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.

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.

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.

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

BACKGROUND:The repairing of bone defect near joint in long bone resulting from complicated comminuted fracture or excision of bone tumor is very difficult. It is a much studied issue to find a feasible solution to this problem.OBJECTIVE: To explore a feasible treatment to bone defect near joint in long bone through comparative observation of 3 reconstruction methods.DESIGN: A completely randomized experiment with self-control and mutual control.SETTING: Laboratory for Experimental Animals, First Hospital of Jilin University.MATERIALS: Twelve healthy adult hybrid dogs, 5 males and 7 females weighing 12 to 18 kg, were recruited.METHODS: The bone defects near joints were established in upper femoral condyle in the 12 dogs, which were reconstructed by 3 operation styles: only filling with bone cement, filling with bone cement + autogenous ilium bone graft, and filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate. There was one dog in each method. The specimens were harvested at the end of weeks 3, 6, 12and 24, respectively, after operation. One week before specimens were harvested the fluorescent labeling was prepared; we conducted vascular perfusion of disulphine blue before the animals were executed.MAIN OUTCOME MEASURES: A series of examinations were carried out, including X-ray film, biomechanical test, intravascular perfusion and tetracycline fluorescent labeling. The bone healing, blood supply recovery and biomechanics were observed in the three groups.RESULTS: The 12 dogs all entered the result analysis. ① Results of Xray examination: Two cases of fracture occurred in experimental side at 6and 12 weeks in group Ⅰ; one case of fracture occurred in experimental side at 6 weeks in group Ⅱ. No fracture happened in group Ⅲ. ② Bone stiffness assayed with biomechanics: It decreased in experimental side as compared to control side by 67% and 70% in group Ⅰ; 66%, 76% and 46% in group Ⅱ; and 8% in group Ⅲ. ③ Specimen observation after operation: Bone formation, callus, and blood supply recovery were significantly better in group Ⅲ than in groups Ⅰ and Ⅱ at all stages.CONCLUSION: The third operation, filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate, is an ideal method of bone reconstruction. It can recover bone function, and prevent complications such as refracture and bone nonunion.

AIM:To study testicular pathological change and its pathogenesis. METHODS:Testicular structure of alloxan induced diabetic rats was observed under light microscopy (LM)and transmission electron microscopy(TEM). Activity of superoxide dismutase(SOD),glutathione peroxidase(GSH-PX)，nitric oxide synthase(NOS)and content of malondialdehyde (MDA),nitric oxide(NO) were detected biochemically in testicular homogenate. RESULTS:It is manifestated as atrophy of seminiferous tubule and germinal arrest under LM and expansion of mitochondria and smooth endoplasmic reticulum, cytoplasmic inclusion of sertoli cell under TEM.Activity of SOD, GSH-PX decreased while activity of NOS, content of MDA, NO increased in diabetic rats compared with control one. CONCLUSION:Disturbance of spermatogenesis and damage of sertoli cell are the main morphological change of diabetic testis, lipid peroxidation and NO may be involved in it.

BACKGROUND: Following bone marrow mesenchymal stem cells (BMMSCs) infusion therapy, which factor promotes BMMSCs migrated to correct position is a key point, currently, adhesion molecule is thought to be playing an important role in mediating BMMSCs migration. OBJECTIVE: To investigate the expression of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1) in rat BMMSCs. METHODS: BMMSCs were in vitro separated from rat bone marrow by directly adherence method. The expression of VCAM-1 and ICAM-1 were identified by using immunocytochemical staining, and the expression rates of antigen were tested by flow cytometry, in addition, their mRNA expressions were measured by RT-PCR. RESULTS AND CONCLUSION: Immunocytochemistry demonstrated that BMMSCs weakly expressed VCAM-1, but strong expressed ICAM-1. Flow cytometry showed that the expression rate of VCAM-1 was 6%, and the expression rate of ICAM-1 was 100%. RT-PCR showed that BMMSCs expressed a low level of VCAM-1 mRNA but a high level of ICAM-1 mRNA. It revealed under physiological condition, BMMSCs expressed a low level of VCAM-1, whereas they expressed a high level of ICAM-1.

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.