Objective To establish a two-way evaluation system and to explore the application effect of two-way evaluation method in clinical nursing teaching.Methods We carried out two-way evaluation and individual evaluation test to 40 nursing students practicing in the Department of Inter nal Medicine of our hospital in 2012 and 20 teachers responsible for teaching.By using the envelope method,nursing students and teachers were randomly divided into two groups,with 20 nursing students and 10 teachers in the experimental group and the control group respectively.Students' assessment form and the teachers teaching level evaluation table were made,and teachers of both group gave scores every two weeks to the nursing students by nursing students' evaluation sheet,and the score of feedback were given to the nursing students in experimental group.At the same time,the nursing students in experimental group gave scores every two weeks to the teachers of the same group by the teachers' teaching evaluation sheet,and feedback the results.SPSS 13.0 was used to make statistical analysis and the scores of nursing students and teachers of both groups and the last scores were compared with paired sample T test of mean.The results of the experimental group and the control group in the same period were compared with two independent samples T test of mean.Results Comparing the nursing students'scores of both groups with the scores they themselves got last time,the scores of the fourth,sixth,and the eighth week were statistically significant(P＜0.05)and comparing the experimental group teachers' score with and the scores they themselves got last time,the scores of the fourth,sixth,and the eighth week were also statistically significant(P＜0.05); from the fourth week on,nursing students' scores in experimental group compared with those in control group in the same period,show the differences statistically significant(P＜0.05).Conclusion Two-way evaluation system is beneficial to improving the enthusiasm and initiative of the teachers and students.Two-way evaluation and bidirectional interaction are helpful to timely detection of problems and improvement and can effectively improve the quality of clinical nursing teaching in internal neurological medicine.

Objective To evaluate the effect of recombinant activated factor Ⅶ (rⅦa) in treatment of hemorrhagic shock after severe multiple injuries with coagulopathy.Methods Sixteen cases of coagulopathy after severe multiple injuries administered with rⅦa between July 2011 and June 2012 were reviewed.The requirements of blood product and coagulogram variation were comparatively studied before and after rⅦa therapy.Results After rⅦa therapy,bleeding was brought to a halt in 24 hours for nine cases and in 72 hours for seven cases.In the end,13 out of the 16 cases survived in the absence of myocardial infarct,cerebrovascular accident or deep vein thrombosis.Requirements of red blood cells,fresh frozen plasma,cryoprecipitate and platelet (PLT) were decreased at 48 hours after the final therapy as compared with those at 48 hours prior to the primary therapy,but statistical significance only existed in the reduction of fresh frozen plasma and cryoprecipitate (P ＜ 0.05).The coagulogram indices including prothrombin time (PT) and activated partial thromboplastin time (APTT) at 4 hours after the final therapy presented statistical differences from those prior to the primary therapy (P ＜ 0.05).Conclusion rⅦa is an important,effective and safe auxiliary means for surgical hemostasis of coagulopathy after severe multiple injuries.

Objective To investigate the effect of insulin-like growth factor-1(IGF-1) and basic fibroblast growth factor (bFGF) on the differentiation of human dental pulp stem cells in vitro. Methods Mono-cell suspension was separated from the human adult dental pulp with collagenase Ⅰ and dispase digestion. Colony-forming efficiency of cells was calculated. Cells were observed under an invert microscope. Dentin sialoprotein (DSP), dentin matrix protein 1 (DMP-1) and dentin sialophosphoprotein (DSPP) mRNA of the 3rd passage cells induced with IGF-1 and bFGF in vitro were detected by immunohistochemistry and RT-PCR. Results Clonogenic cells were obtained from dental pulp and colony-forming efficiency of cells was 2.6-3.5 colonies/10 4 cells. Human specific DSP, DMP-1 protein and DSPP mRNA expressed in colony-forming cells after 7 d of induction with IGF-1 and bFGF in vitro. Conclusion Adult stem cells might exist in human dental pulp. Dental pulp stem cells could differentiate into odontoblast under the induction of IGF-1 and bFGF.

Objective To explore the underlying anatomy of iliac vein compression syndrome (IVCS) using CT, and discuss the imageological index for subtype diagnosis and potential clinical significance. Methods We retrospectively analyzed the imageological data of 69 IVCS patients from July, 2009 to June, 2014. According to CT findings, patients were categorized to simple IVCS (sIVCS, the iliac vein is compressed by only the anterior iliac artery, n=22), lumbar degeneration?related IVCS ( dIVCS, besides the iliac artery, the lower lumbar degenerative changes including osteophyte, protruded disc, etc. pressed the iliac vein from the back, n=33) and other IVCS causes (oIVCS, including tuberculosis, inflammation and fracture hematoma of the lumbar spine, n=14); meanwhile, 69 age? and sex?matched subjects was set as a control group. Evaluated indexes were onset age, course of lower limb swelling and pain, size of the iliac vein tunnel ahead lumbar (IVTAL), lower lumbar spine forward curvature angle (LLSCA), iliac vein?pressed signs by lower lumbar degeneration, compression sites, scope of deep venous thrombosis and interventional therapeutic effect. The differences of those indexes of various groups were compared. Data as onset age, course of disease, sizes of IVTAL and LLSCA were evaluated using variance analysis of the general linear model, with Bofferroni test correction for multiple comparisons. Data as iliac vein?pressed site, scope of venous embolism and therapeutic effect were assessed by crossing table χ2 test. All statistical analyses were performed using SPSS17.0 software (SPSS company, Chicago, USA). Bilateral P≤0.05 were considered to be significant. Results The onset mean age was (61.5 ± 10.6) yr. in dIVCS, (42.3 ± 6.5)yr in sIVCS. and(53.1 ± 16.8)yr. in oIVCS with a significant difference ( F=11.030, P<0.01). Mean sagittal diameter of the IVTAL and LLSCA were(2.3±0.5)mm and(121.8±5.4)° in dIVCS and(2.5± 0.5)mm and(124.4 ± 3.9)° in sIVCS, respectively; which were smaller than those of control group [(6.4 ± 1.6)mm and(127.5 ± 7.3)° , respectively ] and oIVCS [(5.9 ± 2.3)mm and(129.5 ± 5.9)° , respectively ](F=125.275,P<0.01 for sigittal diameter and F=7.95,P<0.01 for LLSCA). The degenerative changes compressing the iliac vein of dIVCS had 41 sites of 33 patients which were respectively the discal forward protrusion or bulge (51%, 17/33), vertebral anterior osteophyte (50%, 16/33)and lower lumbar vertebrae slippage (19%,8/33). The compression sites of dIVCS located exactly anterior to the fifth lumbar(18/33, 56%), the intervertebral disk between the fourth and fifth lumbar(9/33, 26%), the right front (3/33, 9%) and left front (3/33, 9%) of the fifth lumbar, however, that of sIVCS sited the right front(14/22, 64%), exactly the front(4/22, 18%)of the fifth lumbar and exactly anterior(4/22, 18%)to the intervertebral disk between the fourth and fifth lumbar, with a significant difference of location distribution(χ2=19.305, P<0.01). In sIVCSs, deep vein thrombosis of all exceeded the iliac vein length and implicated the femoral vein by 27%(6/22)and the popliteal vein by 73%(16/22), while in dIVCSs 18%(6/33)patients had deep vein thrombosis in the iliac vein, 30%(10/33)in the femoral vein and 52%(17/33)in the popliteal vein, and in oIVCSs, 30%(4/14)patients had deep vein thrombosis in the iliac vein, 40%(6/14)in the femoral vein and 30%(4/14)in the popliteal vein, with a significant difference of thrombosis scope(χ2=9.28, P<0.01). 86%sIVCSs needed intravenous stent?implanted operation to obtain effective treatment, only 52%dIVCSs were performed stent?implanted operation for effective therapy, none of oIVCSs had stent?implanted operation before the iliac vein recanalization. Conclusion CT can precisely display the pathological anatomy features of different IVCS patients, which can potentially help clinicians plan accurate treatment strategy.

Objective To investigate the life quality and influencing factorin stroke patient.MethodTotally 205 hospi-talized stroke patientin the neurology departmenwere investigated with SF-36 scale .The datwere performed the descriptive sta-tistic,t-tesand multiple linearegression analysi.ResultThe scoreof general healthy statu,physiological function ,physiolog-ical role ,somatipain and social function in the patientwith stroke were significantly lowethan thain the national norm (P＜0 . 01) .The recurrence frequency ,age ,comorbidity ,education level and income were significanfactoraffecting the life quality in the stroke patien.Conclusion The level of general health statu,physiological function ,physiological role ,somatipain and social function are decreased significantly .Therefore iirecommended to perform the pertinenintervention in the clinical work .

Objective To study the relevant factors of malignant change of colorectal adenoma. Methods The clinical data of 276 cases of colorectal adenoma admitted in our hospital in recent 14 years were analyzed retrospectively . Results Malignant change rate of the adenoma in the left colon was significantly higher than that in right colon(P

Objective To analyze the clinical effect of vacuum sealing drainage (VSD) on skin and soft tissue injury in elderly patients.Methods A total of 75 patients with severe skin and soft tissue injury who met the inclusion criteria were enrolled in this study.They were divided into two groups based on admission dates:the observation group (n =40,receiving VSD treatment,oddnumber date admission) and the control group (n=35,receiving routine dressing changes,even number date admission).The clinical indexes including pain score,wound healing time,infection rate and complications were analyzed and compared between the two groups.Results There was a significant difference in the average length of hospitalization between the two groups (21.3 days vl 30.7 days,t=7.60,P=0.0000).The infection rate was lower in the observation group than in the control group (12.5％ or 5/40 vs.54.3％ or 19/35,x2=13.12,P=0.0003).The incidence of complications was lower in the observation group than in the control group (15.0％ or 6/40 vs.42.9％ or 15/35,x2=5.87,P=0.0154).There were no deaths in the observation group,but one patient died from acute pulmonary embolism in the control group during hospitalization.Conclusions VSD can alleviate pain,reduce the infection rate,shorten the length of hospitalization and decrease bedridden complications in elderly patients with severe skin and soft tissue injury,and has valuable applications in clinical practice.

Objective To study the mechanisms of Curcumin-induced apoptosis on human gastric cancer cell line SGC-7901.Methods SC,C-7901 cells were treated with various concentrations of Curcumin and the growth inhibition rates of it were accessed by MTT method.Apoptosis of gastric cancer cells were in- spected by flow cytometry.The expression of Fas and survivin in gastric cancer cells were evaluated by west- ern blot.Results Curcumin could effectively inhibit the growth of gastric cancer cells in dose-dependent and time-dependent manners,the sub-peak appeared and the apoptotic rate was increased.The expressions of Fas was higher in Western blot,meanwhile,the expressions of survivin was decreased.Conclusion Curcumin could significantly inhibit the growth and induce apoptosis of gastric cancer cells(SGC-7901),Curcumin could probably through up-regulating Fas and down-regulating surviving to induce apoptosis.

Objective To investigate the effect and mechanism of tripterygium wilfordii combined with aescine in treatment of acute lung injury (ALI) following trauma.Methods A total of 120 patients with posttraumatic ALI were divided into four groups:tripterygium wilfordii + aescine group (combined group),tripterygium wilfordii group,aescine group,and control group according to random number table,with 30 patients per group.Regardless of the same conventional therapy,the patients in combined group were treated by orally or gastrically administered tripterygium wilfordii multiglycoside as well as aescine intravenously,once a day for 12 days; on the contrary,the same method but only with tripterygium wilfordii or aescine was respectively performed in tripterygium wilfordii and aescine groups.Blood gas analysis before and after treatment,length of ICU stay,fatality rate and incidence of ARDS in each group were observed.Changes in levels of inflammatory mediators (TNF-oα,IL-1,IL-6 IL-8,etc)were detected at days 4,8,and 12 after medication.Results Shorter length of ICU stay and lower ARDS incidence as well as 12-day fatality rate were detected in each treatment group as compared with control group,especially in combined group (P ＜ 0.05).Respiratory rate,PaO2 and oxygenation index (PaO2/FiO2) in each treatment group presented better amelioration than those in control group and especially better results were observed in combined group (P ＜ 0.05).Plasma levels of TNF-α,IL-1,IL-6,and IL-8 in each treatment group were lower than those in control group (P ＜ 0.05).Conclusions Tripterygium wilfordii and aescine havetherapeutic effect on posttraumatic ALI.Moreover,synergetic use of the two drugs achieves synergistic effect and better outcome.

Objective To explore the characteristics and rehabilitation treatment methods of young ischemic stroke combined with congenital myopathy. Methods The clinical data of one young patient with ischemic stroke combined with congenital myopathy was retrospective analyzed, and its pathological feature and rehabilitation treatment methods were also analyzed. Results The etiology may be artery dissection mural thrombus fell off. Conclusion The etiology of young ischemic stroke should be clear diagnosed, and the intensity of rehabilitation training need attention.