Modern management is in essence management of people and the idea and strategy of humanistic management infiltrate into various management activities of a hospital. Our hospital has attempted to enhance the ideological quality and vocational level of the nursing staff by the theory of humanistic management. As a result of such measures as stimulating the nursing staff's thirst for knowledge, enlarging the scope of rewards, increasing the work pressure of young nurses in a proper way, providing room for the free development of head nurses, implementing dynamic management, and adopting democratic management with a high degree of openness, the ideological quality of the nurses has been greatly enhanced. At the same time, measures have been taken to ensure from 3 links that their vocational level keeps improving as well.

To investigate the effects of Compound Zhebei Granule (CZBG), a compound traditional Chinese herbal medicine, combined with adriamycin (ADM) on mdr 1 gene expression in tumor xenografts in nude mice.

Objective To investigate the effects of Compound Zhe Bei granule (CZBG) combined with doxorubicin on the expression of GST and Topo - Ⅱ in K562/A02 cell line multidrug resistance tumor xenografts in mice. Methods Tumor xenografts model was established by injecting the multidrug resistance cell line K562/A02 in the axillary flank of BALB/c - nu - nu mice. Drug - comgbination of CZBG intragastric administration and doxorubicin intraperitoneal injection ( i. p. ) was given to the BALB/c - nu nude mice. The tumor xenografts were made into slice after the dissection, and the expression of GST and Topo - Ⅱ in K562/A02 tumor xenografts in mice was investigated by immunohistochemical technique. The integral optical density (IOD) of GST and Topo- lⅡ in K562/A02 tumor xenografts was measured by Image ProPlus 6.0. Results Compared with the single treatment of doxorubicin i. p group,the combination of the doxorubicin and CZBG with dosage classified by three types( high, middle, low) can decrease IOD of GSH and Topo - Ⅱ in K562/A02 tumor xenografts with statistical significance( P

Discussion teaching mode was carried out in the teaching of histology and embryol-ogy for clinical medical undergraduates in Chongqing Medical University from aspects of proposing questions, group learning, class discussing and summarizing. Classroom tests were accompanied to evaluate the teaching effect. It showed the discussion teaching achieved satisfactory effects. The correct answer rate of 92.36%students was≥60%. Students not only acquired knowledge but also increased their comprehensive abilities. The well-supervised topics, active participation of students and timely summary of teachers at the end of the class were the key factors in the practice of the discussion teaching mode.

Objective To detect the level of CD64 and serum procalcitonin (PCT ) and investigate the diagnosis value of CD64 and serum PCT in cirrhosis patients with spontaneous bacterial peritonitis (SBP) .Methods Participants were categorized in‐to three groups including liver cirrhosis with SBP(45 patients) ,liver cirrhosis without SBP(93 patients) and health personnel(50 persons) .CD64 was detected by flow cytometry and serum PCT was measured by electroc hemiluminescence immunoassay .The li‐mosis vein blood samples were obtained from the patients with SBP at the time of 24 h after admission ,before antibacterial drugs use and 7 days after the effective treatment of antibacterial drugs .The CD64 and serum PCT were detected with the limosis vein blood samples .At the same time ,the complete blood count ,liver ,kidney and blood coagulate functions were tested .The participants in other two groups were detected the CD64 ,serum PCT ,complete blood count ,liver ,kidney and blood coagulate functions at the same time .Results The level of CD64 and serum PCT in cirrhosis patients with SBP were significantly higher than those in liver cirrhosis without SBP and normal controls (P< 0 .01) .ROC curve analysis showed that the sensitivity and specificity of CD64 and serum PCT were 95 .5% ,93 .8% and 96 .1% ,85 .2% respectively .Conclusion CD64 and serum PCT can be determined as the im‐portant indicator in early diagnosis and efficacy criterion .

Objective To explore the clinical features of patients with surgical malignant peritoneal mesothelioma.Methods From April 2008 to November 2012,the clinical data of 14 patients with surgery and pathologically diagnosed malignant peritoneal mesothelioma were retrospectively analyzed.Results Among the 14 patients,13 cases had a history of asbestos exposure.There were 10 cases with abdominal pain,seven cases with bloatting,and one case with intermittent vaginal bleeding.There were 13 cases with asbestos plaques,14 cases with organ infiltration,nine cases with little or no ascites,one case with mild lymph nodes enlargement in peritoneal cavity,but no case was found with distant metastasis.There were three cases with diffuse type and 11 cases with localized type.Serum CA125 level increased in seven cases.Seven cases received postoperative chemotherapy,and the average survival time was five months after surgery.To the closing date,two patients with localized peritoneal lesions are still alive.Conclusions The incidence of the group of patients with malignant peritoneal mesothelioma is closely related to the contact with asbestos.Localized type is the dominant type,without lymph nodes enlargement and distant metastases.Survival rate may improve in patients with early surgery.

Objective: To investigate the relationship between M2-polarized macrophages and early response in multiple myeloma and its molecular mechanism. Methods: Two hundred and forty bone marrow biopsy tissue were collected and M2-polarized macrophages were stained by anti-CD163 monoclonal antibody. In vitro M2-polarized macrophages were derived from human peripheral blood mononuclear cell or THP-1 cells and identified by flow cytometry. Two myeloma cell lines RPMI 8226 and U266 were co-cultured with M2 macrophages using a transwell system. We measured myeloma cells proliferation through CCK-8 method and the pro-inflammatory cytokines expression (TNF-α and IL-6) by ELISA. Real time PCR was applied to measure chemokines (CCL2 and CCL3) , chemokine receptors (CCR2, CCR5) , VEGF and their receptors. In addition, flow cytometry was used to analyze the apoptosis of myeloma cells induced by dexamethasone. Results: ①Patients with high percentage of M2 macrophage involvement in bone marrow showed poorer response (23.9% versus 73.0%, χ²=60.31, P<0.001). ② In vitro the proliferation of RPMI 8226 cells (P=0.005 at 24 h, P=0.020 at 36 h) or U266 myeloma cells (P= 0.030 at 24h, P=0.020 at 36h) co-cultured with M2-polarized macrophages was higher than control group. ③In vitro the apoptotic rate of RPMI 8226 cells (29.0% versus 71.0%, t=4.97, P=0.008) or U266 myeloma cells (24.9% versus 67.7%, t=6.99, P=0.002) co-cultured with M2-polarized macrophages was lower than control group. ④ In vitro M2-polarized macrophages promoted myeloma cells secreting higher level of IL-6, TNF-α and higher expression of CCL2, CCL3, CCR2, CCR5, VEGFA, VEGFR-1,-2 compared with the non-macrophage co-culture system. Conclusion M2-polarized macrophages promote myeloma cells proliferation and inhibit apoptosis through a very complex mechanism involving pro-inflammatory cytokines IL-6 and TNF-α, chemokines and related receptors such as CCL2, CCL3, CCR2, CCR3, and VEGF as well as related VEGFR.

Objective:To explore the significance of skin and facial behaviors characteristics identifying the etiology of childhood epilepsy.Methods:Clinical data of 53 epilepsy children with skin and facial behaviors treated in the inpatient/outpatient of Children′s Hospital of Nanjing Medical University from August 2013 to August 2019 were retrospectively analyzed.Relevant case reports were reviewed through literature review.Results:All 53 children were diagnosed with epilepsy, including 28 cases diagnosed as tuberous sclerosis with the clinical clue of depigmentation spots, 5 cases diagnosed as cerebrovascular hemangioma with the clinical clue of crimson nevus, 5 cases diagnosed as mitochondrial brain disease combined with lactic acidosis and stroke like attack with the clinical clue of hairy and thin body, 5 cases diagnosed with Menkes disease with the clinical clue of sparse and curling hair and white skin, 1 case diagnosed as Alexandria disease with the clinical clue of large head circumference, 1 case diagnosed as giant cerebral leukodystrophy combined with subcortical cysts with the clinical clue of large head circumference, 1 diagnosed as type Ⅰ glutaric acidemia with the clinical clue of large head circumference, 2 cases diagnosed as Angelman syndrome with the clinical clue of happy face and mental retardation, 2 cases diagnosed as Rett syndrome with the clinical clue of stereotyped hand behavior, 1 case diagnosed as Aicardi-Goutières syndrome with the clinical clue of skin pigmentation and loss of spots, 1 case diagnosed as microdeletion of chromosome 1 with the clinical clue of wide eye distance and tooth loss, and 1 case diagnosed as neurofibromatosis with the clinical clue of café-au-lait-spots.Supported by the above characteristics, all cases had a clear diagnosis by imaging or genetic testing.Conclusions:characteristics of skin and facial behaviors is of great significance in the diagnosis of epilepsy etiology, and proficiency in the skin and facial behavior characteristics of childhood neurological diseases is conducive to the etiological diagnosis of epilepsy.

Objective To explore the clinical curative effect of interventional treatment of fibroids, evaluate its clinical application effect and provide a reference for future clinical treatment. Methods This study retrospectively analyzed the clinical data of 29 fibroid cases who admitted in our hospital from March 2016 to March 2019. All patients were performed X-ray guided uterine artery embolization (UAE). The study observed and recorded the volume of uterine and fibroid, menstruation, hormone levels, the post-operative complications etc. before and after the treatment. Results Patients were reexamined once every three months after the treatment, three times in a row. It was found that the patients’ postoperative uterine volume and fibroid volume were significantly smaller than preoperative volume (P < 0.05), and the difference was statistically significant. The postoperative menstrual cycle, menstruation, menstruation time were significantly improved (P < 0.05), and the difference was statistically significant. The postoperative LH, E2, FSH levels had no significant change (P > 0.05), and the difference was not statistically significant. There were two abdominal pain cases, one hematoma case and one vomite case during the postoperative observation period. These symptoms disappeared after the symptomatic treatment, and no serious symptoms such as high fever and pelvic infection occurred. Conclusion Interventional therapy of fibroids can effectively reduce the size of fibroids, significantly improve the quality of life of patients, with small damage, rapid recovery, preservation of the uterus and other advantages, which is worthy of further clinical application and promotion.

Talents are the core driving force to promote the high-quality development of public hospitals,and the talent team building is an important factor for hospitals to get sustainable development and improve comprehensive competitiveness.In view of the shortage of high-level talents,the imperfect talent reserve system,and the lagging personnel management mechanism of public hospitals and the resulting unreasonable talent team structure and talent gap,public hospitals should take talent team building as the starting point,pay equal attention to the introduction and training of talents,interact with discipline construction and talent construction,vigorously promote the construction of personnel management system and mechanism innovation,form a standardized,scientific,refined and efficient modern hospital management system,so that the effectiveness of talents can be max-imized,and provide intellectual support for the high-quality development of public hospitals.