Objective To develop a nursing standard of baccalaureate program for Shanghai Jiaotong University to guide and improve the training quality of nursing students.Methods On the basis of literature review,the nominal group technique and Delphi survey technique were used to develop the standard.Results The training objective and the training plan included attitude,knowledge and ability constituted the standard.Conclusions The deficient of dominating personalities or obedience to authority which existed in traditional group discussion can be diminished in this study.The nominal group technique is a scientific and professional method for the construction and evaluation of nursing program.

Objective To investigate blood flow dynamics adjacent to regional myocardial segments in coronary artery disease(CAD) patients and to explore the association of the two CAD features.Methods In 43 CAD patients,velocity vector imaging (VVI) was used to evaluate the wall motion and classify normal myocardial segments (NS),relatively abnormal and obviously abnormal wall motion segments (RS and OS) by systolic peak strain (Ss).Vector flow mapping (VFM) was used to show blood flow dynamics in the heart chamber,including blood flow (Q) heading towards or away from the apex during a heart beat and time to every peak flow (T).Results Compared with NS,both RS and OS showed a higher systole Q + (blood flow heading towards the apex during systole) and lower diastole Q + (blood flow heading towards the apex during diastole) and shortened T2 (adjusted time interval between E and A peaks).Systole Q + was positively correlated with Ss but negatively with segmental ejection fraction (SEF).Diastole Q + was negatively correlated with early and late diastolic peak velocity (Ve and Va) but positively with Ve/Va.T2 was negatively correlated with Ve but positively with Ve/Va and early diastolic peak strain rate (SRe).Conclusions VFM might be a new tool to quantitatively assess change in regional blood flow dynamics in patients with CAD.

BACKGROUND:Bone morphogenetic protein (BMP) has strong osteoinductibility. At present, it becomes a hot topic to find a proper carrier for BMP. Calcium phosphate cement (CPC) may become a favorable carrier for BMP for its many merits. OBJECTIVE: To evaluate using the CPC/BMP composite as well as only CPC to repair experimental avascular necrosis of femoral head (ANFH).DESIGN: A randomized controlled experimental study SETTING: Experimental Animal Laboratory of the 208 hospital of Chinese PLAMATERIALS: The subjects were 24 healthy adult rabbits of either sex,weighing 2.5-3.0 kg. BMP was provided by Research Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University of Chinese PLA. CPC was developed together by Department of Orthopaedics, First hospital of Jilin University and Department of Orthopaedics, Aichi Medical University, Japan and Mitsubishi Material Corporation, Japan)METHODS: This experiment was conducted in the Animal Laboratory,the 208 Hospital of Chinese PLA between April 2003 and April 2004.The CPC/BMP composite was constructed by combining calcium phosphate cement (CPC) with bone morphogenetic protein (BMP). The 24 rabbits were randomly divided into two groups: CPC group and CPC/BMP group, 12 rabbits in each group. The models of experimental avascular necrosis of femoral head (ANFH) were made. Then the CPC or CPC/BMP composite were filled into the bone defects. The specimens were harvested separately at the end of 3 and 12 weeks after operation. A series of examinations were carried out including radiograph, histomorphology, and observation under transmission electron microscope (LEM).MAIN OUTCOME MEASURES: Bone formation, degradation of materials and repairing of bone defects in each group.RESULTS:Totally 24 rabbits were examined and analyzed. ① The results of general observation and X-ray examination on the bone defect regions in two groups: at week 12 in CPC group much new bone formed, the volume of CPC decreased. In CPC/BMP group more new bone formed. The phenomena of degradation and absorption were evident and the volume of the material decreased evidently. ② The results of histology observation and transmission electron microscope (TEM) observation in femoral heads in two groups: at week 12 in CPC group CPC decreased and there were some interspaces between CPC and new bone. New bone trabecula enlarged. Juvenile osteocytes could be found with round nucleus, chromatin deviating to one side, rough endoplasmic reticulum (rER) swelling and there were the phenomena of mitochondrion vacuolated and mitochondrial cristaes broken. In CPC/BMP group, CPC was dispersed with new bone intruded into the material and enwrapping each other. Osteoblasts contacted with CPC granules tightly whose rER and mitochondrion in cytoplasm increased and swelled. Many capillaries invaded the material and were encircled by many osteoblasts.CONCLUSION: CPC is an ideal carrier to BMP. The CPC/BMP composite has stronger steoconductibility and osteoinductibility in ANFH repairing than CPC, and is effective in repairing experimental avascular necrosis of femoral head.

This paper reports the nursing care of 7 patients with liver cirrhosis during pregnancy and childbirth. During the pregnancy period,nursing care focused on integrated management,monitoring of the dynamic changes of liver cirrhosis and individualized care. During delivery and perioperative period,supportive treatment was implemented and complications such as upper gastrointestinal hemorrhage,postpartum hemorrhage and infections were prevented. The 7 patients got through the perinatal period safely.

Objective:To evaluate the safety and efficacy of endoscopic cryoablation (ECA) in patients with upper tract urothelial carcinoma (UTUC).Methods:The clinical data of 9 patients with UTUC treated with ECA from April 2018 to September 2019 were retrospectively analyzed. Patients consisted of 3 males and 6 females, with median age of 76 years old (ranging from 50 to 88 years old). Among the patients, 6 cases had tumors of ureter, 1 case had tumor of renal pelvis and 2 cases had tumors of renal pelvis combined with ureter. Of the 9 patients, two had bilateral UTUC, six were presented with single lesion, three were presented with multiple lesion. The size of tumors were (1.53±0.91)cm. The tumors of all cases were localized (≤stage T 2), and there was no carcinoma or suspicious lymph node/distant metastasis. All patients enrolled in this study had strong will to choose kidney-sparing therapy. Biopsy, resection of intraluminal lesion with laser and cryoablation under ureteroscopy or percutaneous nephroscopy was performed under general aneasthesia.Ureteroscopy was performed 3 months after cryoablation. Perioperative complications and follow-up results were recorded and assessed. Results:Cryoablation was successfully performed in patients under ureteroscopy (n=8) or nephroscopy (n=1). The median cryoablation time was 6 (ranging from 4-16) minutes. The median follow-up was 16 months (ranging from 4-24 months). No tumor recurrence was observed at primary sites during follow-up. Two patients with multiple lesions were observed denovo ureteral neoplasms outside the primary sites 3 months and 6 months after cryoablation and treated with second cryoablation. One case died due to cardiovascular events 4 months after surgery. One patient underwent ureteral stricture during follow-up and received ureteroscopic balloon dilatation. No recurrent stricture was found in this case during the subsequent follow-up of 16 months. The other 5 cases showed no recurrence or complications like stricture during follow-up.Conclusions:ECA could probably be a promising treatment for localized UTUC. No recurrence in primary site and low incidence of ureteral stricture was observed during follow-up. The efficacy and safety of ECA need to be verified with large sample study.

Objective To investigate the effect of different doses valsartan on atherosclerosis in rabbits. Methods 53 white rabbits were randomly divided into control group,cholesterol group,and valsartan group of high-,middle-,and low-dose.The positive expression of pro-oncogene c-myc and c-fos mRNA was studied with in situ reverse transcription-PCR)ISRT-PCR).The histoppathological changes of aorta were observed.Results)1) Positive expression rate of pro-oncogene c-myc and c-fos mRNA was significantly higher in cholesterol than that in the qontrol group.The rate of positive expression was remarkably lower in the high-dose valsartan group than that in the cholesterol group)P

Objective To study the impact of HIV and hepatitis C virus ( HCV ) infection on peripheral expression of antiviral protein A3G and plasma IFN-αlevels.Methods Untreated patients with chronic hepatitis C(HCV infection group, n=43), AIDS(HIV infection group, CD4 +T<200 cells/μL, n=45) and HIV/HCV co-infection (CD4 +T<200 cells/μL, n=45) were recruited in the study, and 23 healthy subjects were also enrolled as controls.A3G mRNA in peripheral blood mononuclear cells (PBMC) was measured by quantificational real-time PCR, and plasma IFN-αlevel was determined by enzyme linked immunosorbent assay (ELISA).Rank-sum test and Spearman rank correlation analysis were performed. Results A3G mRNA levels in HIV infected group, HIV/HCV co-infected group, HCV infected group and healthy control group were 4.89 (0.59), 4.85 (0.71), 3.89 (1.08) and 3.69 (0.81) lg copies/mL, respectively.A3G mRNA levels in HIV infected group and HIV/HCV co-infected group were much higher than those in healthy control group (Z=-6.306 and -6.280, P<0.01) and HCV infected group (Z=-7.358 and -7.275, P<0.01).Plasma IFN-αlevels in HIV infected group, HIV/HCV co-infected group, HCV infected group and healthy control group were 2.79 (1.25), 2.05 (1.29), 2.32 (1.84) and 2.16 (2.19) pg/mL, respectively.Plasma level of IFN-αin HIV infected group was higher than that in the HIV/HCV co-infected group (Z=-2.332, P<0.05), but no significant difference was observed among other groups (all P>0.05).There was no significant correlation between plasma IFN-αlevel and A3G mRNA expression (rs =0.04, P>0.05), and the levels of A3G mRNA and IFN-αshowed no correlation with HIV RNA and HCV RNA (all P>0.05).Conclusions A3G is highly expressed in PBMCs from HIV infected patients, and it may not be affected by the infection of HCV.A3G mRNA is not closely correlated with IFN-α, and it has not significant influence on HIV RNA and HCV RNA replication.

Background:Small bowel capsule endoscopy(SBCE)has become a first-line procedure for examining small bowel diseases. Aims:To evaluate the diagnostic value of SBCE in patients with mid-gastrointestinal bleeding(MGIB). Methods:MGIB patients who underwent SBCE from Jan. 2012 to Dec. 2014 at the Third People’s Hospital of Bengbu were enrolled. Diagnostic value of SBCE in MGIB was analyzed. Re-bleeding was followed up by outpatient visit and telephone. Results:Forty-four consecutive MGIB patients underwent SBCE procedures,the detection rate was 95. 5% and the positive rate was 65. 9% . Vascular abnormality(37. 9% ),inflammation(31. 0% )and tumor(20. 7% )were the three major etiology in SBCE positive patients. Follow-up results showed that re-bleeding rate in SBCE positive group was significantly higher than in non-positive group(41. 4% vs. 13. 3% ,P < 0. 05). Conclusions:Vascular abnormality is still the most major etiology of MGIB,meanwhile the proportions of inflammation and tumor are increasing. SBCE has a high detection rate and positive rate in initial screening of MGIB,and the risk of re-bleeding in patients with negative SBCE is low.

Objective To prepare liposomes of glycyrrhizic acid, and evaluate its liver targeting property in mice. Methods The liposomes were prepared with conventional rotary-evaporated film-ultrasonication method.The liposomes were injected into the mouse tail vein, and the concentration of glycyrrhizic acid was detected by RP-HPLC.The glycyrrhiz-ic acid injection was taken as control.The targeted indicators, including the relative tissue exposure ( re ) , targeting effi-ciency (te), and index of peak concentration ratio (Ce), were used to evaluate the liver targeting property.Results The re was 1.4, Te of the liposomes was 0.092, and te of the injection was 0.059.The Ce of the liver was 1.59, and the Ce of the blood was 0.99.Conclusion Compared with glycyrrhizic acid injection, the glycyrrhizic acid liposomes show good liv-er-targeting property.

Objective To evaluate the changes of levator ani muscle contractility in different postpartum periods by observing the contractility of postpartum women's levator ani muscle.Methods Forty-six postpartum women and 43 nulliparous women were included in the object.All of those went through translabial pelvic floor ultrasound examinations.Images of their levator hiatus would be recorded at the conditions of rest and contraction.The hiatal length (L)and the area (A)of levator hiatus were measured,then the differences were obtained between rest and contraction conditions,recording as ΔL andΔA.Relevant data were analyzed.Results There was no obvious statistical difference of L and A between the groups (P >0.05).The ΔL and ΔA of the 6-8 weeks were the minimum in this objective(P <0.05). However,there was no statistical difference between nulliparous women and the postpartum 6-8 month's women(P >0.05).Conclusions After delivery,the contractility of levator ani muscle became weaker,but could recovery effectively after about half a year.