Objective To explore the effect of Contract Learning Methodology in teaching of clinical nursing.Methods 88 nursing students were randomized into the control group(n=46)and experiment group(n=42).The former and the latter adopted the Contract Learning Methodology and conventional teaching methodology,respectively.The two groups were assessed and compared in terms of their scores of clinical nursing theory and manipulation.Results The students in the experiment group were comprehensively better then those in the control group in terms of theoretical and manipulative exams,writing of nursing histories, writing of reading reports,basic nursing,communicating ability and comprehensive achievements(P<0.01).Conclusion The Contract Learning Methodology may fortify the sense of discipline in nursing students,enhance the sense of teaching in teachers and therefore propel the quality of teaching and learning.

Objective To investigate the time and implant selection in conversion from external fixation to internal fixation of tibial shaft fracture.Methods Data of 57 cases of tibial shaft fracture fixed externally followed by internal fixation from February 2003 to February 2012 were analyzed.Internal fixation (intramedullary nails or plates) initiated within 2 weeks (Group A,n =.35) and over 2 weeks (Group B,n =22) were compared in outcomes.Results One infection (3％) and four poor bone healing (11％) were observed in Group A.Five infections (23％) and three poor bone healing (14％) occurred in Group B.For intramedullary nail fixation,no infection was observed in Group A but infection rate of44％ was found in Group B.For plate internal fixation,infection rate was 8％ for both groups.Conclusions The conversion from internal fixation to internal fixation had better start within 2 weeks,with better resuhs,lower rate of infection and safer in comparison with that over 2 weeks.In addition,pin-tract infection is the high risk factor for infection after the conversion of the fixation.

Objective To compare the effect of active compression-decompression cardiopulmonary resuscitation(ACD-CPR) with standard- cardiopulmonary resuscitation(S-CPR) on ventricular function in a canine ventricular fibrillation model. Methods Ventricular fibrillation was induced in anesthetized and instrumented canine. Twenty-four dogs were randomly assigned to either ACD-CPR group or S-CPR group.After 4 minutes of untreated VF,two-dimension echocardiography was used to evaluate the left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV) and left ventricular ejection fraction (LVEF) of every canine of the two groups when they were undergoing cardiopulmonary resuscitation. Results During ventricular fibrillation, both ACD-CPR group and S-CPR group showed decreased LVEDV compared with pre-ventricular fibrillation, but not statistically significant( P ＞0.05).LVEDV was increased in ACD-CPR group compared with S-CPR group, but not statistically significant (P＞ 0. 05). Both ACD-CPR group and S-CPR group showed significantly increased LVESV compared with pre-ventricular fibrillation,of which the difference was statistically significant ( P ＜0. 001). Both ACD-CPRgroup and S-CPR group showed significantly decreased LVEF compared with pre-ventricular fibrillation,of which the difference was statistically significant (P ＜0. 001). LVEF was increased in ACD-CPR group compared with S-CPR group,of which the difference was statistically significant ( P = 0.019). Conclusions Compared with S-CPR,ACD-CPR resulted in higher LVEF.

Objective To evaluate the role of T?type calcium channels in up?regulation of spinal Ca2+∕calmodulin?dependent protein kinase Ⅱ ( CaMKⅡ) expression in rats with neuropathic pain. Meth?ods Forty?eight male Sprague?Dawley rats, weighing 230-270 g, in which intrathecal catheters were suc?cessfully implanted, were divided into 4 groups ( n=12 each) using a random number table: sham opera?tion group (group S), neuropathic pain group (group NP), normal saline group (group NS), and T?type calcium channel blocker mibefradil group ( group M ) . The model of neuropathic pain was established by chronic compression of the dorsal root ganglion ( DRG) . Normal saline 20μl and mibefradil 200μg ( dilu?ted to 20μl in normal saline) were injected intrathecally at 5 days after compression of the DRG in NS and M groups, respectively. Before intrathecal catheter implantation ( T1 ) , before compression of the DRG ( T2 ) , at 5 days after compression of the DRG and before intrathecal administration ( T3 ) , and at 30, 60, 120 and 240 min after intrathecal administration ( T4?7 ) , the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured. The rats were sacrificed after the last measure?ment of the pain threshold at T7 , and the lumbar enlargement segments of the spinal cord were harvested for determination of CaMKⅡ expression by Western blot. Results Compared with group S, the MWT was significantly decreased, and TWL was significantly shortened at T3?7 , and the expression of spinal CaMKⅡ was significantly up?regulated in NP and M groups (P<0.05). Compared with group NP, the MWT wassignificantly increased, and TWL was significantly prolonged at T4?6, and the expression of spinal CaMKⅡwas significantly down?regulated in group M (P<0.05), and no significant change was found in the parame?ters mentioned above in group NS (P>0.05). Conclusion T?type calcium channels are opened, the intra?cellular free calcium ion concentrations are increased, and activated spinal CaMKⅡ is involved in the de?velopment of neuropathic pain in rats.

OBJECTIVETo study the predicting effect of proly 4-hydroxylase beta polypeptide (P4HB) in treating non-small cell lung cancer (NSCLC) patients by Yiqi Chutan Recipe (YCR).

METHODSTotally 46 stage III and IV NSCLC patients were treated by YCR for 4 therapeutic courses. Effect was assessed by RECIST of solid tumor. P4HB expression was detected in the lung cancer tissue by immunohistochemical assay. Factors affecting disease control rates (DCR) of YCR were analyzed by Logistic regression analysis. The correlation between P4HB expression and the effect of YCR was analyzed.

RESULTSThe DCR of advanced NSCLC treated by YCR was 36.96% (17/46 cases). P4HB was high expressed in advanced lung cancer tissue (6/15 cases). Gender, initial treatment, and retreatment are independent factors for affecting DCR of treating lung cancer by YCR.

CONCLUSIONP4HB might be taken as a factor for predicting the effect of YCR in treating NSCLC.

Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Lung ; Lung Neoplasms ; drug therapy ; metabolism ; Male ; Procollagen-Proline Dioxygenase ; metabolism ; Protein Disulfide-Isomerases ; metabolism

Objective To determine urinary iodine level among babies and infants aged 0-30 months in Ningxia, and to provide scientific evidence for strengthening iodine supplement or decreasing salt iodine level in special population. Methods One thousand four hundred and eighty-three babies and infants were selected randomly from 664 administrative villages of 22 counties (city or district) by two-stage sampling method. Urinary iodine was tested with the arsenic cerium catalysis spectrophotometric method and related influencing factors were analyzed. Results Urinary iodine median was 216.5 μg/L of the whole autonomous region, and the value that was lower than 100 μg/L, accounted for 19.1%(283/1483), 100 - 300 μg/L accounted for 49.3%(731/1483), higher than 300 μg/L, accounted for 31.6% (469/1483). Urinary iodine median was in 130.6 - 328.4 μg/L of all counties, which was higher than 100 μg/L. The urinary iodine median of men(223.2 μg/L) was slightly higher than that(210.2 μg/L) of female, no significant difference was observed(Z = - 1.76, P > 0.05). Urinary iodine level changed little when child was younger than one year old(Z = - 0.624, P > 0.05). Then the value dropped gradually after one year old(χ2 = 13.59, P < 0.05), decreased with age by month, and the proportion of the value smaller than 100 μg/L was increased gradually. Urinary iodine level(257.5 μg/L) of child whose mother had taken iodine oil pills was higher than that (221.2 μg/L) of child whose mother had significant difference was observed(Z = - 2.54, P < 0.05). The urinary iodine level (239.1 μg/L) of child who received breast feeding was higher than that (204.2 μg/L) of child without breast feeding among one year old and younger infants and babies, significant difference was observed (Z = - 2.74, P < 0.05). Conclusions Current iodine level in iodized salt is probably higher than suitable in Ningxia, and the value could be decreased. It is unnecessary to strengthen iodine supplement procedure in special population other than people in Xiji county.

Objective To investigate the iodine nutritional level of 5 special groups (newly married women,pregnant women, lactating women, babies and infants, and students) in Ningxia, and to provide the basis for formulating prevention and control strategies. Methods Clustering and random sampling method were used. In 2008 and 2009, in the 22 counties investigated, in every county with 9 townships or more, nine townships were randomly selected according to their sub-area positions of east, west, south, north and center; four villages were randomly selected in each chosen township, four people with special needs and 2 infants were randomly selected for urine samples collection in each chosen village. In every county with 9 or less townships, one township was randomly selected respectively in east, west, south, north and center sub-areas; four villages were randomly sampled in each chosen township, eight people with special needs and 3 infants' urine samples were randomly collected in each chosen village. In the 22 counties, one township was randomly selected respectively in east, west,south, north and center sub-areas, one village elementary school was randomly sampled in each chosen township,twenty students aged 8 - 10 were randomly selected to collect their urine samples in each school. The iodine concentration was determined by arsenic-cerium contact method. Results A total of 6894 copied of urine samples from newly married women, pregnant women, lactating women, babies and infants, and students were examined, the urinary iodine medians were 209.3, 187.4, 184.0, 216.5, 216.3 μg/L, respectively. From low to high in the order was lactating women, pregnant women, newly married women, students, babies and infants. The level of urinary iodine of babies and infants, pregnant women and lactating women were appropriate, the one of newly married women and students were higher than appropriate. The proportion of less than 100 μg/L of urinary iodine of the 5 kinds special groups were 11.1% (53/475), 35.4% (308/871), 35.4% (659/1863), 19.1% (283/1483), 8.4%(185/2202), respectively, while the urinary iodine of the pregnant women and lactating women were relatively high. The urinary iodine medians of the 5 special groups were also very different among counties. Conclusions The urinary iodine of the 5 special groups in Ningxia presents obvious differences between populations and regions.Current iodized salt is sufficient to ensure iodine nutrition needs for the 5 special groups. But married women and students have higher levels of iodine nutrition, indicating that the salt iodine concentration of Ningxia residents have cut space, full consideration of the 5 special groups and regional differences should be taken.

?AlM: To evaluate the clinical effects and security of posterior chamber implantable Collamer lens ( lCL ) implantation in patients with extreme highly myopia.
?METHODS:ln this study, 18 patients ( 32 eyes ) with extreme highly myopic patients who had undergone posterior chamber lCLs implantation from July 2010 to July 2013 were evaluated. Diopter -10. 5 ~ 19. 0D, and astigmia -0. 5 ~4. 5DC. Changes in intraocular pressure ( lOP ) , refraction, visual acuity and corneal endothelium, anterior chamber depth, iris, high arch, lens were noted at 1d, 1wk, 1, 3mo and 1a after surgery respectively, and follow-up was of 1a.
? RESULTS: Before surgery, the uncorrected visual acuity (UCVA) were 0. 01~0. 05, and the best spectacle-corrected visual acuity ( BSCVA) were 0. 4 ~ 1. 0. One month after surgery, the UCVA were 0. 5~1. 2. The mean vault were 547±222 μm (95%CI 442~672μm) and 528±268μm (95%CI 354 ~635μm) for 1mo and 1a, respectively (P = 0. 81), and there was no significant difference. Anterior subcapsular opacities in 1 eye, mild and transient increase in lOP in 3 eyes, and chronic pigment dispersion in 2 eyes were observed. There was no serious complication.
?CONCLUSlON: Posterior chamber phakic intraocular lens implantation is an effective and safe method for correcting patients with extreme highly myopia.

The deep fermentation technique of Tricholoma matsutake is systemically studied in this paper firstly. The best culture determined by orthogonal test is 3g/L of cornflour, 1g/L of glucose, 1g/L of bean cake flour, 1mL/L of corn steep liquid, 1g/L of KH 2PO 4. The best fermenting condition is: 25℃, rotating speed 160 r/min, pH5.0,inoculating amount 10%, 120mL culture medium per 500mL flask. Under these conditions, the mycelia reach 12.94g/L after fermenting 12d.

OBJECTIVETo improve the accuracy of preoperative evaluation of cervical lymph node metastasis in thoracic esophageal squamous carcinoma.

METHODSForty-two patients with thoracic esophageal squamous carcinoma underwent neck ultrasonography. Enlarged lymph nodes with their long axis greater than 10 mm and a short-to-long axis ratio greater than 0.5 were considered as metastatic.

RESULTSPreoperative neck ultrasonography revealed the enlarged lymph nodes in 16 patients, but only in 5 (31%) cases the nodes were palpable. Among them 9 were classified as metastatic (cM(1-LN)), including 4 patients with palpable nodes. In 5 cM(1-LN) patients surgical intervention was canceled and the remaining 37 patients underwent trans-thoracic esophagectomy. Cervical node metastasis (pM(1-LN)) was confirmed pathologically in 6 surgical patients, 4 with tumors invading the adventitia (pT3) and the other 2 into the surrounding structure (pT(4)) (pT(1), pT(2) vs. pT(3), pT(4), P = 0.020). All 6 pM(1-LN) patients had concomitant mediastinal node metastasis and 4 of them had upper abdominal node metastasis. Statistically significant relationship was detected between cervical and abdominal nodal status (r = 0.536, P = 0.007). In comparison with the results of pathological examination and treatment response, the accuracy and sensitivity were 81% and 95% (P = 0.043), 36% and 82% (P = 0.081), respectively, for palpation and ultrasonography. Five out of 39 (13%) patients had their therapy changed due to ultrasonographic findings.

CONCLUSIONSNeck ultrasonography for cervical lymphadenopathy is of high sensitivity and accuracy, which plays an important role in the preoperative evaluation and therapeutic decision-making.

Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; secondary ; surgery ; Esophageal Neoplasms ; pathology ; surgery ; Female ; Head and Neck Neoplasms ; diagnostic imaging ; secondary ; surgery ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Neck ; diagnostic imaging ; Sensitivity and Specificity ; Ultrasonography