Objective To investigate the effect of virtual simulation teaching method in the comprehensive experimental teaching.Methods In experimental teaching of nursing,simulation medical records were compiled,plans were implemented,experiment guidance materials were preliminarily formed and teaching effect was evaluated.Results The application of virtual simulation teaching in nursing comprehensive experiments reflected the comprehensiveness of teaching content,and the comprehensiveness of knowledge,ability and capacity.It could train students creative ability,exploring spirit,enhance the sense of professional and humane care consciousness,train the communication skills and strain capacity,make active teaching atmosphere,improve the quality of teaching.Conclusions This teaching method can make students achieve mastery through a comprehensive multi-disciplinary knowledge,improve the ability of solving practical problems,help nurses to develop the comprehensive professional quality.

SDF-1α, a ligand for the chemokine receptor CXCR4, is well known for mediating the migration of breast cancer cells. In a previous study we demonstrated that a synthetic 21-mer peptide antagonist of CXCR4 (NT21MP) derived from the viral macrophage inflammatory protein II could antagonize tumor growth in vivo by inhibiting cellular proliferation and inducing apoptosis in breast cancer cells. However, the role of SDF-1α in the signaling pathways underlying the proliferation of human breast cancer cells and associated signaling pathways and inhibiting signal pathways of NT21MP remained unclear. The present study investigated the mechanism of NT21MP on anti-tumor in breast cancer in vitro. The effect of NT21MP on the viability of cells was determined by the MTT assay. Annexin V-FITC and PI staining was performed to detect early stage apoptosis in SKBR3 cells treated with SDF-1α and AMD3100 or NT21MP. Western blotting techniques were used to assay the composition of phosphoproteomics and total proteins present in the SKBR3 breast cancer cells. RT-PCR and Western blotting technique were used to detect the effect of NT21MP and AMD3100 on Bcl-2 and Bax expression. The results indicated that SDF-1α prevented apoptosis and promoted the proliferation of SKBR3 human breast cancer cells. As compared with untreated SKBR3 cells, Treatment with SDF-1α significantly increased cell viability, and NT21MP abolished the protective effects of SDF-1α dose-dependently (P<0.05). There was a significant decrease in the percentage of apoptotic cells after SDF-1α treatment as compared with control group (2.7%±0.2% vs. 5.7%±0.4%, P<0.05). But pretreatment of SKBR3 cells with NT21MP significantly attenuated the antiapoptotic effects of SDF-1α as compared with SKBR3 cells without NT21MP pretreatment. The proliferative and anti-apoptotic effects of SDF-1α in SKBR3 cells were associated with an increase in AKT and ERK1/2 phosphorylation as well as a decrease in Bax expression and an increase in Bcl-2 expression. These changes in intracellular processes were blocked by NT21MP in a dose-dependent manner(P<0.05). In conclusion, NT21MP efficiently inhibits SDF-1α-induced proliferation and antiapoptosis in SKBR3 cells by reducing the levels of phosphorylated AKT and ERK1/2, as well as decreasing the ratio of expression of Bcl-2 relative to Bax.

Objective To investigate the risk factors and outcomes of acute kidney injury (AKI) in patients after intra--coronary stent implantation.Methods A retrospective and case control study was done with data analysis in 325 patients who underwent intra-coronary stent implantation from January 2010 to March 2011.The patients were divided into two groups as per the criteria of AKI identified on the 7th day after implantation of stent.The variables to be studied included:(1) age,gender,hypertension,diabetes,cerebrovascular disease,left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate,hyperuricemia,proteinuria,emergency operation,hydration,and medication (ACEI/ARB,statins) before operation; (2) dose of contrast media,operation time,hypotension during intra-operative period; and (3) postoperative:hypotension.The variables were analyzed with the process of One-way ANOVA and multivariate Logistical regression analysis.Consequently,the independent risk factors of AKI in patients after intra-coronary stent implantation could be found.Further,the prognosis of AKI patients was analyzed.Results Of the 325 patients,51 (15.7％) developed AKI.Compared the normal group,hospital stay (P ＜ 0.01 ) and in-hospital mortality (P ＜ 0.05) increased significantly in the AKI group.Monofactorial analysis showed that age,pre-operative laboratory and clinical data including left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate, hyperuricemia, proteinuria, hydration and emergency operation, and intraoperative information such as operation time and hypotension,and postoperative hypotension in AKI patients group were significantly different in comparison with control group ( P ＜ 0.05 ). Multivariate logistic regression analysis revealed that elderly age (OR =0.253),pre-operative proteinuria (OR =5.351 ),preoperative left ventricular insufficiency ( OR =8.704),eGFR ≤ 60 ml/ ( min · 1.73 m2 ) ( OR =6.677 ),prolonged operation time ( OR =1.017),intra-operative hypotension ( OR =25.245 ) were independent risk factors of AKI ( P ＜ 0.05 ).Conclusions AKI is a common complication and associated with increase in mortality after intra-coronary stent implantation.Increase in age,pre-operative proteinuria,pre-operative left ventricular insufficiency,pre-operative low estimated glomerular filtration rate,prolonged operation time,intra-operative hypotension are the independently risk factors associated with AKI.

objective To explore the indication of mechanical ventilation and evaluate the effects of mechanical ventilation with the least delay on the Severe cases of hand-foot-mouth disease(HFMD).Methods Retrospective cohort study was conducted among the severe HFMD cases(n=66)admitted to pediatric intensive care unit(PICU)between July 2008 and september 2009.Sixty-six cases were divided into two groups:42 cases(group A,July 5 to October 31,2008)were ventilated with the common mechanical ventilation,24 cases(group B,April 21 to september 30,2009)were ventilated at least delay when the symptoms of neurogenic pulmonary edema appeared.Then the diffcrences on the survival rate and the mortality in the group A and group B were investigated.Results Twenty out of 42 patients died(47.6%),eighteen were cured(42.6%) and four showed improved signs(9.5%)in group A.Twenty-two out of 24 patients were cured(91.7%),two showed improved signs(8.3%)and no death in group B.The clinical effect of group B was much better tllan group A(P<0.001).Conclusion Early mechanical ventilation would improve the survival rate and decrease the mortality of severe hand-foot-mouth disease.

Objective To investigate the differences between subjective and objective sleep quality in recurrent depressive patients and the correlative factors. Methods Thirty-two cases of recurrent depressive patients(the recurrent group) and 32 cases of first episode depressive patients(the control group)who met the inclusion were recruited in this study. The subjectivesleep quality ,mood and objective sleep quality of patients were estimated by Pittsburgh sleep quality index(PSQI),Hamilton anxiety Scale(HAMA),Hamilton depression Scale(HAMD),respectively. O ne whole-night polysomnography (PSG) was recorded. Results On subjec-tivesleep quality,the total sleep time was shorter,the sleep latency was longer,and the sleep efficiency was lower in the recurrent group compared with the control group. On objectivesleep quality ,the wake times were increased , the NREM1 phase was longer,the NREM2 phase was shorter,the RME phase was longer,the proportion of REM phase was increased,and the latency of REM phase was shorter in the recurrent group compared with the control group(P<0.05,respectively). There were significant differences between the subjective and objective sleep quali-ty in both groups,while the differences in the recurrent group were more significant(P < 0.01). In the recurrent group,thedifference of the total time between the subjective and objective sleep was positively correlated with PSQI score,the duration of disease and the number of attacks(P < 0.05),while,the differences of the sleep latency and sleep efficiency between the subjective and objective sleep were both positively correlated withPSQI score and the HAMA-14 score,respectively(P<0.05). Conclusion There was a significant difference between the subjec-tive and objective sleep quality of patients with recurrent depression ,and the differences were related to the course of disease,the number of attack,PSQI score and HAMA-14 score.

BACKGROUND:Deep vein thrombosis occurred during waiting period before operation affects the prognosis of calcaneal fractures. Therefore, it has important clinical significance for its accurate diagnosis. The staging of thrombosis during waiting period before operation for calcaneal fractures is rarely reported. OBJECTIVE:To detect the incidence and risk factors of deep vein thrombosis in patients with calcaneal fracture by ultrasound elastography imaging after staging diagnosis of thrombosis. METHODS:Al objects were included in the study from patients with calcaneal fractures waiting for surgery in the Qinghai University Affiliated Hospital between 2008 and 2015. Patients received preoperative duplex ultrasonography. Those with thrombosis received ultrasound elastography. The incidence of thrombosis was calculated. According to medical records, age, sex, body mass index and history of smoking were col ected. The correlation between thrombosis and above factors was analyzed by multiple Logistic regression analysis. RESULTS AND CONCLUSION:(1) One hundred and forty-nine patients were final y included. Of these, 22 (14.8%) were found to affect deep vein thrombosis in the lower limb. The incidence of acute thrombosis was 9.4%. (2) Multiple Logistic regression analysis suggested that age (P=0.009, OR=1.063, 95%confidence interval (CI) 1.010–1.117), body mass index (P=0.019, OR=1.302, 95%CI 1.124–1.430), history of smoking (P=0.017, OR=5.124, 95%CI 1.347-18.359), and operation waiting time (P=0.000, OR=5.190, 95%CI 1.396–19.266) were risk factors of acute lower extremity deep venous thrombosis. (3) These results suggest that the incidences of preoperative deep vein thrombosis and acute deep vein thrombosis are very high. The risk assessment of acute deep vein thrombosis should be taken according to the patient’s age, smoking history, body mass index, as wel as the time waiting for surgery. The corresponding diagnosis and treatment program should be given to patients with thrombosis.

Objective To evaluate the effect of two dosages of the dyclonine hydrochloride mucilage on removing bubbles in bowel preparation before colonoscopy. Methods Data of 774 patients who received colonoscopy from November 2015 to April 2016 in People's Hospital of Xinjiang Uygur Autonomous Region were randomly divided into groups A, B and C. As the control group, group A only used four boxes of polyethylene glycol ( PEG) for bowel preparation and drank 50 mL water after bowel preparation;group B was given 10 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG for bowel preparation;group C was given 20 mL dyclonine hydrochloride mucilage with 50 mL water after four boxes of PEG. Intestinal cleanliness, intraluminal gas bubbles and satisfaction were graded by endoscopic physicians. Polyps of less than 5 mm were recorded and adverse reactions were observed. Results There were no significant differences in intestinal cleanliness among groups A, B and C (P>0. 05).The intraluminal gas bubbles grading, physician satisfaction and detection rate of polyps of less than 5 mm of groups B and C were significantly better than those of group A( P<0. 01) , and group C was superior to group B in these variables ( P<0. 01) . The proportion of levelⅠandⅡin foam evaluation in group C was higher than that in group B ( P<0. 01) . Conclusion Dyclonine hydrochloride mucilage can eliminate the bubbles inside the intestine, and the effect of 20 mL dyclonine hydrochloride mucilage for bowel preparation is superior to 10 mL.

OBJECTIVETo investigate the effect of Oxaliplatin (L-OHP) on cell cycle in hepatocellular carcinoma cell line HepG2 and the involved mechanism.

METHODSInhibitory effect of L-OHP on the proliferation of HepG2 cells was determined by MTT assay. Cell cycle distribution was shown by flow FCM. The expression levels of cyclinD1, CDK2, CDK4, p16, p21, p53 were detected by RT-PCR and Western blot.

RESULTSMTT method revealed that L-OHP inhibited proliferation of hepatocellular carcinoma HepG2 cells in a dose- and time-dependent manner. L-OHP induced S cell cycle arrest in HepG2 cell; down-regulated the levels of CDK4, cyclinD1 and up-regulated the levels of p21, p53. There were no significant changes of CDK2 and p16 after L-OHP treatment.

CONCLUSIONL-OHP inhibits the proliferation of HepG2 cells by blocking cell at S stage, which may be resulted from the activity of CDK4, CyclinD1 and p21.

Carcinoma, Hepatocellular ; drug therapy ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cyclin D1 ; metabolism ; Cyclin-Dependent Kinase 2 ; metabolism ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; Hep G2 Cells ; Humans ; Liver Neoplasms ; drug therapy ; Organoplatinum Compounds ; pharmacology ; Tumor Suppressor Protein p53 ; metabolism

Objective Find abnormal changes of plasma lipid metabolism-related proteins before 20 weeks of gestation in patients with hypertensive disorder of pregnancy(HDP), and preliminarily investigate the role of plasma apolipoprotein C4 elevation in HDP. Methods A nested case-control study was used. The plasma were collected from pregnant women who underwent routine prenatal examination in Guangzhou Women and Children's Medical Center from November 2014 to March 2017. Label-free mass spectrometry was used to detect the differences in plasma lipid metabolism-related proteins before 20 weeks of gestation between 12 pairs of HDP patients and normal controls, and different 48 pairs of samples were used for verification. The protein with the most significant difference multiples was screened to study its effects on monolayer permeability and nitric oxide secretion of endothelial cells. One-way ANOVA was used for comparison between groups, and P<0.05 was considered as statistically significant difference. Results Compared with the control, the lipid metabolism-related proteins, APOC4, Fatty acid-binding protein 4 (FABP4), Apolipoprotein E (APOE), Apolipoprotein C3 (APOC3) and Beta-2-glycoprotein 1(APOH) raised to 1.94, 1.82, 1.59, 1.55 and 1.38 times, phospholipid transfer protein (PLTP) decreased to 0.78 times in plasma before 20 weeks of pregnancy of patients with HDP (t value were 2.499, 2.497, 2.081, 2.098, 2.426 and 2.564, respectively, P<0.05). Cell experiments results showed that 50 ng / ml APOC4 significantly increased 20％ HUVEC single layer cell permeability to FITC-labeled dextran (F=455.4, P<0.01), and significantly decreased the level of nitric oxide in the supernatant of HUVEC culture by 25％ (F=61.92, P<0.01). Conclusions Before diagnosis, plasma protein levels involved in lipid metabolism in HDP patients have been changed, resulting in abnormal lipid metabolism. APOC4 can increase the permeability of vascular endothelial cells, inhibit endothelial source of NO secretion, cause endothelial dysfunction.

Objective To explore the effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)combined with chemotherapy on progres-sion-free survival(PFS)in advanced non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)mutation.Methods A total of 110 advanced NSCLC patients with EGFR mutation in our hospital from January 2019 to April 2021 were selected as research objects.Ac-cording to different therapeutic plans,they were divided into group A with 37 cases(anlotinib chemo-therapy),group B with 32 cases(icotinib chemotherapy)and group C with 41 cases(anlotinib plus icotinib and chemotherapy).The short-term effect,levels of vascular growth factors before and after treatment,and the incidence of adverse reactions were compared among the three groups.After 2 years of follow-up,survival curve was drawn by Kaplan-Meier method,and survival rate and PFS were compared in three groups by Log-rank.Results The objective response rate(ORR)was 68.29％in the group C,which was significantly higher than 43.24％in the group A and 40.62％in the group B(P＜0.05);after treatment,levels of serum vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)and platelet-derived growth factor(PDGF)in the group C were significantly lower than those in the group A and the group B(P＜0.05);the total incidence of adverse reac-tions was 29.27％in the group C,which showed no significant differences when compared to 24.32％in the group A and 25.00％in the group B(P＞0.05).By the time of the last follow-up,the 2-year overall survival rate was 74.29％in the group C,which was significantly higher than 51.09％in the group A and 45.03％in the group B(Log-rank x2=6.478,P=0.039);the medi-an PFS in the group A,the group B and the group C was 9.0,8.6 and 13.2 months respectively,and differences were statistically significant(Log-rank x2=6.264,P=0.043).Conclusion For the advanced NSCLC patients with EGFR mutations,combination medication of EGFR-TKI com-bined with chemotherapy can effectively increase ORR,reduce levels of serum vascular growth fac-tors,prolong the PFS,and the safety is good.