Objective:To probe the implement of inquiry -based teaching in nursing ethics. Method:105 nursing students attended the innovation of inquiry-based teaching for Nursing Ethics. Results:88. 5% nursing students satisfied with innovation of teaching;82 . 9% nursing studentsethics awareness was enhanced largely in understanding for nursing ethics;68 . 6% nursing students considered that their ability for ethical thinking has been enhanced largely;93 . 3% nurs-ing students thought that nursing ethics was important. Different inquiry methods for nursing students led to different level of analysis ability for ethic cases(P﹤0. 001). Conclusions:It's necessary to perform the innovation of inquiry-based teaching, promoting the student's activity, focus on learning process and enhancing the students comprehensive ability.

Sixty cases of type 2 diabetes with diabetic peripheral neuropathy (DPN), 46 cases of type 2 diabetes without DPN and 50 healthy persons were recruited. Plasma homocysteine (Hcy), serum folic acid, vitamin B 12 levels and the mutations of Hcy metabolism related enzyme-methyhenetetrahydrofolate reductase (MTHFR) were assayed in individuals in this study. The results showed that high Hcy, low folic acid and vitamin B 12 levels are related with DPN in the patients with type 2 diabetes. The mutation of MTHFR C677T is associated with diabetes, but not with DPN.

Objective To investigate the influence of pertussis toxin(PTX)on G protein-coupled estrogen receptor(GPER)-mediated activation of phosphatidylinositol 3-kinase(PI3K)/protein kinase B (Akt)signaling activated by 17 β-estradiol(17β-E2)in endometrial carcinoma cells.Methods Expressions of GPER protein were detected by immunohistochemical SP method in Ishikawa and HEC-1A cells.Changes of levels of GPER,ERα and ERβ protein and the activation of Akt protein were observed by western blot in the two cells after they were treated by PTX for 30 minutes at different concentrations(0,0.1,0.5,1.0 μg/ml),and then co-stimulated with with 1 × 10-6 mol/L 17β-E2 respectively at different time (Ishikawa 30 minutes,HEC-1A 15 minutes).Results(1)Immunohistochemical SP method showed that GPER was positive stained in cell cytoplasm of Ishikawa and HEC-1A cell.(2)After co-treated with PTX at different concentrations(0,O.1,0.5,1.0 μg/ml)and 10-6 mol/L 17β-E2,in Ishikawa cell,the ratio of pAkt/Akt was 0.74 ±0.54,0.34 ±0.06,0.18 ±0.03,0.07 ±0.15,the gray values of GPER was 0.872 ± 0.490,0.395 ± 0.054,0.145 ± 0.014,0.034 ± 0.008,and with increasing concentration of PTX,the ratio of p-Akt/Akt and the expression of GPER decreased gradually(P ＜ 0.05),which was most obviously when the concentration was 1.0 μg/ml(F =63.729,P =0.0001;F =160.284,P =0.0001);ERα and ERβ protein had no significant change among different groups(P ＞0.05).In HEC-1A cell,the ratio of pAkt/Akt was 0.73 ±0.09,0.26 ±0.14,0.11 ±0.03,0,the Gray values of GPER is 0.927 ±0.134,0.485 ± 0.022,0.194 ± 0.004,0,and with increasing concentration of PTX,the ratio of p-Akt/Akt and the expression of GPER decreased gradually(P ＜ 0.05),which were also completely inhibited when the concentration was 1 μg/ml(F =1039.321,P =0.0001;F =109.646,P =0.0001),ERα protein had no significant differences(P ＞ 0.05)among different groups.ERβ was negatively expressed.Conclusion The results proposed that the activation of PI3K/Akt signaling in Ishikawa and HEC-1A cells could be inhibited after blocking the role of GPER by PTX.

BACKGROUND:Alveolar bone remodeling and sustained absorption due to tooth extraction seriously affect the implanting conditions and morphology of hard and soft tissue in implant zone. OBJECTIVE:To evaluate the effect of nano-hydroxyapatite/polycaprolactone electrospinning scaffolds to improve the osteogenic effect of bone defects around immediate implants. METHODS:Tissue-engineered bone was prepared by combining canine bone marrow mesenchymal stem cels with nano-hydroxyapatite/polycaprolactone electrospinning scaffold. Bilateral mandibular second premolars from six dogs were extracted mandibular second premolar, and an immediate implant was placed in the mesial fossa of the mandibular second premolar. Three-wal bone defects was made buccaly using titanium nails, then tissue-engineered bone and Bio-Oss bone powders were implanted bilateraly covered by colagen membranes (Bio-Gide). Imageology examination was performed to measure bone gray levels immediately, 4, 8, 12 weeks after surgery. After 12 weeks, the mandible was removed completely, toluidine blue staining was used for observation of microstructure, new bone formation, bone morphology and implant osseointegration. RESULTS AND CONCLUSION: Between the two groups, there was no difference in bone mineral density at each time point after surgery, indicating that the effects of the two materials to promote bone regeneration process are basicaly the same. After implantation, the dense lamelar bone formed in the bone defect region of tissue-engineered bone group, mature bone cels, Haversian canal, and implant osseointegration were visible. While, in the Bio-Oss group, the lamelar bone was dense, a smal amount of Bio-Oss particles distributed within new bone tissues, fewer bone cels were found, a part of Haversian canal was shown to have blood capilaries, and new bone was in close conjunction with the implant. These findings indicate that the nano-hydroxyapatite/polycaprolactone electrospinning scaffold combined with bone marrow mesenchymal stem cels and Bio-Gide colagen membrane can promote the regeneration of alveolar bone around the implant.

Objective: To explore the clinical effect of the multi-point, multi-level suspension as well as fixation using midfacial soft-tissue spaces for midface lifting. Methods: A total of 65 patients with aging midface were admitted at the First Affiliated Hospital of Fujian Medical University from October 2017 to February 2019. Among them, 47 patients underwent primary blepharoplasty and midface lifting. Eighteen patients, including 5 patients with lower eyelid retraction or ectropion after blepharoplasty, underwent secondary midface lifting after blepharoplasty. The preseptal space was separated under orbicularis oculi muscle by palpebral margin incision. The orbicularis retaining ligament and the tear trough ligament were severed through preperiosteal plane. The preseptal space was connected with premaxillary space and prezygomatic space. The malar fat pad and superficial fascia were vertically suspended and fixed on the periosteum of infraorbital ridge by selected medial, middle and lateral points. The orbicularis oculi muscle was suspended and superolaterally fixed at lateral orbital periosteum. Therefore, the midface could be lifted by multi-point, multi-level suspension and fixation. Results: All incision healed in the first stage. Eyelid separation occurred to 1 patient, around 1 month after the operation. Tarsal strip lateral canthoplasty was performed for repair. Local protuberance of lateral lower eyelid occurred to another patient shortly after the operation, but improved after 3 months by lid massaging. No other complication was observed in the rest of the cases. All patients were followed up for 1 to 8 months and the results were satisfactory. Conclusions It is simple and practicable to utilize midfacial soft-tissue spaces. This method could benefit patient of less trauma, bleeding, and complications, and good clinical effect. It is a good choice for rejuvenation of the midface, especially for secondary midface rejuvenation after blepharoplasty, or complicated with lower eyelid retraction and ectropion.

This article reported a survived case of amniotic band syndrome (ABS) following fetal reduction by radiofrequency ablation. The woman conceived monochorionic diamniotic twin pregnancy spontaneously. Prenatal ultrasound at 24 weeks of gestation indicated twin-twin transfusion syndrome (stage Ⅲ), and radiofrequency ablation for fetal reduction was successfully performed after formal consent. At 28 +6 weeks, ultrasound reexamination revealed significant edema in the left foot of the fetus, with banding around the ankle, as well as the strangulation mark and narrowing rings. Fetal ABS (ⅡB stage) was diagnosed after multidisciplinary consultation. An immediate emergency cesarean section was performed and a live male baby was born. A thin amniotic band could be seen wrapping around the left ankle of the newborn for several rounds, with obvious strangulation marks about 1 cm deep into the skin, and significant edema on the dorsum and sole of the foot, and the submalleolus area. The amniotic band was released at once, and the edema faded gradually after surgery. After a follow-up of 28 days, the lower limbs of the newborn became normal.

Objective To analyze the individualized CTV-to-PTV margin dose and positioning errors in radiotherapy for esophageal cancer for improving the treatment accuracy while meeting dose requirements.Methods Fifty-four esophageal cancer patients admitted to Sun Yat-sen University Cancer Center at Huangpu District from June 2021 to June 2022 were enrolled.All of the patients underwent CBCT scans in each fraction,and a total of 1283 CBCT images were collected.The image registration between CBCT image before radiotherapy and planning CT image was carried out to obtain errors in vertical(VRT),longitudinal(LNG),lateral(LAT),Roll,Pitch,and YAW directions.The mean values of six-dimensional positioning errors in the first 5 fractions were calculated,and the results were compared with the total fractional errors using the single sample t-test method for determining the differences.The CTV-to-PTV margin was calculated with the formula(margin=2.5∑+0.7δ),and the calculated margins were divided into 5 groups:Group A(5 mm expansion in all directions),Group B(7.9 mm expansion in LAT direction,and 5 mm expansion in other directions),Group C(11.03 mm expansion in LNG direction,and 5 mm expansion in the other directions),Group D(6.36 mm expansion in VRT direction,and 5 mm expansion in the other directions),and Group E(7.9 mm expansion in LAT direction,11.03 mm expansion in LNG direction,and 6.36 mm expansion in VRT direction).Simulation planning was conducted for 10 patients.Results The proportions of differences between the mean values of six-dimensional errors in the first 5 fractions and the total fractional errors in 54 patients were analyzed.There was no significant difference in 192 out of the 324 directions in 54 patients,accounting for 59.26%(P>0.05).Among them,the LAT,LNG,VRT,Pitch,Roll and YAW directions accounted for 64.81%,57.41%,51.85%,64.81%,57.41%and 59.26%of the total cases.The calculated CTV-to-PTV margin was 7.90,11.03 and 6.36 mm in LAT,LNG and VRT directions.The statistical analysis showed that the differences in the coverage rates of organs-at-risk and target areas among the 5 groups of CTV-to-PTV margins were trivial(P>0.05).Conclusion Using the positioning errors in the first 5 fractions of radiotherapy for esophageal cancer to predict subsequent positioning errors is feasible.The reasonable individualized margin in radiotherapy for esophageal cancer can reduce the inter-fractional off-target rate without increasing the dose delivered to organs-at-risk.The study provides a reference for the target volume margin of esophageal cancer and an important basis for precision treatment.

Objective:To investigate the effect of total alkaloid of harmaline (TAH) on inducing cellular autophagy and degradating of neurotoxic proteins Tau and α-synuclein (α-Syn).Methods:(1) The in vitro cultured PC12 cells were divided into blank control group, and 1, 2.5, 5, 10, 20 and 50 μg/mL TAH groups, respectively; and they were treated with 0, 1, 2.5, 5, 10, 20 and 50 μg/mL TAH for 24 h; cell morphology and number were observed, and cell survival rate was determined by MTT assay. (2) PC12 cells were divided into blank control group, rapamycin group, and 1, 2.5, 5, 10 and 20 μg/mL TAH groups; these cells were treated with same amount of solvent, 50 nmol/L autophagy activator rapamycin, and 1, 2.5, 5, 10 and 20 μg/mL TAH for 4 h, respectively, and the number of autophagosomes was detected by immunofluorescent staining. (3) PC12 cells were divided into blank control group, rapamycin group, and 10 μg/mL TAH group; these cells were treated with same amount of solvent, 50 nmol/L rapamycin, and 10 μg/mL TAH for 4 h; the protein expression levels of p62 and microtubule-associated protein 1 light chain 3 II (LC3-II) was detected by Western blotting. (4) PC12 cells were divided into blank control group, chloroquine group, TAH group, and TAH+chloroquine group; these PC12 cells were treated with 50 nmol/L autophagy inhibitor chloroquine, 10 μg/mL TAH, and 10 μg/mL TAH+50 nmol/L chloroquine for 4 h, respectively; the LC3-II protein expression was detected by Western blotting. (5) PC12 cells were divided into TAH group and blank control group; 10 μg/mL TAH and same amount of solvent were given to each group for 4 h, and then, the phosphorylated mammalian target of rapamycin (p-mTOR) and phosphorylated 70-KD ribosomal protein S6 kinase (p-P70S6K) protein expression levels were detected by Western blotting. (6) Tet on HEK293 cells with Tau-green fluorescent protein (GFP) overexpression were divided into blank control group, TAH group, doxycycline group, doxycycline+TAH group, doxycycline+TAH+3-MA group, and doxycycline+TAH+chloroquine group. Cells in the later 4 groups were treated with 200 ng/mL Tet system inducer doxycycline for 24 h; cells in the blank control group were treated with same amount of solvent, those in the TAH group were treated with 10 μg/mL TAH, and cells in the latter 3 groups were treated with 10 μg/mL TAH, 10 μg/mL TAH+5 mmol/L 3-MA, and 10 μg/mL TAH+50 nmol/L chloroquine, respectively, for 24 h; the changes of green fluorescence intensity of these cells were observed under laser confocal microscope. The Tau-GFP and LC3-II protein expression levels were detected by Western blotting. (7) HEK293 cells with stable α-Syn expression were divided into blank control group, chloroquine group, TAH group and TAH+chloroquine group; these cells were treated with same amount of solvent, 50 nmol/L chloroquine, 10 μg/mL TAH and 10 μg/mL TAH+50 nmol/L chloroquine for 24 h, respectively; the α-Syn and LC3-II protein expression levels were detected by Western blotting. Results:(1) As compared with that in the blank control group, the cell survival rate in 20 and 50 μg/mL TAH groups was significantly lower, and that in the 50 μg/mL TAH group was statistically lower than that in 20 μg/mL TAH group ( P<0.05). (2) As compared with that in the blank control group, the number of autophagosomes in rapamycin group, and 10 and 20 μg/mL TAH groups was significantly increased, and that in 10 μg/mL TAH group was statistically higher than that in 20 μg/mL TAH group ( P<0.05); 10 μg/mL TAH group was selected for subsequent experiments. (3) As compared with the blank control group, the rapamycin group and TAH group had significantly decreased P62 protein expression and significantly increased LC3-II protein expression ( P<0.05). (4) As compared with that in the blank control group, the LC3-II protein expression in the chloroquine group, TAH group and TAH+chloroquine group was significantly increased, and LC3-II protein expression in TAH+chloroquine group was statistically higher than that in chloroquine group ( P<0.05). (5) The p-mTOR and p-p70S6K expression levels in the TAH group were significantly decreased as compared with those in the blank control group ( P<0.05). (6) The Tau-GFP protein expression in doxycycline group was significantly increased as compared with that in the blank control group ( P<0.05); that in doxycycline+TAH group was significantly decreased as compared with that in the doxycycline group ( P<0.05); that in the doxycycline+TAH+3-MA group and doxycycline+TAH+chloroquine group was statistically increased as compared with that in doxycycline+TAH group ( P<0.05). The LC3-II protein expression in the TAH group was significantly increased as compared with that in the control group, that in the doxycycline+TAH group was significantly increased as compared with that in the doxycycline group, that in the doxycycline+TAH+3-MA group was significantly decreased as compared with that in the doxycycline+TAH group, and that in doxycycline+TAH+ chloroquine group was significantly increased as compared with that in the doxycycline+TAH group ( P<0.05). Conclusion:TAH may activate autophagy by inhibiting the mTOR/p70S6K signaling pathway, which in turn promotes the degradation of neurotoxic proteins Tau and α-Syn.

Objective To analyze the effects of different supplements on anemia related indexes in rural children. Methods A stratified method was adopted, and six villages (towns) in and around Qinghai Province were selected as intervention sits for the present study. A total of 304 children from 2 to 6 years old at each intervention site meeting the inclusion criteria were screened and divided into three groups (A, B, and C), who were intervened for 3 months. Serum vitamin A, vitamin D and hemoglobin levels were measured before and after the intervention. Results The hemoglobin level of 304 children before intervention was (118.65±16.07) g /L, and the prevalence of anemia was 9.54%. The vitamin A value, vitamin D value and hemoglobin value were increased after three months of the intervention. The changes of vitamin A value, vitamin D value and hemoglobin value in rural children in group C were significantly higher than those in groups A and B. The increase in vitamin A value in rural children aged 3 years was significantly higher than that in other age groups, and the increase in hemoglobin in rural children of 1 year old was significantly higher than that in other age groups. The increase in vitamin A value of rural children of other ethnic groups (mainly Tibetans) was significantly higher than that of Han and Hui nationalities, and the increase of hemoglobin value in Hui rural children was significantly higher than that in Han and other ethnic groups. Conclusion Vitamin A combined with iron dextran tablets was effective in preventing anemia in rural children.

BACKGROUND: The clinical features of enthesitis in patients with psoriatic arthritis (PsA) have been reported in some Western countries, but data in China are very limited. This study aimed to describe the characteristics of enthesitis in Chinese patients with PsA and compared them with those in other cohorts. METHODS: Patients with PsA enrolled in the Chinese Registry of Psoriatic Arthritis (CREPAR) (December 2018 to June 2021) were included. Data including demographics, clinical characteristics, disease activity measures, and treatment were collected at enrollment. Enthesitis was assessed by the Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesitis score (MASES), and Leeds enthesitis index (LEI) indices. A multivariable logistic model was used to identify factors related to enthesitis. We also compared our results with those of other cohorts. RESULTS: In total, 1074 PsA patients were included, 308 (28.7%) of whom had enthesitis. The average number of enthesitis was 3.3 ± 2.8 (range: 1.0-18.0). More than half of the patients (165, 53.6%) had one or two tender entheseal sites. Patients with enthesitis had an earlier age of onset for both psoriasis and arthritis, reported a higher proportion of PsA duration over 5 years, and had a higher percentage of axial involvement and greater disease activity. Multivariable logistic regression showed that axial involvement (odds ratio [OR] 2.21, 95% confidence interval [CI], 1.59-3.08; P <0.001), psoriasis area and severity index (PASI) (OR: 1.03, 95% CI: 1.01-1.04; P = 0.002), and disease activity score 28-C reactive protein (DAS28-CRP) (OR: 1.25, 95% CI: 1.01-1.55; P = 0.037) were associated with enthesitis. Compared with the results of other studies, Chinese patients with enthesitis had a younger age, lower body mass index (BMI), a higher rate of positive human leukocyte antigen (HLA)-B27, more frequent dactylitis, and a higher proportion of conventional synthetic disease-modifying antirheumatic drugs' (csDMARDs) use. CONCLUSIONS Enthesitis is a common condition among Chinese patients with PsA. It is important to evaluate entheses in both peripheral and axial sites.
Humans ; Arthritis, Psoriatic/drug therapy* ; East Asian People ; Enthesopathy/complications* ; Registries ; Severity of Illness Index ; Spondylarthritis/epidemiology*