Objective To evaluate the effect of management by objective implementation in neurology department nurse training.Methods Divided the nursing students into the experimental group and the control group according to their student ID,there were 100cases in each group.Routine training was used in the control group,while the training based-on management by objective was used in the experimental group.Compared the intervention effects between the two groups.Results The scores of theory,skills and the comprehensive performance in the experimental group was significant higher than that of in the control group respectively,P＜0.01.The excellent rate of theory and skills in the experimental group was 57.95％ (2 434/4 200) and 49.74％ (1 691/4 200),which was significant higher than those of in the control group [28.62％ (1 202/3 400) and 21.91％ (745/3 400)],P＜0.01.The intervention measures had increased the theoretical scores 21.011 times,OR=21.011,95％CI 9.752-45.269,increased the skills scores 14.625 times,OR=14.625,95％ CI7.032-30.416,increased the comprehensive performance 23.993 times,OR=23.993,95％CI1.085-51.934.Conclusion The implementation of management by objective on nurse training can improve the trainee's theory and professional knowledge,the nursing skill can be improved also.So the comprehensive training effect is higher than before.

Objective To evaluate the safety and efficacy of the technique of transoral Orvil EEA stapler (OrVil) for laparoscopic gastrectomy of gastric cancer in our hospital.Methods Between Sep 2012 and Aug 2013,73 patients at our department underwent open (n =36) or laparoscopic (being reconstructed by OrVil,n =37) gastrectomy.Early surgical outcomes of the two groups were compared to assess the effectiveness,security and postoperative complications of OrVil procedure.Results The two groups had similar mean numbers of dissected lymph nodes (29 ± 10 vs.31 ± 14,t =-0.697,P =0.488),lengths of postoperative hospital stay (14 ± 5 vs.12 ± 3 d,t =1.933,P =0.057) and postoperative complications (11 vs.11,P =0.939).Intraoperative blood loss was significantly less (189 ± 79 vs.343 ± 90 ml,t =-7.782,P =0.000) and time to first flatus significantly shorter (2.9 ±0.5 vs.3.5 ±0.6 d,t =-4.714,P =0.000) with the use of OrVil.Operation time of laparoscopic group was significantly longer than that of open group (266 ± 97 vs.204 ± 39 min,t =3.607,P =0.001).There was one each anastomotic leakage in both groups.Conclusions With the suitable approach and skillful technique,OrVil is a technically safe and feasible surgical procedure for the treatment of gastric cancer.

Objective The thesis is written for the purpose of getting understanding of the ultrasound clinical teaching statues. Methods Conducting cluster surveys through clinical graduates of Grade 2006 and the seven-year-program students of Grade 2002 of Guangzhou TCM. Data is analyzed through statistics of SPSS13.0. Results It shows that the time of students practicing in ultrasound division is generally and comparably less,and graduates are generally poor in ultrasound basic knowledge. At the same time,the teaching in ultrasound division has been considered to be normative,however,the teaching level of teachers are not in the same standard,and teaching contents are in poor targets,which will bring about adverse impacts to the professional studies for graduates. Conclusion Ultrasound Clinical Teaching Status of graduates is not optimistic for Guangzhou TCM,and we should regulate or make some adjustments of enhancing the teaching standards of teachers,teaching contents and teaching methods,etc.

With the innovation of radiotherapy equipment and the promotion of targeted therapy and immunotherapy,the therapeutic mode and status of radiotherapy in non-small cell lung cancer(NSCLC)are constantly changing. For early NSCLC,stereotactic radiotherapy may be an alternative to surgery,but the optimal segmentation model still needs to be explored. As for locally advanced NSCLC,postoperative radio-therapy is still controversial for operable patients,the results of consolidated immunotherapy after concurrent chemoradiotherapy in inoperable patients are encouraging,prophylactic cranial irradiation does not improve sur-vival. Local radiotherapy for patients with oligometastasis is expected to prolong survival.

OBJECTIVETo investigate the effect of luteolin on the proliferation and collagen expression of hepatic stellate cells.

METHODSThe effect of luteolin on proliferation and collagen synthesis of hepatic stellate cells isolated from the liver of Wistar rats were determined by (3)H-TdR and (3)H-Pro, and procollagen gene expression was also detected by DIG-labeled gene probe and in situ hybridization.

RESULTSThe proliferation and collagen synthesis were significantly and dose-dependently inhibited by luteolin when the concentrations reached 10 micromol/L and 20 micromol/L respectively (t=2.542, P<0.05; t=3.650, P<0.01). The type I, III procollagen mRNA expression was decreased by 25 micromol/L luteolin, in which the type I procollagen mRNA was reduced with statistical significance (x(2)=6.850, P<0.01).

CONCLUSIONSLuteolin inhibits the proliferation and collagen expression of hepatic stellate cells in vitro. It may have a preventive or therapeutic role in liver fibrosis.

Animals ; Cell Division ; drug effects ; Cells, Cultured ; Collagen ; biosynthesis ; drug effects ; Expectorants ; pharmacology ; Flavonoids ; pharmacology ; Liver ; cytology ; Luteolin ; Protein Synthesis Inhibitors ; pharmacology ; Rats ; Rats, Wistar

OBJECTIVETo study the molecular mechanism of anti-tumor effect of Danshensu (DSS) focusing on whether it is related to its antioxidation effect on redox state of non-small cell lung cancer A549 cells and relevant nuclear transcription factors and signal pathway.

METHODDPPH radical scavenging, ferric reducing, ferrous iron chelating assay and DCFH-DA fluorescence staining of ROS were introduced to detect antioxidant activity and ROS scavenging activity in vitro; MTf was adopted to analyze the effect of DSS on A549 cells viability at different time and dose. Western blot was used to detect the effect of DSS on the protein expression of hypoxiainducible factor HIF-1alpha and redox regulating transcription factor Nrf2 in A549 cells and the phosphorylation of upstream Akt, ERK1/2 MAPK.

RESULTDSS could reduce the ROS level in A549 cells in a dose-dependent manner, which was related to it's strong DPPH radical scavenging activity. Moreover, DSS inhibited A549 cells proliferation in both dose- and time- dependent manner. Further study on molecular mechanism indicated that DSS suppressed redox regulator Nrf2, and down-regulated the phosphorylation of Akt and ERK1/2. However, DSS had no effect on HIF-la expression.

CONCLUSIONDSS might have the effect on treating non-small cell lung cancer by scavenging ROS and then inhibiting phosphorylation of Akt, ERK1/2 and down-regulating Nrf2 expression in A549 cells.

Carcinoma, Non-Small-Cell Lung ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; NF-E2-Related Factor 2 ; metabolism ; Oxidation-Reduction ; drug effects ; Phosphorylation ; Proto-Oncogene Proteins c-akt ; metabolism ; Reactive Oxygen Species ; metabolism ; Transcription Factors ; metabolism

Objective Acute aortic dissection occurs when a tear in the inside of the aorta causes blood to flow between the layers of the wall of the aorta,forcing the layers apart.In most cases this is associated with a sudden onset of severe chest or back pain,often described as "tearing" in character.The main management includes medication,endovascular repair and surgery.Medical management plays an very important role in the management of acute aortic dissection.Aortic dissection generally presents as a hypertensive emergency.Individuals can benefit from blood pressure control and anti-impulse therapy in perioperative period.

Objective To study the effect of estrogen on proliferation of astrocytes in hippocampus of mice following middle cerebral artery occlusion(MCAO).Methods One hundred and eight Kunming mice were randomly divided into estrogen group(n=54)and saline group(n=54).The animals in two groups underwent right MCAO with tissue samples taken at 3,6,12,24,48and 72h after MCAO.The ischemic site was detected and the ischemic size was measured with TTC staining,the damage of neurons in hippocampus was assayed with HE staining,the expression of GFAP in hippocampal astrocytes was detected with immunohistochemical staining.Results The cerebral infarction size was significantly smaller in estrogen group than in saline group at different time points after MCAO(P＜0.05,P＜0.01)especially at 12hafter MCAO(31.50％±3.36％vs 54.50％±5.68％,P=0.019).The damage of hippocampal neurons aggregated with the prolonged ischemia time in two groups and was milder in estrogen group than in saline group at the same time points.The expression level of GFAP positive cells in bilateral hippocampal areas was higher when the ischemia time was prolonged and was significantly higher in ischemic hippocampus of estrogen group than in that of control group except at 6hin CA3ischemic area(P＜0.05).Conclusion Estrogen can protect mice against focal cerebral ischemia,stimulate the genesis of astrocyte synapses,alleviate neuronal damage after ischemia,and can thus reduce the size of cerebral infarction.

Objective To explore the clinical effect of the endoscopic electrocoagulation combined with nasal micro packing in the treatment of refractory epistaxis .Methods 120 patients with refractory epistaxis were selected as the research subjects ,and they were divided into two groups by the single blind randomly methods ,60 cases in each group.The control group was given vaseline gauze for hemostasis of nasal cavity ,and the observation group received endoscopic electrocoagulation combined with nasal packing hemostasis micro treatment .The cure rate ,the incidence of complications ,recovery of nasal mucosa of nasal ventilation time , recovery time , the total amount of bleeding , pain score and recurrence rate of the two groups were compared .Results The cure rate in the observation group was 96.67％,which was significantly higher than 81.67％ in the control group(χ2 =6.988,P<0.05).The incidence rate of complications and pain score in the observation group were 8.33％,(3.65 ±1.09)points,respectively,which were significantly lower than 21.67％,(5.23 ±1.72) points in the control group (χ2 =4.183,t =6.010,all P<0.05).The total amount of bleeding significantly reduced (t=6.344,P<0.05),the recovery of nasal ventilation time and recovery time of nasal mucosa significantly decreased (t=7.119,6.183,all P<0.05).The patients were followed up for 6 months,the recurrence rate in the observation group was 1.67％,which was significantly lower than 11.67％in the control group(χ2 =4.821,P<0.05).Conclusion The endoscopic electric coagulation combined with nasal micro packing in the treatment of refractory epistaxis has significant effect ,it can effectively promote the recovery of patients,reduce complications and recurrence ,the prognosis is good .

Objective To evaluate the result of laparoscopic pancreaticoduodenectomy (LPD).Methods We retrospectively analyzed the perioperative clinical data of 111 consecutive LPD procedures performed from Jan 2015 to Aug 2018 at Department of General Surgery,the Affiliated Hospital of Xuzhou Medical University.Results Of the 111 patients undergoing laparoscopic procedure,24 patients (21.6％) had abdominal surgery history.The mean operative time was (360.9 ± 108.9)minutes.The mean blood loss was (270.9 ± 184.9)m1.The mean operative time of pancreatojejunostomy and choledochojejunostomy was (46.2 ± 11.6) minutes and (19.0±7.2) minutes,respectively.The mean postoperative hospital stay was (14.9 ± 4.7) days.The rate of pancreatic fistula grade B was 6.3％ and pancreatic fistula grade A was 20.7％.The rate of bile leakage was 1.8％.Second surgical operation was necessary for 5 cases (4.5％),delayed postoperative hemorrhage occurred in 2 cases (1.8％).The mean number of lymph nodes harvested was(14.2 ± 7.9) and the positive rate number was (0.9 ± 1.8).Conclusions LPD improves the operation quality,reduces intraoperative hemorrhage and accelerates the postoperative recovery.