Objective To observe and investigate the effects of the case-based learning assisted with WeChat software in the teaching of nursing constitution regulating theory. Method The two classes of nursing undergraduate Grade 2013 were randomized into the case-based learning (CBL) group and the traditional teaching group (LBL). WeChat group combined with CBL group made preparation before class, including teachers writing the cases and thinking questions, WeChat sending teaching information, students discussing problems in group and collecting information. In class, students gave presentation and made speech, and the teachers made comments, did summary and gave scores to students' performance. In LBL group teacher prepared a lesson, and taught lessens assisted by multimedia PPT. After class, we used the test of nursing constitution regulating and teaching effect questionnaire to compare the differences between the two groups, using SPSS 21.0 for data statistics, and t test for measurement data. Results The single choice score, multiple choice score and the total score of the test of nursing constitution regulating in the CBL group were (52.46±4.35), (33.42±3.11), and (85.88±5.72), higher than the LBL group which were (47.63±5.84), (29.88±4.55), and (77.50±7.88). The difference was statistically significant. Scores of self-study ability, interest in learning, literature retrieval ability, communication and cooperation ability, TCM differentiation and the examination scores in CBL group were significantly higher than that in LBL group. Conclusion The case-based learning assisted with WeChat software can inspire the interest of learning, cultivate the self-study ability and practice the ability of TCM differentiation. It is worthy of being generalized.

AIM: To observe the effects of Cidan Capsule and Shenyi Capsule(ginsenoside Rg_3) with intraarterial therapy for advanced primary liver cancer. METHODS: Sixty cases with advanced primary liver cancer patients were randomly divided into two groups,30 cases of the treatment groups were treated with Cidan Capsule and Shenyi Capsule with intraarterial therapy,30 cases of the controls were only treated with intraarterial therapy.(RESULTS:)(1) The two groups(CR + PR) efficiency were 70%(21/30) and 33.3%(10/30) respectively.The statistical analysis was significantly different(P

Objective To explore the changes of glutathione and nicotinamide adenine dinucleotide phosphate levels and their significances among elderly patients with acute myocardial infarction,elderly patients with angina pectoris and elderly people with normal coronary artery.Methods Totally 64 elderly patients with acute myocardial infarction were selected according to the clinical manifestation,electrocardiogram and myocardial markers.68 elderly patients with angina pectoris and 66 subjects with normal coronary artery (control group) were enrolled according to the coronary artery radiography.Peripheral venous blood in all subjects were taken and plasma glutathione (reduced form GSH and oxidized form GSSG) and nicotinamide adenine dinucleotide phosphate (reduced form NADPH and oxidized form NADP+) were measured.The GSH/GSSG ratio and NADPH/NADP+ redox potentials were calculated according to Nernst equation.Results Compared with control group,GSH level in acute myocardial infarction group and angina pectoris group significantly increased(4.04 ± 0.77 μmol/L,5.89 ± 0.85 μmol/L,7.55 ± 0.93 μmol/L; P＜0.05 or 0.01),GSSG decreased(0.70±0.05 μmol/L,0.61±0.04 μmol/L,0.53±0.03 μmol/L;P＜0.05 or 0.01),GSH/GSSG ratio increased(5.18±1.06,9.76±1.67,12.80±1.93; P＜0.05 or 0.01).The GSH/GSSG redox potentials decreased(-123.49 ± 1.18 mV,-126.21 ± 1.01mV,-128.71 ±1.29 mV;P＜0.05 or 0.01).Compared with control group,NADPH in acute myocardial infarction group increased(5.72 ± 0.44 nmol/L,6.83± 0.55 nmol/L ; P＜0.05),NADPH/NADP ratio increased (2.29±0.10,2.58±0.26,P＜0.05),the NADPH/NADP+ redox potentials significantly decreased (-306.3±2.44 mV,-312.1±2.53 mV; P＜0.05).Conclusions The imbalance of plasma redox status migrating to oxidization may have close relationships with atheromatous plaque formation,plaque rupture and thrombosis.

Objective To investigate the relationship among the average checking time of biochemistry results ,mental health of biochemistry results checkers and the rate of medical complains .Methods 258 biochemistry results checkers from 17 hospitals of Guangdong were tested by using symptom checklist(SCL‐90) ,biochemistry results checking time questionnaire and medical com‐plaints questionnaire .Results Compared with the national model data ,the mental health levels of biochemistry results checkers were worse relatively .The mental heath did not have gender difference ,however ,female checkers were significant worse than males in horror .The mental heath didn′t have gender difference between secondary and advanced technicians .However ,the junior techni‐cians were significant worse than technicians of other levels in obsession ,somatization ,anxiety ,depression and horror .The average checking time of biochemistry results was correlated with mental health of biochemistry results checkers .The average checking time of biochemistry results had relationship with the rate of medical complains .Conclusion The mental health conditions of biochemis‐try results checkers are bad .No mental health difference exists in gender .The junior technicians′mental heath are significant worse than secondary and advanced technicians .There are some relationships between the average checking time of biochemistry results , mental health of biochemistry results checkers and the rate of medical complains .

Objective To study the imaging features of sacroiliac joints(SIJ) in patients who were misdiagnosed as spondyloarthritis(SpA).Methods A total of 34 patients with chief complaint of back pain and misdiagnosed as SpA from January 2007 to April 2013 in Department of Rheumatology Chinese PLA General Hospital were enrolled.The imaging,clinical manifestations,laboratory examinations data were analyzed.Result The main reason for misdiagnosis as SpA was because of sacroiliitis presenting on imaging.The final diagnoses included 24 patients as SIJ infection,4 patients as neoplastic diseases,2 patients as metabolic bone diseases,2 patients as sacroiliac joint degeneration,1 patient as gout of sacroiliac joint,1 patient as diffuse idiopathic bone hypertrophy.For patients with infection,there were 10 patients receiving X-ray and 22 patients receiving CT of SIJ.However,5 and 7 patients had negative results respectively.These patients with infection had abnormalities in MRI including all with bone marrow edema,21 patients with erosion of bone and joint,22 patients with muscle involved.As to the patients with malignancies,SIJ CT scan appeared normal.Bone marrow edema and erosion in MRI were found in all neoplasm patients expect one as ependymoma.Adjacent muscles were involved in the patient with Ewing's sarcoma.Either X-ray or CT in other patients demonstrated obvious abnormalities,but only mild erosion of bone was found in MRI.Conclusion Bone marrow edema of SIJ in MRI represented not only in patients with SpA.Rheumatologists should analyze the clinical manifestations and laboratory examinations comprehensively in order to avoid the misdiagnoses.

Objective To evaluate the therapeutic efficacy of gamma knife in treatment of primary trigeminal neuralgia Methods Retrospectively analysis of 120 cases with primary trigeminal neuralgia treated by gamma knife in our department From Jan. 2003 to Mar. 2008 were performed. All cases were treated with the 4 mm collimator and targeted at the proximal nerve at the root entry zone located by MRI. The target dose varied from 80 -90 Gy. Results After a follow-up of 20. 0 ±4. 5 months, complete relief of pain occurred in 69 patients (57. 5%), 50% -90% relief in 34 (28. 3%), relief less than 50% in 12(10.0%) but no relief in 5(4.2 %).The efficient rate was 95. 8% . The common complications include numbness, absence of corneal reflex. 83 patients (69. 2%) experienced temporal facial numbness and 14 patients (11. 7%) reported continuous numbness after treatment of the gamma knife. Conclusions Gamma knife radiosurgery is a minimally invasive technique for the treatment of primary trigeminal neuralgia with few complications.

Objective To investigate the present situation of nursing professional environments in our hospital and provide theoretical basis for mapping out relevant countermeasures. Method A questionnaire survey was conducted among 338 nurses in our hospital by using the general information questionnaire and practice environment scale (PES). Result The dimensions of PES by their average scores in descending sequence included leadership and ability of nurse administers, doctor-nurse cooperation, foundation for high quality care nurses′participation in hospital affairs, and sufficient manpower and resources. Conclusion In order to provide good and healthy work environment for nurses, nursing administrators should provide enough nursing manpower resoures and apply excitation mechanism in their hospital.

ObjectiveTo study the water/fat ratio of patients with pancreatic ductal adenocarcinoma (PDAC) and mass-forming focal chronic pancreatitis (MFP),and to provided guide for the clinicians.MethodsThirteen patients with PDAC,8 patients with MFP and 20 healthy volunteers were scanned by GE 3.0T MR IDEAL sequence.The signal strength of outcome images was measured; the water/fat ratio analysis was performed.Two kinds of formula were applied,the first was WF1 =SW/SF,the second was WF2 =( SIP + SOP) / ( SIP - SOP).SW was the signal strength of water,SF was the signal strength of fat,and SIP was the signal strength of in-phase,while SOP was the signal strength of opposite phase.ResultsBy using the WF1 formula,the water/fat ratio of normal pancreas,PDAC,MFP was 7.97 ±0.95,9.94 ±1.19,5.08 ±0.49,respectively.By using the WF2 formula,the water/fat ratio of normal pancreas,PDAC,MFP was 11.51 ± 1.62,13.87 ±1.84,5.73 ±0.65,respectively.The difference among the three groups was statistically significant (P ＜ 0.05 ) under the same formula.The value of WF2 was higher than that of WF1,the difference in PDAC groups was also statistically significant ( P ＜0.05 ).ConclusionsThe water/fat ratio of pancreas among PDAC,MFP and normal pancreas is different.PDAC has the highest water/fat ratio,followed by the normal pancreas; MFP has the lowest ratio.

In recent years, Shenyi Capsule has been proven to have certain anti-angiogenic effects, and to be effective to many cancers, but its effects on advanced esophageal cancer are scarcely studied.

Objective To investigate the quinolone resistance determinants in ciprofloxacin-resistant Acinetobacter bau-mannii (ABA)clinical isolates.Methods One hundred and fourteen ciprofloxacin-resistant ABA strains were collected from six Chinese hospitals .The quinolone resistance determining region ( QRDR) of 4 target genes ( gyrA, gyrB, parC and parE) was amplified , sequenced and compared with the reference genome of ATCC 17978 to identify possible resistance-related mutations.Nine plasmid-mediated quinolone resistance (PMQR) genes (qnrA, qnrB, qnrC, qnrD, qnrS, qepA, aac(6′)-Ⅰb-cr, oqxA and oqxB) were also amplified, and the amplicons were then sequenced to determine their character-istics.Results Almost all isolates (113/114, 99.1%) harbored a substitution in codon 83 of gyrA gene, leading to a Ser83Leu mutation.Meanwhile,58.8%(67/114) of the isolates possessed dual mutations of GyrA-Ser83Leu and GyrA-Ser80Leu, which were known determinants for ciprofloxacin resistance .There were also multiple non-synonymous substitu-tions in gyrB, leading to Arg393Ser, Arg393Cys, Thr401Ala, Pro406Ser, Val430Phe, Cys440Ser and Gly480Arg muta-tions with prevalence rates of 95.6%, 0.9%, 96.5%, 96.5%, 100%, 96.5%and 96.5%,respectively.For parE, all the seven mutations were synonymous and found in more than 96%of the tested isolates.For PMQR genes, although 83.3%(95/114) of the isolates were positive for aac(6′)-Ⅰb, nocrmutations were identified.None of the other eight PMDR genes were found in our strain collection .Conclusion Although multiple mutations are identified in gyrB and parE, these mutations might be the characteristic SNP markers for specific clones , unlikely linked to quinolone resistance .No PMQR is found in the tested isolates.Mutations in chromosomal QRDR (GyrA-Ser83Leu and ParC-Ser80Leu) are the main determi-nants of ciprofloxacin resistance in our ABA collection .