Objective:To study the effect of applying different teaching methods about mechanism of labor.Methods:Selecting the second class of nursing speciality as a experiment group,the third class as a control group.Results:The experiment group's records was highter than the control group's,the differences between the two groups were statistically significant(P

Objective To evaluate the application of DNA image cytometry in screening cervical intraepithe-lial neoplasia and cervical cancer.Methods 80 patients with cervical intraepithelial neoplasia admitted during No-vember 2012 and November 2014 were involved in this study.The samples from all the patients were taken by cervix brushes and prepared for 2 slides:one for liquid-based cytology staining, read by cytologist, and the other for Thi-onin-Feulgen staining, tested by DNA image cytometry.The biopsy was performed with direction of colposcopy if one test was positive to verify the sensitivity and specificity of the two methods of staining.Results 70 cases were positive by DNA image cytometry and 27 ones were positive by liquid-based cytology.There was statistically signifi-cant difference in the sensitivity between the DNA image cytometry and the liquid -based cytology ( 94.8% vs. 38.8%;p<0.05), but no difference in the specificity between them (99.6%vs.99.8%).Conclusion Besides its good specificity, DNA image cytometry is more sensitive in screening cervical intraepithelial neoplasia and cervical cancer.

Objective To investigate the differences of miRNA-21 and miRNA-146a expression between colorectal neoplasms tissues and serum of the patients with colorectal neoplasm,and the clinical significance was analyzed.Methods The endoscopic biopsy tissues and serum samples of 100 colorectal cancer (CRC),80 colorectal adenoma (CRA)patients and 65 healthy controls were collected.The expressions of miRNA-21 and miRNA-146a were detected by quantitative real time polymerase chain reaction.The relationship between the expression and clinicopathological features were analyzed.And then,the diagnostic value of expression difference of serum miRNA in colorectal neoplasm were evaluated. The Mann-WhitneyU test and Kruskal-Wallis test were performed for comparisons between groups,and the correlation of miRNA expression between tissues and serum was analyzed by Spearman test.Results
The expressions of miRNA-21 in the tissues of CRC and CRA were 8.573 ±0.898 and 7.746 ±1 .183, respectively,which were significantly higher than that of healthy controls 6.160 ±0.835 (U =120.129 and 33.230,both P <0.01).The expressions of miRNA-21 in the serum of CRC and CRA were 1 .829± 0.303 and 1 .624 ±0.226,respeotively,which were higher than that of healthy controls 1 .391 ±0.221 (U =40.353 and 15 .512,both P < 0.01 ).The expression of miRNA-21 in the serum and tissues of patients with CRC were both higher than those of patients with CRA (U =11 .384 and 10.189,both P <0.01).The expression of miRNA-21 in patients with CRC was associated with TNM stage and lymph node metastasis.The expression level of miRNA-21 in CRA was correlated with histological types.The results of Spearman analysis indicated that the expression of miRNA-21 in the tissues and serum of patients with CRC was positively correlated (r=0.459,P <0.01).The expression of miRNA-146a in the tissues and serum of CRC patients were 2.556±0.351 and 0.249±0.038,respectively,which were lower than those of healthy controls (3.428 ±0.328 and 0.279 ±0.053)(U =102.134 and 30.111 ,both P <0.01).The expression in the tissues and serum of CRA patients were 3.255 ±0.332 and 0.290±0.036, respectively,which were also lower than those of healthy controls,however the difference was not statistically significant (U = 3.936 and 3.180,both P > 0.05 ).The expression of miRNA-146a in the tissues and serum of CRC patients were both lower than those of CRA patients (U =73.809 and 21 .123, both P <0.01).The degree of decreased expression of miRNA-146a in CRC patients was correlated with TNM staging and tumor differentiation degree,however there was no correlation between the expression in CRA and clinical features.According to receiver operating characteristic (ROC)curve analysis,the AUC of miRNA-21 ,miRNA-146a and a combination of them in CRC and health individuals was 0.889, 0.791 and 0.863,respectively;in CRA and health individuals was 0.784,0.692 and 0.761 ,respectively;in CRC and CRA was 0.705 ,0.820 and 0.713,respectively.Conclusion The different expressions of miRNA-21 and miRNA-146a had potential values in early detection of colorectal cancer.

Over the past two decades, multiple drug-resistant infections have escalated globally with the significantly increased morbidity and mortality due to the unreasonable uses of antimicrobial agents in areas such as animal husbandry, industry and medicine. As the situation of drug resistance has been progressively serious, anti-drug-resistant clinical strategies have attracted widely social concerns. This review will report the current status of antibiotic resistance and the mechanism of antibiotic-resistance all over the world. The anti-drug resistance strategies are the emphasis of our report, including the new indication of old antibiotics, the combination of existing antibiotics, the development of new antibiotics, nano-antibiotics, and non-infection treatment with immunomodulators and phage. This review aims to further understand the current situation of drug resistance, which optimizes the strategies of drug-resistant bacteria and clinical services.

Objective To investigate the current situation of the flow maternal health management in Jinyun ,and propose in‐tervention strategies according to the results .Methods Medical records of maternal in 18 confinements hospitals in Jinyun during October 2009 to September 2013 were selected and retrospectively analyzed ,including 16 ,430 cases of household registered mater‐nal and 1 ,301 non‐household registered maternal .Maternal health management of household registered maternal and non‐household registered maternal were compared;and maternal health care management satisfaction survey were implemented for 100 cases in each group .Results The household registration book built rate ,early build rates ,system management rate ,postpartum visit rates were 99 .2% (16 297/16 430) ,96 .7% (15 882/16 430) ,95 .8% (15 733/16 430) ,and 97 .7% (16 ,057/16 430) in household regis‐tered maternal ,while which were 74 .5% (969/1 301) ,64 .0% (832/1 301) ,59 .0% (768/1 301) and 65 .5% (852/1 301) in non‐household registered maternal ,the difference was statistically significant (P<0 .05);3 cases were not satisfied during the childbirth hospitalization in household registered maternal ,the dissatisfied rate was 1 .5% ,12 cases were not satisfied during the childbirth hospitalization in non‐household registered maternal ,the dissatisfied rate was 6 .0% ,the difference was statistically significant (P<0 .05) .Conclusion There is a considerable gap in maternal Jinyun flow maternal health management and local residence ,and we should strengthen the flow of maternal health care management ,making it a fair quality of health care management and opportuni‐ties ,thus contributing to local economic and social development .

Objective To determine the value of liver analysis application in liver segmentation and planning of surgery.Methods Thirty patients suspected having hepatic disease were recruited in this study.Contrast-enhanced CT examinations were performed with Philips Brilliance 64-slice CT,and multi-phase images were obtained.The patients were divided into group B(with focal hepatic lesion,15 patients),and group A(without hepatic lesion,15 patients).We use the portal-venous(60-70 s)images to analysis.Liver volume and vessel recognition were edited manually if necessary,then liver segmentation proceeded automatically.All data were analyzed by the t test,chi-square test,Mann-Whitney U analysis,with SPSS 15.0 software.Results There was no significant difference of post-processing procedure between the two groups(P =0.361).The liver volume was(1374.61 ±444.05)cm3 in the group B and(1225.70±272.07)cm3 in the group A(P=0.108).The accuracy of vessel recognition was no significant difference between the two groups(P=0.87).21 vessels were recognized incorrectly include 18 hepatic veins.Conclusion The liver analysis application provides a 3D reconstruction allow vivid observation of liver segmentation and accurate estimation of the liver volume.It has broad prospect in diagnosing and surgical planning of the liver disease.

Objective To evaluate the effectiveness of professional nurses in atrial fibrillation (AF) anticoagulation management system.Methods 217 consecutive patients with nonvalvular AF were enrolled.All patients received warfarin therapy for 3-6 months after catheter ablation for AF,who were divided into experimental group (n=102) and control group (n=115) by random digits table.The patients of control group adjusted their warfarin doses by following doctor's advice when discharged and by visiting the outpatient clinic regularly after discharged.The patients of treatment group adjusted their warfarin doses under the guidance of one well-trained nurse.Days of the international normalized ratio (INR) value achieved therapeutic anticoagulation range (2.0-3.0) for the first time,the effective anticoagulation rate that defined as more than 70％ of INR values between 2.0-3.0 after titration period,the ratio of times of INR value 2.0-3.0 to total times after titrating and INR monitoring frequency were compared between the 2 groups.Results In treatment group,days of the INR value achieved therapeutic 2.0-3.0 for the first time were less than that in control group (8 d vs.15 d,P＜0.01),the effective anticoagulation rate [45.1％(46/102)] and the ratio of times of INR value 2.0-3.0 to total times after titrating (67.6％±18.5％) was significantly higher than that in control group [31.3％(36/115) and 62.0％±23.1％ respectively,P＜0.05].INR monitoring during the whole period and after titrating were more frequently in treatment group [(9.4±2.2)times vs.(8.4±2.7) times,P＜0.05;(7.9±2.4) times vs.(6.3±2.8) times,P＜0.01].The number of patients in treatment group who monitor INR less than 3 times after titrating was larger than that in control group (18 vs.1,P＜0.01).Conclusions The participation of professional nurses in atrial fibrillation anticoagulation management system was helpful not only in achieving INR 2.0-3.0 more quickly but also in improving the effective anticoagulation rate.

Objective To evaluate the influence of grape seed proanthocyanidin extract (GSPE) on sunburn cell formation and p53 protein expression induced by acute ultraviolet injury. Methods Ten volunteers were enrolled in this study. The buttock region served as the exposed region. Four areas were randomized and delineated on the buttock: one area (control area) received no exposure or product, the other 3 areas were exposed to two minimal erythema doses (MED) of simulated solar radiation (SSR) for 3 days. Of the 3 exposed areas, one area (SSR) received no product before exposure, one area (SSR + Veh) was pretreated with vehicle, the third area (SSR + GSPE) with the samples of GSPE. GSPE or vehicle was applied 30 minutes before each exposure at 2 μL/cm2. Skin biopsy was performed 24 hours after the last exposure, and skin specimens were subjected to hematoxylin eosin (HE) staining and histochemical analysis for p53 protein. Results There was a statistical difference in the number of sunburn cells per high power field (×200) between SSR sites and SSR + GSPE sites (29.8±11.1 cells vs 2.2±0.2 cells, P<0.01). A significant decrease was noticed in the account of p53 protein-positive cells per high power field (×200) in SSR + GSPE sites com-pared with the SSR sites (4.6±0.7 cells vs 19.3±3.4 cells, P<0.05). Conclusion GSPE exerts a poten-tial protective effect against acute ultraviolet injury and can serve as a natural sunscreen.

To understand the higher medical clinical teaching base teachers'demand for the training of basic teaching skills,we use our self-made questionaire to make a survey on teachers of specialty and the result shows that the trachers of different age and different technical post title have different demand.We thus put forward some suggestions to enhance the clinical teaching base teachers'teaching level

Objective To explore the clinical value of real‐time elastography in evaluating rabbit carotid vulnerable plaque . Methods Thirty male New Zealand rabbits ( weighted from 2 .0 to 3 .0 kg) were all fed with high cholesterol diet for one week before balloon injury of their right common carotid arteries . Then they were categorized randomly into two groups which were continued fed by high cholesterol diet for 6 and 12 weeks ,respectively . Ultrasound and real‐time elastography of their right common carotid arteries were applied after their anesthesia by ear marginal vein . Strains of the carotid plaques were measured and analyzed statistically by two independent experienced sonographers . All the rabbits were sacrificed by air embolism method after all the examinations . The atherosclerotic rabbit common carotid lesions were dissected ,fixed for pathologic examination , and graded according to the standard of American Heart Association ( AHA) ,which were compared with the real‐time elastography findings . Results Real‐time elastography had well repeatability between different operators . Consistency between elastography and the AHA pathology was quite good ,with the Cohen′s kappa= 0 .803 (95% CI 0 .669 to 0 .938) . Strains of different regions in a plaque had statistically significant difference ( P <0 .000 1) . By using strain higher than 0 .37% ,the sensitivity and specificity of detecting a lipid core were 88 .0% and 81 .6% ,and area under ROC curve was 0 .902 (95% CI 0 .810 -0 .959 , P < 0 .0001) . Conclusions Real‐time elastography can display the inner elastic characteristics of the rabbit carotid plaques ,and may help evaluate the grading of a plaque . The strain value may help detect a necrotic core ,thereby help evaluate the stability of a plaque .