Objective:To evaluate the application method and effect of standardized scenario simulation teaching based on Kirkpatrick model in vocational protection education for nursing students.Methods:A historical controlled trial study was designed. Practical nursing students enrolled in 2018-2019 and 2017-2018 were selected into the experimental group ( n=203) and control group ( n=196), respectively. The experimental group adopted standardized scenario simulation teaching in the prevention and control education of needlestick injuries, and the control group adopted traditional classroom lecture. Using the Kirkpatrick model, the teaching effect of needlestick injuries protection for nursing students were compared between the 2 groups from such 4 levels as in reaction level, learning level, behavior level and results level. Results:There was no significant difference in the baseline data between the two groups in terms of age, gender, educational background and test scores of nursing professional knowledge as compared to that before practice. In reaction level: the nursing students' satisfaction of experimental group in teaching methods ( t=25.149, P<0.001) and teaching environment ( t=12.827, P<0.001) are higher than that of the control group, with statistical significance. In learning level: the test scores of needlestick injury knowledge in experimental group were significantly higher than those in control group ( t=8.221, P<0.001). In behavior level: the level of needlestick injury protection behavior in the experimental group was significantly higher than that in the control group ( t=9.250, P<0.001), and the knowledge conversion rate in the experimental group was higher than that in the control group ( t=6.054, P<0.001). In results level: the needlestick injuries incidence of experimental group was significantly lower than that of the control group ( χ2=15.815, P<0.001), the reported rate of needlestick injuries of experimental group was significantly lower than that of the control group ( χ2=14.185, P<0.001). Conclusion:The implementation of standardized scenario simulation teaching can effectively improve the effectiveness of vocational protection learning and reduce the incidence of needlestick injuries.

Objective To explore protein expression and significance of MAGE genes in colorectal carcinoma(CRC)tissues.Methods The expression of MAGE genes were studied by using tissue chip and immunochemistry methods in primary CRC tissue and paired adjacent tissue samples in 97 cases.Data were analyzed with x2-test by SPSS 16.0 software.Results The protein expression of MAGE-A3,MAGE-A4 and MAGE-A10 genes were 57％(56/97),63％(61/97)and 28％(27/97)respectively in 97 cases of primary adenocarcinoma.The protein expression frequency of MAGE-A3 in poor colorectal adenocarcinomas was significantly higher than in well-and moderately disfferentiated adenocarcinomas(x2 =9.133,P =0.010).MAGE-A10 in poor colorectal primary adenocarcinomas was significantly higher than in well and moderately adenocarcinomas(x2 =15.280,P =0.000); MAGE-A10 protein expression was significantly higher in stage TNM Ⅲ + Ⅳ than in stage TNM Ⅰ + Ⅱ(x2 =4.227,P=0.040); MAGE-A10 gene expression was higher in metastasis lymphoid node than in no metastasis lymphoid node(x2 =5.557,P =0.018),and the expression level was higher in primary lesion with the increasing of the numbers of lymphoid node metastasis(x2 =7.296,P =0.026).Conclusions The protein expression of MAGE genes is associated with the tumor differentiation,TNM stage and lymphoid node metastasis.MAGE-A3 and MAGE-A10 genes are the possible prognosis marker and potential target of immunotherapy of CRC.

ObjectiveTo investigate the expression of Snail in bladder urothelial carcinoma and evaluate its relationship with E-cadherin and a subset of T cell groups.MethodsImmunohistochemical method was used to detect the expression of Snail and E-cadherin proteins in tissue from 156 cases of bladder urothelial carcinoma and 80 cases of the para-cancerous mucosa. The proteins expression status was analyzed with clinico-pathological data. Meanwhile, correlations with Snail and CD4+, CD8+, CD4+/CD8+ were analyzed.ResultsThe positive rate of Snail in bladder urothelial carcinoma was 65.4％ , which was significantly higher than that in para-cancerous mucosa (48.8％). The expression of Snail was significantly correlated with the clinical stage, pathological grade, tumor quantity, distant metastasis and tumor recurrence.There was negative correlation between the expression of Snail and E-cadherin in bladder urothelial carcinoma. Positive expression of Snail had a negative correlation with the number of CD4+ and CD4+/CD8+ , whereas it had no significant correlation with the number of CD8+.ConclusionsBy inhibition of the E-cadherin expression and inducing local immunosuppression, Snail might play an important role in the process of the invasion and metastasis of bladder urothelial carcinoma.

Four patients with coexistence of sarcoidosis and primary Sj(o)gren syndrome (pSS) were retrospectively analyzed.All patients were female,who were referred to our department mainly because of respiratory symptoms.Positive antinuclear antibody (ANA) was detected in 2 patients and anti-Sj(o)grens syndrome A (SSA) antibody positive in 1 patient.All patients presented specific histologic patterns of both sarcoidosis and pSS.Publications related to coexistence of these two diseases were reviewed.Forty-one patients were finally included in the analysis,among whom 37 confirmed patients were from literature search.There were 37 women and 4 men.The main clinical features presentation were xerophthalmia in 40,xerostomia in 38,hilaradenopathies in 28,interstitial lung disease in 15,respiratory symptoms in 13.The main immunologic data were positive ANA in 23,SSA antibody in 19,anti-Sj(o)grens syndrome B antibody in 10 and rheumatoid factor in 12.All patients presented specific histologic patterns of both diseases.Patients with both sarcoidosis and pSS of ten represent multisystemic involvement and positive immunologic parameters,as well as the dual expression of specific histologic characteristics.

OBJECTIVETo analyze the perioperative complications of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture.

METHODSFrom June 2009 to December 2011, 63 patients with osteoporotic vertebral compression fracture underwent PKP, there were 18 males and 45 females with an average age of 75.3 years ( ranged, 62 to 91). All patients with severe back pain and without neurological symptoms and signs, which were confirmed by X-ray and MRI. Among them,there were 63 cases with severe osteoporosis, 37 cases with hypertension, 10 with coronary artery disease, 29 with anemia, 26 with diabetes, 11 with chronic obstructive pulmonary diseases and 8 with gastritis and peptic ulcer. The common perioperative complications were retropectively reviewed.

RESULTSPreoperative complications occured in 9 cases (14.3%), including hypostatic pneumonia (1 case), electrolyte disturbances (2 cases), urinary tract infection (2 cases), moderate anemia(2 cases),electrolyte disturbances combined with moderate anemia (1 case), hypostatic pneumonia combined with delirium (1 case). Intraoperative and postoperative. complications occurred in 17 cases (26.9%), there were bone cement correlated complications in 9 cases (14.3%), in which 2 cases of toxic reaction of bone cement and 7 cases of leakage (2 cases had clinical symptoms); there were non-bone cement correlated complications in 3 cases (4.8%), in which 1 case of focal hematoma caused by paracentesis, 1 case of transient nerve injury, 1 case of left intercostal neuralgia;there were transient hyperpathia in 5 cases after operation. All complications result in no severe consequence after treatment.

CONCLUSIONPerioperative complications of percutaneous kyphoplasty are not uncommon,however,these complications may not cause serious consequence after active treatment,so prevention and treatment are important for it.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Intraoperative Complications ; etiology ; Kyphoplasty ; adverse effects ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies

Though all the marketed drugs of dipeptidyl peptidase IV inhibitors are structurally different, their inherent correlation is worthy of further investigation. Herein we rapidly discovered a novel DPP-IV inhibitor 8g (IC50 = 4.9 nmol.L-1) which exhibits as good activity and selectivity as the market drugs through scaffold hopping and drug splicing strategies based on alogliptin and linagliptin. This study demonstrated that the employment of classic medicinal chemistry strategy to the marketed drugs with specific target is an efficient approach to discover novel bioactive molecules.
Dipeptidyl-Peptidase IV Inhibitors ; chemical synthesis ; chemistry ; Drug Design ; Drug Discovery ; methods ; Humans ; Hypoglycemic Agents ; chemical synthesis ; chemistry ; Linagliptin ; chemical synthesis ; chemistry ; Molecular Structure ; Piperidines ; chemical synthesis ; chemistry ; Structure-Activity Relationship ; Uracil ; analogs & derivatives ; chemical synthesis ; chemistry

Objective To assess the clinical application of contrast-enhanced MR angiography using three-dimensional(3D)time-resolved imaging of contrast kinetics(CE-MRA 3D-TRICKS).Methods TRICKS is a high temporal resolution(2—6s)MR angiographic technique using a short TR(2.8— 4.0 ms)and TE(0.9—1.3 ms),partial echo sampling and the central part of the k-space being updated more frequently than the peripheral part of the k-space.Pre-contrast mask 3D images are first acquired and 15--20 sequential 3D images following bolus injection of Gd-DTPA are then acquired.Results Thirty patients underwent contrast-enhanced MR angiography using TRICKS.Twelve vertebral arteries were well displayed on TRICKS.Seven of them showed normal,bilateral vertebral artery stenosis was shown in 1 case, and unilateral vertebral artery stenosis was shown in 4 wth aecompaning ipsilateral carotid artery bifurcation stenosis in one case.Bilateral renal artery showed normal in 4 cases,and the artery in transplanted kidney showed normal in one case and stenosis in another case.The cerebral artery showed normal in 2 cases, sagittal sinus thrombosis was detected in one case and intracranial arteriovenous malformation in one case. Pulmonary artery displayed normal in 3 cases,pulmonary artery thrombosis was seen in one case and pulmonary sequestration's abnormal feeding artery and draining vein was revealed in one case.The feeding artery in left lower limb fibrolipoma was showed in one case.The radial-ulnar artery artificial fistula stenosis was seen in one case,and left antebrachium hemangioma was showed in one case.Conclusion TRICKS can clearly delineate the whole body vascular system and can reveal any vascular abnormality.It is convenient and with high successful rate,which make it the first method of choice in displaying vascular abnormality.

Objective To compare the clinical efficacy and safety of ti-cagrelor and clopidogrelin the treatment of acute myocardial infarction in patients with percutaneous coronary intervention ( PCI ) after thrombolytic therapy.Methods A total of 130 ST -segment myocardial infarction (STEM) patients were randomly divided into control group (n=64) and treatment group ( n=66 ).The patients of control group were given clopi-dogrel 300 mg, maintenance dose 75 mg qd.The patients of treatment group were given ticagrelor 180 mg, maintenance dose 90 mg bid.All the patients of two groups received selective PCI successfully after 8-10 d treatment.The change of thrombolysis in myocardial infarction ( TIMI ) flow grades after operation , left ventricular ejection fraction ( LVEF) and left ventricular end -diastolic dimension ( LVEDD ) , the incidence of no-reflow/slow flow and adverse drug reactions after operation were compared between two groups.Results After operation, the TIMI flow grades and LVEF in treatment group were significantly higher than those in control group ( P<0.01 ).After operation , the LVEDD in treatment group was lower than that in control group , with significant difference ( P<0.01 ).The incidences of no -reflow/slow flow in treatment group and control group were 3.03%and 14.06%respectively , there was statistically significant difference in two groups ( P<0.05 ).Only some minor bleeding events happened in the two groups , there was no statistically significant difference in two groups after operation 6 months ( P>0.05 ).Conclusion Ticagrelor could support better clinical efficacy than clopidogre in selective PCI after thrombolytic therapy for acute myocardial infarction , which has a stronger anti -platelet aggregation function without increasing the incidence of bleeding events.

Objective To explore a precise method with a microwave antenna for puncture of pulmonary nodules and analyze phenomena that affect the puncture results. Methods Clinical data of 107 cases with solitary malignant pulmonary nodules were collected, and the mean length of pulmonary nodules was 13.6±0.6 mm in CT axial position. A thread-hanging method was used to assist the puncture of pulmonary nodules. The procedure was successful when the needle was not withdrawn and inserted into the central region of the nodule. The success rate and complications of the pulmonary procedure were recorded. The incidence of the following phenomena were also documented: needle coercing, needle slipping, needle tip pushing, pulmonary nodule prolapsing, radial nodule deformation, nodular masking, and radial movement distance of needle tip. Results In all of 107 cases evaluated, the antenna puncture was successful in 101 cases (94.4%) but failed in 6 cases (5.6%). Pneumothorax and pulmonary hemorrhage occurred in 23 (21.5%) and 19 cases (17.8%), respectively. The following phenomena occurred: needle coercing in 9 cases (8.4%), needle slipping in 6 cases (5.6%), needle tip pushing in 19 cases (17.8%), pulmonary nodule prolapsing in 15 cases (14%), radial nodule deformation in 14 cases (13.1%), and nodular masking in 5 cases (4.7%). The mean radial adjusting distance of needle tip was 0.7±0.4 cm. Conclusion The thread-hanging method can assist in the accurate puncture of microwave antenna for pulmonary nodules. We should focus and deal with phenomena that may occur and affect the result of puncture.

Adolescent ; Apolipoproteins E ; blood ; Humans ; Hyperlipoproteinemias ; complications ; Hypolipidemic Agents ; therapeutic use ; Kidney Diseases ; blood ; drug therapy ; pathology ; Kidney Glomerulus ; blood supply ; pathology ; Male ; Thrombosis ; pathology