Background and purpose: With the increase of aging population, elderly patients (age ≥70 years) with esophageal squamous cell carcinoma occurred more and more. However, few studies have focused on elderly esophageal squamous cell carcinoma patients. This study aimed to assess the outcomes and prognostic factors for elderly patients with esophageal squamous cell carcinoma treated after deifnitive chemoradiotherapy. Methods:We retrospectively analyzed 53 patients (age≥70 years) with esophageal squamous cell carcinoma and treated with deifnitive radiotherapy with or without chemotherapy from Fudan University Shanghai Cancer Center from Mar. 2009 to Dec. 2011. Results:Median age was 74 years. Twenty-nine patients underwent radiotherapy, 24 patients underwent radiochemotherapy. 1-, 2-, 3-, and 5- year survival was 62%, 44%, 33% and 19% respectively. Grade 2 and above acute radiation-induced esophageal toxicity and radiation pneumonitis occur rate was 6% and 9% respectively. No treatment-related deaths occurred and no patients experienced any grade 4 and above toxicities. Multivariate analysis identiifed treatment modality, tumor site and smoking history as independent prognostic factors for overall survival. Conclusion:Radiotherapy may be an acceptable treatment option for elderly patients with esophageal squamous cell carcinoma. In appropriately selected patients, concurrent chemotherapy could bring a better overall survival.

Objective To explore the relativity between clinical learning organization culture and core competency among registered nurses,to offer theoretic basis and practical advices for improving core competency among registered nurses.Methods 680 registered nurses in three tertiary hospitals in Ji'nan city were investigated with the general information questionnaire,Competency Inventory for Registered Nurses and the Dimensions of The Learning Organization Questionnaire.Results The total score and all the four subscales of learning organization were positively correlated with the core competency among registered nurses(P＜0.01),the dimension of overall situation senses and strategic leadership were the main influencing factors.Conclusions The cultivation of nurses' overall situation senses should be strengthened,providing strategic leadership for learning,strengthening cooperation and innovation,and promoting inquiry and communication.These will help increase core competency among registered nurses and improve their general competence.

Objective To investigate the effects of microRNA-155 (miR-155) inhibitor on JAK/STAT1 (Janus kinase/signal transducer and activator transcription 1) signaling pathways in the injured lung tissue induced by lipopolysaccharide (LPS).Methods One hundred and twenty BALB/c mice were randomly divided into control group (n =40),LPS group (n =40),and inhibitor + LPS group (n =40).LPS group and inhibitor + LPS group were made by injection of LPS 20 mg/kg intra-peritonealy,whereas equivalent volume of normal saline was given instead in the control group.The 80 mg/kg of miR-155 inhibitor was injected into caudal vein 24 h before LPS injection in inhibitor + LPS group.Mice were sacrificed at 6 h,12 h,24 h,and 48h separately after LPS injection,and lung tissue were collected.The levels of tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) of lung tissue were measured using the enzyme-linked immunosorbent assay (ELISA).Using histopathological examination,the injury of lung tissue was evaluated.The expressions of miR-155,STAT1 mRNA,SOCS1 mRNA in lung tissue were assayed by fluorescent quantitative reverse transcription polymerase chain reaction (qRT-PCR).Results The miR-155 expression induced by LPS increased at 6 h,12 h,24 h and decreased at 48 h.The miR-155 expressions in LPS group were (8.52 ± 1.12) at 6 h,(11.04 ±0.99) at 12 h,(15.84 ±0.80) at 24 h and (4.03 ± 2.55) at 48 h.In the inhibitor + LPS group,the expressions of miR-155 were lower compared with LPS group,showing significant differences at 12 h (t =6.08,P ＜ 0.01),and at 24 h (t =23.64,P ＜ 0.01).STAT1 mRNA and SOCS1 mRNA both reached peak levels at 6 h after LPS injection.The levels of STAT1 mRNA in LPS group were higher than those in inhibitor + LPS group,showing significant differencesat6h (t=4.41,P＜0.01),12h(t=2.69,P＜0.05),and24h (t=3.62,P＜0.01).The levels of SOCS1 mRNA in inhibitor + LPS group were higher than those in LPS group,showing significant differences at 6 h (t =4.55,P ＜0.01),12 h (t =4.12,P ＜0.01),24 h (t =2.38,P ＜ 0.05).TNF-α reached its peak value at 6 hours and IL-10 reached its peak value at 48 hours.Both TNF-α and IL-10 were higher in LPS group than those in inhibitor + LPS group showing significant differences at 6 h,12 h,24 h (P ＜0.01).The pathologic examination indicated the lung injury in inhibitor + LPS group was milder than that in LPS group.Conclusion The miR-155 increased in lung tissue of endotoxemic mice.miR-155 inhibitor may suppress JAK/STAT1 signaling pathway and protect the lung tissue.

Objective:To investigate the model,quality as well as effect of teaching-in-English in five-year clinical medicine program of Hainan Medical University.Methods:The questionnaire was carried out among clinical medicine undergraduates of 2012-2015 grades in Hainan Medical University,to investigate studying time,studying habits and the impact of teaching in English.Additionally results of CET-4,CET-6 and overseas internship from undergraduates of 2012-2015 grade,as well as the result of phased medical licensing examination and post-graduate entrance examination from undergraduates of 2012 were accordingly collected from the Teaching Management Department.Results:For the Chinese students in international classes,the average time of self-study was 161.49 min,58.3％ had preview before classes,and 90.7％ had habit of review after classes.Thus the first time pass rate,total pass rate,first time excellent rate and total excellent rate of CET-4 and CET-6 of international classes were significantly higher than those of regular classes.The result of post-graduate entrance examination in 2016 showed that the score,pass rate and acceptance rate of international classes of 2012 grade were significantly higher those of regular classes (P ＜ 0.01).Conclusions:Teaching-in-English reform in Hainan Medical University has achieved initial success.Chinese students from international classes are superior to those from regular classes in many aspects.However,there are still many problems,and effective measures should be implemented to promote teaching quality continuously.

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cell Survival ; drug effects ; Cells, Cultured ; Cerebral Cortex ; cytology ; drug effects ; Dose-Response Relationship, Drug ; Neurons ; drug effects ; Nickel ; toxicity ; Rats ; Rats, Wistar

OBJECTIVE To develop a non-paper,interactive,multiplex medium way,and to obtain the information disinfection protection on second level of time.METHODS Using the computer,the touchscreen,the personal digital assistant(PDA),the general packet radio service(GPRS),the pronounciation(man-machine conversation),the video frequency and the other advanced technology methods,to study and develop an electronic version of intelligent search engine system for disinfection protection.RESULTS Touching namely attained the applied and guided information,such as to fulfil exactly the disinfection technology standard for the medical workers in medical establishments,to provide the post work instruction;to correctly guide the disinfection protection for common family;and to build the communication platfrom with the enterprisers in order to meet the demand for disinfection protection appliances from the society,hospital and family.CONCLUSIONS The intelligent search engine system is feasible applying to use.

Objective To understand the pathogenic distribution and epidemiological trend of hand-foot-and-mouth disease (HFMD),and provide evidence for the prevention and control of HFMD.Methods Children who were diagnosed with HFMD in a hospital between January and December 2015 were investigated,real time fluorescence PCR was used to detect enterovirus universal type EV,enterovirus 71 (EV71),and Coxsackievirus A16 (CoxA16) in specimens from children with HFMD.Positive rates and distribution of various types of EV among children of different months,genders,age groups,and infection types were analyzed.Results A total of 837 throat swab specimens from HFMD children were collected in 2015,380 (45.40％) of which were EV positive specimens.Virus typing showed that 110 (28.95 ％),7 (1.84 ％),6(1.58 ％),and 257(67.63 ％) were positive specimens for EV71,CoxA16,EV71 + CoxA16,and other types of EV.HFMD had a high prevalence since April,reached a peak in May-June,and remained high incidence in July-December.Positive rates of EV in children of different months were statistically different (P＜0.05).The age of onset was mainly in children under 3 years.Positive rates of EV and constitute ratios of different types of EV in children of different age groups were all statistically different (all P＜0.05).The positive rate of EV in severe HFMD cases was higher than common cases (65.34％ vs 27.06％,P＜0.001).The proportion of severe cases in children with EV71 infection and other types of EV infection were 90.00％ and 60.70％ respectively;children with EV71 + CoxA16 double infection were all severe cases.Constitute of EV types in children with different infection types was statistically different(P＜0.001).Conclusion In 2015,EV infection in hospitalized children with HFMD in this hospital was mainly caused by other types of EV (nonEV71 and non-CoxA16),the high prevalence season,high-risk population under 3 years of age,and severe cases should be paid high attention,prevention and treatment should be performed well.

Objective To investigate the model, quality as well as effect of teaching-in-English in five-year clinical medicine program of Hainan Medical University. Methods The questionnaire was carried out among clinical medicine undergraduates of 2012–2015 grades in Hainan Medical University, to investigate studying time, studying habits and the impact of teaching in English. Additionally results of CET-4, CET-6 and overseas internship from undergraduates of 2012–2015 grade, as well as the result of phased medical licensing examination and post-graduate entrance examination from undergraduates of 2012 were accordingly collected from the Teaching Management Department. Results For the Chinese students in international classes, the average time of self-study was 161.49 min, 58.3% had preview before classes, and 90.7% had habit of review after classes. Thus the first time pass rate, total pass rate, first time excellent rate and total excellent rate of CET-4 and CET-6 of international classes were significantly higher than those of regular classes. The result of post-graduate entrance examination in 2016 showed that the score, pass rate and acceptance rate of international classes of 2012 grade were significantly higher those of regular classes (P < 0.01). Conclusions Teaching-in-English reform in Hainan Medical University has achieved initial success. Chinese students from international classes are superior to those from regular classes in many aspects. However, there are still many problems, and effective measures should be implemented to promote teaching quality continuously.

Objective To determine the in vitro activities and interac-tions of cefoperazone-sulbactam (2: 1, 1:1) combined with minocycline against 39 strains of imipenem-resistant Acinetobacter baumannii. Methods The protocol was designed by checkerboard method and the minimal inhibitory concentrations (MICs) of cefoperazone-sulbactam (2 : 1, 1:1) combined with minocycline against the 39 strains of A. bau-mannii were determined by agar dilution method. The fractional inhibito-ry concentration index (FICI) was calculated according to MIC results. The results of the FICI were interpreted as follows : synergy, FICI ≤0. 5 ; antagonism, FICI > 4 ; no interaction, FICI > O. 5-4. 0. Results No interactions of synergy nor antagonism were found. The FICI were all be-tween 0. 5 and 4. 0 in these two combination groups. Conclusion In our study, the interactions of cefoperazone-sulbactam (2: 1, 1:1) com-bined with minocycline against the 39 strains of A. baumannii showed in-different.

Objective To investigate the learning organization culture in the nurses of different working seniority,so as to provide a reference for the construction of learning organization.Methods A total of 680 registered nurses in three tertiary hospitals were investigated with general information questionnaire and the Learning Organization Questionnaire in nursing.Results Six hundred and eighty questionnaires were distributed.There were 636 valid questionnaires and the valid returned rate was 93.5％.Significant difference was found in the nurses with different working seniority (F =28.655,307.027,164.362,4.887,150.052,respectively;P ＜0.01).The nurses with work seniority more than 21 years had the highest scores of learning organization [(23.76 ± 3.33),(21.60 ± 1.44),(21.08 ± 1.70),(12.61 ± 1.37),(79.06 ± 5.11)],while the nurses with work seniority between 1 and 10 years had the lowest scores [(21.35 ± 2.51),(17.21 ± 1.44),(17.68 ± 1.62),(11.85 ± 1.84),(68.08 ±4.91)].And the scores of nurses with work seniority between 11 and 20 years were in the middle level [(22.88 ± 3.42),(19.66 ± 1.52),(19.79 ± 1.54),(12.17 ± 2.02),(74.50 ± 6.57)].Conclusions The nurses with shorter working seniority have stronger wish to improve the learning organization culture,so the learning organization should be strengthened.Further research should be done so as to increase core competency and improve the organization construction.