The article analyzes the problems of nurse-patient communication in nurse interns,and proposes the strategies of cultivating nurse-patient communication ability to reduce nurse-patient disputes and improve the overall quality of nursing students.

Objective To analyze the CT and MRI features of giant cell tumors of the skull. Methods 8 cases of giant cell tumors of the skull proven surgically and pathologically were analyzed retrospectively. CT and MRI(6 cases with post contrast CT and 5 cases with post contrast MRI scans)were performed in all cases. All tumors were excised surgically. Two weeks later,all patients undertook postoperative radiotherapy with the dosage of 4 500-6 000 cGy for five to six weeks. Results CT scan showed bone destruction and calcification. Most of the tumours were well defined with low signal intensities on T1 WI images, T2 WI images showed ununiformity signal. The low signal on T1 WI was still low signal intensity on T2 WI which suggested calcification. All patients had no distinctive change within the follow up period. Conclusion CT is able to clearly show bone destruction and calcification. MRI is superior to CT in demonstrating the outlines of the tumours. CT and MRI are effective methods in the diagnosis of the giant cell tumors. Surgery and postoperative radiotherapy are effective methods in the treatment of the giant cell tumors.

Objective To discuss MRI characteristics of dysplastic gangliocytoma of the cerebellum.Methods MRI manifesta-tions of 13 cases with dysplastic gangliocytoma of the cerebellum verified by operation and pathology were analyzed retrospectively. Results All of 13 cases were located in the cerebellar hemisphere and vermis.The lesions presented striated pattern of iso-intensity signal and hypo-intensity signal on T1-weighted images.The sign of tiger stripes was the feature in dysplastic gangliocytoma on T2-weighted and FLAIR images.All of the tumors showed slightly striated enhancement after intravenous administration of contrast agent.The mass effects of dysplastic gangliocytoma of the cerebellum along with the forth ventricle and brain stem oppressed were seen in all cases.NAA was mildly reduced on magnetic resonance spectroscopy (MRS)in 7 cases of dysplastic gangliocytoma of the cerebellum.Conclusion There are distinctive manifestations in MRI images for dysplastic gangliocytoma of the cerebellum,which has crucial diagnostic value before operation.

Objective To observe the effect of fluvastatin(Flu) on differentiation and induction of human promyelocytic leukemia HL-60 cells and provide the theoretical foundation for treatment of human promyelocytic leukemia.Methods The cultured HL-60 cells were treated with 20 ?mol?L-1 Flu,the morphological changes of the cell differentiation were examined.The NBT reduction capability was detected in HL-60 cells treated with Flu for 72 h.After HL-60 cells were treated with 20 ?mol?L-1 Flu for 5 d,they were stained with non-specific esterase and the percentage of differentiation cells was analyzed.Results The HL-60 cells treated with Flu showed smaller cell body,reducing proportion of nucleus to cytoplasm,the nucleus tortuosity,fold or sublobe.There were specific granules and vacuoles in cytoplasm,displaying that some cells had differentiated to relative mature cells.As compared with control group,the NBT reduction capability in HL-60 cells treated with Flu for 72 h was significantly higher than that in control cells(P

Objective To compare the clinical value of 18F-FDG PET imaging and 99Tcm-MDP whole body bone imaging in detection of bone metastases. Methods 43 patients were undergone 18F-FDG PET and 99Tcm-MDP imaging within 2 weeks. 28 of them were with confirmed bone metastases by other examinations or follow-up and the remaining 15 were confirmed without bone metastases. The results of the 2 different modalities were analyzed. Results Among 28 patients with confirmed bone metastases, PET and MDP accurately diagnosed 26 and 27, respectively. The sensitivity of them were 92.9 %(26/28), 96.4 %(27/28), Among the remaining 19 cases without bone metastases, PET and MDP correctly gave 14 and 8 negative results, respectively. The specificity of them were 93.3 %(14/15), 53.3 %(8/15), and accuracy of them were 93.0 %(40/43), 81.4 %(35/43). The differences between specificities and accuracies of the two methods were significant, while no significant difference between the sensitivities of the two methods. Conclusion For the detection of bone metastases in patients with malignant tumors, 18F-FDG PET showed a similar sensitivity but better specificity and accuracy compared with 99Tcm-MDP bone scan. For patients with suspected bone metastases, negative finding or single hot spot in 99Tcm-MDP imaging, 18F-FDG PET imaging was recommend as a further and complementary assessment of bone metastases.

ABSTRACT:Objective To explore cardiac function and myocardial collagen type I in diet-induced insulin-resistant rats and the effect of telmisartan on cardiac diastolic function in diet-induced insulin-resistant rats. Methods We randomized 27 Wistar rats into control group (n = 9 ),high-fat group (n = 9 ),and telmisartan treatment group (n = 9 ).At the end of the study,left ventricular end diastolic pressure (LVEDP)and left ventricular systolic pressure (LVSP)of the rats and ± dp/dt were detected by carotid artery intubation.Masson cardiac staining was used to observe cardiac fibrosis,and collagen volume fraction (CVF)was measured.ELISA method was used to detect the concentration of plasma PICP and ICTP.Results Compared with the control group,in high-fat group LVEDP was significantly higher and -dP/dtmax decreased significantly (P < 0.01 );the plasma PICP level and the ratio of PICP/ICTP were significantly increased (P <0.01),cardiac collagen volume
fraction was significantly higher (P <0.01).After 22 weeks’telmisartan intervention,compared with the high-fat group,LVEDP and LVSP were significantly decreased (P < 0.01 ),but -dP/dtmax significantly increased (P <0.05).The level of the plasma PICP and PICP/ICTP were significantly decreased (P < 0.05 );left ventricular myocardial tissue collagen volume fraction content was decreased (P <0.01).The correlation analysis showed that cardiac collagen volume fraction in insulin-resistant group was positively correlated with insulin resistance index but negatively correlated with -dp/dtmax (P < 0.01 ).Conclusion Insulin resistance promoted the synthesis of myocardial type I collagen,leading to increased myocardial collagen deposition and decreased cardiac diastolic function.Telmisartan may improve diastolic function partly by improving insulin resistance and reducing the deposition of myocardial collagen type I.

AIM: To compare the measurement of anterior chamber depth(ACD) inclusive of corneal thickness using intrao-cular lens(IOL) master and ultrasound biomicroscopy (UBM) and evaluate the repeatability of each method.METHODS: Two consecutive measurements of ACD were prospectively performed using IOL master and UBM in 60 eyes in 60 individuals. Mean values were compared using the paired t test. For each individual, ACD measure-ments was performed 5 times to estimate the repeatability of each method by a coefficient of variation(CV).RESULTS: The mean ACD was 2.95±0.25mm with the IOL master and 2.96±0.22mm with the UBM. This diffe-rence was not statistically significant (P=0.631).The coefficient of variation (CV) was 0.56%±0.26% and 0.65%± 0.36% in IOL master and UBM, respectively.CONCLUSION: The mean ACD of IOL master was the same as UBM. The repeatability of IOL master is better than UBM.

To assess the impact of the operational simulation training system on the cultivation of ophthalmic students.
●METHODS: Four hundred and eighty ophthalmic students in China Medical University from 2009 to 2011 were chosen as objects and divided into two groups at random. The students in the experimental group used operation simulation training system combined with traditional teaching methods, while the students in the control group only used traditional teaching methods. We examined the operation skills and the confidence of all the students half a year later.
●RESULTS: The improvement of the operation skills during the suture technique examination, and the confidence for operation technology were significantly different in two groups. The basic skills of the students in the examination groups improved apparently during the operational simulation training and they were full of confidence to their operational technique.
●CONCLUSlON: The operational simulation training is useful for promoting the clinical ability for ophthalmic students and should be widely popularized.

BackgroundRetinitis pigmentosa (RP) has the genetic and phenotype heterogeneity.To determine the disease-causing gene is a foundation of gene therapy.Objective This study was to localize the pathogenic gene and screen the gene mutation associated with Han Nationality autosomal dominant retinitis pigmentosa (ADRP) in a Chinese family.MethodsTwenty-one families enrolled this study,including 12 patients with ADRP and 9 individuals with normal phenotype.Perimetry,fundus examination,electrooculogram ( EOG ) and electroretinogram (ERG) were performed in 12 patients.Genetic linkage analysis was performed on the subjects in all known genetic loci related to ADRP with a panel of microsatellite markers.Subsequently,the mutation screening of rhodopsin gene was screened by direct DNA sequencing.This study was approved by Ethic Committee of Zhongnan Hospital of Wuhan University.Informed consent was obtained from each subject.ResultsThe fundus appearance of the proband was in accordance with the ADRP,and the EOG and ERG showed undetectable.Contractive visual field also was exhibited in the proband.Linkage analysis showed that the maximum logarithm of the odds(LOD) score reached 3.6671 at marker D3S1292 at recombination fraction θ =0.0.The results of direct DNA sequencing revealed a C→ G transversion mutation at codon 53 in exon 1 of rhodopsin gene,which resulted in a proline to arginine change (Pro53Arg) in 12 patients.However,no similar mutation was found in the unaffected members of this family.ConclusionsThe missence mutation Pro53Arg in rhodopsin gene cosegregate with the RP disease.It is determined to be a pathogenic factor of this ADRP family.

Objective To investigate pathogenic factors,clinical characteristics,pathological changes in 6 patients with localized or disseminated intestinal neuronal dysplasia(IND).Methods The clinical retrospective study was performed in 6 cases with localized and disseminated IND.Results In 6 patients,constipation and partial intestinal obstruction were the major symptoms.Preoperatively,dia-gnoses were revaluated as intestinal stenosis in 2 cases,long sigmoid in 2 cases and long-segment aganglionosis and total gastrointestinal IND in the rest 2 cases,respectively.Exploratory laparotomy was performed on all these patients.Pathological study suggested that 4 of them were localized IND,on whom enterectomy and intestinal anastomosis were performed successfully.However,2 cases of disseminated IND died postoperatively.Conclusions Disseminated IND may be caused by congenital factors,while localized IND by the acquired factors which including intestinal obstruction,local ischemia or inflammation.The surgical interventions are effective for localized IND,and intestine transplantation might be prospective treatment for disseminated IND.