As the main drug in colorectal cancer chemotherapy,oxaliplatin is gradually infiltrated into other malignancies therapy.But oxaliplatin-induced peripheral neuropathy limits its clinical application.The mechanisms of oxaliplatin neurotoxicity are not yet clear.Recent researches show that the acute neurotoxicity of oxaliplatin is mediated through changes in Na + transient conductances.And the function of the mitogen-activated protein kinases in chronic neuropathy has already been demonstrated in vitro.Furthermore,numerous indicators can be used to predict oxaliplatin-induced peripheral neuropathy,which bring the hope for improving the continuity of chemotherapy and realizing personalized medicine therapy.

OBJECTIVEWe used functional magnetic resonance imaging (fMRI) to explore the effects of noxious coldness and non-noxious warmth on the magnitude of cerebral cortex activation during intraoral stimulation with water.

METHODSSix male and female subjects were subjected to whole-brain fMRI during the phasic delivery of non-noxious hot (23 °C) and no- xious cold (4 °C) water intraoral stimulation. A block-design blood oxygenation level-dependent fMRI scan covering the entire brain was also carried out.

RESULTSThe activated cortical areas were as follows: left pre-/post-central gyrus, insula/operculum, anterior cingulate cortex (ACC), orbital frontal cortex (OFC), midbrain red nucleus, and thalamus. The activated cortical areas under cold condition were as follows: left occipital lobe, premotor cortex/Brodmann area (BA) 6, right motor language area BA44, lingual gyrus, parietal lobule (BA7, 40), and primary somatosensory cortex S I. Comparisons of the regional cerebral blood flow response magnitude were made among stereotactically concordant brain regions that showed significant responses under the two conditions of this study. Compared with non-noxious warmth, more regions were activated in noxious coldness, and the magnitude of activation in areas produced after non-noxious warm stimulation significantly increased. However, ACC only significantly increased the magnitude of activation under noxious coldness stimulation.

CONCLUSIONResults suggested that a similar network of regions was activated common to the perception of pain and no-pain produced by either non-noxious warmth or noxious coldness stimulation. Non-noxious warmth also activated more brain regions and significantly increased the response magnitude of cerebral-cortex activation compared with noxious coldness. Noxious coldness stimulation further significantly increased the magnitude of activation in ACC areas compared with noxious warmth.

OBJECTIVE To improve the diagnosis level of Penicillium marneffei culture identification in the grass-roots laboratories.METHODS The patient′s blood or bone marrow were innoculated to BacT/Alert 3D blood culture system.when positive sample was found,the culture fluid and node tissues were smeared to take,Gram stain.The pathogens suchas small long branch,septate hyphae,sausage-shaped cell,were transferred to Colombia blood plate,sand Paul agar and CHROMagar Candida chromogenic culture medium to observe the 25 ℃ and 35 ℃,to observe the colony morphology and cell characteristics.The relevant biochemical reaction tests,were cutler taken.RESULTS The foundation of identifying P.marneffei culture:it is a dimorphic fungus,cultured for fungal phase at 25℃,and for yeast phase at 35℃.Both could produce wine red pigment.Morphology under the microscope:culture had typical broom-shaped sticks at 25℃,and round,oval,blunt and slightly curved at both ends,and sausage-shaped thallus that had horizontal septum.Biochemical results:both could assimilate and ferment glucose to produce acid,urea luciferase positive.Both could be inhibited by Actidione,and couldn′t assimilate fermenting lactose.CONCLUSIONS The appropriate medium for the P.marneffei is Sabourand′s medium.The appropriate stains of the cell morphology and structure are lactic acid cotton blue staining and Gram staining which are suitable for the grass-root level laboratories.

Objective To investigate the spatiotemporal expression patterns and the relationship of α-sarcomeric actin(α-SCA) ,α-smooth muscle actin(α-SMA) and intermediate filament protein desmin with the maturation of the prenatal and the neonatal mouse hearts. Methods Serial sections of the embryo mouse and the neonatal mouse hearts were immunostained with antibodies against α-SCA, α-SMA and desmin. Results Ventricle and outflow tract of embryonic day(ED) 9 heart showed stronger expression of α-SCA and α-SMA, but desmin expression was lower. In the atrium, the expressions of α-SCA and α-SMA were restricted to the dorsal and ventral walls. In the sinus venosus, only a few weakly stained α-SCA positive cells were detected. No desmin expression was found in the atrium and sinus venosus. The expressions of α-SCA, α-SMA and desmin were increased to their highest level at ED 12. The higher expression of α-SCA remained to the postnatal stages. After ED 12, the expressions of α-SMA and desmin gradually decreased in different parts of the heart, but their expressions in the right ventricle persisted longer. After birth,desmin expression was mainly concentrated in the Z lines of I bands and intercalated disks. Conclusion The presence of spatiotemporal differences in the expression of α-SMA and desmin reveals regional differences in cardiomyocyte maturation in various parts of the embryonic mouse heart. The right ventricle shows a relatively slow pace of maturation. The α-SMA may contribute to a peristaltoid contraction pattern of the embryonic myocardium with a slow shortening speed, and a relatively higher level of desmin is required for the maturation of the sarcomere.

Objective To explore the theory of curriculum contents for gerontological nurse practitioner training which is suitable for the situation of our country. Method Delphi technique was used in this research to build content indicators of gerontological nurse practitioner training curricu-lum, and calculate the variation coefficient. Results The theory training curriculum includes founda-tions of gerontological nursing, geriatric syndrome, facilitating physiological balance and general gero-tological care modules and 41 core indexs. Every coefficient of variation is less than 20 percent [(4.35±0.71), (4.63±0.57), (4.55±0.57), (4.67±0.55)]. The mean values of the importance (4.54± 0.622) and general characteristics are more than four. Conclusion The content setting of the geron-tological nurse practitioner training theory course not only highlights the training characteristics of the geriatric care, but also has comprehensive and systematic content, reflects humanistic care spirit and pays attention to developing nurses’clinical practice ability. Therefore, it is worthy of reference and promotion.

Objective To evaluate the efficiency of glycogen phosphorylase BB (GPBB) and heart-type fatty acid binding protein (H-FABP) in the early diagnosis of neonatal myocardial injury (NMI). Methods The GPBB and H-FABP levels in the blood were detected at 3, 6, 12 and 24 h after onset of the NMI. The GPBB and H-FABP levels were compared among NMI, Non-NMI and control groups. The NMI diagnosis sensitivity and specificity for GPBB, H-FABP, GPBB combined with H-FABP were compared. The relationships of GPBB, H-FABP levels with the risk factors were analyzed. Results The GPBB and H-FABP levels of NMI group were higher than those of Non-NMI and control groups (P < 0.01). The diagnosis sensitivity of four time points (3, 6, 12 and 24 h) of combined GPBB and H-FABP were higher than those of the GPBB and H-FABP (P < 0.05). The GPBB and H-FABP were negatively correlated with blood glucose level, positively correlated with asphyxia degree and septicemia degree. Conclusion The combined application of GPBB and H-FABP can improve sensitivity in the early diagnosis of NMI.

Objective To investigate the current status of nurses'' needlestick injuries during venous blood sampling, evaluate effective prevention strategies.Methods A stratified cluster sampling method was used to investigate clinical nurses in China by questionnaire, contents of questionnaire included the general information of nurses, training and management on venous blood sampling among nursing staff, adherence to wearing gloves before blood sampling, the occurrence of needlestick injuries during the process of venous blood sampling in the past year and so on.Results A total of 2 861 questionnaires were distributed, and 2 575 valid questionnaires were recovered.93.17％ of the investigated nurses had participated in the training of venous blood sampling regularly;87.15％ received regular check of venous blood sampling;before venous blood sampling, only 72.74％ knew whether the patient had bloodborne infectious disease;only 61.01％ wore gloves during blood sampling.Incidence of needlestick injuries during venous blood sampling was 20.78％ in the past year.There was no significant differences in the incidence of needlestick injuries when using 3 different types of needles(Pearson x2=1.649, P=0.438).48.21％ of needlestick injuries occurred during disposing medical waste.Conclusion The training and management on nurses'' venous blood sampling is better in China, but incidence of needlestick injuries is still high.It is necessary to formulate safety operation regulations of venous blood sampling, standardize the operation procedures and specify the contents of training, so as to correct nurses'' unsafe behavior during venous blood sampling.

Objective To explore the clinical characteristics, risk factors of mortality and antimicrobial therapy of carbapenemresistant Klebsiella pneumoniae (CRKP) bloodstream infections. Methods A 5-year retrospective study was conducted for 60 patients with CRKP bloodstream infection, who were treated in Chinese People's Liberation Army (PLA) General Hospital during the period from June 2011 to August 2016. The patients were assigned to death (n=24) or survival (n=36) group according to 28-day survival after bloodstream infection to identify the predictors of mortality. The patients treated with combination antimicrobial therapy (n=32) were compared with those received monotherapy (n=14). Results A total of 60 nonduplicate CRKP blood isolates were identified. The 28-day mortality was 40.0％ (24/60). High APACHE Ⅱ score (OR=1.15, 95％ CI 1.0-1.3, P=0.048) was identified as an independent risk factor for 28-day mortality in patients with CRKP bloodstream infection. The 46 patients receiving antimicrobial therapy showed 28-day mortality of 34.8％. Univariate analysis indicated that the 28-day mortality rate was similar between the patients receiving combination antimicrobial therapy and those receiving monotherapy. Conclusions Bloodstream infection due to CRKP is associated with high mortality. APACHE II score is an independent predictor for mortality in patients with CRKP bloodstream infection.

Objective:To explore the application and effect of the online teaching in the clinical nursing practice of obstetrics and gynecology during the coronavirus disease 2019 (COVID-19) epidemic.Methods:A total of 26 undergraduate nursing interns in the obstetrics and gynecology department of Xiangya Hospital of Central South University during the epidemic period were enrolled in this study. The interns accepted online practical teaching, and the teaching effect was analyzed and evaluated through the results of the exit examination and online teaching satisfaction.Results:The theoretical course scores of nursing students are all above 80 points, among which 22 (84.62%) are above 90 points. The operation scores are all above 90 (94.04±2.96) points. The results of the online teaching satisfaction survey show that, 23 (88.46%) nursing students are satisfied with the effect of their online practice.Conclusion:The online teaching mode during COVID-19 epidemic can help nursing students master the theoretical knowledge of obstetrics and gynecology, improve their clinical reasoning ability, strengthen their practical operation skills, and enhance their autonomous learning ability.

Objective We used functional magnetic resonance imaging (fMRI) to explore the effects of noxious coldness and non-noxious warmth on the magnitude of cerebral cortex activation during intraoral stimulation with water. Methods Six male and female subjects were subjected to whole-brain fMRI during the phasic delivery of non-noxious hot (23 ℃) and noxious cold (4 ℃) water intraoral stimulation. A block-design blood oxygenation level-dependent fMRI scan covering the entire brain was also carried out. Results The activated cortical areas were as follows: left pre-/post-central gyrus, insula/ operculum, anterior cingulate cortex (ACC), orbital frontal cortex (OFC), midbrain red nucleus, and thalamus. The activated cortical areas under cold condition were as follows: left occipital lobe, premotor cortex/Brodmann area (BA) 6, right motor language area BA44, lingual gyrus, parietal lobule (BA7, 40), and primary somatosensory cortex SⅠ. Comparisons of the regional cerebral blood flow response magnitude were made among stereotactically concordant brain regions that showed significant responses under the two conditions of this study. Compared with non-noxious warmth, more regions were activated in noxious coldness, and the magnitude of activation in areas produced after non-noxious warm stimulation significantly increased. However, ACC only significantly increased the magnitude of activation under noxious coldness stimulation. Conclusion Results suggested that a similar network of regions was activated common to the perception of pain and nopain produced by either non-noxious warmth or noxious coldness stimulation. Non-noxious warmth also activated more brain regions and significantly increased the response magnitude of cerebral-cortex activation compared with noxious coldness. Noxious coldness stimulation further significantly increased the magnitude of activation in ACC areas compared with noxious warmth.