The training of clinical skill is closely linked with medical personnel education.However,traditional paper-type training materials were unable to meet the training needs.As a new type of training materials,trial-and-error video-type clinical skill training materials (abbreviated as TEVT clinical skill training materials) have gradually attracted attention with its characteristics of lively and interesting,potentially informative,high acceptance among students,the advantages' of stimulating students' initiative exploration and consideration,fostering students' critical spirit and humanities.On the basis of analyzing the advantages' of TEVT training materials,we discussed the developing specialties of TEVT clinical skill training materials from four aspects as the material orientation and the application object,material sources,constructing the developing team and editing the teaching materials.Furthermore,we reflected the application prospect of TEVT clinical skill training materials in the future,in order to explore an available implementation path for the development of TEVT clinical skill training materials.

Objective To summarize the experience in nursing 2 patients with anti-glomerular basement membrane disease.Method The nursing measures such as close observation of disease condition,careful nursing of medication,nursing during the treatment of double filtrated plasmapheresis and mental care to the patients and their family members.Results After treatment,the concentration of anti-GBM antibody was declined and the level of serum creatinine was also decreased.The renal function got rccovered to a certain extent.Conclusion Such nursing points as close observation of renal and pulmonary pathgenesis,timely and accurate administration of medicine according to doctor's orders and active observation and prevention of complication from double filtrated plasmapheresis are key.

Objective To characterize the medial femoral circumflex artery based on three-dimensional computed tomographic angiography (3DCTA) so as to provide anatomical aids for diagnosis and treatment of hip injuries.Methods To do this research the 3DCTA data of 103 patients (206 hips) were collected who underwent 3DCTA from March 2012 to June 2014 for examination of the pelvis and lower extremities.They were 55 men (mean age,54.7 ± 15.9 years) and 48 women (50.0 ± 16.1 years).① The origin and course of the medial femoral circumflex artery was observed.② The length of the artery trunk was measured.The distances between the origin(A) of the artery to the main anatomical marks [the peak of greater trochanter (B),the inward peak of lesser trochanter (C),and the crosspoint (D) of the femoral artery and the pubic edge or the acetabulum inlet edge] were measured.Comparisons of the measurements were conducted between genders.③ The distance between point A and point E,the starting point of the femoral profound artery,was measured.Comparisons of the measurements were conducted between genders.Results 2.9％ (3/103) of the subjects had their bilateral medial femoral circumflex arteries originate from the femoral artery,94.2％ (97/103) had their bilateral medial femoral circumflex arteries originate from the femoral profound artery,and 2.9％ (3/103) had one medial femoral circumflex artery originate from the femoral artery and the other from the femoral profound artery.1.9％ (4/206),76.7％ (158/206) and 21.3％ (44/206) of the subjects had the artery of screw type,of circuitous type and of straight type,respectively.The artery trunk goes posteriorly and medially after it is issued,divides into branches along the course,continues to go around the back of the femoral neck,and finally goes to the outward and upper direction.There were no statistical differences between males and females regarding length of the artery trunk,or distances between points AB,AC,AD or AE (P ＞ 0.05).Conclusion Since 3DCTA can clearly demonstrate the origin,course and anatomical morphology of the medial femoral circumflex artery,it can be used to provide anatomical aids for clinical evaluation and treatment of hip injury.

Objective To observe the expression of protein kinase C(PKC)isoforms in pulmonary artery of chronic inflammatory pulmonary hypertension(PHT)rats.Methods Chronic inflammatory PHT model rats were established induced by monocrotaline(MCT).Western blotting analysis was used to detect the expression of four PKC isoforms(PKC?,PKC?Ⅱ,PKC? and PKC?)in pulmonary arteries of rats during the development of PHT.Results The values of mean pulmonary artery pressure and right ventricular hypertrophy index increased significantly after the injection of MCT,which suggested successful formation of PHT.Western blotting analysis showed that PKC?,PKC?Ⅱ and PKC? isoforms were presented in pulmonary arteries of normal and PHT rats,while PKC? isoform was not detected.The expressions of PKC? in both cytosolic and membranous fractions increased within 14 days,and decreased a little during the development of PHT.But the increase of PKC? in cytosolic fraction was much more obvious than that in membranous fraction.The highest expression of both PKC?Ⅱ and PKC? in cytosolic fractions appeared at the eighth day,while the expression of both isoforms in membranous fraction went up continuously.Conclusions PKC?,PKC?Ⅱ and PKC? isoforms were involved in the development of chronic inflammatory PHT.The changes of their expression might be the results of PKC isoforms translocation which is related to the proliferation regulation of pulmonary artery smooth muscle cells.

OBJECTIVE To investigate the application of blood test in the prognosis of nasal NK/T-cell lymphoma.METHODS The clinicopathologic and follow-up data of 62 patients with nasal NK/T-cell lymphoma proven by pathological examination were collected.The blood lactic dehydrogenase(LDH),globulin(GLB),albumin(ALB),hemoglobin(Hb),and white blood cell(WBC) were examined in these patients.The correlation between these factors and prognosis were analyzed with univariate analysis and multivariate analysis.RESULTS Of the 62 patients,47 were males and 15 were females.Their median age was 42 years.Ninety two percent of the patients were in Ann Arbor I/Ⅱ stage,and 76 % had international prognostic index(IPI) of 0 or 1.Before treatment,92 % of the patients had ECOG performance status(PS) score of 0-1,26 % had anemia,53 % presented B symptoms.The median overall survival time was 27 months(95 % CI:10-45months).In univariate analysis,gender,age,PS score,LDH,IPI,B symptoms,Hb and WBC were statistically significantly correlated to the prognosis.In multivariate analysis,Hb1 were statistically significant unfavorable prognostic factors.CONCLUSION Hb together with B symptoms and PS score may be independent prognostic factors for nasal NK/T cell lymphoma.

0.05).Phlebitis occurred in 3 cases(4.2%) in PICC group,pneumothorax happened in 2 cases in CVC group.Calhelerization failure in CVC group was 7 cases who then received PICC successfully.No deep vein thrombosis occurred in either group. Conclusions:PICC has no possible severe complications of central venous access such as pneumothorax.The new method provides a safe,reliable and effective venous access for mid and long term usage in old patients.

Objective To examine the expression of lipoxygenases (LOXs)on human pancreatic carcinoma and their effects on proliferation and apoptosis of human pancreatic carcinoma in vitro.Methods Expression of 5- LOX and 12-LOX in the tissue of human pancreatic carcinoma and pancreatic cancer cell line (SW1990) was detected by immunohistochemical staining and RT-PCR.To examine the effects of polyunsaturated fatty acids on pancreatic cancer cell line,the proliferation rate of SW1990 cells treated with arachidouic acid (AA),docosahexaenoic acid (DHA) and eicosapentenoic acid (EPA) was analyzed by MTT and the incorporation of bromodeoxyuridine (BrdU) methods.An annexinV/propidium iodide (PI) assay with flow cytometry and in situ terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin end labeling (TUNEL) assay were used to identify potential induction of apoptosis by the unsaturated fatty acids.The effects of 5-LOX inhibitor (MK-886) and 12-LOX inhibitor (baicalein) on the proliferation of SW1990 cells were determined by above methods.Results Both 5-LOX and 12-LOX were over expressed in the tissue of human pancreatic carcinoma and the pancreatic cancer cell line.AA had a stimulatory effect on the growth of SW1990 cells while EPA and DHA had an inhibitory effect in a dose-dependent manner.The apeptosis of SW1990 cells co-cultured with DHA or EPA lasting for 24 hours was increased markedly.Furthermore, both MK-886 and baicalein in a dose-dependent-manner inhibited the growth of SW1990 cells ard induced a significant increase of apoptotic cells rate.Conclusions Expression of lipoxygenase is up-regulated in human pancreatic cancer. Polyunsaturated fatty acids have regulatory effects on the growth of pancreatic carcinoma in vitro.AA stimulates proliferation of pancreatic cancer cell line,while DHA and EPA suppress proliferation,simultaneously inducing apoptosis of pancreatic cancer cell line.Blocking the functions of lipoxygenase with its inhibitor exerts a negative regulatory effect on the growth of pancreatic carcinoma in vitro.Lipoxygenase might be a novel therapeutic target for the pancreatic cancer.

Diffuse large B-cell lymphoma (DLBCL) is a highly heterogeneous malignant tumor in lymphatic and hematopoietic systems. The majority of the DLBCL patients can be cured with standard chemotherapy, but around 30%to 40%of these patients can suffer from relapse and die from the disease. Double-hit lymphoma (DHL) is an unclassifiable tumor that mainly forms in DLBCL and B-cell lymphoma. The features of this tumor resemble those of DLBCL and Burkitt's lymphoma (BCLU), including short survival time, poor prognosis, and easy relapse. Given these unique characteristics, DHL has attracted much research attention over the years. Although BCLUs are more prone to DHL, DLBCL is the most common lymphoma in DHL. Accordingly, this review focuses on the epidemiology, clinical characteristics, diagnosis, molecular genetics, treatment, and prognosis of double-hit DLBCL.

Stereotactic body radiation therapy (SBRT) has been applied in extracranial metastases effectively,with the characteristics of concentrated dose distribution in target region,great dose gradient change in surrounding region and low dose in normal tissue beside target region.The radiation biology characteristics of SBRT,therapeutic mechanism,integration of SBRT into standard systemic therapy regimens have been studied further.

Objective To study the recent clinical efficacy of compound matrine injections combined with concurrent chemoradiotherapy in the treatment of locally advanced gastric cancer. Methods Totally 65 cases of untreated locally advanced gastric cancer were randomly divided into treatment group (33 cases) and control group (32 cases). The control group was treated by the conformal intensity modulated radiotherapy combined with chemotherapy. On the basis of the control group, the treatment group was given compound matrine injections 20 mL/time, once a day for 5 weeks. The recent curative effect, the quality of life and adverse reaction of the two groups were observed. Results The recent curative effect rate of the treatment group was 66.67% (22/33), the control group was 40.63% (13/32), the difference was statistically significant (P=0.031). On hematologic toxicity, leukopenia occurred in the treatment group was 30.30% (10/33), the control group was 65.63% (21/32), the difference was statistically significant (P=0.004). KPS of 26 cases (78.79%) improved in the treatment, and 18 cases (56.25%) improved in the control group. Conclusion The effects of compound matrine injections combined with concurrent chemoradiotherapy for locally advanced gastric cancer are good, they can improve short-term efficacy, reduce side effects, and improve the quality of life.