Objective:To verify the effects of microlecture based on robot carrier on standardized residency training of orthopedics.Methods:Sixty orthopedic residents from our hospital were divided into two groups according to different training methods. One was control group ( n = 30), receiving regular training methods, and the other one was experimental group ( n = 30), receiving additional microlecture based on robot carrier besides regular training methods. The teaching effects of the two groups were compared after the training in orthopedics department. SPSS 20.0 was used for t test. Results:There was no significant difference between the experimental group and the control group in theoretical tests results [(88.63±10.24) vs. (87.85±9.62), P > 0.05]. The operation test scores in experimental group (92.12±7.52) were significantly better than that in control group (85.35±8.12), with statistical significance ( P < 0.05). The satisfaction scores for teaching in experimental group (90.00%) was significantly higher than that in control group (70.00%) ( P < 0.05). Conclusion:Microlecture based on robot carrier could enhance abilities of skills operation for orthopedic residents during the standardized residency training and improve their satisfaction for the teaching effect.

Objective To investigate the cognition and treatment rate of hormone replacement therapy (HRT)in perimenopause women.Methods A survey was conducted in 262 perimenopause women first coming to outpatients care.A predesigned structured questionnaire was used to collect information:the symptoms of perimenopa-use women,the cognition and acceptance to the treatment.Results Finally,248 women with the mean age of (50.30 ±2.10)years finished the questionnaire,the natural menopause age was (48.90 ±1.90)years.48.79% of these women understood the role of HRT in clinical application,and only 12.50% knew the side effect of HRT. Among them,35.48% thought that HRT was necessary for the duration of perimenopause.40.73% of them had the attitude to treatment with HRT.After the education of perimenopausal acknowledgement,117 patients (47.18%) accepted the treatment with HRT.Conclusion It showed that the awareness and treatment rate of HRT in perimeno-pause women was low.The health education should be strengthened to improve the level of perimenopause health care.

Objective To investigate the prevention and treatment of the complications due to CT-guided percutaneous transthoracic biopsy. Methods CT-guided percutaneous transthoracic needle biopsy was performed in 168 patients aged from 14 to 79 years old. The complications and the contributing factors were analyzed. The methods for the prevention and treatment of the complicaitons were suggested. Results CT-guided percutaneous transthoracic needle biopsy was succeeded in 168 cases. The major complications associated with CT-guided needle biopsy included pneumothorax (8.33%) and pulmonary hemorrhage (20.24%). Pneumothorax was associated with the lesion size, lesion location, and times of puncture. Pulmonary hemorrhage was associated with the lesion size as well as the pre-operative evaluation of the vascular structures with contrast CT. Chest tube placement was performed in 1 out of 14 cases of pneumothorax. Other cases were not particularly treated. Conclusion The prevention of complications is important for CT-guided needle biopsy. The key factors to prevention the complications include accurate location of the lesions and correct evaluation of the vascular structures before the operation and skillful intraoperative puncture.

Objective To investigate the effect of low molecular weight heparin calcium combined with breviscapini in treating a-cute exacerbation of elderly chronic pulmonary heart disease and its mechanism.Methods 86 patients with acute exacerbation of elderly chronic pulmonary heart disease in our hospital from October 2011 to June 2013 were randomly divided into two groups. There were no significant differences in age,gender and disease condition between the two groups.44 cases were in the therapy group and the other 42 cases were in the control group.Both two groups received the routine therepy.On this basis the therapy group was added with low molecular weight heparin calcium and breviscapini.Then the improvement of clinical symptoms and the changes of plasma nitric oxide (NO)and endothelin-l (ET-1)after treatment were observed in the two groups.Results The total effective rates in the therapy group and the control group were 90.1%and 71.4% respectively;the levels of plasma NO and ET-1 after treatment in the two groups were significantly improved,but the improvement in the therapy group was better than that in the control group with the statistical difference between them(P <0.05).Conclusion Low molecular weight heparin calcium combined with breviscapini can significantly improve the symptoms in the ederly pulmonary heart disease,decrease the lung arterial press,re-lieve the load of right ventricle and affect the levels of plasma NO and ET-1 with less adverse reactions.

This study was aimed to observe the effects of Gui Curcuma extract on proliferation, collagen production, and matrix metalloproteinase (MMP) expression by hepatic stellate cells (HSC-LX2). HSC-LX2 were cultured in DMEM broth (10% FBS), then treated with Gui Curcuma extract (with the concentration of 0, 22.5, 45, 90 μmol·L-1) for 24 h. The proliferation of HSC-LX2 was measured by MTT assay; injury in HSC-LX2 was indicated with LDH re-lease; collagen I production was detected by ELISA; and MMP-l expression was determined by Western blot. The re-sults showed that Gui Curcuma extract (with the concentration of 22.5, 45, 90 μmol·L-1) dose-dependently inhibited proliferation of HSC-LX2 by 16.2%, 43.9%, 59.4% in MTT assay, respectively. The IC50 was 59.1 μmol·L-1. There was no significant impact on LDH release. The Gui Curcuma extract (with the concentration of 45, 90 μmol·L-1) can significantly reduce the expression of collagen I level (P< 0.01), whereas MMP-1 expression was significantly uplift-ed (P< 0.05) by Gui Curcuma extract (with the concentration of 45, 90 μmol·L-1) in Western blot. It was concluded that Gui Curcuma extract had the potential to prevent hepatic fibrosis, through inhibiting proliferation and collagen I production, and increasing MMP-1 protein expression.

Objective:To explore the status of job burnout among clinical nursing teachers in different depart-ments, in order to provide reference for the nursing education management .Methods:The questionnaire of Maslach Burnout Inventory ( MBI) of revised Chinese Version was distributed to 535 clinical nursing teachers .Results:The incidence of job burnout was 48 .3%, while the incidences with mild , moderate and severe job burnout accounted for 18 .9%, 15 .7%, 9 .3%respectively .Clinical nursing teachers in different departments have diffrences on oc-cupation actions .Clinical nursing teachers in the operation room revealed a significant greater personal accomplish -ment, but the emergency department scored lower .The teachers in emergency department scored higher on emotion-al exhaustion than those in other departments , and the teachers in oncology department is the secondary in scores of emotional exhaustion .The scores of the teachers in oncology department were the highest on depersonalization among all the departments,while the teachers in infection department is at the secondary place .Conclusion:The clinical nursing teachers'job burnout should be paid attention to .Strategies including intervention by nursing education management and teachers'learning and training should be taken to reduce the damage of physical and mental health caused by burnout and increase the clinical care and teaching quality .

Objective To investigate the relationship between myeloperoxidase(MPO) and ankle brachial index(ABI) in patients with htypehypertension.Methods A total of 133 patients were enrolled in this study,and divided in to htypehypertention group(n=72),non-htypehypertension group(n=30) and normotension group(n=31).Their Hcy,ABI and MPO levels were measured and compared.Results The ABI in htypehypertention group and non-htypehypertension was significantly lower than that in normotension group (P<0.05),ABI in non-htypehypertension group was lower than that of htypehypertonsion group(P<0.05).MPO and CRP in the htypehypertension group was significant higher that those of normotension group(P<0.05).The ABI was negatively related with the serum MPO and CRP levels in htypehypertention group (r=-0.712,-0.722,P<0.05).Conclusion ABI is closely related with MPO,and play an important role in diagnosis of artery function impairment and high risk of htypehypertension patients.

[ ABSTRACT] AIM:To study the influence of insulin resistance on fatty liver in the mice fed with high-fat diet (HFD).METHODS:Male 8-week-old C57BL/6J mice were randomly divided into HFD group (with 60% calories by high saturated fatty acid) and control group (with chow diet).The mice in both groups were fed for 12 weeks.The body weight, liver weight, serum triglyceride (TG) and total cholesterol (TC), and blood glucose and insulin levels were meas-ured.Hyperinsulinemic euglycemic clamp experiment was applied to reflect insulin sensitivity .The lipid deposition in the liver was analyzed by HE staining , Sudan IV staining and measurement of liver fat content .The phosphorylation levels of IRS1 and Akt, and the protein levels of SREBP-1 and FAS were determined by Western blot to reflect the activities of insu-lin signaling and lipid synthesis .RESULTS:Compared with control group , the body weight and liver weight were signifi-cantly increased in HFD group .TG and TC contents in serum and liver tissues were remarkably increased in HFD group . High-fat diet induced insulin resistance , as evidenced by increased serum insulin levels , reduced glucose infusion rate and decreases in IRS1 and Akt phosphorylation levels .In livers of HFD group, HE staining showed that the cytoplasm of hepa-tocytes was filled with vacuoles .Sudan IV staining also displayed that many different sizes of red lipid drops existed in the hepatocytes , and the protein levels of SREBP-1 and FAS were significantly increased .In primary normal hepatocytes with exogenous oleic acid intervention for 48 h, the phosphorylation levels of IRS 1 and Akt were reduced , and the protein ex-pression of SREBP-1 and FAS was significantly increased in a dose-dependent manner .CONCLUSION: Feeding with HFD leads to insulin resistance , resulting in activation of lipid synthesis and accumulation of lipid deposition in the liver , thus inducing fatty liver .

Objective To investigate and evaluate the changes of PYK2 expression in hippocampal neurons and microglial cells in Kainate acid-induced status epilepticus. Methods Kainate acid-induced status epilepticus was established in rats, and by using immunostaining, changes of PYK2 expression in hippocampal neurons and microglial cells was investigated. Results Expression of PYK2 in hippocampal pyramidal neurons was markedly decreased after kainate acid-induced status epilepticus. However, 24h after the epileptic onset, a pronounced up-regulation of PYK2 and phosphor-PYK2 immunoreactivities were evident in amoeboid microglial cells. The upregulation of PYK2 and phosphor-PYK2 was in accordance with the morphological changes of the activated microglial cells. Conclusion PYK2 was activated in microglial cells after seizure. Furthermore, the activation of PYK2 in microglial cells after seizure might be related to the morphological and behavioral changes of microglial cells after activation.

Objective To investigate and evaluate the changes of phospho PYK2 and phospho p38MAPK expression in neurons after focal cerebral ischemia. Methods Focal ischemia reperfusion model was established in rats, and by using immunostaining, the changes of phospho PYK2 and phospho p38MAPK expression in neurons was observed. Results Faint phospho PYK2 and phospho p38MAPK immunoreactivity were revealed in normal cortical neurons. Fifteen minutes after the ischemia onset, a pronounced upregulation of phospho PYK2 and phospho p38MAPK immunoreactivities were evident in these ischemia attacked neurons. The immunoreactivities of phospho PYK2 and phospho p38MAPK reached its peak at 30min after ischemia, and decreased 60min after ischemia. Conclusion Cerebral ischemia was able to induce neuronal PYK2 phosphorylation. The activation of PYK2 might link ischemia attack to the p38MAPK signaling pathway to initiate the neuronal response to the stress stimuli