Objective To obtain a two-dimensional evaluation result of the quality of examination paper on fundamental nursing and the students' performance,so as to find the weakness and problems in teaching and learning,and to put forward some suggestions.Methods With the S-P chart analytic system which was designed by using the technology of Excel VBA,we made an analysis of 164 papers of fundamental nursing.Results Both the P-curve and S-curve were in the lower right corner.There wasn't any long vertical line in P-curve.There wasn't any long horizontal one in S-curve either.Caution index of 4 questions and 15 students exceed 0.75.The totality difficulty index of the paper was 0.79.The suitability index was 0.43.The stability index was 0.48.Conclusions Propositional contents about physician orders management,gastric lavage,administering medication,observation of disease and pain need to be reformed into both wide coverage and clear focuses.There are no faults in students' grades.Different learning levels do exist,but with little difference.S-P chart affords multiplex and huge amount of information.Its graphics and parameters help to analyze both the students' and teachers' performance from the macroscopic and microcosmic angle,so as to make teachers self-reflective on teaching fundamental nursing and producing papers from various aspects.

Objective To explore the method of radiological diagnosis of early attacking congenital syphilis. Methods Seven cases of early attacking congenital syphilis of bone were retrospectively analyzed, diagnosed serologically, and were taken X-rays of the long bones. Results Bone radiographs abnormalities were identified in 6 of 7cases. Five cases suffered periotities, six cases metaphysitis, and three cases combined with diaphysitis. Seven cases had swollen soft tissue. The vertebraes, craniums and epiphysitis were not found abnormal in 7 cases. Diffusion, multiple and symmetric metaphysitis, periosteitis and osteitis were the radiological characters of congenital syphilis of bone. Conclusion Radiography can affirm the diagnose of early attacking congenital syphilis and definite the arrange and depth. Radiographs of the extremities should be routinely taken in suspected infants.

Objective To illustrate the different levels of fundamental nursing skills of undergradu ate nursing students,and explore the characteristics of the assessment method.Methods With descriptive statistics,one-way analysis of variance after rank transformation,and multiple comparison (Scheffe),we made an analysis of 1 340 assessment records of fundamental nursing skills.Results The score distributions of all the skills,but the skill of measuring vital signs,conformed to Gaussian distribution.The overall distribution shaped in peak state and was negative skewness,showing bias towards 70 to 90 score levels.The score levels of 60 and 70 were significantly higher than that of their surrounding levels.The scores of aspiration of sputum,oxygenic therapy and aseptic technique were the lowest,while the scores of closed bed making and intramuscular injection were the highest.Conclusions The score distribution of fundamental nursing skills is rational,which shows the methods of teaching and assessment are generally believable.But the individual bias cannot be ignored.The majority of students get high grades.Different levels do exist among different skills because of abstract or concrete characteristics and principal matters.

ve To explore the sanitary quality of swimming pool water of public places. Methods The sanitary quality of swimming pool water of 7 public places was monitored, and the sanitory facilities equiped in swim-ming pools were investigated in Jiangyin. Results The pH values, the levels of turbidity and urea in swimming pool water all accorded with the related sanitary standards, and their related qualified rates were 93.9% , 98.5% and 98.5% respectively. For water temperature and residual chlorine, the qualified rates were lower, 3.0% and 19.7% respectively. Both the levels of turbidity and urea were positively correlated with the openning durations of swimming pools (P

With the change of medical mode and deepening of the medical education reforms,such educational idea as giving prominence to practice is widely used to improve students' comprehensive quality and innovative ability and practice ability. The medical shool of Tibet university has established long-term apprentice mechanism during the before class and playtimes and found four county hospitals, five health clinics in towns and townships and gradually improved the construction of mutual win-win 9clinical teaching bases. In this way it has been cultivating many advanced medical personnels, who are reliable, available, able to stay, and highly praised by the employers.

BACKGROUND: Overexpression of phosphorylated Tau protein is a factor of dementia, and scholars abroad find that APP17 peptide may have effect on it.OBJECTIVE: To observe changes of phosphorylated Tau protein Ser202/Thr205 of mice with diabetes mellitus (DM) after injection of APP17 peptide.DESIGN: Randomized control study.SETTING: Department of Pathology, Capital University of Medical Sciences; Department of Brain Aging, Xuanwu Hospital, Capital University of Medical Sciences.MATERIALS: The experiment was carried out in the Pathological Department of Capital University of Medical Sciences and Brain Aging Department of Beijing Xuanwu Hospital. A total of 18 male Kunming mice of 8 weeks old and weighing 28-32 g were randomly divided into control group, DM group and APP17 peptide group with 6 in each group.METHODS: DM models were induced by streptozotocin (STZ) through selectively destroying β-islet cells; meanwhile, APP17 peptide was intraperitoneally injected into mice. Four weeks later, brain tissue underwentimmunohistochemical staining with AT-8 (Ser202/Thr205, a special monoclonal antibody).MAIN OUTCOME MEASURES: ① Morphological observation; ② AT-8 distribution; ③ quantitative analysis of immunohistochemical staining.RESULTS: Positive AT-8 cells in DM group were distributed in retrosplenial cortex, hippocampus, thalamus, hypothalamus, etc.; however, those incontrol and APP17 peptide groups were only distributed in retrosplenial cortex and hippocampus, and poorly stained.CONCLUSION: Positive AT-8 cells may be widely distributed in neurons of brains of DM mice; however, APP17 peptide may normalize the expression of positive AT-8 cells.

Objective To evaluate the prognostic factors of brain metastasis from non-small cell lung cancer and suggest a individualized treatment method proposal with prognostic estimation. Methods From Dec. 2003 to Jan.2007, 183 patients received whole brain radiation therapy (WBRT) were retrospectively analyzed. Kaplan-Meier method was used to analyze the survival. Logrank test was used to evaluate the difference between the groups. Multivariate survival analysis was conducted using a Cox proportional hazard regression model with a backward stepwise procedure. Results The overall l-, 2- and 3-year survival rate was 40.6%, 16.6% and 11.3%, respectively, but with a median survival time of 10.0 months (95% CI 8.6-11.4 months). In multivariate analysis, RAP grouping, weight loss, LDH in blood serum and treatment method were independent prognostic factors. The median survival time of WBRT alone, WBRT with chemotherapy, surgery with chemoradiotherapy and WBRT with Gefitinib was 9.0, 9.0, 22.0 and 13.0 months, respectively, but their difference were statistical significant (X2 = 10.37, P = 0.016). Conclusions The main prognostic factors of brain metastasis from non-small cell lung cancer are RAP grouping, weight loss, LDH in blood serum and treatment method. The survival time is prolonged by proper multidiseiplinary management than WBRT alone. The effect of combined treatment of surgery with chemoradiotherapy is favorable for the patients operated with single region of metastasis.

Objective To evaluate the outcome of radiotherapy for recurrent esophageal cancer after surgery and to determine the prognostic factors. Methods From Jan 2004 to Dec 2009, 93 patients of esophageal carcinoma with loco-regional recurrence as the first site of failure after surgery were retrospectively reviewed. Kaplan-Meier method was used to analyze the survival. Logrank test was used to evaluate the difference between the groups. Multivariate survival analysis was conducted using a Cox proportional hazard regression model with a backward stepwise procedure. Results The overall survival rates at 1, 2 and 3 years were 40. 9% , 10. 1% and 6. 7% ,respectively,but with a median survival time of 11.0 months(95% CI 9. 4-12. 6) . In univariate analysis, age,PS, radiation dose and retreatment methods were independent prognostic factors. In multivariate analysis, only radiation dose and retreatment methods were independent prognostic factors for overall survival. Conclusions The prognosis of patients with postoperative loco-regional recurrence of esophageal cancer is poor. However, a long-term survival maybe expected by definitive chemoradiotherapy.

Objective To investigate the optimal treatment planning of intensity modulated radiotherapy (IMRT) for non-small cell lung cancer (NSCLC) .Methods Two types of treatment plans were designed for 11 patients with inoperable NSCLC disease.In the first plan(PTV60 plan) ,60 Gy was prescribed to the planning target volume(PTV) which was created using CTV(GTV +6-8 mm) plus the margin for organ motion and setup uncertainties.In the second plan(PTV70 plan) ,70 Gy was prescribed to the PTV which was created using GTV plus the margin for organ motion and setup uncertainties.The dose-volume histogram,the planning target volume coverage,and other dosimetric parameters of normal structures were compared between the two plans.Results These two plans were not significantly different in the dose heterogeneity,but commpared with the PTV60 plan,the PTV70 plan significantly improved 60 Gy volume with regard to PTV coverage.The values of V_(20) and V_5 of lung were reduced in average by (1.69 ±0.42) % ,and (1.29 ±1.09) % (t ＝ 0.047,0.264,P ＝ 0.002) ,respectively.Conclusions The planning of 70 Gy to the PTV using GTV plus the margin for organ motion and setup uncertainties might be better than that of 60 Gy to the PTV using CTV(GTV +6-8 mm) plus the margin for organ motion and setup uncertainties.

Objective:To evaluate the vital signs changes,influence factors in different grades of hy-pertension patients during the treatment of acute pulpitis,in order to obtain the risk prevention measures. Methods:In this study,90 different grades of hypertension patients with acute pulpitis were recruited from February 201 4 to February 201 5 in the Department of Oral Emergency,Peking University School and Hospital of Stomatology.The information about the patients’general health,oral treatment,life signs of change information was collected.Patients were divided into high risk group,middle risk group, and low risk group (30 patients for each group).Results:(1 )Compared with the preoperative,systolic blood pressure (90%),diastolic blood pressure (80%),heart rate increase (1 00%)were increased in the high risk group.The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group (P<0.01 ).At the same time,the systolic blood pressure of 1 /4 (26.7%)patients in high risk group increased more than 20 mmHg (1 mmHg=0.1 33 kPa),and the diastolic blood pressure of 2/5 patients in high risk group increased more than 1 0 mmHg,the difference was statistically significant compared with the other two groups (P<0.05).(2)Compared with the pre-operative,the average increase of the maximum peak were increased [systolic blood pressure (1 8.0 ± 1 .5)mmHg,diastolic blood pressure (8.0 ±1 .7)mmHg],the mean of heart rate changes [(7.0 ± 0.3)beats per minute]was also increased in the high risk group,while these two indicators were de-creased in the low risk group and the middle risk group.The electrocardiogram (ECG)was changed in 6 cases during the treatment in the high risk group.No significantly changed were observed in the low risk group and the middle risk group.(3 ) Compared the risk assessment in preoperative with that in postoperative,in the middle risk group,23 cases were evaluated as medium risk in final evaluation,6 as low risk,and 1 as high risk (risk assessment increased);in the high risk group,20 cases were evaluated as high risk,7 as very high risk,and 3 as medium risk (risk assessment decreased).Conclusion:Oral treatment is very safe for patients with hypertension,but the risk factor,target organ damage,and com-plications will also increase the risk of cardiovascular events in elderly patients during the acute pulpitis treatment.Dentist should take some measures to avoid the risks.