Objective To explore the teaching efficacy of applying scene simulation in enteral nutrition nursing skills training.Methods Totally 126 nursing students were randomly divided into 2 groups:experiment group with scene simulation teaching method and control group with traditional teaching method.Comparison of teaching efficacy between the two methods was made.Results The students in experiment group can skillfully complete nutritional care and get the praise of teachers.The satisfied patients made by students in experiment group were higher than those in control group 14.28％ - 19.05 ％ ( P＜0.05 ).The assessment scores of theoretic knowledge test and enteral nutrition nursing manipulation examination and comprehensive nursing skill test were higher in experimental group than in control group 6.69 - 11.94 ( P＜0.005 ).Conclusion Scene simulation teaching method is suitable for enteral nutrition nursing skill training and is favored by nursing students.

Gitelman's syndrome (GS) is an autosomal recessive hereditary tubulopathy.It is caused by sodium reabsorption in the distal convoluted tubule of the renal unit,which is not yet fully cured.It is characterized by great heterogeneity with clinical manifestations.Some patients with no symptoms,were confirmed by hypokalemia with physical examination.The others can be manifested as fatigue,nocturia,polydipsia and hypotension.Less literature is reported about GS combined with osteoarthrosis.In this report,the author reported a patient of GS with osteoarthrosis characterized by hypokalemia,hypomagnesemia,metabolic alkalosis,lower blood pressure,and swelling and pain in left knee joint.The symptoms were improved after treatment with potassium and magnesium supplementation

Liquid-assisted surface desorption atmospheric pressure chemical ionization mass spectrometry (LA-DAPCI-MS)was used directly for the analysis of healthy rat liver (normal control group);acute alcoholic injury rat liver(alcohol model group)and Zhizi Dahuang decoction-treated rat liver (ZZDHD group)sections with the mass spectrometry images obtained simultaneously.Principal component analysis (PCA)was employed for the differentiation of livers of the groups;and 3 phospholipids;PC (34 ∶2);PC(36 ∶4)and PC(38 ∶4);were found to be the main factors.LA-DAPCI mass spectrometry images showed that the 3 phospholipids were evenly distrib-uted in liver under the spatial resolution of 0.01 mm2.Contents of 3 PCs in the model group were decreased in alcohol model group compared to the normal control group and the ZZDHD group;which revealed the relationship between acute alcoholic liver injury and intrahepatic phospholipid variation.The results showed that ZZDHD had protective effect on acute alcoholic liver injury-induced intrahepatic phospholipid variations at the molecular level.

Objective To observe the protection of human lens epithelial cells(HLEC) by different polar alkaloids extracted from Herba Dendrobii(HD).Methods We extacted the Herba Dendrobii powder with ethanol,and then treated the extract with falling-film concentration,acidification,salting out,chloroform extraction,and washing with water.Different polar alkaloids were extracted from HD after the above treatment.The protective effect of HD alkaloids was observed on HLEC,which were cultured with DMEM medium containing 10% fetal calf serum.Ten groups were set up for the experiment: normal control group,model group,high-and low-dose water-soluble alkaloids groups,high-and low-dose fat-soluble alkaloids groups,high-and low-dose low-polar alkaloids group,and high-and low-dose weak-polar alkaloids groups.The high-dose dosage of the alkaloids was 25.0 ?g/L and low-dose dosage was 12.5 ?g/L.Methyl thiazolyl tetrazolium(MTT) assay was used to evaluate the proliferation of HLEC under the different conditions of interventions.Results The single-factor experiments showed that the highest extracting rate of HD alkaloids was obtained under the conditions of extracting the powder with 80% ethanol for 3 times and for 3 hours.The results of protective experiment showed that the proliferation of HLEC in the model group was inhibited by hydrogen peroxide(H2O2),and the inhibitive rate was lower in low-dose fat-soluble alkaloids group than that in the model group(P

Flipped classroom as a new teaching mode provides a new idea for the reform of teaching and learning of medical genetics. This paper analyzes the feasibility of flipped classroom applied in medical genetics teaching and puts forward the concrete teaching design and practice process. That is, establishing task list, making teaching materials, drafting progress process and so on before class; implementing group reporting, teacher reviewing and in-class test in class; after class conducting comprehensive evaluating, summarizing and feedback, etc. Meanwhile, combining the practice, the experience and deficiency of flipped classroom is summarized in the end. Preliminary evaluation shows that the flipped classroom teaching im-proves students'!autonomous learning initiative, but it still needs to be improved in the course of medical genetics.

Public health education is the core and foundation of the development of public health.Therefore,it is an urgent problem to explore the effective ways to improve public health education and to enhance the service abilities of public health,which meets the needs of development of modern public health.On the basis of analyzing the present situation of public health education in our country,this paper discusses the necessity of introducing the concept of integrated medicine in public health education,and then puts forward the corresponding settlement measures to solve the specific problems by utilizing the concept,thinking and method of integrated medicine,which aim to provide a certain theoretical basis for cultivating high-quality public health talents and accelerating the development of public health disciplines in China.

AIM: To detect whether N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) inhibits epithelial-mes-enchymal transition in A549 cells induced by TGF-β1 through suppressing the expression of heat shock protein 27 (HSP27) and zinc finger proteins Snail (including SNAI1and SNAI2) which ultimately inhibited the deposition of type I and type III collagens.METHODS:The colocalizations of HSP27 and SNAI1/SNAI2 respectively on A549 alveolar epi-thelial cells induced by TGF-β1 were measured by confocal microscopy .The expression of HSP27, SNAI1 and SNAI2 at mRNA level was detected by real-time PCR.Western blotting analysis was used to detect the expression of HSP 27, SNAI1 and SNAI2 on epithelial-mesenchymal transition in A549 cells induced by TGF-β1 and also the deposition of type I and type III collagens in A549 cells transfected with HSP27shRNA prior to TGF-β1 stimulation.RESULTS: Compared with control group, TGF-β1 increased the expression of HSP27, SNAI1, SNAI2, type I and type III collagen, which decreased significantly followed by Ac-SDKP intervention.The expression of SNAI1, type I and type III collagen decreased signifi-cantly after transfected with HSP27shRNA in A549 cells, which had the similar effect on Ac-SDKP intervention.CON-CLUSION:Ac-SDKP inhibits the transition of cultured A 549 cells to myofibroblasts and attenuates collagen synthesis by suppressing the expression of HSP 27 and zinc finger proteins SNAI 1 and SNAI2.

Objective:To investigate the clinical characteristics and outcome of novel coronavirus pneumonia (COVID-19)patients with different body mass index (BMI), and to provide the basis for disease assessment and prognosis.Methods:The clinical data of 541 patients with COVID-19 diagnosed in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 16 to March 28, 2020 were collected. The patients were divided into normal weight group, overweight group, and obesity group according to BMI. The clinical characteristics and outcomes of the three groups were compared. The correlation between BMI and clinical classification was analyzed by ordinal logistic regression.Results:There were 288 cases (53.23%) in normal weight group, 193 cases (35.67%) in overweight group, and 60 cases (11.09%) in obesity group. Compared with normal weight group, overweight and obesity groups displayed higher proportion of hypertension, with increased levels of white blood cells, neutrophils, C reactive protein, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and triglyceride in laboratory test results, and higher proportion of severe and critical illness ( P<0.05 or P<0.01). After adjusting for age, gender, and underlying diseases, regression analysis showed that higher BMI predicted more severe clinical classification ( OR=1.079, 95% CI 1.010-1.154). Conclusion:In COVID-19 patients, overweight and obese patients are more likely to develop into severe and critical illness, suggesting that obesity may be an important risk factor affecting the clinical outcome of COVID-19.

Objective To summarize the outcome of nasopharyngeal carcinoma ( NPC) treated by helical tomotherapy in the Chinese PLA general hospital. Methods Between September 2007 and August 2010, 121 newly diagnosed NPC patients were treated by radiotherapy with Tomotherapy system, with ( n =90) or without ( n = 31) concurrent chemotherapy or molecular target therapy. The prescription dose was 70 - 74 Gy/33f to primary tumor and positive lymph node planning target volume,60. 0 - 62. 7 Gy/33f to high risk planning target volume, and 52 -56 Gy/33f to low risk planning target volume. Acute side-effects were evaluated with RTOG/EORTC criteria. Results The remission rate of primary lesion and positive lymph nodes was 95. 0％ and 99. 0％ , respectively. The follow-up rate was 100％ . The number of patients with 1 ,2 and 3 years followed-up were 99 , 49 , and 7. The 1-, 2-and 3-year local relapse-free survival rates were 97. 30％ , 97. 3％ and 97. 3％ , respectively. The 1-,2-and 3-year nodal relapse-free survival rates were 100％ , 100％ and lOO％, respectively. The 1-, 2-and 3-year distant metastasis-free survival rates were 98. 4％ , 96. 3％ and 96. 3％ , respectively. The 1-, 2-and 3-year overall survival rates were 96. 5％ ,92. 6％ and 86. 8％ , respectively. Acute toxicities of skin, oral mucosa and xerostomia with grade 0,1,2 and 3 were 5. 0％ , 74. 4％ , 15. 7％ and 4. 9％ ; 0. 8％ , 37. 2％ , 57. 9％ and 4. 1％ ; 3. 3％ , 53. 7％ ,43. 0％ and 0％ , respectively. Xerostomia restored with time, no grade 2 or more xerostomia was observed 1 year after radiation therapy. Concurrent chemotherapy significantly increased incidence of mucositis,esophagitis and tracheitis. Conclusion Helical tomotherapy is efficient, secure and effective modality for the treatment of nasopharyngeal carcinoma.

[Abstract ] Objective Silicosis is one of the most serious occupational diseases in China .In this study,we explored the reg -ulatory effect of N-acetyl-seryl-aspartyl-lysyl-proline ( Ac-SDKP ) on angiotensin ( Ang ) Ⅱ-induced extracellular signal-regulated ki-nase ( ERK1/2) and Jun N-terminal kinase ( JNK) signals and its inhibitory effect on the differentiation of human embryonic lung MRC-5 fibroblasts to myofibroblasts via Ang Ⅱ-induced ERK1/2 and JNK signals . Methods Human embryonic lung MRC-5 fibro-blasts were induced by Ang Ⅱand pre-treated with the JNK signal inhibitor ( SP600125 ) , the ERK1/2 signal inhibitor ( PD98059 ) or Ac-SDKP.The proliferation of the cells was measured by MTT assay .The expressions of αS-MA, SRF, p-ERK1/2 and p-JNK were determined by immunocytochemical staining , and the expression levels of these proteins and collagen Ⅰwere detected by Western blot .Results The A value of Ang Ⅱ group (0.56 ±0.08) measured by MMT assay was 2.07 fold as control group ( 0.27 ±0.05 ). Pretreatment with SP600125 , PD98059 and Ac-SDKP, the A value were (0.39 ±0.02), (0.40 ±0.03) and (0.36 ±0 0.5) that had a statistical significance with Ang Ⅱgroup.The up-regulation of colla-gen type Ⅰ,α-SMA, SRF were induced by Ang Ⅱ by 4.50, 3.50 and 3.00 fold compared with control group.Moreover, the expression of p-ERK1/2 and p-JNK were increased as 6.71 and 7.90 fold as control. Pre-treatment with Ac-SDKP could inhibit p-JNK and p-ERK1/2 to 29.79% and 46.84% compared with AngⅡ group. Conclusion Ac -SDKP can inhibit the differentiation of human embryonic lung MRC-5 fibroblasts to myofibroblasts by regulating AngⅡ-induced JNK and ERK1/2 signals.