Objective To explore the role of problem-based learning(PBL) nursing ward round on critical thinking capacity of nurses from surgical departments. Methods All nurses from surgical depart-ments were randomly divided into the experimental group(86 nurses) and the control group(85 nurses) by drawing lots. Objects from the experimental group received PBL nursing ward round training twice a week for 8 months, while those from the control group used the traditional nursing ward round training. The influ-ence of the different teaching methods on the critical thinking capacity of the nurses was assessed before and after the training, using critical thinking disposition inventory-Chinese version (CTDI-CV). Results Total critical thinking capacity was improved significantly in the experimental group after the training. All sorts of critical thinking characteristics were strengthened in different degree. Conclusions PBL nursing ward round training can effectively facilitate the critical thinking capacity of surgical nurses.

According to the super-position principle of the reinforcement of biological activities, a series of novel E-substituted 2, 3-diaryl propenoic acyloxy phosphonate derivatives were designed and synthesized. And the structures of the target compounds were confirmed by IR, 1H NMR, 13C NMR and elemental analysis. Furthermore, the cytotoxicities of all compounds on A-549, SGC-7901 and EC-109 in vitro were evaluated by MTT assay, and some of them showed good antitumor activity. Among the active compounds, especially, the IC50 value of compound 3e was (12.7 ± 1.9) μmol x L(-1) against A-549 cells, similar to cisplatin [IC50 = (8.0 ± 1.5) μmol x L(-1)], compounds 3g and 3k had better inhibition effect on EC-109 cells growth, with the IC50 values of (9.5 ± 1.8) μmol x L(-1) and (11.5 ± 0.9) μmol x L(-1) respectively, and compounds 3i and 3k exhibited good cytotoxic property on A-549, SGC-7901 and EC-109, which were worth further investigation.

Objective To study the preventive effect of biliary duct injury(BDI)of three-dimensional spiral CT cholangiography(SCTC)before laparoscopic cholecystectomy(LC).Methods A retrospective analysis was carried out for 30 patients suffering from cholelithiasts concurrent with choledocholithiasis from July 2007 to June 2009.EAndoscopic sphincterotomy(EST),then three-dimensional SCTC was carried out through endoscop-ic nasobiliary drainage(ENBD)before IX,and the preventive effect of BDI was evaluated.Results The visibility of intra-hepatic bile duct,the hepatic bile duct and the common bile duct were 100% the visibility of chol-ecyst bile duct was 73% ,and three-dimensional SCTC can tell the position of cholecyst duct,BDI was not happened in all these patients.Conclusion Three-dimensional SCTC before LC can decrease the possibility of BDI.

ObjectiveAfter intratympanic gadolinium administration through the tympanic membrane,three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) was performed to evaluate endolymphatic visualization and its diagnostic value in Meniere's disease.MethodsTwenty-four hours after intratympanic gadolinium administration through the tympanic membrane,19 patients with unilateral Meniere's disease diagnosed clinically underwent 3D-FLAIR and 3D-Balance-FFE imaging at 3.0 T MR scanner.The enhanced imaging of perilymphatic space in bilateral cochlea,vestibular and (or) canal were observed.Scala tympani and scala vestibule of bilateral cochlear basal turn were scored respectively.The enhanced range of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem were measured. Wilcoxon tests and paired t tests were used.ResultsThe gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and (or) canal,so the endolymphatic space was clearly visualized on 3D-FLAIR imaging.The score of scala vestibuli between the affected side (3 cases scored 2,9 cases scored 1,7 cascs scored 0) and the healthy side ( 15 cases scored 2,2 cases scored 1,2 cases scored 0 ) were significantly different ( U =3.090,P ＜ 0.05 ).The area of enhanced vestibular were (5.77 ± 2.33) mm2 and (8.11 ± 3.32) mm2 for the affected side and the healthy side,which were significantly different ( U =3.090,P ＜ 0.05 and t =2.638,P ＜ 0.05 ).Conclusions According to 3D-Balance-FFE MRI and the enhancement of perilymphatic space,3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can be used to show the border between the perilymph and the endolymph and confirm endolymphatic hydrops,thus providing radiographic evidence for the diagnosis of Meniere's disease.

Objective To evaluate the effect of continuity of health education model for patients undergoing bone cancer during the first chemotherapy.Methods This model was designed based on KAP(Knowledge,Attitude or Belief,Practice) theory,literature review and questionnaire and performed in 103 bone cancer patients during the first chemotherapy.Results All the patients were assessed,with the founding that the pass rate of knowledge test,treatment compliance and degree of satisfaction were increased significantly(all P<0.05).Conclusions The health education model could help patients learn knowledge about bone cancer,build health behavior and deal with complications.Additionally,it improves the pass rate of knowledge test,satisfaction, and compliance.

Objective: To understand the basic characteristics, sexual behavior and the use of recreational new drugs of young men who have sex with men (MSM) in Tianjin, and to explore the characteristics of young MSM who use recreational drugs, so as to provide reference for the policy making of HIV/AIDS prevention and control in universities. Methods: From January 1, 2018, solstice to December 31, 2018, participants were recruited in the bathrooms, bars and social network sites in Tianjin by snowball sampling. The basic demographic information, sexual behavior and recreational drug use of the participants were collected through face to face interviews and questionnaires. Logistic regression was used to analyzed the characteristic differences drug users and non users among young MSM. Results: A total of 826 young MSM were included in the study, 32 were infected with HIV, and the overall prevalence rate was 3.87 %. Totally 371 (44.92%) were drug users. Rush Poppers were the most common used drug ( 98.65 %). Of the young MSM using new drugs, 306 (82.48%) multiple drugs were used, 65 people ( 17.52 %) only one drug has been used. Among new drug users, multiple drug users had higher HIV prevalence rate (16.92%) than single drug users (4.57%). There were statistically significant differences between drug users and non users in age, age of first sexual behavior, household registration, sexual orientation, education level, sexual partners seeking routes, unprotected anal intercourse and HIV testing history( OR=3.70，5.51，0.51，0.60，4.64，0.40，0.52，1.98，2.29，P <0.05). Conclusion The utilization rate of recreational drugs among young MSM in Tianjin was high. Relevant departments should strengthen the propaganda of recreational drugs and HIV prevention among college students, improve the sexual health awareness of young MSM, and establish a long term HIV and recreational drug prevention system.

Background::Evidence indicates that low muscle strength is associated with an increased cardiovascular diseases (CVDs) risk. However, the association between muscle strength changes based on repeated measurements and CVD incidence remains unclear.Methods::The study used data from the China Health and Retirement Longitudinal Study in 2011 (Wave 1), 2013 (Wave 2), 2015 (Wave 3), and 2018 (Wave 4). Low muscle strength was defined as handgrip strength <28 kg for men or <18 kg for women, or chair-rising time ≥12 s. Based on changes in muscle strength from Waves 1 to 2, participants were categorized into four groups of Normal-Normal, Low-Normal, Normal-Low, and Low-Low. CVD events, including heart disease and stroke, were recorded using a self-reported questionnaire during Waves 3 and 4 visits. Cox proportional hazards models were used to investigate the association between muscle strength changes and CVD incidence after multivariable adjustments. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated with the Normal-Normal group as the reference.Results::A total of 1164 CVD cases were identified among 6608 participants. Compared to participants with sustained normal muscle strength, the CVD risks increased progressively across groups of the Low-Normal (HR = 1.20, 95% CI: 1.01-1.43), the Normal-Low (HR = 1.35, 95% CI: 1.14-1.60), and the Low-Low (HR = 1.76, 95% CI: 1.49-2.07). Similar patterns were observed for the significant associations between muscle strength status and the incidence risks of heart disease and stroke. Subgroup analyses showed that the significant associations between CVD and muscle strength changes were consistent across age, sex, and body mass index (BMI) categories.Conclusions::The study found that muscle strength changes were associated with CVD risk. This suggests that continuous tracking of muscle status may be helpful in screening cardiovascular risk.

In recent years,enhanced recovery after surgery(ERAS)has been widely used in clinical practice,aiming to optimize perioperative management measures through evidence-based medicine and reduce the physical and mental trauma,stress reactions,and complications of surgical patients through multidisciplinary collaboration.This paper examined the clinical practice of ERAS from the perspective of medical humanities,reviewed its development and characteristics,and first pointed out that the concept of"minimal harm"laid the medical humanities foundation for ERAS.However,the concept of"minimum harm"faced ethical and realistic challenges in practice,such as differentiated cognition between benefits and non-harm,the tension between generalization and personalization,and the gap between rehabilitation continuity and family care.This paper led into the caregiving perspective of social sciences,proposed"optimal care"as a supplement to the medical humanities concept of ERAS,and introduced its connotation and practice.The combination of"minimal harm"and"optimal care"can provide theoretical guidance for medical humanistic care in ERAS and innovate the practical path of medical humanities into clinical practice.

In recent years,enhanced recovery after surgery(ERAS)has been widely used in clinical practice,aiming to optimize perioperative management measures through evidence-based medicine and reduce the physical and mental trauma,stress reactions,and complications of surgical patients through multidisciplinary collaboration.This paper examined the clinical practice of ERAS from the perspective of medical humanities,reviewed its development and characteristics,and first pointed out that the concept of"minimal harm"laid the medical humanities foundation for ERAS.However,the concept of"minimum harm"faced ethical and realistic challenges in practice,such as differentiated cognition between benefits and non-harm,the tension between generalization and personalization,and the gap between rehabilitation continuity and family care.This paper led into the caregiving perspective of social sciences,proposed"optimal care"as a supplement to the medical humanities concept of ERAS,and introduced its connotation and practice.The combination of"minimal harm"and"optimal care"can provide theoretical guidance for medical humanistic care in ERAS and innovate the practical path of medical humanities into clinical practice.

In recent years,enhanced recovery after surgery(ERAS)has been widely used in clinical practice,aiming to optimize perioperative management measures through evidence-based medicine and reduce the physical and mental trauma,stress reactions,and complications of surgical patients through multidisciplinary collaboration.This paper examined the clinical practice of ERAS from the perspective of medical humanities,reviewed its development and characteristics,and first pointed out that the concept of"minimal harm"laid the medical humanities foundation for ERAS.However,the concept of"minimum harm"faced ethical and realistic challenges in practice,such as differentiated cognition between benefits and non-harm,the tension between generalization and personalization,and the gap between rehabilitation continuity and family care.This paper led into the caregiving perspective of social sciences,proposed"optimal care"as a supplement to the medical humanities concept of ERAS,and introduced its connotation and practice.The combination of"minimal harm"and"optimal care"can provide theoretical guidance for medical humanistic care in ERAS and innovate the practical path of medical humanities into clinical practice.