Objective To explore the efficacy of the case and scenario teaching method in the neurosurgery practice teaching.Methods By cluster sampling,153 nursing students underwent rotary practice in neurosurgery department in People's Hospital of Three Gorges University from September 2011 to July 2012 were trained with the case and scenario teaching method.Scenario simulation training combined with case playback teaching was used in practice teaching.At the end of the internship,nursing students' satisfaction was investigated and their operational capacity was evaluated.Self-designed questionnaire was adopted to evaluate satisfaction.Operational capacity evaluation scores of nursing students were divided into several parts:basic operation examination (30％),specialized operation (30％),professional theory (30％) and teacher evaluation (10％).Data were analyzed using Excel spreadsheet for entry.Countif and Count function formula were used to calculate eligibility and the passing rate.Results Nursing students had high evaluation on case playback teaching methods.By this method,153(100％) nursing students considered that the learning initiative was improved.At the end of the internship,passing rates of basic operation examination,specialized operation,professional theory were 98.69％ (151/153),96.73 ％ (148/153) and 100％ while the total passing rate was 100％.Conclusion The case and scenario teaching method could develop the study positivity and practice ability of nursing students and can enhance the internship efficacy.

Objective To explore the effective nursing and long-term safety training mode, early intervention on safety awareness of junior nurses, regulate the safety behavior, ensure patient safety. Methods The ideas and methods of HSE management system (health, safety and environment trinity management system) were introduced, from training needs research, safety courses design, safety behavior training, training process management,safety knowledge clinical application and training quality control implementation of systematic management.From 2013 to 2014 low seniority nurses safety training for 2 years, including new hospital nurse per year.Taking the self contrast before and after experimental design, safety knowledge to master the situation, the nurse's satisfaction and quality of care and safety management before and after training were compared. Results The actual class qualified rate and safety knowledge awareness and the excellent and good rate of safety skills assessment after training were 80.10%(157/196), 92.34%(181/196),96.43%(189/196), which were higher than those of 65.30%(128/196), 81.63%(160/196), 88.78%(174/196) before training, and the differences were statistically significant, χ2=10.81,9.94,7.07,P<0.01. The overall satisfaction of the nurses for safety training was 92.35%(181/196)after training, which was higher than that of 80.61%(158/196)before training, the difference was statistically significant, χ2=16.37, P < 0.01.The qualified rate of nursing quality for the critically ill patients after training was 90.13%(210/233), which was higher than that of 81.48%(176/216) before training, the difference was statistically significant, χ2= 6.94, P < 0.01. The patient safety and quality, the quality of nursing records were 95.81%(206/215), 95.29%(688/722) after training, respectively, which were higher than those of 89.60%(181/202), 85.10%(577/678) before training, the differences were significant, χ2=5.98,4.17, P<0.05. Conclusions Improved safety training is normative, practicability and maneuverability, safety behavior norms, improve the risk identification and emergency handling ability, reduce nursing risk, close to the clinical need for safety management, safety training for nurses to provide the basis for sustainable development.

Objective Percoll density gradient centrifugation and Ficoll-Hypaque density gradient cen-trifugation, which are frequently-used methods for separation of tumor-associated macrophages (TAMs) from solid carcinoma were compared, in order to find an effective way to separate TAMs from colorectal carcinoma (CRC). Furthermore, we studied the best adherence time of separating macrophage among mononuclear cells. Methods specimens were collected from CRC patients , after digesting into single cells , TAMs were separated from the same specimen by 100% Ficoll, 35% percoll and 25% combined with 65% percoll respectively. After these pre-liminary separation, the collected cells were purified a second time by adherence separation. The purity of TAMs were detected by immunofluorescence. Results TAMs purity from Ficoll-Hypaque density gradient centrifugation was 80.18%, statistically higher than that from Percoll density gradient centrifugations (54.33% and 10.93% re-spectively). Conclusion Compared to Percoll density gradient centrifugation, Ficoll-Hypaque density gradient centrifugation is a more effective and simple way to isolate TAMs from colorectal carcinoma , suggesting it can be wildly used in clinical and basic medical research. 2-4 hours is the best adherence time for isolating macrophage.

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Objective To analyze the risk factors of malignant glaucoma for primary angle-closure glaucoma(PACG) patients after surgery.Methods Clinical data of elderly patients with PACG who had received surgical treatment at our hospital between 2013 and 2016 were retrospectively analyzed.Patients were divided into two groups according to whether they suffered (Group A) or not (Group B) from malignant glaucoma after surgery.Results A total of 238 patients (315 eyes) were retrospectively analyzed: 17 cases (22 eyes) in Group A and 221 cases (293 eyes)in Group B.The index of axial length, chamber depth and crystal thickness was lower in Group A than in Group B,and the difference was statistically significant(P<0.05).Univariate analysis showed that age under 50, continuous high intraocular pressure, axial length below 22 mm, chamber depth below 2 mm, crystal thickness below 4.5 mm, completely closed anterior chamber angle and chronic angle-closure type were the possible risk factors for malignant glaucoma after surgery (P<0.05).The logistic regression analysis showed that age under 50 and axial length below 22 mm were independent risk factors for malignant glaucoma for PACG patients after surgery.Conclusion PACG patients,especially those who are young or with short axial length,are more vulnerable to malignant glaucoma.

Objective To understand the situation of eosinophils absolute value and percentage in the population of occupational health examination in Changsha City ,and to analyze the distribution situation of physical examination abnormal results of eosino‐phils absolute value(EOS) and percentage(EOS% ) .Methods The blood cell analysis results and physical examination abnormal manifestations in 22 135 cases of occupational health examination were statistically analyzed .Results Among cases of EOS absolute value and EOS% increase ,the majority had the changes of EKG abnormality ,fatty liver ,etc .the minority were reactive and clonal increase ,meanwhile the cases of unknown cause eosinophils increase also accounted for a large proportion .Conclusion It is sugges‐ted that a large number of experiments and clinical studies should be carried out for further investigate the significance of eosino‐phils increase in the occupational health examination .

OBJECTIVE　To detect the trace glutaraldehyde in the fluid from venous circuit tube of hemodialysis,a HPLC assay was developed.METHODS　20 mL fluid taken from the venous circuit tube were derived with DNPH for 3 h,then filtered and injected. Chromatography was conducted on C18 column at 29℃.The mobile phase was consisted of 60% CH3N and 40% H3PO4 with the flow rate at 1 mL*min-1, and the detetion wavelength was at 365 nm.RESULTS　The concentrations of glutaraldehyde in the fluid ranged from 14.99 to 37.40 μg.mL-1.CONCLUSION　This HPLC method is simple and accurate to detect the trace glutaraldehyde remained in the fluid from venous circuit tube.

Objective To observe the clinical features of retinal arterial occlusion (RAO) in youth.Methods This is a retrospective case review.Nine patients (9 eyes) with RAO were enrolled in this study.There were 6 males (6 eyes) and 3 females (3 eyes).The average age was (14.22± 3.93) years.The best-corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus color photography and fundus fluorescein angiography were performed.All patients underwent systemic evaluation including blood routine,erythrocyte sedimentation rate,blood lipids,vasculitis screening,homocysteine level,antiphospholipid antibody,blood coagulation,neck vascular ultrasound,and cardiac color ultrasound and electrocardiogram examination.All patients received oxygen therapy,blood medications and symptomatic treatment.Meanwhile,the patients with autoimmune diseases were received systemic glucocorticoid therapy.The follow-up was ranged from 6 to 12 months.The visual acuity and fundus change before and after treatment were compared.Results among 9 patients,one patient had systemic lupus erythematosus,one patient had congenital heart disease,one patient had hypergammaglobulinemia,and carotid artery color ultrasonography showed that the internal carotid artery vessels faltered in 2 cases.The BCVA was 0.01-0.12.Among 9 eyes,there were 5 eyes (55.6％) with retinal branch artery occlusion (BRAO),2 eyes (22.2％) with central retinal artery occlusion (CRAO),2 eyes (22.2％) with ciliary retinal artery occlusion (CLAO).CRAO eyes showed positive RAPD (relative afferent pupillary defect),fine retinal artery and the corresponding vein,pale white retinal edema in posterior area and macular cherry-red spot.BRAO eyes manifested as inferior temporal artery occlusion and pale white retinal edema around them.CLAO eyes showed temporal ligulate grey-white retinal edema.At the last follow-up,BCVA improved and retinal vessels returned to normal in 7 eyes (77.8％);BCVA unchanged and no improvement in fundus in 2 eyes (22.2％).Conclusion Adolescent RAO is mostly partial occlusion,the prognosis is generally good after early active treatment.

Surface modification of titanium implants is a hot topic for improving osteointegration and includes physical, chemical, bioactive and anodization methods. Among these methods, anodization methods can form TiO2 nanotube structures with a uniform and stable structure, and TiO2 nanotubes and substrates have high binding strengths and osteogenic properties and represent an excellent method for implant modification. TiO2 nanotube osteogenesis is closely related to its morphology, diameter and physicochemical characteristics. Therefore, the structure of TiO2 nanotubes with optimal osteogenic performance can be prepared by regulating these factors. At present, research on TiO2 nanotubes is mostly focused on composite treatments with TiO2 nanotubes, namely, the combination of other implant modification methods (physical method, chemical method, biological method) and TiO2 nanotubes to form a composite structure to work synergistically to treat osteogenesis. TiO2 nanotube composite treatment is a good prospective application for the further preparation of TiO2 nanotube-modified structures with strong osteogenic properties.

Hepatolithiasis is a common biliary tract disease in China and other Asian countries.It has insidious onset,recurrent disease,and may lead to biliary cirrhosis or even cancer in the late stage without inter-vention.At present,surgery is considered to be the best choice for treatment.In the 21st century of minimally inva-sive surgery,traditional procedures such as partial hepatectomy,choledochotomy,cholangioenterostomy and liver transplantation can be performed with the assistance of laparoscopy and da Vinci robots,and emerging endoscopic techniques such as endoscopic retrograde cholangiopancreatography(ERCP)and percutaneous transhepatic cho-ledochoscopic lithotripsy(PTCSL)have also been developed,bringing better treatment for patients with hepatoli-thiasis.As treatment options are becoming more varied,there are also some clinical problems that need to be addressed.In this article,we would like to briefly review the current surgical treatment modalities in order to provide a theoretical basis for optimizing the treatment modalities.