Objective To investigate the effect of applying scenario simulation practice in the professional ICU nursing students' emergency and intensive care intensified skill training before internship.Methods Totally 120 professional ICU nursing students from grade 2010 and 2011 were enrolled.Control group included 60 students from grade 2010 and experimental group included 60 students from grade 2011.Studnets in control group accepted standardized routine training while those in experimental group accepted scenario simulation practice.All students participated in skill examination after training.Two questionnaires were designed to survey nursing students and clinical teachers respectively at one month after internship.One questionnaire was to evaluate students' attitude to the training and the other one was to survey clinical teachers' evaluation of students' abilities.T test was used to statistically analyze skill examination performance and questionnaire scores between two groups.Results Skill examination performance of experimental group was better than that of control group (P＜0.01).Effects of intensified training were better in experimental group than in control group (P＜0.05,P＜0.01) including the aspects of combining theory and practice,shortening internship role transition time,enhancing selfconfidence of clinical practice and relieving tension anxiety before practice,etc.Clinical teachers thought that the experimental group's analysis ability,strain capacity,operation ability,communication ability,team cooperation ability and actively acquiring knowledge ability were stronger than those of control group (P ＜ 0.01).Conclusions Scenario simulation practice is helpful to improve operation ability and comprehensive ability.Nursing students can adapt to the clinical work better.Findings may be beneficial to the improve-ment of teachers' professional level.

Objective To investigate the clinical value of the duodenum double lumen cannula suction in duodenal rupture repair.Methods According to the operation methods,60 patients with duodenal rupture undergoing duodenal repair were divided into the surgical drainage alone group(26 cases)and double sets attract tube group (34 cases).The surgery effect and complications were observed.Results The difference of traffic flow 7 days after the operation between the two groups was statistically significant(t =7.564,P <0.05).The length of stay and hospital costs of the surgical drainage alone group were more than those of the double sets attract tube group,the differences were statistically significant(t =3.567,4.123,all P <0.05).The fistula,intra -abdominal infections,wound infec-tions,pulmonary infection rates of the surgical drainage alone group were 30.77%,42.31%,46.15%,26.92%, which were higher than 2.94%,11.76%,8.82%,2.94%,5.88% of the double sets attract tube group,the differ-ences were statistically significant(χ2 =8.949,7.330,10.950,2.986,5.116,all P <0.05).Conclusion Applica-tion of the double lumen cannula duodenal suction in duodenal rupture repair can significantly reduce the incidence of postoperative complications,has certain security,it is recommended in clinical practice.

This study was aimed to analyze the major protein composition of centipedes (Scolopendra subspinipes mutilans L.Koch.), and the ACE inhibitory activity of its hydrolysis. Albumins, gulbulins, coixins and glutelins were sequentially extracted from centipedes flour with corresponding buffer and then quantified by Kjeldahl method and Brandford. Hydrolysation of four kinds of proteins of centipedes and the residues were conducted with pepsin. The hydrolysis was ultrafiltrated (MWCO=3 000) and lyophilized. The peptides (≤3 kD) were obtained to evalu-ate the ACE inhibitory activity by RP-HPLC. The results showed that the total protein content of centipedes was (62.69±1.41)%. Among which the contents of albumins, globulins, coixins, glutelins and residual were account-ing for (6.42±0.31)%, (7.94±0.24)%, (4.31±0.34)%, (40.66±0.56)% and (25.78±0.60)%, respectively. The inhibition rate of hydrolysis of four kinds of protein and residual were 50.28%, 57.37%, 31.15%, 58.99%, 80.81%, respectively. It was concluded that centipedes were rich in protein and the hydrolyzate of all proteins manifested ACE inhibitory activity at different extent. The residual and glutelins indicated strong ACE inhibitory potential by hydrolysis. This research provided valuable sights for exploring hypotensive activity and functional food from centi-pedes.

Objective To investigate the effect of ultrasound-guided subcostal transverses abdominis plane (TAP) block with dexmedetomidine after laparoscopic radical operation. Methods 40 patients underwent laparoscopic radical operation for colorectal cancer were randomized into dexmedetomidine group (group DEX) and control group (group CON). All the patients received ultrasound-guided subcostal TAP block after operation, Group DEX with dexmedetomidine 1 μg/kg and 0.25% ropivacaine to 20 ml, and group CON with 0.25% ropivacaine 20 ml. All the patients were assessed with Ramsay scores and the pain at rest and on coughing were assessed with Visual Analogue Scale (VAS), 2, 6, 12, 24 and 24 hours after operation. The highest level and the duration of sensory blockade, the first time and the total times of pressing the analgesia pump in the first day after operation, and the requirements of sufentanil were recorded. First flatus time, first diet time and the length of hospital stay were compared. Results The scores of VAS were significantly less (P<0.001), and the Ramsay scores were more in the group DEX than in the group CON (P<0.01) 2, 6 and 12 hours after operation; with the longer time of sensory blockade (P<0.001), the later to first press the analgesia pump (P<0.001), the less frequence of pressing the analgesia pump (P<0.001), and less dosage of sufentanil (P<0.001). The first flatus time, first diet time were significantly earlier in the group DEX than in the group CON (P<0.001), with the less length of total hospital stay (P<0.001). Conclusion Dexmedetomidine can promote the anaesthesia of ultrasound-guided subcostal TAP block with ropivacaine and improve the recovery after laparoscopic radical operation.

This study was aimed to optimize the hydrolysis conditions of Coix prolamin, which occupied the highest content in total protein of it, and then evaluate the angiotensin-converting enzyme (ACE) inhibitory activity of the corresponding hydrolysates. Pepsin was used to hydrolyze prolamin and OPA method was applied to determine the degree of hydrolysis. The optimum conditions of hydrolyzing prolamin were obtained by orthogonal design subse-quently. The ACE inhibitory activity of small molecular weight (less than 3 kD) peptides gained by ultrafiltration of the hydrolysates was assayed by RP-HPLC method. The result showed that the optimized hydrolysis conditions were substrate concentration of 1%, enzyme-to-substrate ratio of 1:5 and hydrolysis duration for 48 h. The hydrolysates exhibited an ACE inhibitory ratio of (83.40 ± 0.93)% at the concentration of 0.1 mg·mL-1. It was concluded that prolamin hydrolysates displayed a high ACE inhibitory activity in vitro, which provided guidance for further research of antihypertensive component and development of functional food from Coix.

Objective To observe the incidence of fragmented QRS complex (fQRS)and ST Segment depression fQRS (STD fQRS)during the first 48 hours after non-ST elevation myocardial infarction(NSTE MI)and discuss the value of predicting mortality in patients with NSTE MI .Methods Based on the ECGs ,the patients with NSTE MI were divided into two groups :fQRS and non fQRS group .And then fQRS group was divided into two sub-groups :STD fQRS and non-STD fQRS group .Their mortality was studied during long-term follow-up .Results (1)731 patients with NSTE ACS [the NSTE MI group(n=609) and the UA group(n=122)] were studied .The incidence of fQRS in the NSTE MI group was higher than that of the UA group .(2)All cause mortality in the fQRS group were higher than that in the non-fQRS group ,and all-cause mortality in the STD fQRS group were higher than that in the non-STD fQRS group ,all the above results were not only in the early stages of NSTE MI ,but also in the long term fol-low-up .(3) Multivariate Cox regression analysis revealed that STD fQRS was an independent significant predictor for all cause mortality ,but not of the fQRS .Conclusion The STD fQRS may be an independent predictor of mortality in patients with NSTE MI .

Objective:To investigate the correlation between certain unhealthy lifestyles and the incidence of gastroesophageal reflux disease (GERD),thus to provide the lifestyle guidelines for GERD patients.Methods:Retrospective study were conducted for 402 GERD and 276 non-GERD out-patients in Department of Gastroenterology,Third Xiangya Hospital,Central South University from August,2014 to August,2015 based on questionnaire survey,then the correlation of unhealthy lifestyles with GERD were analyzed.Results:The top 10 common symptoms for GERD were as follows:reflux,acid regurgitation,postprandial fullness,heartburn,swallow obstruction or pain,epigastric burning sensation,paraesthesia pharynges,poststernal pain,chronic laryngopharyngitis,and chronic cough.The top 8 unhealthy habits closely related to GERD were as follows:fast-eating,over-eating,spicy preferred diet,sweets preferred diet,anxious,soup preferred diet,high-fat diet,and hot eating.Single-factor analysis showed that GERD was markedly correlated to gender (male),age (≥ 60 years),BMI,smoking,alcohol fast-eating,over-eating,hot-eating,spicy preferred diet,high-fat diet,acid preferred diet,sweets preferred diet,hard food preference,strong tea preference,coffee preference,immediately on bed after meal,difficult defecation,dyscoimesis,anxious,and too tight belt,respectively (P＜0.05).Logistic multiple regression analysis indicated that the largest risk factor for GERD was the fast-eating (OR=3.214,95％ CI 2.171 to 4.759,P＜0.001) followed by the overeating (OR=2.936,95％ CI 1.981 to 4.350,P＜0.001),elderly population (OR=2.047,95％ CI 1.291 to 3.244,P=0.002),too tight belt (OR=2.003,95％ CI 1.013 to 3.961,P=0.046),and hot-eating (OR=1.570,95％ CI 1.044 to 2.362,P=0.030).Conclusion:The elderly people are at high risk for GERD,and unhealthy habits like fast-eating,over-eating,too tight belt,and hot-eating is closely related to GERD.The lifestyles such as chewing food thoroughly,splitting the meals up,warm and cool diet,keeping patients out of the too tight belt are necessary for GERD patients.

Objective To study the mRNA expression levels and clinical significance of omsomucoid 1-like protein 3 (ORMDL3) gene in the peripheral blood of recurrent wheeze children under 3 years old.Methods Peripheral blood specimens of 25 recurrent wheeze children including 14 non-atopy patients (group A) and 11 atopy patients (group B) that were registered in the First Affiliated Hospital of Nanjing Medical University,from Sep.2010 to Sep.2012 were enrolled based on the inclusion criteria and 24 non-allergic controls(the children with food allergy,drug allergy or ectema was excepted).The mRNA expression levels of ORMDL3 gene were detected by reverse transcription (RT)-PCR and clinical features were analyzed.Results The expression levels of ORMDL3 were up-regulated in the peripheral blood specimens of group B compared with group A (t =14.12,P ＜ 0.01).Compared with peripheral blood specimens from normal subjects,mRNA expression of ORMDL3 were significantly increased in recurrent wheeze children(t =10.29,5.73,P ＜0.01).The incidence of wheeze groups exist gender differences,male ＞ female.Wheeze usually with a high incidence in winter and spring.Conclusions The increase of ORMDL3 gene expression levels were correlated with recurrent wheeze under 3 years old especially in atopy group and may be involved in the pathogenesis of recurrent wheeze.

The usage of electronic cigarettes (e-cigarettes) sparked an outbreak of unidentified vaping-related lung disease in the US during late 2019. With e-cigarettes becoming more and more popular, smokers have more options other than conventional cigarettes. Under these circumstances, a comprehensive evaluation of the general safety of new tobacco and tobacco-related products, represented by e-cigarettes, to human health is necessary. In this review, we summarize the current research on potential negative impacts of e-cigarette exposure on human health. In particular, studies detailing the relationship between e-cigarettes and the digestive system are summarized, with mechanisms mainly including hepatic metabolic dysfunction, impaired gut barrier, and worsened outcomes of inflammatory bowel disease (IBD). Although believed to be safer than traditional cigarettes, e-cigarettes exert adverse effects on systemic health and induce the development of multiple diseases including asthma, cardiovascular disease, and IBD. Moreover, nicotine-containing e-cigarettes have a negative impact on the childhood development and increase the risk of arterial stiffness compared to the non-nicotine e-cigarettes. However, non-nicotine e-cigarette components have detrimental effects including promoting liver damage and metabolic disorders.

Objective To observe the effects oftelmisartan (TEL) on learning and memory functions of animal models of Alzheimer's disease combined with hypertension.Methods Seventy male spontaneously hypertensive rats were randomly assigned into 7 groups:control group,sham-operated group,model group,low TEL group (1 mg/[kg· d]),high TEL group (10 mg/[kg· d]),low TEL+GW9662 group (Tel 1 mg/[kg·d]+GW 1 mg/[kg·d]),and high TEL+GW9662 group (Tel 10 mg/[kg·d],GW 10 mg/[kg·d],n=10);the lateral cerebral ventricle of rats in the later 5 groups were injected with beta-amyloid peptide 1-42 (Aβ1-42);rats in the sham-operated group were given the same volume of normal saline,and those in the control group did not give any treatment.The learning and memory abilities of these rats were detected by Morris Maze test;microglia level and casepase-3 expression were assessed by immunohistochemical stainning.Results Constant-bearing navigation indicated that as compared with the model group,the high TEL+GW9662 group,control group and sham-operated group had significantly shorten escape latency on the 3rd d of experiment (P＜0.05),and as compared with the model group,the low TEL group,high TEL group and high TEL+GW9662 group had significantly shorten latency (P＜0.05).Spatial probe test showed that the times of crossing the platform,target quadrant residence time in the low TEL group,high TEL group and high TEL+GW9662 group were significantly larger/longer than those in the model group (P＜0.05).The casepase-3 expression and microglia level in the CA1 area of model group were significantly higher than those in the control group (P＜0.05);The Ibal and caspase-3 expressions in the low TEL group,high TEL group and high TEL+GW9662 group were significantly weaker than those in the model group (P＜0.05).Conclusion TEL has preventive effect on cognitive decline in rat models of Alzheimer's disease complicated with hypertension,and can be restrained by GW9662,which suggests that these benefits might be partly resulted from PPAR-γ activation and intracranial infection inhibitation.