Objective To study the temperature control method of the cooling water system for Siemens medical proton and heavy-ion synchrotron.Methods The return water temperature was used as the input variable of the control program,temperature prediction method was applied to controlling valve opening,and the capacity of water tank at backwater-side was increased to enhance temperature buffer capability.Results The optimized system adapted itself to multi loading conditions of the synchrotron,which achieved 2 ℃ peak elimination in case of return water at 32 ℃ or less to limit the input water temperature within (27±1) ℃.The failure rate of temperature deviation was decreased from 64％ to 8％.Conclusion The optimized cooling water system with three-layer structure fulfills the requirements of Siemens proton heavy-ion synchrotron operation.

Objective: To investigate the effects of nursing process on the support of early enteral nutrition(EEN) in severely burned patients.Methods: EEN was carried out in 97 patients with severe burns by retention of naso-gastric(intestinal) feeding tube and continuous drip of nutritious fluid.97 patients were divided by different periods into two groups:group A and group B.The nursing process was used in group B.A series of parameters including the bearing to enteral nutrition,the patients′ nourishment,the occurance rate of complication,the time of wound healing and the cure rate were observed and analysed.Results: The bearing to EEN of the patients in group B was better than that in group A(P

The functional experimental teaching reform plays a very important role in raising the teaching resources,consummating the experimental teaching management system,enhancing the student to practice the ability and so on and has obtained the good effect.But it also faces some problems waiting urgently to be solved and further perfected,to which this article has made the analysis and the discussion from the management science angle.The goal lies in deepening the educational reform in functional experiment unceasingly to provide the model.

Objective: To analyze the influencing factors for bladder cancer in Taizhou,and to provide evidence for strengthening the prevention and treatment of bladder cancer in Taizhou. Methods : A total of 500 cases of bladder cancer diagnosed in Taizhou Hospital from 2012 to 2017 were selected as a case group,and 504 patients without tumor or urinary system diseases during the same period were selected as a control group. A structured questionnaire was used to retrospectively investigate the demographic information,occupational exposure（whether they were exposed to aromatic amine,polycyclic aromatic hydrocarbons,tobacco,tobacco smoke or heavy metals at work）,healthy behaviors and diets of the two groups one year before admission. A Logistic regression model was used to analyze the influencing factors for bladder cancer. Results : There was no significant differences in sex,age,ethnicity,education and marital status between the case group and the control group（P > 0.05）. Patients with occupational exposure history accounting for 31.60% in the case group and 24.60% in the control group,for overweight/obesity were 37.60% and 31.74%,for smoking were 55.80% and 46.23%,for high vegetable intake frequency were 43.80% and 52.58%,for high fruit intake frequency were 55.40% and 62.70%,for physical activity were 24.60% and 31.75%,respectively. The results of multivariate logistic regression analysis showed that occupational exposure（OR=1.861,95%CI：1.229-2.836）,overweight/obesity（OR=1.374,95%CI：1.021-1.863）,current smoking（OR=1.664,95%CI：1.101-2.503）and previous smoking（OR=1.454,95%CI：1.016-2.066）were the risk factors for bladder cancer. High vegetable intake frequency（OR=0.731,95%CI：0.566-0.947）,high fruit intake frequency（OR=0.659,95%CI：0.463-0.927）and vigorous physical activity（OR=0.566,95%CI：0.403-0.798）were the protective factors for bladder cancer. Conclusion Occupational exposure,overweight/obesity,current smoking,previous smoking were the risk factors for bladder cancer. High vegetables intake frequency,high fruit intake frequency and vigorous physical activity were the protective factors for bladder cancer.

Obesity is a serious public health issue affecting both children and adults. The causes that drive obesity appear to be complex,and a consensus hypothesis is that obesity is influenced by a mixture of envi-ronmental,genetic,and many other factors. Recent evidence suggests that gut microbiota is involved in the con-trol of body weight,energy homeostasis and inflammation,and gut microbiota,plays a role in the pathophysiolo-gy of obesity. Natural delivery,breastfeeding,and early antibiotic resistance are beneficial to maintaining the bal-ance of intestinal microbiota,which may reduce the risk of future obesity. Prebiotics and probiotics may alter the composition of gut microbiota and affect food intake and appetite and body weight. Exploring the relationship be-tween gut microbiota and obesity might provide new methods to prevent and treat children obesity.

Objective: To investigate the changes of B cell-activating factor (BAFF) and a proliferation- inducing ligand (APRIL) in serum of children with Henöch- Schönlein purpura nephritis (HSPN), and to explore their role in the pathogenesis of children HSPN. Methods: A total of 28 children with HSPN who were before treatment were selected in Department of Pediatrics Nephrology and Rheumatology, Shengjing Hospital of China Medical University from November 2017 to August 2018.Sixteen children with Henöch-Schönlein purpura were selected as HSP group, and 20 healthy children were selected as healthy control group.Followed the HSPN guideline to cure the patients for 6-8 weeks.The clinical data were collected.Serum levels of BAFF and APRIL were measured by adopting enzyme-linked immunosorbent assay (ELISA). Results: (1)Changes of serum BAFF level: the serum levels of BAFF in HSPN children were significantly lower than those in the HSP group and the healthy control group[ HSPN group (0.652±0.360) μg/L, HSP group (1.276±0.459) μg/L, healthy control group (1.285±0.299) μg/L, F=17.519, P=0.000]. Moreover, the serum levels of BAFF in before treatment were significantly lower than those in after treatment [before treatment (0.652±0.360) μg/L, after treatment (0.860±0.262) μg/L, P<0.05). However, there were no significant di-fferences in the serum levels of BAFF between HSP group and healthy control group (P>0.05). (2)Changes of serum APRIL level: the serum levels of APRIL in HSPN and HSP children were both significantly higher than those in healthy control group, but there were no marked differences between the 2 groups [HSPN group (2.285±1.015) μg/L, HSP group (2.609±1.264) μg/L, healthy control group (1.677±0.118) μg/L, F=3.647, P=0.016]. There were no significant differences in the serum levels of APRIL between before treatment and after treatment [ before treatment (2.285±1.015) μg/L, after treatment (2.042±0.695) μg/L, P>0.05]. (3)Pearson correlation analysis results showed that the serum levels of BAFF were negatively correlated with 24 h urinary protein, urinary microalbumin, and urine red blood cell count (r=-0.587, -0.608, -0.515, all P<0.05). The serum levels of APRIL were positively correlated with serum IgA(r=0.588, P<0.05). Conclusions The level of serum BAFF decreased and APRIL increased in children with HSPN, which was related to the degree of renal involvement.It suggests that BAFF and APRIL may be related to the pathogenesis of HSPN in children.

ObjectiveTo perform pharmacology problem-based learning (PBL) and evaluate its effects.MethodsPBL was performed for the clinical medicine class of grade 2007 and the satisfactory degree of students to teaching effects was observed with questionnaire. Results The students thought that PBL teaching had substantial contents and proper schedule and increased learning interest. Students' participating degree, mutual communication and controlling discussion procedure were fine,which reached the expected learning objective. ConclusionsThe effects of PBL teaching were excellent and most of our students could accept it.

Henoch-schonlein purpura nephritis(HSPN) is the most common secondary glomerular disease in children.The pathogenesis of HSPN is unclear.In recent years,there have been some reports on B lymphocyte activating factor(BAFF) and a proliferation inducing ligand (APRIL),new members of the tumor necrosis factor family,as well as their association with HSPN.This paper reviews the related research from the following aspects:structure and biological functions of BAFF and APRIL,the role of BAFF/APRIL in the pathogenesis of HSPN,the prospect of BAFF and APRIL targeted biological agents in the treatment of HSPN.It provides a reference for further research on BAFF/APRIL system and HSPN.