Objective To explore the application of “PBL -Seminar” teaching method in nursing teaching for undergraduates majoring in nursing.Methods 54 nursing undergraduates from July 2012 to April 2013 were set as control group receiving the traditional teaching method, and another 52 nursing undergraduates from July 2013 to April 2014 at internship were set as experimental group, receiving “PBL -Seminar” teaching method, and then the two groups were compared in terms of teaching effects.Results The patient satisfaction was obviously improved, and the qualification rate of the nursing students and the comprehensive evaluation score were significantly higher as com-pared with the control group (p <0.5).Conclusion “PBL -Seminar” teaching method can effectively improve the effect of the nursing internship of nursing undergraduates and the teaching quality for the nursing undergraduates.

OBJECTIVEThis study investigates the effect of temporomandibular joint osteoarthritis (TMJOA) on different stages of condylar three-dimensional position and provides a theoretical basis for clinical application.

METHODSThe cone beam computed tomography (CBCT) images of 108 TMJOA patients were analyzed and divided into four stages based on the stage standard of osteoarthrosis X-ray performance proposed by Xuchen Ma in 2005. A total of 28 defect-free temporomandibular joint disorders were used as the control group. Differences in condylar position and condylar axis horizontal angle were evaluated and compared.

RESULTSNo significant differences were found in terms of sagittal relationship, but condylar axis horizontal angle showed a significant difference (F = 3.872, P = 0.005). The horizontal angle values of stage 1 in the TMJOA group were lower than those in stages 2 and 3 (P = 0.027, P = 0.000), whereas the horizontal angle values of stage 2 and control groups were lower than those of stage 3 group (P = 0.004, P = 0.047).

CONCLUSIONCondylar horizontal angle differed in each stage of TMJOA, but no significant difference between the parasagittal positions of the condyles was observed in each stage.

Case-Control Studies ; Cone-Beam Computed Tomography ; Humans ; Mandibular Condyle ; Osteoarthritis ; diagnostic imaging ; Temporomandibular Joint ; diagnostic imaging ; pathology ; Temporomandibular Joint Disorders ; diagnostic imaging

The arrangement of fascicles of musculocutaneous nerve at different levels in brachial plexus were studied in 22 adult cadavers. The nerve fascicles were dissociated and traced under operative microscope. At the distal end of the musculocutaneous nerve, the muscular and cutaneous fascicles are separated.The muscular fascicles are situated at the latero-anterior quadrant of the cross-section of the nerve.The mixed fascicle are become predominated proximally. The muscular and the muscular predominated mixed fascicles are still situated at latero-anterior quadrant. At the level 1 cm below the clevicle, 1cm and 1.5 cm above the clevicle,the fascicles of the nerve are situated at the lateral superio-anterior quadrant of the crosssection of relative parts of brachial plexus. The fascicles of the nerve are situated at the anterior quadrant of the crosssection of superior trunks. The fibers of musculocutaneous nerve are originate from C5, C6 and C7, being 31.6,％, 64.6％ and 3.8％,respectively.

Objective To investigate the effect of bedside comprehensive ability training and critical thinking on the improvement of the personality maturity of pediatric nurses. Methods A total of 102 nurses with pediatric working years within one year were selected,and then they were arranged to receive critical thinking in combination with bedside comprehensive ability training for 6 months. After the training, pediatric nurses′ critical thinking ability, bedside comprehensive ability and personality maturity were evaluated. Results Before training, the total score of Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) , total score of bedside comprehensive ability, personality maturity score were 288.21±25.44, 75.24±2.51, 84.01±32.26, after training, they were respectively 324.18±25.93, 92.65±3.17, 125.57±35.47. Comparison of the scores before training and after training showed statistically significant difference(t=7.071, 30.750, 6.190,P < 0.05 or 0.01). Setting personality maturity as the dependent variable, and and CTDI-CV and bedside comprehensive ability as the independent variables, regression analysis showed that CTDI-CV and bedside comprehensive ability had a positive impact on the personality maturity. Conclusions The ability of pediatric nurses' critical thinking ability and bedside comprehensive ability training can promote the improvement of personality maturity of pediatric nurses.

Objective To study on the relationship between the levels of homocysteine(HCY) ,folic acid and vitamin B12 and pregnancy-induced hypertension(PIH) in different pregnancies .Methods 539 pregnant women who registered for prenatal exami-nation of pregnant in the hospital were selected as research subjects .And there were 87 cases of PIH(PIH group) and 452 cases of normal pregnancy(normal pregnancy group) among them .The fasting blood samples were collected respectively in early pregnancy (8-10 weeks and 12-14 weeks of pregnancy) ,mid pregnancy(18 pregnancy weeks and 24 pregnancy weeks) ,and late pregnancy (30 pregnancy weeks and 36 pregnancy weeks) ,and the levels of HCY ,folic acid and vitamin B12 were measured .At the same time ,the supplements of folic acid and vitamin B12 and the incidence of PIH and birth defects were asked ,registered and checked . Results Compared with normal pregnancy group ,the serum HCY level of PIH group significantly increased in medium and late pregnancy periods (P<0 .05) ,and had no statistical significance in early pregnancy(P>0 .05) .In mid and late pregnancy periods , the serum HCY levels of PIH group and normal pregnant group negatively correlated with serum folic acid levels (r<0 ,P<0 .05) , and did not correlate with vitamin B12 levels (P>0 .05) .Conclusion In middle and late pregnancy periods ,if the serum HCY level of pregnant women increased ,the risk of PIH increased significantly .

Objective: To prepare a nanoprobe, anti-human melanoma ganglioside single chain variable fragment (GD/ScFvMEL) antibody conjugated with CdTe quantum dot, and to observe its ability to specifically bind human malignant melanoma cells. Methods: The GD/ScFvMEL gene was cloned into pET32a (+), and the plasmid was then transformed into E. coli BL21 (DE3) for GD/ScFvMEL protein antibody expression. The expressed GD/ScFvMEL antibody was purified by denaturing method and further refolded by modified dialysis method. The purified GD/ScFvMEL antibody was analyzed by SDS-PAGE. The GD/ScFvMEL-QDs nanoprobe was prepared by conjugating GD/ScFvMEL antibody with CdTe quantum dot, and its specificity was observed by incubating with MGC-803 cells and melanoma A375 cells. Results: The recombinant pET32a-GD/ScFvMEL was constructed and confirmed by PCR, restriction endonuclease analysis and DNA sequencing. The proportion of expressed GD/ScFvMEL antibody in total bacteria proteins was about 40% as detected by SDS-PAGE. The purified- and refolded-GD/ScFvMEL antibody was effectively conjugated with CdTe quantum dot, and the resulting GD/ScFvMEL-QDs nanoprobe was successfully prepared. The GD/ScFvMEL-QDs nanoprobe could specifically bind melanoma A375 cells, but could not bind stomach cancer MGC-803 cells. Conclusion: We have successfully prepared an anti-human melanoma ganglioside single-chain antibody-CdTe quantum dot nanoprobe, which can specifically bind melanoma cells.

Objective:To investigate the application value of combined detection of hypoxia-inducible factor-1α (HIF-1α), N-terminal proBNP (NT-proBNP) and thromboxane B 2 (TXB 2) in the prediction of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction. Methods:The clinical data of 136 patients with acute ST-elevation myocardial infarction who received treatment in Jinhua Municipal Central Hospital, China between February 2018 and September 2019 were retrospectively analyzed. These patients were assigned to MACE group ( n = 33) and no MACE group ( n = 103) according to whether MACE occurred. The basic data was compared between the two groups. Serum levels of HIF-1α, NT-proBNP and TXB 2 prior to PCI were analyzed. The receiver operating characteristic (ROC) curve was plotted to investigate the application value of combined detection of serum HIF-1α, NT-proBNP and TXB 2 levels in the prediction of acute ST-elevation myocardial infarction after PCI. Results:At 6 months after PCI, MACE occurred in 33 out of 136 patients with acute ST-elevation myocardial infarction, with the incidence of 24.26%. There were no significant differences in age, sex and accompanied diseases between MACE and no MACE groups (all P > 0.05). Serum HIF-1α level in the MACE group was significantly lower than that in the no MACE group [(31.54 ± 5.26) ng/L vs. (37.18 ± 6.94) ng/L, t = 4.286, P < 0.05]. Serum levels of NT-proBNP and TXB 2 in the MACE group were (1 246.83 ± 243.71) μg/L and (125.13 ± 20.16) ng/L, respectively, which were significantly higher than those in the no MACE group [(876.92 ± 173.04) μg/L, (95.73 ± 18.24) ng/L, t = 9.617, 7.835, both P < 0.05]. ROC curve analysis showed that the optimal cutoff values of serum HIF-1α, NT-proBNP and TXB 2 levels in the prediction of MACE occurrence in patients with acute ST-elevation myocardial infarction after PCI were 32.67 ng/L, 1 018.27 μg/L and 112.19 ng/L, respectively. The sensitivity and specificity of combined detection of serum HIF-1α, NT-proBNP and TXB 2 levels in the prediction of MACE occurrence in patients with acute ST-elevation myocardial infarction after PCI were 69.70% (23/33) and 98.06% (101/103), respectively. The specificity of the combined detection of serum HIF-1α, NT-proBNP and TXB 2 levels was higher than that of detection of serum HIF-1α, NT-proBNP or TXB 2 level alone. The area under the curve (AUC) plotted regarding the prediction of MACE occurrence in patients with acute ST-elevation myocardial infarction after PCI by combined detection of serum HIF-1α, NT-proBNP and TXB 2 levels was 0.901, which was significantly higher than the AUC obtained for detection of serum HIF-1α, NT-proBNP or TXB2 level alone ( Z = 2.007, 1.991 and 2.217, all P < 0.05). Conclusion:Combined detection of serum HIF-1α, NT-proBNP and TXB 2 levels exhibits a higher value in the prediction of MACE occurrence in patients with acute ST-elevation myocardial infarction after PCI than detection of serum HIF-1α, NT-proBNP or TXB 2 level alone.

Objective: To analyze clinical features and electroneuromyography (ENMG) results of chronic mild occupational carbon disulfide poisoning cases. Methods: A total of 344 patients diagnosed with chronic mild occupational carbon disulfide poisoning based on GBZ 4-2002 Diagnostic Criteria of Occupational Chronic Carbon Disulfide Poisoning were selected as study subjects from 2006 to 2019 using the retrospective study method. Their clinical data was collected and analyzed. Results: The main symptoms of the study subjects were dizziness, headache, insomnia, dreaming, memory impairment, numbness and weakness in the distal extremities. Positive signs mainly included symmetrical glove and stocking distribution like sensory disorders in the distal extremities, and the weakening or absent Achilles tendon reflex and knee reflex. The incidence of symptoms and signs increased with the length of service (all P<0.01). The incidence of fundus and venous changes in patients was 41.3%, which increased with the length of service (P<0.01). ENMG examination showed varying degrees of abnormalities in the peripheral motor and/or sensory nerves in all patients, with a higher incidence of motor nerve abnormalities than sensory nerve abnormalities (21.1% vs 3.7%, P<0.01). The incidence of motor nerve abnormality was higher on the right side than the left side (23.7% vs 18.5%, P<0.01). The incidences of motor nerve abnormalities from high to low in the order were median nerve, common peroneal nerve, ulnar nerve and posterior tibial nerve (34.9% vs 27.9% vs 16.6% vs 5.1%, P<0.01). The incidences of sensory nerve abnormalities from high to low in the order were median nerve, ulnar nerve and sural nerve (5.2% vs 5.1% vs 0.7%, P<0.01). The incidences of left ulnar nerve, right ulnar nerve and right median nerve were higher in male patients than in female patients (15.2% vs 5.3%, 24.0% vs 11.7%, 44.8% vs 28.7%, all P<0.05), while the incidences of the left and right common peroneal nerve in lower extremity motor nerve were lower in male patients than in female patients (18.4% vs 52.1%, 21.2% vs 46.8%, all P<0.01). Conclusion: Chronic mild occupational carbon disulfide poisoning was mainly manifested as multiple peripheral nerve injury. ENMG results showed that the distal motor nerve conduction abnormalities were more sensitive than the sensory nerve conduction abnormalities, with a higher degree of impairment in the upper limb than the lower limb, and more impairment in the right side than the left side.

Objective To analyze the relationship between N-nitrosodimethylamine (NDMA) and the risk of digestive tract cancers.Methods The papers about the relationship between NDMA and the risk of digestive tract cancers published from 1980 to 2012 were retrieved following databases:Chinese BioMedical Literature Database (CBM),the Chinese Journal Full-text Database (CNKI),Wanfang Database,PubMed and EBSCO.The fix and random effect model was used and statistical analyses were conducted by using RevMan 5.1 software.Results Thirteen papers were found,in which 7 about digestive tract cancers were used in this Meta analysis.The NDMA had significant positive effect on the incidence of digestive tract cancers (RR=1.12,95％ CI:1.03-1.21).The relationship between NDMA and esophageal cancer was not significant (RR =1.18,95 ％CI:0.98-1.41) but NDMA could increase the risk of gastric cancer (RR=1.08,95％ CI:1.00-1.18).For the subtypes of esophageal and gastric cancer,NDMA had positive relationship with esophageal squamous cell carcinoma (RR=l.72,95％ CI:1.01-2.96),but had no significant relationship with esophageal adenocarcinoma,cardiac carcinoma and gastric adenocarcinoma.Conclusion The population-based cohort studies have showed that the NDMA could significantly increase the risk of digestive tract cancers,but the effects differed with subtypes of esophageal and gastric cancer.However,it is necessary to collect more evidence due to the limited studies and obvious differences in the study design,sampling and exposure measurement of these cohort studies.

OBJECTIVE： To study the effects of atorvastatin combined with carbon monoxide releasing molecule 3 （CORM-3） on inflammation and oxidative stress indexes in atherosclerotic （AS） vulnerable plaque model rats. METHODS： The rats were randomly divided into control group （normal saline， i.g.）， model group （normal saline， i.g.）， statin group （atorvastatin 2 mg/kg，  i.g.）， and statin+CORM-3 group （atorvastatin 2 mg/kg， i.g.+CORM-3 10 mg/kg， i.p.）， with 8 rats in each group. Control group was fed with basal diet， and the right common carotid artery was exposed to surgery without injury and was treated with normal saline instead of drug； other three groups were fed with high-fat diet+right common carotid artery injury+heteroprotein injection to induce AS vulnerable plaque model， for 10 weeks； and then they were given relevant medicine for intervention， once a day， for consecutive 2 weeks. 24 h after last medication， abdominal artery blood was collected； the concentration of LDL-C and HDL-C were determined by fully automatic biochemical analyzer. The levels of hs-CRP， IL-10， MCP-1 and MMP-9 in plasma were detected by ELISA； plasma levels of MDA and oxidized low density lipoprotein （ox-LDL） were determined by chemical colorimetry； the protein expression of heme oxygenase-1 （HO-1） was determined by Western blot. The pathological changes of right common carotid artery were observed under light microscope. RESULTS： Compared with control group， the levels of LDL-C， hs-CRP， MCP-1， MMP-9， MDA and ox-LDL， and protein expression of HO-1 were increased significantly （P＜0.05）， while the levels of HDL-C and IL-10 were decreased significantly in model group （P＜0.05）； the right common carotid artery formed obvious AS plaques. Compared with model group， the levels of LDL-C， hs-CRP， MCP-1， MMP-9， MDA and ox-LDL were decreased significantly in statin group and statin+CORM-3 group in model group （P＜0.05）， while the levels of HDL-C， IL-10 and the protein expression of HO-1 were increased significantly （P＜0.05）. Except for LDL-C and HDL-C， the improvement of other indexes in statin+CORM-3 group was more significant than statin group （P＜0.05）； pathological changes of right common carotid artery in statin group were not obvious， but the pathological changes of rats in statin+CORM-3 group were significantly alleviated and plaque structure also tended to be more stable. CONCLUSIONS： Atorvastatin combined with CORM-3 is better than atorvastatin alone in improving inflammation and oxidative stress indexes of AS vulnerable plaque model rats， and can promote the stability of AS vulnerable plaques.