Nursing simulation teaching is one of the important measures in nursing teaching reform. As an advanced medical teaching model, SimMan synthetic simulation has been recognized by medical educators both at home and abroad for its advantages of high simulation, repeatability, case diversity and process controllability. Our country has relied on the SimMan synthesis simulation person to carry on the nursing simulation teaching for many years, usually as a teaching strategy into the course of teaching. Its advantages and innovation are affirmed by nursing educators and learners, but still face challenges in the design of simulation teaching, the development of functions and the improvement of equipment utilization. It is worthy discussing deeply by nursing educators.

Objective To study the prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy and to analyze its influencing factors .Methods One hundred and fifty patients with distant metastasis after nasopha-ryngeal carcinoma radical radiotherapy were followed up .Their clinical data were collected to conduct the prognosis analysis and in-fluencing factors analysis .Results The median survival time in the follow up cases was 13 .50 months ,the one-year survival rate was 49 .8% ,two-year survival rate was 31 .0% and three-year survival rate was 19 .3% .The Cox model single factors analysis re-sults showed that the N stage in initial diagnosis ,whether conducting chemotherapy in initial diagnosis ,time interval from radiother-apy finish to distant metastasis occurrence ,metastasis site ,chemotherapy after distant metastasis ,chemotherapy cycles and palliative radiotherapy were the prognosis related influencing factors (P<0 .05) ,in which the N stage ,metastatic site ,chemotherapy after dis-tant metastasis ,time interval from radiotherapy finish to distant metastasis occurrence and palliative radiotherapy were the inde-pendent influencing factors of prognosis(P<0 .05) .Conclusion The independent factors of prognosis in the patients with distant metastasis after nasopharyngeal carcinoma radical radiotherapy are the N stage at initial diagnosis ,metastatic site ,whether having chemotherapy after distant metastasis ,time interval from radiotherapy finish to distant metastasis occurrence and whether conduc-ting the palliative radiotherapy .