaldehyde (MDA) were determined.Results The mice showed shortness of breath and signs of exhaustion 1 hour after poisoning, getting worse on 3-5 days, but returned to normal 14 days after poisoning. Under the light microscope, it showed that the control group had no significant pathological changes in lung tissue. One day after the ingestion, pulmonary alveolar structure disorder, obvious hemorrhage, edema and infiltration of inflammatory cells were found. At 3 days, the pathological changes in the lung tissue were more pronounced. They were less pronounced on 7 days, and inflammatory changes disappeared on 14th day, but alveolar structure disorder remained. Immunohistochemical test showed that HO-1 was seldom expressed in the lung tissue, and a little amount was expressed in the mucosal epithelial cells of the airway in control group. It was shown that inflammatory cell and endothelial were mainly distributed in the mucosal epithelial cells of airway 1 day after poisoning followed by a gradually decrease tendence, and came to normal level of control group 7 days after poisoning. It was shown by Western Blot that HO-1 (gray value) in lung tissue increased 6 hours after poisoning (2.438±0.467 vs. 0.475±0.167,P< 0.01), peaked at 1 day (9.200±0.940 vs. 0.475±0.167,P< 0.01), continued to increase till 7 days after poisoning, and it lowered to normal level thereafter (0.825±0.260 vs. 0.475±0.167,P> 0.05). The SOD activity (μU/L) in lung tissue was lowered 6 hours after poisoning, and it was significantly lower than that of control group (649.681±13.951 vs. 1 167.051±15.744,P< 0.01), and it continued to decrease up to 14 days after poisoning (859.733±121.079 vs. 1 167.051±14.744,P< 0.01). MDA content (μmol/L) in the lung tissue homogenate was elevated 6 hours after poisoning with significant difference compared with that of the control group (4.542±0.266 vs. 3.705±0.176,P< 0.01). It peaked on day 1 (5.956±0.281 vs. 3.705±0.176,P< 0.01), then it declined and reached normal level 3 days after poisoning (4.134±0.168 vs. 3.705±0.176,P> 0.05).Conclusion HO-1 expression was increased significantly in lung tissue of mice with acute paraquat poisoning, which may be considered as an important protection mechanism against paraquat poisoning.