Considering a variety of theories such like Dunkin's, Centra's and Kolitch's, a set of 13 indicators are designed to evaluate effect of courses taken in high education of China currently, compro-mised by chief aspects of course designing, practicing, and effect. Three courses including medical nursing, humanistic cultivation and communication skills in nursing and fundamentals of nursing in a nursing de-partment are chosen to be objects of questionnaire survey about the above indicators. The results show that there are significant differences in curriculum effectiveness between different courses. The scores are 2.81, 2.80 and 2.60 respectively, and teachers and students have different evaluation on the same indicators of the same curriculum,which provides a reference for teachers, colleges and universities and teaching management departments to promote the improvement of teaching quality.

Chordoma ; Female ; Humans ; Middle Aged ; Nasal Septum ; Nasopharyngeal Neoplasms ; Nose Neoplasms

Adenoidectomy ; Adenoids ; pathology ; surgery ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Postoperative Period

Adult ; Choristoma ; Female ; Humans ; Nasopharynx ; pathology ; Paranasal Sinus Diseases ; Pituitary Neoplasms ; Sphenoid Sinus ; pathology

AIM: To evaluate the changes of corneal high - order aberration (including Coma, Spab, RMSh) after laser in situ keratomileusis (LASIK) with femtosecond laser, sub- Bowman keratomileusis ( SBK ) and laser epithelial keratomileusis (LASEK). METHODS: Of 82 myopic patients ( 164 eyes ), 31 patients (62 eyes) were treated by FS-LASIK, 31 patients (62 eyes) were treated by SBK, 20 patients (40 eyes) were treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery. RESULTS: 1) Vision: The uncorrected visual acuity of the three groups had no differences (P>0. 05). 2) Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly (P<0. 05). The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS- LASIK was smaller than the other two groups, with statistical significance (P<0. 05). CONCLUSION: Compared with SBK and LASEK, FS - LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

Objective:To explore the relationship between the type of mutation and clinical features, prognosis, and clinical characteristics of chronic granulomatous disease (CGD) caused by compound heterozygous mutations in the NCF2 gene in children. Methods:The clinical data of 1 case of neonatal CGD caused by compound heterozygous mutations of NCF2 gene at Tianjin Children′s Hospital in August 2019 was analyzed, and domestic and international literatures were searched to summarize the clinical characteristics, gene mutation type and prognosis of CGD caused by NCF2 mutation. Results:The diagnosis of CGD was confirmed by the presence of compound heterozygous mutations c. 196_197insA (p.Arg66Glnfs23X) and c. 1180T>G (p.Tyr394Asp) in the NCF2 gene, accompanied with the clinical manifestations of fever, cough, multiple clumps and nodules in the chest CT at 25 days after birth, and the neutrophil respiratory burst test stimulation index(SI) 23.This new mutation was not reported in the Human Genetic Mutation Database.The child had a residual portion of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity and was followed up until the age of 9 months with an antifungal drug without recurrent infection.A total of 101 cases of CGD patients with NCF2 gene mutation were reported in domestic and international databases.Totally, 33 cases had SI results, with 22 cases below 3, 11 cases above 3, and 8 cases of missense mutations. Conclusions:c. 196_197insA and c. 1180T>G are new mutations in NCF2 gene that can lead to CGD.CGD patients containing missense mutations in the NCF2 gene may have more residual NADPH oxidase activity.

Objective To investigate quantitatively the thermal sensation characteristics of the patients with facial palsy and the value of quantitative thermal test (QTT) in prognostication.Methods The QTT threshold of the fore ear and cheek of 30 patients with peripheral facial palsy was tested,their facial nerve conduction velocity was measured,and House-Brackmann facial nerve grading system was used to estimate facial nerve function at 2～3 weeks,a month,two months and half a year post onset.Results It was found that 12 out of 30 patients had abnor- mal QTT threshold value;the majority of them suffered from herpes virus and diabetes.In those with abnormal QTT, 8 were with diabetes mellitus (account for 66.7%),3 with partial shingles (account for 25%),and 1 with positive serum virus infection (account for 8.3%).Those with normal QTT were significantly different from those with abnor- mal QTT,with regard to the House-Brackmann rating scores after 2 and 6 months post onset (P

OBJECTIVETo observe interventional effects of anti-viral therapy and Compound Qin-gre Granule (CQG) on host cellular immune functions of acute virus infection patients.

METHODSThirty acute virus infection patients were recruited to detect peripheral lymphocyte subsets. They were randomly assigned to two groups, the Western medicine treatment group (treated with anti-virus Western medicine) and the integrative medicine treatment group (treated with anti-virus Western medicine plus CQG). T-cell subsets were re-examined 7 days later. Changes between before and after treatment were observed. Effect on host cellular immune functions and efficacy were compared between the Western medicine treatment and the integrative medicine treatment.

RESULTSCompared with the normal control group, the percentage of peripheral T cells increased, and the percentage of B/NK cells decreased in acute virus infection patients (P < 0.01). Meanwhile, in T cell subsets, the percentage of CD8+ T cells and CD8+ CD38+ T cells increased (P < 0.05, P < 0.01); and percentages of CD4+ T cells, CD4+ CD28 + T cells, and CD8+ CD28+ T cells decreased (P < 0.05, P < 0.01). After one-week treatment, percentages of CD4+ T cells, CD4+ CD28+ T cells, and CD8+ CD28+ T cells increased (P < 0.05, P < 0.01), while the percentage of CD8+ CD38+ T cells decreased (P < 0.01). More significantly, these changes were greater in the integrative medicine treatment group than in the Western medicine treatment group (P < 0.05).

CONCLUSIONSDisarranged cellular immune functions existed in acute virus infection patients. CQG could significantly improve viral infection induced immunologic derangement and immunologic injury.

Fluid therapy has been the focus of attention and dispute. In this paper, there are three aspects including postoperative bowel function, surgical prognosis, and acute diffuse peritonitis. Colloidal supplement and appropriate crystal/colloid ratio should be noted in low perfusion conditions. The different types of fluid in recent studies did not show a significant difference in the long term. The new evidence will be noted in fluid therapy among 2012 SSC Severe Sepsis and Septic Shock Guideline update (unpublished).
Digestive System Surgical Procedures ; Fluid Therapy ; Humans ; Perioperative Care ; Peritonitis ; therapy ; Prognosis ; Shock, Septic ; therapy

Objective:To evaluate the outcome and prognostic factors of conventional radiotherapy followed by intensity-modulated radiation therapy (IMRT) as a boost combined with chemotherapy in the treatment of high-grade gliomas (HGG). Methods:From Nov. 2004 to Nov. 2006, 112 HGG patients were treated with conventional radiotherapy followed by IMRT as a boost combined with chemotherapy. The radiotherapy regimen included first-course conventional radiotherapy and latE-course IMRT as a boost with the total radiation dosage of 57.5- 62.5Gy (27-29 fractions in 37-45 days). All the patients received chemotherapy. Sixty-three patients received temozolomidE-based chemotherapy and 49 patients received semustine plus teniposide chemotherapy. The treatment reaction was recorded. The overall survival rate and local progression-free survival rate were calculated. The prognostic factors were analyzed by using multivariate COX regression model. Results:The acute treatment toxicity was the most at grade 1 to grade 2 and no grade 4 adverse reaction was observed. Three cases had late radiation-induced brain necrosis. The overall 1-, 2-, and 3-year survival rates were 78.9%, 54.7%, and 30.8%, respectively. Multivariate analysis revealed that tumor location (P=0.001) and KPS score (P=0.011) were independent prognostic factors. The 1-, 2-, 3-year local progression-free survival rates were 63.8%, 38.9%, and 10.5%, respectively. Multivariate analysis revealed that tumor location (P=0.001), KPS score (P=0.001), and histologic type (P=0.005) were independent prognostic factors. Multivariate analysis did not reveal the significant correlation of temozolomide chemotherapy with the prognosis of the patients. Conclusion:Postoperative conventional radiotherapy followed by IMRT as a boost combined with chemotherapy has better short-term efficacy in the treatment of HGG and the adverse reaction is tolerable. KPS score, tumor location, and histologic type are important prognostic factors. Temozolomide chemotherapy is not associated with the prognosis of patients.