Craniopharyngioma is a kind of benign tumor of the relict squamous epithelial cells originated from the pituitary gland of cranial cheek pouch in the process of embryonic development. With an overall incidence of 0.13 cases per 100 000 person-years, they may represent up to 5%-10% of intracranial tumors in children. There is always debate regarding the appropriate treatment for craniopharyngiomas which often present symptomatically given their proximity to critical brain structures, and pose significant surgical challenges. And the complications caused by the treatment such as diabetes insipidus, hypothalamic obesity, and hypopituitarism, that throw out a challenge to the postoperative management and the quality of the patients. Craniopharyngioma should be recognized as a chronic disease requiring constant monitoring along with the clinical and multidisciplinary treatment in order to provide optimal care of surviving patients.

Objective To discuss the technique and result of arthroscopic suprascapular nerve release.Methods From February 2008 to February 2011, nine cases of suprascapular nerve compression were treated.Four of them were transverse scapular ligament compression,and 5 cases with cyst compression around spinoglenoid notch,one case was double nerve compression.The patients were manifested nerve compressive symptoms, and MRI, EMG can be a useful tool to identify the locations of compressions. All the patients were treament with arthroscopic nerve release, by transverse scapular ligament releasing or cyst removing. Results The average follow up time was 10 months,the symptoms disappeared,the atrophy or weakness of supraspinatus and infraspinatus muscles were significantly improved after operation. Conclusion The Arthroscopic suprascapular nerve release is an effective,miniinvasive,and fast recovery technique.

As a foreign body, intravascular stent will induce platelet aggregation on the stent surface and activate platelet system and coagulation system, resulting in thrombosis. Smooth muscle cells migrate to injured site and proliferate, leading to intimal hyperplasia and vessel wall remodeling, which induces restenosis. Incidence of intravascular restenosis is determined by stent type, disease of the host, severity of stenosis before implantation and remnant stenosis length following stenting. Inhibition of intimal hyperplasia or improvement of intima formation and vessel wall remodeling can effectively prevent restenosis. Currently, there are many drugs to prevent restenosis, including antiplatelet drug, anti-inflammatory growth factor inhibitor and anti-cell proliferation drugs.

Objective To investigate the team-based learning(TBL) combined with microteaching method in the teaching of undergraduate first aid courses. Methods Totally72 undergraduate nursing students randomly divided into the observation group and control group each including 36 cases by lottery. Nursing students in the observation group received TBL combined with microteaching, while nursing students in the control group received conventional teaching. Results The average score of objective structured clinical examination (OSCE) in observation group was (86.66±5.09) points and the control group was (84.47 ± 5.78) points, the difference was statistically significant (t=3.38, P<0.05). After training,the total score of Critical Thinking Disposition Inventory Chinese Version (CTDI-CV) and 5 dimensions′were (329.39 ± 25.56), (49.33 ± 4.42), (45.11 ± 6.08), (48.17 ± 6.14), (51.08 ± 6.55), (45.06 ± 5.19) points in observation group, and (325.17±27.26), (48.19±4.97),(44.42±6.30), (47.47±6.27), (50.36±7.12), (44.56± 5.13) points before training, the differences were statistically significant (t=2.11- 4.95, P<0.05). Conclusions TBL combined with microteaching method in first aid training course can improve the undergraduate nursing students′first aid ability, critical thinking ability.

Objective To explore the effect of training course based on the model of practical performance which was designed to improve the humanistic caring ability of nursing postgraduates. Methods After conceived, designed and trained the nursing postgraduates, we combined quantitative research method and qualitative research method to understand the effect and the true feelings of the students after taking the training. Results “Humanistic Caring Ability of Nursing Undergraduates Assessment scale (HCANU)“was used before and after 22 nursing postgraduates accepted the training. After training, their total score (86.06±5.16) was higher than before (67.70±5.00) (t=2.665, P<0.01) and 8 dimensions scores were respectively higher than before(P<0.01 or 0.05). The course has improved the humanistic caring ability of nursing postgraduates, enhanced their empathy of nursing objects and promote self-reflection. Conclusions This training course based on the model of practical performance helps to improve the humanistic caring ability of nursing postgraduates and cultivate their humantistic quality.

Objective To investigate influence of cisplatin (DDP) on the tumor inhibition rate,transcriptional levels of CyclinB1 and CyclinD1 of CNE-1 xenograft in nude mice.Methods Tumor mode of nude mice CNE-1 xenograft was established.Then mice were divided into control arm,DDP arm,high speed irradiation arm,simulated intensity modulated radiation therapy (IMRT) arm and simulated IMRT + DDP arm,with 12 mice in each arm.Irradiation dose was 20 Gy with a single fraction.DDP was 15 μg/g weight.The maximum diameter of tumor base was measured every other day.The growth curve was drawn and tumor inhibition rate werevcalculated after 40 days.The transcriptional level of CyclinB1 and CyclinD1 of xenograft was measured by RT-PCR.The results of different groups were compared with one-factor analysis of variance.Results Tumor inhibition rates of the control arm,DDP arm,high speed irradiation arm,simulated IMRT arm and simulated IMRT + DDP arm were-129.1％,-71.2％,42.5％,35.3％ and 47.1％,respectively.There was significant difference between the high speed irradiation arm and simulated IMRT arm (P =0.034),but not between the high speed irradiation arm and simulated IMRT + DDP arm (P =0.222).The transcriptional levels of CyclinB1 in the arms were 0.429,0.386,0.322,0.354 and 0.268.There were significant differences between the high speed irradiation arm and the simulated IMRT arm or the simulated IMRT + DDP arm (P =0.007 and 0.000).The transcriptional levels of CyclinD1 in the arms were 0.716,0.583,0.348,0.495 and 0.296,respectively.There was significant difference between the acute irradiation arm and the simulated IMRT arm (P =0.000),but there was no significant difference between the high speed irradiation arm and the simulated IMRT + DDP arm (P =0.072).Conclusions Irradiation of 20 Gy single fraction,or combined with DDP are effective on the CNE-1 xenograft in nude mice,but DDP alone can only lower the tumor growth speed.Irradiation of 20 Gy single fraction,or combined with DDP,or DDP alone can reduce the transcriptional levels of CyclinB1 and CyclinD1.As the single therapeutic time is prolonged in IMRT mode,the tumor inhibition rate is reduce,and the reduce of the transcriptional levels of CyclinB1 and CyclinD1 is depressed,while combined DDP can compensate the decline of the biological effect.

Objective To observe the dynamic changes of endothelial progenitor cells (EPC)and vascular endothelial growth factor (VEGF) in the patients with acute myocardial infarction (AMI)after percutaneous transluminal coronary intervention (PCI). Methods The level of VEGF before and after PCI in 50 cases with AMI were determined by fluorescence immunoassay and enzyme-linked immunosorbnent assay (ELISA),and the ratio of EPC in flood was checked by flow cytometry.Results The level of EPC was higher after PCI than before PCI [(4.15 ± 0.22)％ vs.(0.59 ±0.02) ％,P＜0.01],and there were positive correlations between EPC and number of coronary artery disease (r=0.45,P ＜ 0.05 ),coronary artery lesions ( r =0.76,P ＜ 0.01 ),left ventricular enddiastolic diameter (r=0.68,P＜0.01),ejection fraction (r=0.75,P＜0.01).The VEGF levels after PCI was increased [(506± 120)μg/L vs.(204±98)μg/L,P＜0.01],and its level was positively related with coronary lesions (r=0.66,P＜0.01),left ventricular ejection fraction(r=0.90,P＜0.01).There was association between rising rates of EPC and VEGF in a short time after PCI within 24 h period (r=0.56,P＜0.01). Conclusions The clinical efficacy and prognosis can be assessed by the changes of VEGF level and EPC ratio before and after PCI operation in AM1 patients.

Objective To discuss the nursing care for patients with advanced hepatocellular carcinoma (HCC) who are receiving transcatheter arterial chemoembolization (TACE) combined with sorafenib. Methods A total of 23 consecutive patients with advanced HCC who met the inclusion criteria were enrolled in this study. TACE was carried out in all patients. Three-five days after TACE the patients started to orally take sorafenib. During the treatment course, the patients were kept under close observation for adverse reactions and complications. After leaving the hospital the patients were followed up by the extended care team members, and health education as well as appropriate nursing intervention was carried out. Results All patients with advanced HCC took sorafenib orally after TACE. The major adverse events and complications were gastrointestinal adverse reactions (n = 22) and transient liver dysfunction (n = 23). After leaving the hospital all the patients received regular follow- up examination and extended nursing care. Conclusion Usually, the incidence of adverse reactions is higher in patients with advanced HCC after TACE combined with sorafenib treatment. Careful in-hospital observation and extended out-hospital nursing can reduce the incidence of adverse reactions and thus improve the patient’s quality of life.

BACKGROUND:Human hypoxia-inducible factor-1 alpha can regulate the expression of osteogenic and angiogenic genes, and promote osteogenic activity. OBJECTIVE:To observe the expression of osteogenic genes in rat bone marrow mesenchymal stem cells carrying human hypoxia-inducible factor-1 alpha slow virus infection. METHODS:Hypoxia-inducible factor-1 alpha was obtained from Hela cells using RT-PCR. Lentivirus expression vector plasmid carrying hypoxia-inducible factor-1 alpha (Lenti-HIF-1α-eGFP) was constructed. 293Ta cells with LentiPac HIV mixed packaging plasmid was packaged, and then lentivirus was obtained. Rat bone marrow mesenchymal stem cells were isolated and cultured using direct whole bone marrow adherent method. Bone marrow mesenchymal stem cells were identified using flow cytometry. Bone marrow mesenchymal stem cells were infected with slow virus for 1, 4, 7 and 14 days. Bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase expression levels were detected in bone marrow mesenchymal stem cells using real-time fluorescent quantitative PCR. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells were effectively infected with Lenti-HIF-1α-eGFP. Real-time fluorescent quantitative PCR results revealed that bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase began to obviously overexpress from 4 days after infection with Lenti-HIF-1α-eGFP until 14 days. Results suggested that hypoxia-inducible factor-1 alpha could elevate the osteogenic activity of bone marrow mesenchymal stem cells.