The problems in nursing postgraduate training in China are summarized,which include the ambiguity of subject orientation,absence of unified standard on training objective,imperfection of tutor team,uncertainty of research direction,lack of scientific research funds,etc.The countermeasures are then proposed,and the direction of nursing postgraduate education reform in China is discussed.

Objective To investigate the relationship between the expression of estrogen receptor (ER),progesterone receptor(PR)and epidermal growth factor receptor(EGFR)in uterine leiomyoma and the recurrence after myomectomy.Methods Eighty cases underwent myomectomy were enrolled in this study.ER,PR and EGFR expression in uterine leiomyoma tissue and normal myometrium tissue were examined by immunohistochemical technique.All the patients were followed up regularly after myomectomy.Results The positive expression rate of ER,PR and EGFR in uterine leiomyoma tissue were significantly higher than those in normal myometrium tissue[88.8％(71/80)vs.48.8％(39/80),92.5％(74/80)vs.30.0％ (24/80),86.2％(69/80)vs.57.5％(46/80),P ＜ 0.05].The recurrence rates in ER,PR and EGFR positive expression patients were significantly higher than those in negative expression patients[42.3％(30/71)vs.22.2％(2/9),41.9％(31/74)vs.16.7％(1/6),42.0％(29/69)vs.27.3％(3/11),P ＜ 0.05].The recurrence times in ER,PR and EGFR positive expression patients were significantly shorter than those in negative expression patients(P ＜0.05).The expression of EGFR had positive correlation with ER and PR(r =0.837,0.702,P ＜ 0.05).Conclusions The recurrence of uterine leiomyoma may have correlation with high expression of ER,PR and EGFR in uterine leiomyoma.

Objective To investigate the clinical efficacy of Xi-Cleft point acupuncture plus surrounding electro- acupuncture in treating occipital neuralgia.Methods Forty-eight patients with occipital neuralgia were randomly allocated to treatment and control groups, 24 cases each. The treatment group received Xi-Cleft point acupuncture plus surrounding electroacupuncture and the control group, surrounding electroacupuncture alone. The VAS score was recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the VAS score in the two groups (P<0.05). There was a statistically significant post-treatment difference in the VAS score between the treatment and control groups (P<0.05). The total efficacy rate was 95.8% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Xi-Cleft point acupuncture plus surrounding electroacupuncture is an effective way to treat occipital neuralgia.

Objective To explore the effects of microstructure grinded on the labial face of porcelain fused to metal crown (PFM) in esthetic prosthesis for anterior teeth. Methods 193 patients with single maxillary incisor tooth defects were repaired with 2 crowns for each one. After the crowns being blent colour and molded, the crown A was not grinded particularly on the labial face and the crown B was done according to the records of the microstructure.The patients were allowed to choose the most satisfied one when 2 crowns were cemented temporarily. Results 36 patients chose the crown A and 157 chose B.The difference was significant ( P0.05). Conclusion The crown has great vitality and accordes with the esthetic standards of the patients by way of being grinded microstructure on the labial face.

Objective To investigate the influence of Trisialoganglioside-GTlb combined with Edaravone Injection on clinical effect and serum related indicators in patients with acute cerebral infarction.Methods A total of 126 cases of patients with acute cerebral infarction in our hospital from October 2010 to May 2016 were selected and divided into observation group and control group,63 cases in each group.Patients in the control group were treated with regular treatment and Edaravone Injection,and patients in the observation group were treated with regular treatment,Edaravone Injection and Trisialoganglioside-GTlb.The clinical effect,NIHSS scores,Barthel index scores,serum level of neuron specific enolase (NSE),S100β protein,superoxyde dismutase (SOD),advanced oxidation protein products (AOPP) and malondiadehyde (MDA) were compared.Results The total effective rate of the observation group (90.48％) was significantly higher than that of the control group (76.19％),the difference between the two groups was statistically significant (P ＜ 0.05).After two weeks of treatment,two groups of NIHSS and Barthel index scores were significantly lower than before treatment,the difference was statistically significant (P ＜ 0.05);and the NIHSS and Barthel index scores of observation group were significantly lower than that of control group,the difference was statistically significant (P ＜ 0.05).NIHSS scores,Barthel index scores of the observation group were significantly better than that of the control group (P ＜ 0.05);The serum level of NSE,S100,AOPP,MDA of two groups after treatment were significantly lower than that before treatment,the difference was statistically significant (P ＜ 0.05);and the above indexes of the observation group was significantly lower than the control group,the difference was statistically significant (P ＜ 0.05);SOD levels of two groups were significantly increased than before treatment,the difference was statistically significant (P ＜ 0.05);and the SOD levels of observation group was significantly higher than that of control group,the difference was statistically significant (P ＜ 0.05).Conclusion Trisialoganglioside-GT1b can synergy improve the clinical effect of Edaravone Injection in patients with acute cerebral infarction,and be good to recovery the neurologic function and ability of daily living,and these may be related to the change of the serum level of NSE,S100β protein,SOD,AOPP and MDA.

Objective To investigate the effect of calpeptin on diaphragmatic injury and atrophy under controlled mechanical ventilation in rats.Methods A total of 24 SPF Sprague-Dawley (SD) rats were randomly divided into anesthetized control group (CON group),24-hour controlled mechanical ventilation group (CMV group),and 24-hour CMV + treatment with calpeptin group (CMVC group),with 8 rats in each group.Animals in the CON group received an intraperitoneal injection of pentobarbital sodium without CMV and continuous infusion of pentobarbital sodium.A small-animal ventilator was used for 24 hours in rats of CMV group.Rats of CMVC were treated with a specific calpain inhibitor calpeptin (4 mg/kg).The drug was injected subcutaneously 2 hours before and 8,15 and 23 hours after mechanical ventilation.Changes in diaphragm ultrastructure,light microscopic picture,and myosin heavy chain (MHC) expression were observed.Results ① Alignment of myofilaments and normal Z-band,and the shape of mitochondria were maintained in CON group as revealed by electron microscope.The signs of misalignment of myofibrils,disruption of Z-band and vacuolar mitochondria were found in CMV group,and they were obviously improved in CMVC group.The density of muscle injury (× 10-2/μm2) in CMV group was significantly higher than that in control group (36.8 ± 13.7 vs.6.4 ± 6.3,t=6.373,P=0.001),and that in CMVC group was significantly lowered (17.6 ± 9.1 vs.36.8 ± 13.7,t=3.694,P=0.002).② In CON group,the diaphragm fibers appeared regular in cross section without pathologic change under light microscopy.Fuzzy muscle striations,irregular muscle fibers,centralized nuclei and swelling of capillary endothelial cells were observed in CMV group,while pathological changes in the CMVC group were milder significantly.③ In CMV group,the density of MHCslow and MHCfast was lower compared with that of CON group,and the gray value was lowered by 61.1％ (t=8.138,P=0.001) and 77.1％ (t=8.844,P=0.001),respectively,especially in MHCfast.However,the gray values of MHCslow and MHCfast were increased by 1.51 folds (t=4.601,P=0.010),and 1.33 folds (t=2.859,P=0.011),respectively,after treatment with calpeptin,and the elevation was more significantly in MHCslow.Conclusions Diaphragmatic injury and atrophy were found after CMV for 24 hour.Calpeptin could reverse the detrimental effects of CMV,and it suggested that calpain plays an important role in modulating the ventilator-induced dysfunction of the diaphragm.

Objective To evaluate the effect of ecoimmunonutrition on systemic inflammatory response in swine with acute necrotizing pancreatitis (ANP). Methods Swine model of ANP was induced by retrograde injection of 5% sodium taurocholate and trypsin into the pancreatic duct. 24h after the ANP models were established, eighteen swine were randomly divided into total parenteral nutrition (PN) group (n = 6), enteral nutrition (EN) group (n = 6), and ecoimmunonutrition (E1N) group (n = 6). Each of the three nutrition formulas was given to each group respectively for eight days. The level of plasma endotoxin and serum concentrations of TNF-α, IL-1β, IL-6 and IL-10 were measured before, 24 h after the induction of ANP and 1,2, 4, 8 d after nutrition support. Results 24 hours after the ANP models were established, the serum level of plasma endotoxin, TNF-α, IL-1β, IL-6 and IL-10, NF-κB activities in EIN group were ( 1.85 ± 0.18) EU/L,(461.59 ± 128.25 ) pg/ml, ( 185.49 ± 58.81 ) pg/ml, ( 354.26 ± 34.63 ) pg/ml, ( 110.32 s 25. 18 ) pg/ml,(51.06 ± 2.27 )%, respectively, which all were significantly higher than those before the ANP models were established, but there were no difference among three groups. Eight days after nutrition support, those levels in EIN group were (1.48 ±0.16 )EU/L, (30.11 ±9.12)pg/ml, (20.17 ±7.04)pg/ml, (36.42 ±7.24) pg/ml and ( 89.46 ± 13.54 ) pg/ml, (9.06 ± 0. 17 ) %, respectively, which all were significantly lower than those of TPN and EEN group ( P ＜ 0. 05 ). The ration of IL-10/IL-6 was 2.51 ± 0.42 in EIN group, and 2.28 ± 0. 19 before the ANP models were established. Conclusions EIN could attenuate endotoxemia, decrease NF-κB activities and serum concentrations of cytokines and maintained the balance of pro- and anti-inflammation.

Objective To evaluate the influence of aging on left ventricular systolic and diastolic function by quantitative tissue velocity image(QTVI) and B-type natriuretic peptide (BNP). Methods Sixty healthy participants aged from 36 to 82 years old were divided into age <60 years group (32 cases) and age≥60 years old group (28 cases). Compared traditional echocardiography,QTVI and BNP between the two groups, and analysised the correlation between age and the abovementioned measurements. Results Compared age ≥60 years group with age <60 years group, the ratio of early to late mitral annulus flow velocity(E/A) (0. 92 ±0. 18 vs. 1. 28 ± 0. 18), mean of systolic mitral annulus velocity (Sm) ([6. 04 ± 0.77] cm/s vs.[6. 89 ± 1. 03] cm/s) ,mean of early diastolic mitral annulus velocity (Em) ([5. 67 ±0.99]cm/s vs. [7.29 ± 1. 11]cm/s),the ratio of Em to Am(Em/Am) (0. 79 ± 0. 13 vs. 1.18 ± 0. 33) were significantly decreased (t =5. 396,2.478,4.075,3. 535, respectively, Ps < 0. 05), whereas mean of late diastolic mitral annulus velocity (Am) ([7. 67 ±0. 80]cm/s vs. [6. 80 ± 1. 16] cm/s),the ratio of E to Em(E/Em) (14. 83 ±4.43 vs. 10. 68 ±2. 85), BNP ([51. 25 ± 12. 21] ng/L vs. [14. 15 ± 6. 68] ng/L) were significantly increased (t =-2. 268,-2.995 and-3. 523, Ps < 0.05) . Age was negatively correlated with Sm, Em, Em/Am, E/A (r =-0.411,-0. 631,-0.622,-0. 614,Ps<0.05),and age was positively correlated with Am,E/Em and BNP (r = 0.481,0.614 and 0. 684,Ps <0. 05). Conclusion Left ventricular systolic and diastolic function decreased with aging. QTVI and BNP could evaluate left ventricular function sensitively and easily.

Objective To investigate the structural response of diaphragm and soleus of the rat after mechanical ventilation (MV), and to explore the specific mechanism of the dysfunction of both muscles.Methods Sixteen male Sprague-Dawley (SD) rats were randomly divided into control group and MV group, with 8 rats in each group. Rats in MV group were treated with controlled ventilation and maintained anesthesia, and those in control group were only anesthetized without MV and maintained anesthesia. The diaphragm and soleus were harvested after MV for 18 hours, and the morphology changes were observed with light microscope. The cross section of muscle fiber was observed by immunofluorescence technique analysis, and the cross-sectional area of muscle fiber was calculated. The ultra structural changes in muscle fibers were observed under transmission electron microscope.Results ① Observed under light microscope, the cross section of the diaphragm and soleus muscle in the control group was regular, the nucleus was normal and the cytoplasm was homogeneous. The fibers in the diaphragm-biopsy specimens from MV subjects were smaller than those from control subjects, whereas these signs were not found in soleus. But fiber atrophy in MV specimens was not accompanied by an inflammatory-cell infiltrate. ② Under the fluorescence microscope, the control group had a smaller cross-section of the slow-twitch muscle in diaphragm, while the fast-twitch muscle fibers werelarger. As compared with diaphragm-biopsy specimens from control, specimens from MV subjects showed decreased cross-sectional areas of slow-twitch and fast-twitch fibers, respectively (μm2: 1069.00±155.24 vs. 1297.12±331.15, 2279.66±442.31 vs. 3031.80±596.11, bothP < 0.05). The disproportionate decrease in fast-twitch fibers cross-sectional areas [(70.42±3.61)% vs. (75.63±2.48)%] resulted inan increase in the percentage of total area occupied by the slow-twitch fibers [(29.58±3.61)% vs. (24.35±2.48)%, bothP < 0.01]. There were no significant differences in cross-sectional areas of slow-twitch and fast-twitch fibers in soleus between control group and MV group (μm2: 3193.80±559.36 vs. 3008.84±559.22, 3392.86±514.56 vs. 3594.35±651.67, bothP > 0.05). ③ In the control group, the muscle fibers of the diaphragm and soleus were arranged orderly, the boundary of the light and dark bands and the Z-line were clear, and there was no autophagy in the visual field. The outer membrane of the mitochondria was complete, and the cristae were in the shape of clapboard. The signs of misalignment of myofibrils, disruption of Z-line and vacuolar mitochondria were found in diaphragm from MV group, whereas these signs were not found in soleus. Diaphragm from MV group exhibited an increase in autophagic vesicles visualized by transmission electron microscopy as compared with control group.Conclusions Controlled MV for 18 hours resulted in diaphragmatic inactivity and promoted muscle injury and atrophy, while autophagy and mitochondrial dysfunction were enhanced. Soleus immobilization for 18 hours was not associated with muscle atrophy. These facts suggest that the signaling associated with diaphragm atrophy during MV may involve different mechanisms compared with other models of muscle atrophy. Diaphragm appeared to be more susceptible to MV.

Objective To analyze the treatment of chemotherapy?failed advanced lung adenocarcinoma cases and the adverse reactions with apatinib. Method Twenty?two patients received treatment of apatinib at a dose of 425 mg/day for two weeks,then at a dose of 675 mg/day for two weeks if could be tolerated. The efficacy was evaluated by the imaging,CEA and NSE. Results The clinical evaluation of patients were complete remis?sion( CR) 0 case,partial remission( PR) 5 cases,steady( SD) 13 cases,progress( PD) 3 cases,1 case termina?ted the treatment due to adverse reactions,and the objective response rate was 23. 8%(5/21),disease control rate was 85. 7%(18/21). After 4 weeks treatment,CEA and NSE were significantly reduced than the previous ((97. 45±79. 05) mg/L vs. (47. 05±31. 89) mg/L,(20. 27±6. 88) mg/L vs. (11. 09±8. 92) mg/L;t=2. 45, 3. 56;P<0. 05) . The impacts on prognosis of different metastatic sites were no statistical significant difference( P>0. 05) . The main side effects were hypertension and proteinuria( 72. 7%,59. 0%) . Conclusion The treatment of chemotherapy?failed advanced lung adenocarcinoma with apatinib has better exact effect,and toxicity could be controlled,so it was worthy of clinical treatment and evaluation of long?term efficacy.