Objective:To explore the communication problems among nursing students in early clinical prac-tice, and to provide reference for clinical nursing education .Methods:Introspecting diary of the clinical communi-cation in nursing students were classified and analyzed by using qualitative research method .Results:5 themes were extracted as following: barriers for communication between nurses and patients , reflection on patient , nurse occupation , clinical teaching and critical reflection on public opinion .Conclusion:Introspecting diary is important to help teachers in teaching , to guide and cultivate nursing students to develop their interpersonal communication competence .

Objective:To study the predictive value of central venous-arterial CO 2 difference (Pv-aCO 2)/arterial-central venous O 2 difference (Ca-vO 2) ratio for progressive organ dysfunction in patients with septic shock after resuscitation. Methods:Septic shock patients receiving resuscitation in ICU were retrospectively enrolled from July 2018 to June 2019 at the First Affiliated Hospital Anhui Medical University. Hemodynamic and laboratory data were collected. Single and multivariate logistic regression model was constructed to explore the independent risk factors of progressive organ dysfunction. The predictive value of hemodynamic parameters to progression of organ dysfunction was determined using receiver operating characteristic (ROC)curve analysis.Results:A total of 99 patients were enrolled with 25 patients (25.25%) progressing to organ dysfunction. The norepinephrine dose [0.61 (0.27,1.42) μg·kg -1·min -1 vs. 0.91 (0.47,2.87) μg·kg -1·min -1], blood lactic acid [2.93 (1.77,5.88) mmol/L vs. 6.15 (2.56,8.59) mmol/L], Pv-aCO 2 [5.00 (3.98,7.85) mmHg(1 mmHg=0.133 kPa) vs. 7.00 (5.00,8.35) mmHg] and Pv-aCO 2/Ca-vO 2 [1.36(1.17,1.69) vs. 2.23 (1.83,2.78)] in patients with progressive organ dysfunction were significantly higher than those in patients without( P<0.05). Multivariate logistic regression analysis suggested that Pv-aCO 2/Ca-vO 2 ( OR=20.48,95 %CI 5.25-79.93, P<0.001) was independent risk factors for predicting organ dysfunction. The cutoff value of Pv-aCO 2/Ca-vO 2 was equal or more than 1.77 with a sensitivity of 80.00% and a specificity of 79.73%. Compared with those with Pv-aCO 2/Ca-vO 2<1.77, patients with Pv-aCO 2/Ca-vO 2≥1.77 had a greater probability of progressive organ dysfunction (47.37% vs. 8.20%, P<0.001). Conclusion:The progression of organ dysfunction in septic patients after resuscitation is associated with poor prognosis. Pv-aCO 2/Ca-vO 2 is a good indicator to evaluate oxygen metabolism and predict the progression of organ dysfunction.

OBJECTIVE To investigate the drug-resistance status of clinically isolated Staphylococcus aureus(SAU) and provide scientific evidence for clinically reasonable use of antibiotics.METHODS Retrospective review was adopted to analyze the specimen source and the clinical distribution of 311 SAU strains.BioMerieux VITEK 32 was used to identify SAU.Antibiotic susceptibility testing was performed by K-B method.RESULTS Isolating rate of meticillin-resistant S.aureus(MRSA) was 48.9%.SAU were resistant to the diverse antibiotics in different degree except for 100% sensitivity to glycopeptide antibiotics.The drug-resistance to antibiotcs in MRSA were all higher than those in meticillin-sensitive S.aureus(MSSA).CONCLUSIONS Monitoring and controlling of antibiotics resistance are effective measures of prevention from nosocomial infections.

As the fourth member of the globin family, cytoglobin ( CYGB) is a hypoxia-induced gene, and its expression is upregulated under hypoxia.CYGB is widely distributed in the living body and has a variety of physiological functions, such as anti-oxi-dative stress, anti-fibrosis, and neuroprotection.It also plays a protective role in cardiovascular disease, cancer, and other hypoxia-re-lated diseases.This article presents an overview on the structure and distribution of CYGB, its physiological functions of anti-fibrosis, anti-cancer and muscle regeneration, and the regulation and the mechanism of its expression under hypoxia.

It provides a new approach to treat myelodysplastic syndromes when decitabine comes out.In order to improve the understanding of the role of decitabine and to provide a reference for the clinical treatment of middle-risk and high-risk myelodysplastic syndromes,this article mianly summarized drug combination,prognostic molecular markers,and reviewed the mechanism of action,main medication regimen in recent 5 years for the treatment of middle-risk and high-risk myelodysplastic syndromes with decitabine.

Background and purpose:More and s’more evidence has demonstrated that DNMT1 was expressed at high levels in many different kinds of human tumor tissues or cells,suggesting that high expression of DNMT1 was closely associated with occurrence and development of tumors.In this study,effect of down-regulation of DNMT1 on cell proliferation and migration ability of esophageal squamous cell carcinoma(ESCC) cell line EC9706 cells was studied and its related mechanism was explored.Methods:Cell proliferation assay was investigated using CCK-8 Kit,cell migration ability was analyzed using Boyden chamber and the expressions of DNMT1 and MMP-2 were detected by Real-time PCR and Western blotting methods.Results:The result of cell proliferation experiment showed that down-regulation of DNMT1 could markedly inhibit cell proliferation in EC9706 cells.After transfection with DNMT1 siRNA,invasiveness and metastasis ability of EC9706 cells displayed an obvious decrease(P

Objective:To clarify whether nutritional risk screening 2002 could be used as a basis for nutritional support for liver surgery patients.Methods:Among the 243 hospitalized patients,61 patients had ≥ 3 NRS 2002 scores,and 41 of them were given nutrition support.The remaining 182 patients scored ＜ 3,and 73 of them were administrated with nutrition support.Results:The incidence of nutritional risk of hospitalized patients in liver surgery was 25 ％.Among the patients at nutritional risk group,67％ were given nutrition support.And the rates of infection related complication were nutritional supported patients significantly lower than that in the no nutrition support group (P ＜ 0.05).Conclusion:Accurate application of NRS 2002 and necessary nutrition support in liver surgery patients could improve nutritional status and clinical outcome.

The Chinese herbal medicine Tianma (Gastrodia elata) has been used for treating and preventing primary headache over thousands of years, but the exact pharmacological mechanism of the main bioactive ingredient gastrodin remains unclear. In present study, the effects of gastrodin on calcitonin gene-related peptide (CGRP) and phosphorylated extracellular signal-regulated kinase1/2 (pERK1/2) expression were observed in rat trigeminal ganglion (TG) after in vitro organ culture to explore the underlying intracellular mechanism of gastrodin on primary vascular-associated headache. CGRP-immunoreactivity (CGRP-ir) positive neurons count, positive area, mean optical density and integrated optical density by means of immunohistochemistry stain were compared at different concentrations of gastrodin, which was separately co-incubated with DMEM in SD rat TG for 24 hours. Only at 5 or 10 mmol L(-1) concentration, gastrodin demonstrated significantly concentration-dependent reduction of CGRP-ir (+) expression and its action closed to 1.2 mmol L(-1) sumatriptan succinate. While at 2.5, 20, and 40 mmol L(-1) concentration, gastrodin did not show remarkable effects on CGRP-ir (+) expression. The optimal concentration of gastrodin (5 and 10 mmol L(-1)) similarly inhibited CGRP-mRNA expression level separately compared with 1.2 mmol L(-1) sumatriptan succinate and 10 micromol L(-1) flunarizine hydrochloride, which was quantitatively analyzed by real-time PCR (RT-PCR). pERK1/2 level was examined by Western blotting after co-cultured with optimal concentration of gastrodin and effective specific ERK1/2 pathway inhibitors PD98059, U0126. The result indicated that gastrodin significantly reduced pERK1/2 protein actions similarly to ERK1/2 pathway specific blockade. It suggests ERK1/2 signaling transduction pathway may be involved in gastrodin intracellular mechanism. This study indicates gastrodin (5 and 10 mmol L(-1)) can remarkably reduce CGRP-ir (+) neuron, CGRP-mRNA and pERK1/2 expression level in cultured rat TG, with its actions similar to the effective concentration of sumatriptan succinate, flunarizine hydrochloride and specific ERK1/2 pathway blocker. The intracellular signaling transduction ERK1/2 pathway may be involved in the gastrodin reducing CGRP up-regulation in rat TG after organ culture.

Objective To explore the effects of sumatriptan on the modulation of calcitonin generelated peptide(CGRP) expression and its involving intracellular signaling transduction mechanisms in rat trigeminal ganglion(TG) after organ culture.Methods Using organ culture in vitro model,54 isolated TGs of SD rats were randomly divided into fresh group ( n =6 ),control group ( n =6 ) and experimental group (n =42,6 TGs for each subgroup).Experimental group included seven subgroups,which were respectively pretreated with four different concentrations of sumatriptan,specific inhibitors of extracellular signalregulated kinases 1/2 (ERK1/2) pathway (U0126 and PD98059 ),and the inhibitor of c-Jun N-terminal kinase (JNK) (SP600125).After co-cultured with above intervention agents for 24 h,CGRP-immunoreactivity (CGRP-ir) positive neurons and CGRP-mRNA expression levels were quantified by immunohistoehemistry stain and real-time polymerase chain reaction,respectively.Phosphorylated ERK1/2 (pERK1/2) and JNK (pJNK) proteins levels were determined by Western-blotting method.Results The CGRP-ir ( + ) neurons expression levels were significantly increased after 24 h organ culture.However,0.10 and 0.50 mg/ml concentrations of sumatriptan remarkably decreased the CGRP-ir ( + ) neurons expression levels.The positive cell percentage,positive optic area,integrated optical density,mean optical density and CGRP-mRNA expression level in TG were significantly reduced than control groups (tPCP =8.652,26.382; tarea =6.220,13.917; tIA =5.606,15.904; tM14 =2.661,21.748; tmRNA =8.032,15.675.P ＜ 0.05 ).The CGRP-mRNA expressions were significantly down-regulated after co-incubation with concentration of 0.50 mg/ml sumatriptan for 24 h in TG of SD rat ( P ＜0.05 ).The levels of pERK1/2 and pJNK protein kinase detected by Western-blotting were significantly reduced by 0.50 mg/ml concentration of sumatriptan,the degrees of which were closed to the ERK1/2 and JNK pathway specific blockers.Conclusion It suggests that the optimal concentration of sumatriptan significantly down-regulates CGRP over-expression via intracellular ERK1/2 and JNK signaling transduction pathways in TG after organ culture.

OBJECTIVE:To study the decoction rate changes of 4 active ingredients in the volatile oil of Curcuma phaeocaulis before and after combined with Sparganium stoloniferum,and provide reference for showing the compatibility mechanism of C. pha-eocaulis and S. stoloniferum. METHODS:HPLC was used to simultaneously determine the contents of 4 active ingredients(curdi-one,curcumol,germacrone and β-elemene) in the volatile oil of C. phaeocaulis after C. phaeocaulis single decoction and com-bined decoction with S. stoloniferum. And the fried rates of each ingredient were compared. RESULTS:Compared with C. phaeo-caulis single decoction,there was significant difference in the fried amounts of curdione,curcumol,germacrone in the volatile oil after combined decoction(P<0.05)and no significant difference in fried rate ofβ-elemene(P>0.05). CONCLUSIONS:The com-bined decoction of C. phaeocaulis and S. stoloniferum can effectively improve the dissolution of curdione,curcumol,germacrone in the volatile oil. It may be the reason for the enhancement of efficacy after compatibility.