Nursing simulation teaching is one of the important measures in nursing teaching reform. As an advanced medical teaching model, SimMan synthetic simulation has been recognized by medical educators both at home and abroad for its advantages of high simulation, repeatability, case diversity and process controllability. Our country has relied on the SimMan synthesis simulation person to carry on the nursing simulation teaching for many years, usually as a teaching strategy into the course of teaching. Its advantages and innovation are affirmed by nursing educators and learners, but still face challenges in the design of simulation teaching, the development of functions and the improvement of equipment utilization. It is worthy discussing deeply by nursing educators.

Objective To investigate the relationship between the changes of blood lipid 4 indexes and lactic acid level with prog‐nosis in children patients with septicopyemia .Methods Ninety‐five children patients with septicopyemia in our hospital from Janu‐ary 2013 to December 2014 were selected ,including 30 death cases(death group and) and 65 survival cases(non‐death group) .To‐tally 60 age‐and gender‐matched healthy children were enrolled as control group .The levels of serum cholesterol (TC) ,triglyceride (TG) ,high density lipoprotein cholesterol (HDL‐C) ,low density lipoprotein cholesterol(LDL‐C) and arterial blood lactate acid (LAC) were measured ,and the results were compared among the three groups .Results The TC and HDL‐C levels in the death group and the non‐death group were lower than those in the control group (P<0 .05) ,the LDL‐C level of the death group was low‐er than that the control group and survival group(P<0 .05) ,while the TG level in the death group and the non‐death group was higher than that in the control group(P<0 .05) ,moreover the TG level in the death group was increased significantly (P<0 .01) . In the excessive inflammation reaction ,the levels of TC ,HDL‐C and LDL‐C were dropped ,which were also decreased with the dis‐ease development ,but the TG level was increased .The LAC level in the death group was higher than that in the control group and the non‐death group ,which in the non‐death group was recovered to the normal level with the disease condition improvement ,while which in the death group was increased with the disease condition progression ,moreover the difference between on 1 d and 3 d had statistical difference(P<0 .05) .Conclusion Monitoring the levels of the blood lipid and lactic acid has an important significance to judge the severity and prognosis in children patients with septicopyemia .

Objective To explore the clinical value of serum inhibin B in predicting ovarian stone.Methods 158 patients were divided 3 groups:73 premature ovarian failure(POF) group and 55 decreasing ovarian stone(DOS) group,while 30 nomal women were taken as the control group,their basal serum inhibin B(INHB),estradiol(E2),follicle stimulating hormone(FSH),resistance index(RI),ovary follicle(OVF),ovary diameter(OVD),and symptom point were detected.Results Comparde with the control group,the level of INHB decreased significantly in the POF group and DOS group(P

To study the roles of glucosylglycerol phosphate synthase (Ggps) in glucosylglycerol (GG) and glycerol biosynthesis, we over-expressed Ggps from either Synechocystis sp. PCC 6803 or Synechococcus sp. PCC 7002 in a Synechocystis strain with a high GG titer, and determined the GG and glycerol accumulation in the resultant mutants grown under different NaCl-stress conditions. Ion chromatography results revealed that GG yield was not improved, but glycerol production was significantly enhanced by over-expression of Ggps from Synechocystis sp. PCC 6803 (6803ggpS). In addition, increasing the NaCl concentration of medium from 600 to 900 mmol/L led to a further 75% increase of glycerol accumulation in the mutant strain with 6803ggpS over-expression. These findings show the role of ggpS in driving the carbon flux to the glycerol biosynthesis pathway, and will be helpful for further improvement of GG and glycerol production in Synechocystis.
Bacterial Proteins ; metabolism ; Culture Media ; Glucosides ; biosynthesis ; Glucosyltransferases ; metabolism ; Glycerol ; metabolism ; Industrial Microbiology ; Sodium Chloride ; Synechococcus ; enzymology ; Synechocystis ; enzymology ; metabolism

BACKGROUND:The correct method selected according to the specific type and characteristics of lumbar disc herniation can achieve satisfactory effect, but in clinic, there stil some patients have recurrence symptoms after treatment. OBJECTIVE:To investigate the recurrence factors of spinal implant internal fixation for the treatment of lumbar disc herniation, as wel as the intervention measures. METHODS:Fifty-two patients with recurrence symptoms of lumbar disc herniation after internal fixation from January 2002 to December 2007 in the Department of Orthopedics, the 306th Hospital of PLA were retrospectively analyzed, including 28 male cases and 24 female cases, the average age was 43.2 years, ranged from 25-52 years. The time form first internal fixation to the recurrence was 3-192 months, average 38 months. The patients had the symptoms of lumbar and bilateral/unilateral leg pain and numbness. Al the patients underwent the anteroposterior radiographs of lumbar spine and the hyperextension and flexion lateral X-ray films to evaluate the stability of the lumbar spine. Lumbar magnetic resonance imaging was used to observe the intervertebral disc situation of the segment treated with lumbar internal fixation as wel as the spinal stenosis and disc degeneration. RESUTLS AND CONCLUSION:Among the 52 patients, 22 cases had recurrence lumbar disc herniation on the same segment after first internal fixation;four cases had recurrence symptoms caused by the spondylodiscitis after implant internal fixation;five cases had scar adhesions caused nerve compression on the site treated with internal fixation;10 cases had the symptoms of lateral recess and nerve root canal stenosis on the site treated with internal fixation;11 cases had recurrence symptoms caused by lumbar instability after internal fixation. It has reality clinical significance to analyze the reasons of recurrence of lumbar disc herniation after internal fixation

Objective To observe colorectal tumor's growth in hyperglycemia mice and its vascular endothelial growth factor (VEGF)'s expression, insulin-like growth factor-1 (IGF-1)'s variation of blood through the experiment, then to ascertain whether type 2 diabetes mellitus (T2DM) danger factors to promote colorectal cancer happen and progress or not. Methods The mouse model of colorectal cancer combined T2DM was established. The volume of tumor was observed. After 5 weeks, all mice were executed and IGF-1 in the blood and the expression of VEGF in the tumor tissue was examined. Results The average tumor volume of colorectal tumor-diabetes group [(1628.5±882) mm3] were larger than that of colorectal tumor group [(1950.2±726) mm3] (P <0.05), and its expression IGF-1 of blood [(105.33±32.32) ng/ml] were higher than that of the control group [(69.83±25.57) ng/ml] and colorectal tumor group [(70.17±25.27) ng/ml] (P <0.05). The expression of VEGF [(70.0±11.5)%] in colorectal tumor-diabetes group were significantly higher than that of colorectal tumor group [(42.9±7.5)%] (P <0.05), too. Conclusion The model of T2DM and transplanted colorectal tumor can be duplicated successfully in ICR mice. Diabetes mellitus may be one reason of promoting colorectal cancer progress. Besides high blood glucose, its mechanism is the high level of IGF-1 which can inhibit apoptosis, promote cell differentiation and hyperplasia, and through inducing VEGF duplicating, heighten its expression, promote the tumor vessel growth, lead to tumor happen and metastasis.

Objective To investigate the effects of chin lift on the patency of upper airway in normal conscious adults using magnetic resonance imaging (MRI).Methods Sixteen healthy volunteers aged 21-35 yr with a body mass index of 17-26 kg/m2 were enrolled in this study.The subjects lay on their back with their heads slightly extended.The lower jaw was first left in standard position.The mouth was slightly open (the distance between the upper and lower incisors was 0.5 cm).The chin was then lifted upward.The upper airway (from the base of slull to the level of vocal cord) was scaned by MRI along the median sagital plane.The length of soft palate,root of tongue and epiglottis and the area of pharyngeal cavity were measured.The position of the rim of epiglottis was examined.The mean percentage changes induced by chin lift were calculated.Results Compared with standard position,chin lift significantly prolonged the length of soft palate,root of tongue and epiglottis and increased the area of pharyngeal cavity.The percentage change in the position of the rim of epiglottis was largest after chin lift.Conclusion Chin lift significantly improve the patency of the upper airway in conscious adult by changing the position of the rim of epiglottis and increasing the area of pharyngeal cavity.

Objective To study and evaluate the therapeutic efficacy of CT-guided radioactive 125Iseeds implantation combined with percutaneous vertebroplasty for spinal vertebra metastases.Methods Fifteen patients and 21 lesions were enrolled in this study.Based on the CT images,a computer-based treatment planning system (TPS) was used to determine the optimal seeds distribution.Under CT-guided,radioactive 125I seeds were implanted into the lesions.Based on the X-ray and CT image after the implantation,quality check was carried out with TPS.The ostalgia-relieving degree and the image alterations of the spinal vertebra metastases lesions were observed.Two months later,15 patients underwent percutaneous vertebroplasty with DSA guidance,bone cement was made according to the ratio methyl acrylic resin polymer/liquid methyl acrylic resin monomer/contrast as 3 ∶ 2 ∶ 1 in injecting paste form.The puncturation through pedicle of vertebral arch and lateral posterior body of vertebra was both adopted in thoracic and lumbosacral vertebrae site.After making sure that the puncturation was completed and there was no leakage in vertebral body,the bone cement was injected into vertebral body quickly.Results Accepted radioactive 125I seeds plantation,relief of pain was obtained.Among 15 patients,8 patients were powerful,6 patients were effective and 1 patient was inefficiency.After treatment,the pain grading significantly decreased.After treatment for 2 months,CT was used to recheck,7 lesions were local controlled,12 lesions had no changes,2 lesions were progress.The responsive rate was 90.5％ (19/21).No serious side-effect happened.Conclusions Radioactive 125I seeds implantation can be a safe and effective method in treating spinal vertebra metastases and obtaining good clinical effects with minimal damage and few complications.Percutaneous vertebroplasty can strengthen the target and relief pain quickly.CT-guided radioactive 125I seeds implantation combined with percutaneous vertebroplasty for the treatment of spinal vertebra metastases has complementary advantages.

Aim To observe the effect of high salt stress on sympathetic nerve activity and brain Apelin and APJ system in pressure overload rats.Methods The suprarenal abdominal aorta was banded in male SD rats to create the pressure overload model.Four weeks later,the rats were fed a high-salt (8%NaCl)diet or a regular-salt (0.3% NaCl)diet for 1 week,and the hemodynamic changes of the rats were recorded.Sym-pathetic activity was evaluated by measuring 24 h uri-nary norepinephrine (NE)by ELISA.Real-time RCR and Western blot method were used to analyze the Ape-lin and APJ expression in the paraventricular nucleus of rats.In another protocol,ML22 1 or benzamil was intracerebroventricularly infused in the aorta banding rats fed with high-salt,and levels of 24 h urinary NE and cardiac index were recorded.In addition,normal SD rats were intracerebroventricularly infused with Na+-rich aCSF for 1 week,and the changes of blood pressure,24 h urine-NE and APJ expression levels were detected.Results In the pressure overload rats fed with high salt diet for 1 week,the mean arterial blood pressure (MAP),heart rate (HR),left ventric-ular end systolic pressure (LVESP),24 h urinary NE and APJ mRNA protein expression in paraventricular nuclear were significantly increased compared with those in control groups (P<0.05 ).However,the he-modynamics,24 h urinary NE and APJ expression showed no significant change in the sham rats fed a high salt diet.In addition,ICV infusion of APJ recep-tor antagonist ML221 or the ENaC antagonist benzamil significantly inhibited the 24 h urinary NE level and HW/BW ratio in the pressure overload rats fed high salt diet (P <0.01 ).Intracerebroventricular infusion of high Na+aCSF for 1 week in normotensive rats also significantly increased the MAP,HR,urinary-NE lev-els and brain APJ expression (P <0.0 1 ).Conclu-sions High salt increases the sympathetic nerve activ-ity in rats with pressure overload model, which is closely related to the brain APJ receptor expression and Na+sensitivity.Brain APJ receptor may be an impor-tant target in the development of salt sensitivity.