Objective Summarize the nursing experiences of abdominoscope for patients with ovarian cysts. Methods Enough preoperative evaluation, careful perioperative nursing and observation were used in 150 patietns with ovarian cysts when cured by abdominoscope. Results All the patients had accepted succesful operation, there were no intensive complication among the patients. Conclusions Proper nursing measures should be developed with therapeutic laparoscopy, nursing cares according to the operation can effetive shorten the course of rehabilitation for patients.

Objective To study the application of problem-based learning in combination with simulating teaching in clinical probation of gynecology and obstetrics. Methods The patten of problem-based learning in combination with simulating teaching was applied to experimental group,and the traditional teaching pattern to control group. The teaching effects were evaluated by evaluation of teacher,questionnaire after class and examination. Results Satisfaction ratio of experimental group was significantly higher than that of control group in questionnaire after class. The fine ratio of experimental group was significantly higher than that of control group in written history and case analysis; but there was no significance in excellence ratio and pass ratio. There was no significance in pass ratio ,fine ratio and excellence ratio of finals between them. Conclusion The application of problem-based learning in combination with simulating teaching in clinical probation of gynecology and obstetrics can develop students'ability to practice and improve the quality of class teaching.

Objective To explore the relationship between 24-hour blood pressure variability after admission and early neurological deterioration in patients with acute non-cardioembolic ischemic stroke.Methods This was a case-control study.Patients with acute non-cardioembolic ischemic stroke within 72 hours after stroke onset were prospectively registered.Clinical and 24 -hour continuous blood pressure monitoring data were recorded, and subsequently compared with regard to whether early neurological deterioration ( END) occurred within 7 days after admission.Factors contributing to END were investigated by logistic regression model.Results Of 221 eligible patients, 59 cases ( 26.7%) exhabited END.Patients with END had higher 24-hour mean systolic blood pressure ( SBP) (145.8 ±18.2 mmHg vs.139.9 ± 20.3 mmHg, P=0.014) and SBP coefficient of deviation (SBP-CV) [9.0(7.3 -11.2) vs.8.4(6.9-10.2), P=0.011].After adjusting for crude variables, multivariate analysis showed that the increase in mean SBP (10 mmHg mean SBP,OR=1.285,95%CI(1.059~1.559) and SBP-CV [1 unit of SBP-CV, OR=1.206,95%CI(1.050~1.384)] was associated with higher risk of END.Conclusions Increased 24-hour blood pressure variability after admission is an independent risk factor for occurrence of END in patients with acute non-cardioembolic ischemic stroke.

Objective To investigate the correlation betw een the short-term blood pressure variability and the recent outcome in patients w ith noncardioembolic ischemic stroke. Methods The patients w ith acute noncardioembolic ischemic stroke admitted to hospital betw een January 1, 2013 to June31, 2015 w ere enrol ed consecutively. The demographic and clinical data w ere col ected, and 24 h ambulatory blood pressure monitoring w as performed and each blood pressure variability parameter w as calculated. The modified Rankin scale (mRS) w as used to evaluate recent neurological outcome at the time of discharge or the fourteenth day in hospital. The mRS score 0-2 w as defined as good outcome, and >2 w as defined as poor outcome. Multivariate logistic regression analysis w as used to determine the correlation betw een the blood pressure and the short-term blood pressure variability indicators and recent neurological outcome. Results A total of 229 patients w ith acute noncardioembolic ischemic stroke w ere enrol ed, and 40.2% of them had recent poor functional outcome. The mean systolic pressure ( 147.8 ±19.6 mmHg vs.137.7 ± 19.1 mmHg; t=3.868, P<0.001; 1 mmHg=0.133 kPa) and the actual variation value of the mean systolic pressure (median, interquartile 11.7 [10.0-14.0] mmHg vs.10.6 [8.2-12.5] mmHg;Z=3.544, P<0.001) of the recent poor outcome group w ere significantly higher than those of the good functional outcome group. Multivariate logistic regression analysis show ed that after adjusting other confounders, the increased mean systolic pressure ( each 10 mmHg increase: odds ratio 1.189, 95% confidence interval 1.013-1.369; P=0.034) and the enlarged actual variation of systolic blood pressure (each 1 mmHg increase:odds ratio 1.182, 95% confidence interval 1.046-1.336; P=0.008) w ere associated w ith the recent poor functional outcome. Conclusions The increased short-term blood pressure variability w as associated w ith the recent poor functional outcome in patients w ith acute noncardioembolic ischemic stroke.

Objective To compare the cognitive function of children with behavior problems and normal children. Methods 87 children with behavior problems were choosed as study group,according to Rutter' s Children Behaviour Qestionnaire. And 87 normal children were choosed randomly as normal control. Chinese Wechsler Intelligence Scale for Children (C-WISC) ,Clinical Memory Scale (CMS) ,Number Cancellation Test (NCT) and the Forth Exceptional Test (FET) were adopted to assess the cognitive function of children in two groups. Results Compared with normal control, arithmetic scale ( ( 10.40 ± 3.02 ) vs ( 12. 13 ± 3.26 ) ), verbal IQ ( ( 121.55 ±12.54) vs ( 129.40 ± 13.98) ), object assembly scale ( ( 9.98 ± 2.79 ) vs ( 11.70 ± 2.78 ) ), performance IQ((97.40±10.84) vs ( 103.93 ±14.22)),full IQ ((112.28±11.14) vs (119.03 ± 12.57)),verbal comprehension IQ ( ( 110.48 ± 11.23 ) vs ( 115.80 ± 12.31 ) ), memory/concentration IQ ( ( 101.25 ± 11.66 ) vs ( 109.40 ± 15.45 ) ),the net scale ( (67.05 ± 33.85 ) vs ( 88.72 ± 22.51 ) ) and error rate( ( 32.27 ± 35.77 ) %vs ( 15.41 ± 10.35 ) % ) were lower in children with behavior problems ( all P ＜ 0.05 ). In study group, the total scale of Rutter' s Children Behaviour Qestionnaire was negatively correlated with memory/concentration IQ, and with net scale(r = - 0. 335, - 0. 367, P ＜ 0.05 );but it was positively correlated with error rate (r = 0. 333, P ＜ 0.05 ). Conclusion Cognitive defects may exist in children with behavior problems.

Objective To investigate the effects of dynamic ventilatory factors on inflammatory response and function of extrapulmonary organs in acute respiratory distress syndrome (ARDS) dogs. Method Thirty-six healthy dogs were randomly divided into 6 groups: normal control group (N group), ARDS group ( M group) and ventilation groups (A～D groups)hased on a series of random number. The ARDS dog model was replicated by iutrawacheal instillation of hydrochloric acid and mechanical ventilation was carried out according to the following protocols. Group A:low VT, low inspiratory flow and high respiratory rate. Group B: large VT, high inspiratory flow and high respiratory rate. Group C: large VT, high inspiratory flow and low respiratory rate. Group D: large VT, low inspiratory flow and low respiratory rate. After 4 hours of mechanical ventilation, animals were sacrificed.Tumor necrosis factor (TNF)-α and intefleukin (IL)-8 levels in blood serum were measured by radioimmunoassay.Histopathological changes of liver and kidney were observed under light microscope. Results The level of IL-8 and TNF-u of group B and C were much higher than those of group D, A and M ( P<0.05), but there was no significant difference among group D, A and M ( P>0.05). The level of IL-8 and TNF-α of group N were much lower than other groups ( P<0.05). The change of histopathology was the most significant in group B and C while the change of histopathology on group C was better than group B. The change of histopathology on group A and D was better than group B and C. The change of group A was similar to group M. All the data were analyzed by statistical F test. There was statistical difference with P<0.05. Comclusions Large tidal volumes with high inspiratory flow and high respiratory rate may increase mediators of inflammation in blood sennn, and aggravate the irflamnnmtory response of extrapulmonary organs. Beducfion of inspiratory flow and respiratory rate ventilation may prevent the occurrence d multiple organ dysfunction syndrome.

Aim To investigate the effect of bufalin on proliferation and expression of WT1 in K562 cells. Methods The colony number of K562 cell was detec-ted with semi-solid culture assay. The cell cycle was measured by flowcytometry, and the expression of WT1 was observed with immunocytochemistry. Subcutaneous tumor models established by K562 cells in BALB/C nu/nu mice were divided into three groups, including model group, bufalin group and positive control group. After 21 days, the subcutaneous tumors were removed for calculating the inhibitory rate of tumor growth. HE staining and immunohistochemistry were used to ob-serve the morphological changes and the expression of WT1 . Results ① Bufalin could significantly decrease the colony number of K562 cell, arrest it at G0/G1 phase and down-regulate its expression of WT1 in a dose-dependent manner. ② Compared with the model group, the tumor inhibitory rate was much higher, while the volume and the weight were obviously lower in the other two groups. ③Bufalin could induce apop-tosis, necrosis, hemorrhage and fibrosis with HE stai-ning, and down-regulate the expression of WT1. Con-clusion Bufalin could inhibit the proliferation, arrest the cell cycle at G0/G1 phase and down-regulate the expression of WT1 in vitro. Bufalin could inhibit the tumor inhibitory rate, the volume and the weight of the subcutaneous tumors, induce apoptosis, necrosis, hemorrhage and fibrosis with HE staining and down-regulate the expression of WT1 .

ObjectiveTo explore the influences of Penehyclidine Hydrochloride on [ Ca2 + ] i and the expression of cysteine-containing aspartate-specific proteases-3 (Caspase-3) in neural cells of neonatal rats after hypoxic-ischemic injury within 12 h.MethodsSeven-day-old Sprage-Dowley rats ( n =128) were randomly assigned into four groups:Sham group ( sham operation group,n =32),hypoxic-ischemic encephalopathy (HIE) group ( HIE models,n =32 ),N group ( HIE models treated with Nimodipine,n =32 ),and P group (HIE models treated with Penehyclidine Hydrocloride,n =32).Brain tissues were collected at different time points (2 h,4 h,6 h,and 12 h) after modeling.We utilized fluorescent microscope to detect the expression of Caspase-3 via making frozen slices of rat brain tissue,while [ Ca2+ ]iof neural cells in live brain slices of rats was measured by laser scanning confocal microscope.ResultsCompared with Sham group,both [ Ca2 + ] i and the expression of Caspase-3 of neural cells increased significantly ( P ＜ 0.01 ) in brain cortex in HIE group.[ Ca2 + ] i and Caspase-3 activity increased gradually with time since 2 h after making HIE models and reached a peak at the time points of 12 h ( P ＜0.05).In N group and P group,both of [ Ca2+ ]i and Caspase-3 decreased compared with HIE group (P ＜0.01 ),however,there was no significant difference between N group and P group ( P ＞ 0.05 ).In addition,[ Ca2 + ] i and Caspase-3 activity had no significant difference between 6 h and 12 h (P ＞ 0.05 ).ConclusionPenehyclidine Hydrocloride can protect the brain tissue from hypoxic-ischemic injury via relief of calcium overload and inhibition of Caspase-3 activity.

Objective To discuss the relationship of drip velocity of nitrate on blood pressure while treating coronary disease,in order to provide appropriate drip velocity for clinical treatment.Methods 155 patients with coronary disease using nitrate to lower blood pressure were selected.They were divided into the nitro glycerin group(85 cases) and the isosorbide mononitrate group( 70 cases) according to difference of medication.The velocity of drugs was adjusted on basis of blood pressure changes.The blood pressure changes at different drip velocities were observed and compared.Results The systolic pressure and the diastolic pressure between two groups showed no difference at 20 drops/min,but the results were the opposite at 30 drops/min.The systolic pressure and the diastolic pressure in the nitro glycerin group showed evident changes at different drip velocities,but in the isosorbide mononitrate group,these changes were not so significant.9 patients in the nitro glycerin group had headache during treatment,no headache occurred in the isosorbide mononitrate group.Conclusions Intravenous use of nitrate at a velocity of 20 drops/min is relative secure.The risk of hypotension will increase if the medication speed increases.lsosorbide mononitrate has little influence on blood pressure.

Objective To evaluate the effectiveness of applying simulation based medical education (SBME) in critical care medicine PBL teaching. Methods Totally 46 undergraduates in medical college of Shanghai JiaoTong University , who participated in critical care medicine PBL teaching in our Hospital from 2012 to 2013 were chosen as research objects. These students were divided into two groups: PBL group (2009 grade, n=24) and SBME-PBL group (2010 grade, n=22). The teaching effectiveness was evaluated by questionnaire survey, theoretical exam, direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (Mini-CEX). Data were analyzed by SPSS 17.0 software. The data of questionnaire survey were expressed as percentage and the assessment results were expressed as x±s. Chi-square and t test were used to do statistical analysis. P<0.05 signi-fies for statistically significant differences . Results ①The results of questionnaire survey showed that:there was no significant difference between two groups in study interests(P=0.665, 0.937, 0.746) and study ability(P=0.937, 0.665). But regarding collaboration ability, SBME-PBL group performed better than PBL group (P=0.019, 0.038, 0.024). ②These was no significant difference in the theo-retical knowledge exam between PBL and SBME-PBL group(P=0.743). But the DOPS scores of car-diopulmonary resuscitation (P=0.000), endotracheal intubation (P=0.023), defibrillation (P=0.002) and central venous catheterization(P=0.047) were all significantly higher in SBME-PBL group than in PBL group. ③In Mini-CEX, there was no statistical difference in physical examination skills (P=0.790) and clinic judgment(P=0.426) between the two groups. However, SBME-PBL group performed better in medical interviewing capacity(P=0.002), humanistic care (P=0.001), counseling skills(P=0.017), organization efficiency(P=0.029) and overall clinical competence(P=0.024) than PBL group. Conclusions SBME can promote the students' team work spirit, basic clinical skills and comprehen-sive clinical capacity in critical care medicine PBL teaching and can improve the teaching quality of critical care medicine.