Problems such as detached knowing and doing , utilitarian tendency , moral practice ability is weak and so forth are now existing in the medical college students'moral practice in the new period .There are not only medical students'personal factors , but also school and social factors .Therefore , it should excavate potential , build good medical students moral practice platform , innovative form of moral practice , motivate medical students to par-ticipate in the moral practice enthusiasm , strengthen the construction of management system , ensuring the medical students moral practice into effect .

ObjectiveTo investigate the relationship of the polymorphism of endothelial nitric oxide synthase (eNOS), the 27-bp variable number of tandem repeats (VNTR) in intron 4 with essential hypertension (EH) of the northern Han nationality in China.MethodsGenotypes, the level of plasma nitric oxide metabolites (NOx) and the activity of nitric oxide synthase (NOS) of 207 EH subjects and 231 healthy subjects were measured by polymerase chain-reaction (PCR).ResultsThe frequencies of ecNOS4a/a,ecNOS4b/a, and ecNOS4 b/b in the healthy group were 0.43%, 13.42% and 86.15% respectively. The frequency of the b allele was 92.86%, and the frequency of the a allele was 7.14%. While the frequencies of ecNOS4 a/a, ecNOS4 a/b,and ecNOS4 b/b in the EH group were 0.49%, 19.32% and 80.19% respectively. The frequency of the a allele in EH group (n=42, 10.15%) was significantly higher than that in the healthy group (n=33, 7.14%)(P<0.05). The plasma NOx level of the EH group was 70.04±14.68 mol/L, and significantly lower than that 84.09±27.27 mol/L in the healthy group (P<0.05). Similarly, both the plasma TNOS and iNOS activities of the EH group were 35.49±12.8 U/ml and 14.92±7.93 U/ml, and markedly lower than that 41.47±13.2 U/ml and 10.11±6.21U/ml in the healthy group (P<0.05). But the activities of eNOS in the EH group and healthy group were not significantly different (P>0.05).ConclusionThe variations of ecNOS4 gene locus may be responsible for the decrement of plasma NOx, both plasma NOx level and activity of NOS decreases in EH patients, so it may be a genetic susceptibility marker for EH of the Han nationality in China.

Objective To analyze the drug-resistance and distribution of nonferments bacteria infection in our hospital and provide the diagnosis and treatment evidence to doctor.Methods 241 nonferments bacteria strains had been separated from patients of Xinqiao Hospital from July 2006 to Jan 2008. Bacteria identify and drug-resistance test were performed by VITEK-Ⅱanalysis system. The drug-resistance result was determined by MIC with the standard of NCCLS.Results The separate rate in patients of neurosurgery, respiration, orthopaedics were 24.94、23.27 and 10.79 respectively. The main source of specimen are sputum. The drug resistance rate were Imipenem (16.9), Amikacin(29.3), Cefepime (33.9) and Cefazidime(39.1) in 241 nonferments bacteria strains. Conclusion The infection of nonferments bacteria must be recognized by doctors, and it would prompt us to use antibiotic properly.

Objective To investigate the correlation between the positive rate of PCR-reverse dot blot genotyping test and the loads of the viral nucleic acid. Methods The fluorescent PCR assay was used to detect the high-risk HPV(HR-HPV)DNA loads in the cervical mucus samples from 1162 female pa-tients. Patients with positive HR-HPV DNA were further analyzed by PCR-reverse dot blot hybridization as-say for HPV genotyping. Results The overall positive rate of genotyping test was 68. 8% . The positive rate of genotyping test had a significant positive correlation with the Log Koc of HR-HPV DNA loads(r=0. 944, P﹤0. 01). The quadratic curve fitting formula was Y= -1. 806+0. 558X-0. 031X2(Y for genotyping positive rate,X for Log Koc of HR-HPV DNA loads). There were significant differences with the positive rate of gen-otyping test among patients with different viral loads(P﹤0. 01). When HR-HPV DNA loads were 104-105 copies/ ml,105-106 copies/ ml,106-107 copies/ ml and more than 107 copies/ ml,the positive rate of HPV genotyping test were 27. 8% ,48. 5% ,74. 0% ,97. 5% and 33. 3% ,51. 5% ,78. 0% ,97. 5% respective-ly by using different genotyping detection reagents. Conclusion The positive rate of PCR-reverse dot blot genotyping test was correlated with the loads of HPV nucleic acid.

Objective To investigate the common bacteria and change in antimicrobial resistance in an intensive care unit (ICU)in the past 5 years,and provide evidence for rational use of antimicrobial agents.Methods Bacteria isolated from ICU patients in a tertiary first-class hospital from 2009 to 2013 were collected,identified,and per-formed antimicrobial susceptibility testing.Results A total of 1 196 bacteria isolates were isolated in 2009-2013, the top five species were Acinetobacter baumannii (A.baumannii,29.60%),Pseudomonas aeruginosa (P . aeruginosa,14.38%),Staphylococcus aureus (S .aureus ,12.21 %),Escherichia coli (E.coli,12.21 %),and Klebsiella pneumoniae (K .pneumoniae ,11 .37%).Resistance rates of S .aureus to oxacillin,gentamycin, clindamycim,ciprofloxacin,and rifampicin showed a decreasing tendency from 2009 to 2013(all P <0.05),and no strain was detected to be resistant to vancomycin during 5 years.Resistance rates of P .aeruginosa to ceftazidime, cefepime,aztreonam,gentamycin,amikacin,tobramycin,and piperacillin/tazobactam decreased gradually (all P <0.05),imipenem resistance rates were 32.26% -46.43% in 2009 -2012 and 16.00% in 2013;A.baumannii maintained a low level resistance to amikacin,tobramycin,and compound sulfamethoxazole(all P <0.05),resistance rates to imipenem were all >80% in 2009-2011 and 10.53% in 2013,A.baumannii had high resistance rates to most antimicrobial agents(resistance rates were >80%)during 5 years.Resistance rates of K .pneumoniae and E. coli to piperacillin/tazobactam,cefazolin,cefepime,amikacin,and aztreonam had a decreased tendency in 2009 -2013(all P <0.05).Conclusion The common bacteria causing infection in the ICU of this hospital showed a down-ward trend,which may be related to the introduction of national policies and management of hospital,continuous management of antimicrobial agents is suggested,antimicrobial agents should be used rationally to prevent the in-crease of bacterial resistance.

ObjectivesTo investigate the composition of clinical classiifcation and pathological patterns and their rela-tionships and change in children with renal disease undergoing biopsy.MethodsA retrospective analysis of pathological and clinical data obtained from children (≤14 year) with renal disease undergoing biopsy from 1984-1997 and from 1998-2011 was performed.ResultsOne thousand four hundred and sixty-two children underwent renal biopsy in 28 years, and 1313 patients were recruited in this study, 824 males (62.8%) and 489 females (37.2%). The mean age was 9 years and 4 months at renal biopsy. There were 921 children (70.1%) with primary glomerular disease (PGD) and 312 children (23.8%) with secondary glomerular disease (SDG). The main clinical classiifcations of PGD were nephrotic syndrome (NS, 31.2%), isolated hematuria (IH, 16.1%), and acute glomerulonephritis (AGN, 11.0%). The main pathological patterns of PGD were IgA nephrop-athy (IgAN, 27.6%), minimal change disease (MCD, 24.0%), and mesangial proliferative glomerulonephritis (MsPGN, 16.9%). The main causes of SGD were lupus nephritis (LN, 40.7%), Henoch-Sch?nlein purpura nephritis (HSPN, 34.3%), and hepatitis B virus related glomerulonephritis (HBV-GN, 19.6%). In this 28 years, the composition of PGD was decreased, however, the compositions of SGD and other renal diseases were increased. Compared with 1984-1997, the pathological manifestations of IgAN, MCD and focal segmental glomeralosclerosis were increased, MsPGN, IgMN, and crescentic glomerulonephritis were decreased in 1998-2011. The difference was statistically significant (P<0.05). In SGD patients, HBV-GN was significantly decreased (P<0.05).ConclusionsPGD is the main disease in children undergoing renal biopsy. IgAN is the most common pathological pattern. NS is the most common clinical classiifcation. In this 28 years, the composition of PGD is decreased, SGD and other renal diseases are increased in children undergoing renal biopsy.

10.3969/j.issn.1007-3969.2013.04.005

Objective To evaluate the values of gastrin‐releasing peptide (pro‐GRP) and neuronspecific enolase (NSE) in differ‐ential diagnosing of small cell lung cancer (SCLC) .Methods Serum samples from 120 SCLC patients ,130 non‐small cell lung canc‐er (NSCLC) ,80 Patients with benign lung disease and 90 healthy donors were collected to detect the level of pro‐GRP and NSE .All data were analyzed by SPSS13 .0 and then we analyzed the serum level and positive rates of the two tumor markers .ROC was gener‐ated by GraphPad Prism 5 .Results The expression level of pro‐GRP and NSE in SCLC group were significant higher than NSCLC group、benign lung disease group and healthy donors group (P<0 .05) .The positive rates of pro‐GRP in SCLC were higher than the other three groups (P<0 .05) .However ,there had no significant difference between SCLC group and NSCLC group in the posi‐tive rates of NSE(P>0 .05) .ROC area under curve of pro‐GRP ,NSE and both were 0 .890 ,0 .810 and 0 .915 ,separately .Conclusion The tumor biomarker of NSE could only identify of benign and malignant lung diseases ,but can not identify the type of lung canc‐er including SCLC and NSCLC ;Nonetheless the tumor biomarker of pro‐GRP could not only identify benign and malignant lung dis‐eases ,but also identify the pathological type of SCLC and NSCLC ;Combined determination of pro‐GRP and NSE had significant values for the differential diagnosis of SCLC .

This study aimed to observe the protective effect of momordicine I, a triterpenoid compound extracted from momordica charantia L., on isoproterenol (ISO)-induced hypertrophy in rat H9c2 cardiomyocytes and investigate its potential mechanism. Treatment with 10 μM ISO induced cardiomyocyte hypertrophy as evidenced by increased cell surface area and protein content as well as pronounced upregulation of fetal genes including atrial natriuretic peptide, β-myosin heavy chain, and α-skeletal actin; however, those responses were markedly attenuated by treatment with 12.5 μg/ml momordicine I. Transcriptome experiment results showed that there were 381 and 447 differentially expressed genes expressed in comparisons of model/control and momordicine I intervention/model, respectively. GO enrichment analysis suggested that the anti-cardiomyocyte hypertrophic effect of momordicine I may be mainly associated with the regulation of metabolic processes. Based on our transcriptome experiment results as well as literature reports, we selected glycerophospholipid metabolizing enzymes group VI phospholipase A 2 (PLA2G6) and diacylglycerol kinase ζ (DGK-ζ) as targets to further explore the potential mechanism through which momordicine I inhibited ISO-induced cardiomyocyte hypertrophy.Our results demonstrated that momordicine I inhibited ISO-induced upregulations of mRNA levels and protein expressions of PLA2G6 and DGK-ζ. Collectively, momordicine I alleviated ISO-induced cardiomyocyte hypertrophy, which may be related to its inhibition of the expression of glycerophospholipid metabolizing enzymes PLA2G6 and DGK-ζ.

Objective:To analyze the application value of narrative education model in clinical teaching of nurses in operating room.Methods:A total of 90 nursing students in the Department of Operating Room, Shanghai Tenth People's Hospital from January 2018 to January 2020 were selected as the research objects and randomly divided into observation group and control group, 45 in each group. The control group was taught by traditional mentoring method, and the observation group was taught by narrative education model. The two groups of nursing students practiced for 4 weeks. After the teaching, the scores of theoretical knowledge and operation were compared between the two groups. The scores of career identity scale and caring ability evaluation scale of the two groups were compared, the scores of each dimension of Chinese registered nurse core competence scale (CIRN) were evaluated, and the feedback of the two groups of nursing students on the teaching methods was analyzed. SPSS 22.0 was used to conduct t-test and chi-square test. Results:The scores of theoretical knowledge and operation in the observation group were (94.52±5.34) points and (88.67±3.98) points, respectively, which were significantly higher than those [(85.67±5.26), (82.24±4.16)] in the control group ( t=7.92, 7.49, all P<0.001). The scores of professional identity scale and caring ability evaluation scale in the observation group were (39.12±5.12) points and (193.14±11.24) points, respectively, which were significantly higher than those [(34.21±4.23), (180.23±11.35)] in the control group ( t=4.96, 5.42, all P<0.001). The scores of various dimensions of CIRN in the observation group were significantly higher than those in the control group ( t=4.72, 7.57, 4.13, 4.66, 6.19, 4.27, 5.48, all P<0.001). The feedback of nursing students in the observation group on teaching methods was significantly better than that in the control group ( χ2=4.29, 6.48, 12.26, 4.44, 7.60, 5.03, P<0.05). Conclusion:Narrative education model can significantly improve the internship effect of operating room interns, with clinical value.