Objective To explore the effect on job competency by reforming Fundamental Nursing courses among undergraduate nursing students.Methods 86 nursing undergraduates in Grade 2011 were recruited as the control group receiving conventional teaching method,while 119 students in Grade 2012 were recruited as the experimental group receiving reform of fundamental nursing courses.The teaching outcomes were evaluated by using Job Competence of Nursing Students Evaluation Form and Medical education environment measurement table.Results The reform of fundamental nursing courses had significantly elevated all the aspects of professional competency among nursing undergraduates (P＜0.01),including personal traits,clinical ability,communication,critical thinking,specialty construction[(35.71 ± 3.82) vs.(33.41 ± 4.77),(55.29 ± 8.29) vs.(43.93 ± 8.68),(22.19 ± 2.71) vs.(19.88 ± 2.96),(16.83 ± 2.85) vs.(14.37 ± 2.71),(37.78 ± 6.31) vs.(32.42 ± 5.72)].Meanwhile,three dimensions of medical education environment for nursing students were also improved,including the student's perception of the teacher,self academic perception,self social perception [(35.23 ±5.72) vs.(31.28 6..22),(21.42 ±4.19) vs.(23.42 ±3.53),(19.44 ± 3.86) vs.(18.19 ± 3.47),t=-4.523、-3.503、-2.308,P＜0.01 or 0.05)].However,there was no significant differences in the aspects of learning perception,environment perception,and the total score of medical education environment (t=-1.866、0.725、-1.705,P＞0.05).Conclusions The professional competence and parts of the teaching environment around the nursing students have been elevated through the reform of Fundamental Nursing course.The reform also laid a solid foundation for the employment of nursing students.

Objective_To explore the influence and mechanism of IL-31 on the expression of VEGF, EGF and EG-FR in 16HBE cells.Methods_16HBE cells were cultured and treated with IL-31 with or without SB203580 or SP600125, real-time PCR and Western blot were applied to determine the mRNA and protein expression of VEGF, EGF and EGFR respectively.Meanwhile, Western blot was used to examine the changes of P38 MAPK and JNK signaling pathways.Results_Compared with control group, the mRNA expression of VEGF, EGF and EGFR was increased markedly under the stimulation of IL-31 ( P<0.01 ) , the expression of p-P38 MAPK and p-JNK signifi-cantly increased ( P<0.01) .Compared with IL-31 group, the expression of p-P38 MAPK significantly decreased in IL-31 combined with SB203580 or SB203580 group ( P <0.01 ) , while the expression of p-JNK markedly decreased in IL-31 combined with SP600125 or SP600125 group( P<0.01) .Compared with IL-31 group, the expression of VEGF was significantly decreased in IL-31 combined with SB203580 or SP600125 group ( P <0.01 ) , while the expression of EGF and EGFR was markedly declined in IL-31 combined with SB203580 group ( P<0.01 ) .Conclusions_IL-31 may up-regulate the expression of VEGF through activating P38 MAPK and JNK signaling pathways and up-regulate the expression of EGF and EGFR through activating P38 MAPK signaling path-way in16 HBE cells.

Objective To determine the effect of different surgical modalities on hemodynamics,systemic major organ injury and survival rate following superior mesenteric artery (SMA) injury in an attempt to search a modality that conforms to principles of damage control surgery (DCS).Methods SMA was exposed in 30 domestic hybrid pigs,leaving the blood flow blocked using non-invasive vessel forceps.The animals were divided into control group,primary anastomosis group (anastomosis group) and temporary intravascular shunt (TIVS) group according to random number table.TIVS group was further divided into three subgroups:shunting for 6 hours group (TIVS-6 h group),9 hours group (TIVS-9 h group) and 12 hours group (TIVS-12 h group).At each time point,the angiography was performed for evaluation of shunt patency; hemodynamic parameters were detected,terminal ileum and SMA samples were harvested for pathological analysis.Results All groups suffered extreme physiological conditions including hypothermia,severe acidosis,hypotension,low cardiac output and low oxygen supply.Less requirement of resuscitation fluid,faster restoration of SMA blood flow,earlier clearance of lactate,milder intestinal ischemia-reperfusion injury and higher survival rate were observed in TIVS-6 h and TIVS-9 h groups,compared with anastomosis group.Patency rate in TIVS-6 h,9 h and 12 h groups was 100％,50％ and 0％ respectively.Pathologic outcome of intestine revealed diffuse intestinal necrosis in TIVS-12 h group and reversible intestinal ischemia-reperfusion injury in TIVS-6 h and 9 h groups.Conclusion For SMA injury in severe hemodynamic disarrangement and jeopardized condition,TIVS shortens intestinal ischemia time,maintains systemic hemodynamic stability,relieves intestinal injury,improves early survival rate and keeps long-term intestine patency when compared with primary vascular anastomosis.

Radiofrequency ablation (RFA) has been playing an important role in the treatment of hepatocellular carcinoma (HCC). It is minimally invasive, easily repeatable and potentially curative. Many centers now accept it to be the best therapeutic choice for patients with early-stage HCC when liver transplantation or surgical resection is not suitable. In this article, we reviewed the indications, techniques , and clinical results of RFA in the treatment of HCC.Suitable patient selection, good pre-treatment planning,complete ablation, and careful post-treatment follow up are important. Techniques, such as artificial pleural effusion and ascites, contrast-enhanced ultrasonography-guided RFA,laparoscopic or open surgical approaches have reduced complications and expanded the indications for RFA.

ObjectiveTo observe the efficacy of L-carnitine in prevention and treatment of toxicity of LFP chemotherapy with gastrointestinal cancer. Methods60 cases of gastrointestinal cancer were divided into 2 groups according to the admission date. The treatment groups received LFP chemotherapy and L-carnitine, while the control group received LFP chemotherapy alone.Both groups received 3 cycles chemotherapy. The gastrointestinal toxicity, neurotoxicity, hematologic toxicity and physical state were compared.ResultsThere were 12 cases of peripheral neurotoxicity in treatment group,the incidence rate was 40.0 ％;but in control group there were 21 patients, and the incidence rate was 70.0 ％. There was a significant difference between the two groups(x2=5.4545,P =0.0195). Anemia in the treatment group was 56.7 ％ (17/30); in the control group the rate was 86.7 ％ (26/30).There was a significant difference between the two groups (x2 =6.698,P =0.0351).After chemotherapy,in the treatment group,there were 4 cases with increasing Karnofsky score ≥ 10,19 patients whose Karnofsky score did not change,and 7 cases with reduced Karnofsky score ≥ 10; in the control group,there was 1 case with increasing Karnofsky score ≥ 10,13 cases with Karnofsky score no changing,and 16 cases with reduced Karnofsky score ≥ 10.The changes in physical state of two groups had a significant difference(x2 =5.711,P =0.0169).The gastrointestinal toxicity,thrombocytopenia,and neutropenia of two groups had no significant difference.ConclusionL-carnitine can reduce peripheral neurotoxicity and hematologic toxicity,improve the patient's physical state in patients received LFP chemotherapy.

Objective To study the formations of several ridges in peripheral artery velocity tracing. Methods The experimental models of constrainting limb and adrenaline were performed in 6 juvenile susscrota domesticas,tbe variations of the external lilac artery velocity tracing observed,and the parameters of peak systolic velocity (PSV), minimum post-systolic velocity (MPV), peak diastolic velocity(PDV) and end diastolic velocity(EDV) were obtained. Results With the increase of downstream circulation resistance, systolic waveshape inclined to acumination, MPV gradually degraded to zero and negatively increased subsequently, diastolic wave amplitude lowered, and EDV gradually decreased to zero. The stronger vasoconstriction was, the more striking the variations were. Conclusions Cardiac ejection forms systolic dominant wave, post-systolic backward ware is the result of backstreaming because of elastic recoil of downstream artery,and diastolic forward ware is the result of blood transient acceleration caused by elastic recoil of upstream artery. Systemic vascular resistance has significant effect on diastolic waveshape,and the occurrence of post-systolic backward ware implies downstream circulation resistance obviously increases.

Objective To study the haemodynamics changes in the proximal upstream artery caused by different degrees of abdominal aorta extremity stenosis.Methods The lateral walls of the abdominal aorta extremity were pinched with the vascular clamp to achieve 1/4,1/2 and 3/4 stenosis or occlusion in 6 juvenile susscrota domesticas,the velocity tracing of the proximal artery recorded,and the parameters of the peak systolic velocity(PSV)and minimum diastolic velocity(MDV)were obtained and statistically analyzed for their correlation with different degrees of abdominal aorta extremity stenosis.Results The diastolic velocity tracing vanished when stenosis reached a certain degree,the needle ridge and low amplitude diastolic velocity tracing emerged when stenosis to a certain extent,and only the needle ridge was present when the abdominal aorta extremity was completely obstructed.PSV reduced with the aggravation of stenosis.Conclusions The proximal upstream artery systolic ridge caused by abdominal aorta extremity stenosis tends to be acUminate,which indicates serious stenosis of the downstream artery.The systolic needle ridge and the absence of diastolic velocity tracing would suggest a complete obstruction of the blood stream in the downstream lumina.

Objective To study the common femoral artery haemodynamics caused by different degrees of abdominal aorta extremity stenosis.Methods The lateral walls of abdominal aorta extremity were pinched with vascular clamp resulting in 1/3,1/2,2/3,3/4 stenosis by turns in 6 juvenile susscrota domesticas.The parameters of peak systolic velocity(PSV),minimum diastolic velocity(MDV),PSV/MDV(S/D)and MDV/PSV(D/S)of common femoral artery were obtained and their correlations with degrees of abdominal aorta extremity stenosis were confirmed by statistical analysis.Results The backwardware vanished or turned to forwardware when stenosis achieved certain degree.PSV had significant negative correlation with stenosis degree(R=0.985,R2=0.969),but D/S had significant positive correlation with stenosis degree when stenosis degree exceed 1/3(R=0.918,R2=0.843).Conclusions It can be concluded there is proximal stenosis disease and change of distal effective circulating blood volume according to the Doppler velocity tracing analysis.PSV and D/S are valuable parameters,however waveform should be ignored.

OBJECTIVE:To strengthen the management of dismounting drugs in hospital and improve pharmacist working effi-ciency by designing and mading an oral dispending desk. METHODS:In order to solve the small number of placing dismounting drugs induced by small capacity of the desk and disorder placement of placing medicines in inpatient pharmacy,our pharmacists de-signed a new kind of oral dispensing desk that can solve the above problems,produced it and put it in the daily clinical work. The application effects were evaluated by comparing the number of placing drugs and deployment time of medical orders before and af-ter applying it. RESULTS:The designed oral dispensing desk included square slots in the bench,round slots on the side,operating table,multi-panel drawer and ordinary drawer,in which,the first two parts could be used for placing drugs with different shapes and different sizes,multi-panel drawer could place oral liquid,granules,etc. The total number of placing drugs was increased from 237 to 290,and the average deployment time of each medical order was shortened from(4.55±0.38)s to(3.52±0.16)s. CON-CLUSIONS:Application of new dispensing desk has not only solved the limited capacity of the desk,disorderly placing dismount-ing drugs,being difficult to locate and manage and other problems,but also improved the deployment speed of pharmacists and promoted standardized management of dismounting drugs.