Objective To understand and explore the lived study feeling and experience of nursing undergraduate students during high- fidelity simulation training so as to provide the evidence of reforming teaching methods and performing the teaching practice of nursing educators. Methods Phenomenological study of qualitative research was used. In- depth interviews were conducted among 4 focus groups. 28 nursing undergraduate students were interviewed to understand their lived study feeling. Results 5 themes were emerged using Colaizzi's phenomenologic method, including cooperating explicitly, integrating theory with practice closely, promoting disease observation ability and nursing decision making, enhancing self-confidence. Conclusions High- fidelity simulation training was beneficial to integrate theory with practice, cultivate students' comprehensive ability and increase clinical practical opportunities.

AIM:To observe the effects of Sini decoction against pulmonary injury induced by ex vivo ischemia-reperfusion in rats. METHODS: The model of ischemia-reperfusion was established. Twenty-four Sprague-Dawley rats were randomly divided into Sham, I/R, and SND groups. Wet to dry lung weight ratio (W/D), mean pulmonary artery pressure (MPAP), SOD activity and MDA contents in pulmonary perfusate and tissue, NOS activity and NO contents in pulmonary tissue were detected. The pathologic changes in pulmonary tissue were also observed by light microscope. RESULTS: The morphological changes of pulmonary injury were alleviated in SND group. Wet/dry ratio, MPAP and MDA contents in pulmonary perfusate and tissue were significantly lower in SND group after ischemic/reperfusion. SOD activity in pulmonary perfusate and tissue, and NO contents in pulmonary tissue were significantly higher in SND group than those in I/R group. No significant difference in NOS activity in pulmonary tissue among three groups was observed. CONCLUSION: These results indicate that SND may have a protective effect on ischemia-reperfusion injured lung by its antioxidant activity and by adjusting NO level.

Objective To study the effect of IGF-1 gene therapy and electric stimulation therapy on the rat models of postpartum stress urinary incontinence, and explore the ideal treatment for this disease.Methods 240 SD female rats were used to establish the model of postpartum stress urinary incontinence by water sac vaginal dilation.148 model rats were randomly selected from 185 successful models and divided into 5 groups:IGF-1 gene therapy, clenbuterol treatment, electric stimulation therapy, injection of empty vector plasmid, and untreated groups.Besides, 20 non-modeled rats were used as blank control group.Urodynamic test was performed, pelvic floor pubococcygeus muscle/muscle weight ratio was calculated, and serum biochemical indices (LDH, CK) were detected, and the morphological changes of pubococcygeus muscle fibers were observed by light microscopy at 1, 21, 42 and 63 days after treatment.Results At 21 days after treat-ment, the maximum bladder capacity, leak point pressure, the contractile force/muscle weight ratio in the IGF-1 group and electric stimulation treatment group were significantly better (P>0.05), and the differences between the IGF-1 group and electric stimulation group were not significant ( P>0.05 ) .Conclusions The effect of IGF-1 gene therapy and electric stimulation on the rat models of postpartum stress urinary incontinence is better than that in the drug therapy group and oth-er groups.

Objective To explore the indications and attention points in one-stage thyroidectomy and bilateral neck dissection for thyroid carcinoma.Methods The clinical and pathological data of 68 thyroid carcinoma patients treated with one-stage thyroidectomy and bilateral neck dissection from Jan 1990 to Dec 2005 were reviewed retrospectively.Results There was no operative death in this series.Of the 68 patients,60 had bilateral and 4 had unilateral positive lymph nodes;4 had negative lymph nodes.The metastatic rate of patients who had unilateral thyroid cancer with contralateral cervical enlarged lymph nodes,bilateral thyroid cancer with unilateral cervical lymph nodes and isthmus cancer with lymph nodes was 100%(7/7),90%(9/10) and 66.67%(4/6) respectively.Postoperative complications include 7 cases of facial and flap edema,2 headache,5 postoperative hoarseness,7 temporary hypoparathyroidism,1 permanent hypoparathyroidism,1 left chylus fistula,and 3 unilateral accessory nerve injury.Conclusions The patients with unilateral thyroid cancer and enlarged contralateral neck lymph nodes,with bilateral thyroid cancer and unilateral cervical lymph nodes,and with isthmus cancer and enlarged lymph nodes are high-risk patient of bilateral neck metastasis,and should be treated with one stage thyroidectomy and bilateral cervical lymph node dissection.The procedure is safe,no serious postoperative complications occurred,and the survival rate and life quality can be improved.

Humans ; Osteonecrosis ; complications ; diagnosis ; Otitis Externa ; complications ; diagnosis ; Temporomandibular Joint ; pathology

Objective To explore the effects of traditional Chinese medicinal herbs (TCMHs) on the expression of tyrosinase gene, melanogenesis and proliferation of melanocytes and elucidate the mechanism of TCMHs in promoting melanogenesis. Methods Seven TCMHs including Herba Ecliptae, Spica Prunellae, Caulis Spatholob, etc, which were known to be effective in activating tyrosinase in vivo, were selected. Brownish guinea pigs were selected as the experimental model. The mRNA in situ hybridization (ISH), Schmorl-staining and dopa-oxygenase staining were performed to observe the effects of TCMHs on gene expression of tyrosinase, melanogenesis and melanocyte proliferation. Results The mRNA ISH showed that these seven drugs, especially Herba Ecliptae,Spica Prunellae and Tribulus terrestris could significantly increase the number of positive cells and the intensity of hybridization signal in the treated group as compared with that in the control group (P 0.1). Conclusions These results suggested that these 7 TCMHs including Herba Ecliptae can upregulate the gene expression of tyrosinase, enhance the melanogenesis and promote the proliferation of melanocytes.

Objective To investigate the dynamic expression of the drug resistance protein P-glycoprotein (P-gp) within 72 hours in the pentylenetetrazol (PTZ)-induced status epilepticus (SE) model, and to identify the optimal detection time to inhibit P-gp. Methods mRNA and protein expressions of P-gp in rats hippocampal tissue were detected by using immunohistochemistry , RT-qPCR and Western blot at different time points after modeling (0, 3, 6, 12, 24, 48, 72 h). Results The mean density of P-gp protein in the hippocampus of status epilepticus model was 0.325 1 ± 0.008 2 at 24 h, and was 0.396 3 ± 0.016 8 at 48 h, which were consistently higher than those of the control group (P < 0.05, P < 0.01, respectively). Results of qRT-PCR showed that MDR1a expression was significantly upregulated at 24 h and at 48 h (P < 0.05, P < 0.01, respectively). Western blot assay revealed that P-gp protein was also significantly increased at 48 h after seizures (P < 0.05). Conclusions The upregulation of P-gp after SE peaked at 48 h, which maybe the optimal detection time to detect drug resistant after SE.

Objective To apply Canadian Occupational Performance Measure (COPM) on the patients injured in Sichuan Earthquake. Methods COPM was applied to evaluate 51 patients in hospital before and 1 months after treatment. The first evaluation confirmed the problems on occupational activities for them. Then the plan was made to solve the problems. The second evaluation was to assess the effect of the treatment.Results The problem of self-care activity is more than that of productive activities and leisure activities(P<0.01). Total scores of performance of occupational activity and satisfaction improved(P<0.01, P<0.01)Conclusion COPM is helpful to confirm the problems of occupational activities and contribute to develope the primary goals for rehabilitation and treatment programs.

Objective To investigate clinical significance and application of modified pelvic floor reconstruction developed by Peking Union Medical College Hospital ( MPFR ) in treatment of severe pelvic organ prolapse (POP) by comparing the effectiveness, quality of postoperative sexual life, life satisfaction and risk factors for POP recurrence with the following two surgical procedures: traditional total vaginal hysterectomy with anterior-posterior colporrhaphy (TVH-APC) and total vaginal hysterectomy with lateral colporrhaphy and sacrospinous ligament fixation and vaginal bridge repair and episiotomy (TVH-LC-SSLFVBR-EP). Methods Totally 173 patients with severe POP and at least two compartments defects of pelvic floor underwent surgeries in the study, 86 patients (group A) were treated by MPFR with polypropylene mesh application, 58 (group B) were treated by TVH-APC, and 29 patients (group C) were treated by TVH-LC-SSLF-VBR-EP. Peri-operative data and outcomes of postoperative courses at 6, 12, 18 months were collected and analyzed, in the meantime, the risk factors of recurrence were studied. Results (1) No statistical difference was observed among the above 3 groups in terms of length of operation, amount of blood loss, length of hospital stay, and morbidity after surgery ( P ＞ 0.05). ( 2 ) Cost hospitalization was ( 11 448 ±3049) Yuan in group A, which was significantly higher than (7262 ± 1607) Yuan in group B and (7140 ± 1817 ) Yuan in group C (P ＜ 0.05 ). (3) The length of vaginal cuff of (7.5 ± 1.4) cm in group A and ( 5.6 ± 1.1 ) cm in group C were significantly longer than (7.1±0.6) cm in group B ( P＜0.05). The width of vaginal cuff of (4.3±0.3) cm in group A was larger than (3.4±0.3) cm in group B and (3.3±0.4) cm in group C (P＜0.05). (4) The recurrence rate at 12 months after surgery was 12.8% (11/86)in group A, which was similar with 17.2%(5/29) in group C (P＞0.05) and significantly less than 36.2% (21/58) in group B (P＜0.05). The rate of active sexual life of 16.3% (14/86) in group A was significantly higher than 1.7% (1/58) in group B and 0 in group C ( P ＜ 0. 05 ). The index of life quality improvement at 12 months after surgery was 48±12 in group A, which was no less than 53±16 in group C ( P＞0.05) and higher than 27 ± 9 in group B ( P＜0.05). (5 ) Mesh rejection was observed in 6 patients in group A within 3 months after surgery, while the posterior vaginal wall was exclusively involved. No difference was found in urinary retention or urinary incontinence among three groups (P ＞0. 05 ). (6) The severe degree of POP, type of surgical procedure ( TVT-APC), anterior compartment defect of pelvic floor,and early days of performing pelvic floor reconstruction surgeries were high risk factors for POP recurrence (P＜ 0.05). Conclusions MPFR has a better curative effect and lower recurrence rate on patients with POP. It can help patients regain integrity of anatomical structure and functions of pelvic floor. TVH-LCSSLF-VBR-EP is also effective.

AIM: To probe into the anti-epilepsy action of artificial Calculus Bovis,by observing its effect on the behavioral of the experimental epileptic rats,neuron loss in the hippocampus and hilus,and GAD positive cell alteration in the hippocampus.METHODS: SD rats were divided into three groups: group A(artificial Calculus Bovis treatment group);group B(acute epilepsy group) and group C(control group).A model of acute epilepsy rats was established by PTZ.The rat's behavioral alteration was observed by the Racine' scale.The neurons in the hippocampus and hilus were calculated by Nissl staining.The GAD positive cells were observed by immunohistochemical staining.RESULTS: The latency of the first seizure in group A was longer than that in group B,while the seizure times in group A was less than that in group B.Besides,in group A,both the neuron loss amount in the hippocampus and hilus and the GAD positive cell loss amount in the hippocampus were less than those in group B.CONCLUSION: The artificial Calculus Bovis prolonged the latency of the first seizure time,decreased the frequency of seizure,and prevented the neuron loss and protected the GAD positive cells.