Objective To explore the effect of application of hospital-school combined three-dimensional teaching mode in the operation nursing practice teaching.Methods 129 students were collected by cluster sampling,then based on class unit,they were randomized into the experimental group (69 students) and the control group (60 students).The experimental group used hospital-school combined threedimensional teaching mode and the control group used traditional teaching mode.Then,both groups had finished an operation nursing comprehensive theoretical examination and a self-report questionnaire for mastery of basic knowledge of operation nursing.Besides,the experimental group had a questionnaire survey of cognitive evaluation for the new teaching mode.Results The average score of operation nursing comprehensive theoretical examination of the experimental group was (77.81 ±9.87),higher than the control group (70.35±12.37); The self-report score for mastery of basic knowledge of operation nursing of the experimental group was (3.94±0.45),higher than the control group (3.68±0.46).The students of the experimental group also considered that the new teaching mode improved their comprehensive knowledge and innovative abilities,critical thinking ability,humanistic care spirit,communication ability,team cooperation ability and innovation ability,etc.Conclusions The effect of application of hospital-school combined three-dimensional teaching mode in the operation nursing practice teaching was good,but it still had some limitations which needed us to pay attention to and to perfect.

Objective:To explore the effect of mind mapping teaching of gastroenterology in the standardized training for general practitioners, and provide new ideas for general practice education.Methods:A total of 65 physicians who were enrolled in the standardized training of general practice from January to December 2017 were collected as the control group, and the traditional teaching method was adopted; another 58 physicians from January to December 2018 were selected as the experimental group, and the mind mapping was adopted based on the traditional teaching method. The learning effect (theoretical and operational results) and the satisfaction questionnaire of trainees and teachers were used as evaluation indicators. SPSS 21.0 was used for t test and chi-square test. Results:The theory exam and clinical skills examination results of experimental group (80.80±5.30, 82.66±5.90) were significantly higher than those of the control group (71.60±5.20, 75.72±4.57), and the difference was statistically significant ( P<0.05). Compared with the control group, the experimental group had better understanding of knowledge points of this discipline, clinical thinking ability, higher learning interest, teamwork ability, innovation ability and teacher satisfaction, with statistical significance ( P<0.05). Conclusion:The mind mapping has more advantages than traditional teaching methods in the standardized training for general practitioners, which can be further extended.

Objective:To compare the clinical characteristics of patients with non-erosive gastroesophageal reflux disease (NERD), reflux hypersensitivity (RH) and functional heartburn (FH), in order to help the differential diagnosis and treatment of the three diseases.Methods:From October 2016 to February 2019, 64 patients with persistent heartburn who had negative endoscopy in the Department of Gastroenterology, the Second Affiliated Hospital of Xi′an Jiaotong University and with negative results of endoscopy examination were consecutively selected, which included 26 NERD patients (NERD group), 12 RH patients (RH group) and 26 FH patients (FH group). The gender, age, body mass index (BMI), presence of hiatus hernia, proton pump inhibitor (PPI) treatment effect, the score and incidence of gastroesophageal symptoms within one month before visit, and the incidence of overlapping functional dyspepsia (FD), postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) of the three groups were compared. One-way analysis of variance, least-significant difference, Kruskal-Wallis H test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:There were no statistically significant differences in gender, age or incidence of esophageal hiatal hernia between NERD group, RH group and FH group (all P>0.05). BMI of NERD group was higher than that of FH group ((23.74±3.10) kg/m 2 vs. (21.26±2.75) kg/m 2), and the difference was statistically significant ( t=3.066, P=0.003). The effective rate of PPI treatment in NERD group was higher than those of RH group and FH group (19, 4, and 11 cases, respectively), the differences were statistically significant ( χ2=5.428 and 5.042, P=0.020 and 0.025). The score and incidence of burning sensation in upper abdomen of NERD group were both lower than those of FH group (0, 0 to 0 vs. 0, 0 to 5; 7.7%, 2/26 vs. 38.5%, 10/26), and the differences were statistically significant ( Z=-2.756, P=0.006; χ2=6.933, P=0.008). There were no statistically significant differences in the score of heartburn symptoms, or the scores and incidence of chest pain, reflux, globular sensation of hysteria, burning sensation of throat, cough, epigastric pain, early satiety or post meal fullness, belching, nausea or vomiting between NERD group, RH group and FH group (all P>0.05). There were no statistically significant differences in the incidence of overlapping FD or overlapping PDS between the NERD group, RH group and FH group (both P>0.05), but the incidence of overlapping EPS of FH group was higher than that of NERD group (46.2%, 12/26 vs. 11.5%, 3/26), and the difference was statistically significant ( χ2=7.589, P=0.013). Conclusions:There are certain differences in the clinical characteristics of patients with NERD, RH or FH, mainly reffected in the PPI treatment effects and whether overlapping EPS. The higher incidence of FH overlapping EPS further strengthens the hypothesis that functional gastrointestinal disorders have a common pathophysiological mechanism.

OBJECTIVETo explore the clinical features and genetic mutation in a family affected with non-syndrome X-linked intellectual disability (NS-XLID) using whole exome sequencing (WES).

METHODSMultiplex ligation-dependent probe amplification (MLPA) was applied to screen potential mutations of Fragile X syndrome (FXS). Whole exome sequencing (WES) and Sanger sequencing were screen for pathological mutations.

RESULTSFXS was excluded by MLPA analysis. WES has discovered in the proband an ARX gene mutation c.88G>T, which was confirmed by Sanger sequencing. Combining his clinical phenotype with information from the OMIM database, it was inferred that the ARX mutation probably underlies the NS-XLID in the proband. The same mutation was found in his mother and two uncles but not in his father and sister.

CONCLUSIONWES is capable of revealing the mutation underlying NS-XLID and can facilitate genetic counseling for the affected families.

OBJECTIVE: To analyze the differences in reflux patterns in 24-hour esophageal pH-impedance monitoring in patients with non-erosive reflux disease (NERD), reflux hypersensitivity (RH) and functional heartburn (FH) and explore the possible mechanism of symptoms in patients with heartburn and negative endoscopic findings. METHODS: Seventy-nine patients with heartburn as the main symptoms but negative endoscopic findings, including 35 with NERD, 16 with RH and 28 with FH, were enrolled in this study.All the patients underwent 24-h esophageal pH-impedance monitoring and esophagogastroscopy, and the results were compared among the 3 groups. RESULTS: Acid reflux episode was significantly increased and weakly alkaline reflux episode was significantly decreased in NERD group in comparison with RH group and FH group ( CONCLUSIONS Patients with NERD, RH and FH had different reflux patterns.Acid reflux is predominant in the NERD, while weakly alkaline reflux is significantly increased RH and FH.In patients with normal esophageal acid exposure but without symptoms or without recorded symptoms during esophageal pH-impedance monitoring, analysis of the total reflux episode, mixed reflux episode, proximal acid reflux episode and percentage can help in the differential diagnosis between RH and FH.
Electric Impedance ; Esophageal pH Monitoring ; Gastroesophageal Reflux/diagnosis* ; Heartburn/etiology* ; Humans ; Hydrogen-Ion Concentration

OBJECTIVE: To investigate the value of positive lymph node ratio (LNR) in predicting the prognosis of patients with esophageal cancer. METHODS: We retrieved the data of a total of 862 patients with esophageal cancer with complete clinical pathology data archived in SEER database in 2010 to 2015. The best cutoff point of LNR was selected using X-tile software. Univariate and multivariate COX proportional hazard models were used to assess the value of LNR in predicting the prognosis of patients after propensity score matching (PSM). RESULTS: The best cut-off point of LNR determined using X-tile 3.6.1 software was 0.16. The patients with LNR < 0.16 and those with LNR≥0.16 showed significant differences in the number of positive lymph nodes, pathological type, T stage and M stage. After 1:1 propensity score matching, the two groups showed no significant difference in the clinical data or pathological parameters. Matched univariate and multivariate COX regression analyses showed that LNR, primary tumor site and M staging were all independent risk factors affecting the prognosis of patients, and among them LNR had the most significant predictive value (LNR < 0.16 LNR≥0.16: HR=1.827, 95% : 1.140-2.929; =0.000). The median survival time of patients with LNR < 0.16 was 31 months (95%: 22.556-39.444 months), as compared with 16 months (95%: 12.989-19.011) in patient with LNR≥0.16 (Log Rank χ=27.392, < 0.0001). LNR had a better accuracy than N stage for assessing the patients' prognosis with an area under the ROC curve of 0.617 (95%: 0.567-0.666), as compared with 0.515 (95%: 0.463-0.565) of N stage (=3.008, =0.0026). CONCLUSIONS LNR≥0.16 is an independent risk factor affecting the prognosis of patients with esophageal cancer and has better prognostic value than N stage.
Esophageal Neoplasms ; Humans ; Lymph Node Excision ; Lymph Node Ratio ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Risk Factors

Objective: To observe the relationship between hyperthyroidism and vascular endothelial injury. Methods: From 2016 to 2017, data of 60 patients with simple hyperthyroidism, autoimmune thyroid disease, cardiovascular and cerebrovascular diseases were collected from the Second Affiliated Hospital of Harbin Medical University. And 60 healthy subjects were enrolled in the same period as a healthycontrol group. The enzyme-linked immunosorbent assay (ELISA) was used to detect the content of vascular endothelial injury markers (vWF), thrombomodulin (TM), endothelin-1 (ET-1), P-selectin in serum of all subjects, as well as the serum thyroid stimulating hormone (TSH), free triiodothyronine (FT₃), free thyroxine (FT₄), anti-thyroglobulin antibody (TgAb), and anti-thyroid peroxidase antibody (TPOAb) in patients with cardiovascular and cerebrovascular diseases levels. The correlation analysis of vascular endothelial injury in the simple hyperthyroidism group, autoimmune thyroid disease group, cardiovascular and cerebrovascular diseases group and healthy control group was conducted. Results: There were statistically significant differences between the healthy control group, the simple hyperthyroidism group, the autoimmune thyroid disease group and the cardiovascular and cerebrovascular diseases group in the serum levels of vWF, TM, ET-1 and P-selectin, respectively(F = 6.56, 9.19, 7.88, 12.45, P < 0.05), and the simple hyperthyroidism group, autoimmune thyroid disease group, cardiovascular and cerebrovascular diseases group were significantly higher than the healthy control group (P < 0.05). Correlation analysis showed that the vascular endothelial injury in the patients with simple hyperthyroidism, autoimmune thyroid disease, and cardiovascular and cerebrovascular diseases groups was statistically significantly different compared with the healthy control group, respectively(χ² = 5.08, 5.08, 8.16, P < 0.05); the risk of vascular endothelial injury in each diseased group was 2.37, 2.37, and 3.07 times higher than that of the healthy control group, respectively. The abnormal rates of TSH, FT₃, FT₄, TgAb and TPOAb in patients with cardiovascular and cerebrovascular diseases were 18.33% (11/60), 15.00% (9/60), 15.00% (9/60), 10.00% (6/60) and 11.7% (7/60), respectively. Conclusion Simple hyperthyroidism and autoimmune thyroid disease are risk factors of vascular endothelial injury.

Adenoviridae ; genetics ; Ebolavirus ; genetics ; pathogenicity ; Gene Transfer Techniques ; Genetic Vectors ; therapeutic use ; Glycoproteins ; genetics ; HEK293 Cells ; Hemorrhagic Fever, Ebola ; genetics ; pathology ; virology ; Humans ; Inflammation ; genetics ; pathology ; virology ; Mucins ; genetics ; Transfection ; Viral Envelope Proteins ; genetics