Objective: To design a system that can simulate earthquake surroundings. In the surroundings, people can be familiar with the omen, strong shock and aftershock of earthquake, thus make right choices and get away when the disaster occurs. Methods: The system consists of an electro-hydraulic servo system, a whole-information sound system and some lighting device; By using the adaptive inverse control method and LMS algorithms, the inverse model (i.e. the controller) is convergent rapidly; The software based on LabVIEW makes the parameters can be modified easily; There is a double dosed-loop structure in the system: an analog closed-loop and a digital closed-loop, and their parameters can be inspected in real time. Results: The system is of very high reliability, and the desired vibration signal can be tracked exactly by output. Conclusion: Earthquake surroundings is simulated vividly. Through the system, people can be familiar with earthquake phenomena, and know lots of knowledge of earthquake.

Objective To build learning evaluation system and indicators connotation of problem-based in small-group teaching model.Methods Delphi technique was used to build learning evaluation system of problem-based for course of nursing education through a two-round expert consultation among 30 experts in Zhejiang province.Results The experts' authority coefficient was 0.89,determination coefficient was 0.90,and familiar confficient was 0.88.The finally learning evaluation system of problem-based for course of nursing education consisted of 3 first-level indicators,14t second-level indicators and 41 third-level indicators.The coordination coefficients of first-level indicators and second-level indicators were 0.37 and 0.31,respectively,there was significant difference,P＜0.01.Conclusion This project has a rigorous and reliable construction process with strong theoretical and practical significance,and could be used as a guidance and reference for problem-based in small-group teaching for course of nursing education.

Objective To study the MRI features and its ultrastructural pathology basis in different myocardial injury areas after acute infarction.Methods 10 rabbits were given ligation of left anterior descending branch 24 hours to make pathologic models.All animals underwent conventional MRI,contrast media dynamic enhancement MRI,cine-MRI and dobutamine stress test.Myocardial blood flow was measured with radioactive micropheres to define risk regions.Ischemic and infarcted regions were defined as Even's blue and 2,3,5triphenyltetrazolium chloride(TTC)negative regions respectively,and made electron microscopy specimens to observe the changes of mitochondria and myofibril.The myocardial ultrastructural injury was scored and graded.Results There were no significant change on T 1WI,but the signal intensity on T 2WI increased significantly after AMI.The diseased myocardium became thinning were seen in 40% cases,and the abnormal flowing high signal were seen in 60% cases.The dynamic enhancement time-signal intensity curves were different in normal,ischemic and infarcted regions.Cine-MRI showed the cardiac wall movement impairing and the wall thick thinning,but the wall movement reinforcing and the wall thick thickening after dobutamine stress.The water content of ischemic and infracted myocardium were marked higher than normal myocardium.The myocardial blood flow in diseased regions were decreased significantly than that in normal regions.The volume density and numerical density of mitochondria in different injury regions showed significant differences.Conclusion MRI appearances of AMI were associated with the injury degree of myocardial ultrastructure and the residual myocardial blood flow.

Objective: In order to understand temporal and spatial distributions of alternating electromagnetic field (AEMF) of a coil thoroughly, the 3-D finite-element models of this kind of Biomagnetic Fields are established and analyzed for the research on bioeffect of magnetic field on microcirculation. Methods: Designing CAD models, setting boundary conditions, meshing models and obtaining numerical solutions were completed all within Comsol Multiphysics in terms of the theory of electromagnetic field. Results: Axial and radial plot of spatial attenuation rate of the AEMF, which were accordance with measured data, were simulated while the temporal and spatial distributions of AEMF were acquired. Conclusion: Models of 3-D finite-element of this kind of biomagnetic fields which appeared to exactly simulate the real magnetic field were first established systematically, and solved the placing problem of magnetic fields for the research on bioeffect of magnetic field on microcirculation and provided platforms for the simulation of hemodynamic of blood flow in the magnetic field.

Parkinson's disease is an incurable disease, the various therapeutic methods can not completely prevent the development of the disease, and the early treatment can achieve the effect of delaying the progress of this disease. The etiology and pathogenesis of the disease are explained by the theory of collateral disease, and the drug therapy of traditional Chinese medicine (TCM) guided by the theory may obtain satisfactory clinical therapeutic effect. The theory is a continuously deepening process to diagnose a disease from syndrome differentiation-disease differentiation-syndrome differentiation, being consistent with the fundamental thought of TCM.

Objective To study the effects of rituximab combined with CHOP chemotherapy on serum Thymidine kinase 1 (TK-1) and vascular endothelial growth factor (VEGF) in patients with non-Hodgkin lymphoma,and to provide guidance for clinical research.Methods A total of 24 patients with non-Hodgkin's lymphoma treated in our hospital from January 2013 to March 2016 were randomly divided into the control group and the observation group,and each with 12 cases.All patients were examined before and after treatment,the control group was only treated with CHOP chemotherapy,and the observation group was treated with rituximab combined with CHOP chemotherapy.The patients were followed up within 1-2 years after treatment.The therapeutic effects of all patients were observed,the TK-1 and VEGF levels were measured and the incidence rate of adverse reactions was recorded.Results The efficiency rates of patients in the observation group and the control group were 66.67％ and 50.00％,respectively after treatment,and the observation group was significantly better than the control group,the difference was statistically significant (P＜0.05);the TK-1 and VEGF levels of the two groups were significantly decreased after treatment (P＜0.05),there was a statistically significant difference.But the two indexes of observation group was significantly lower than the control group,the difference was significant (P＜0.05);the control group showed 1 case of liver dysfunc tion after treatment,4 cases of gastrointestinal dysfunction,1 case of decreased white blood cells,while the observation group were 1,3 and 1 case,respectively.There were no significant differences between two groups (P＞0.05).Conclusion With the treatment of rituximab combined with CHOP chemotherapy,serum TK-1 and VEGF levels of patients with non-Hodgkin lymphoma decreased significantly,the poor prognosis has been significantly improved,and this treatment is worth popularizing in clinical application.

Objective To investigate the expression levels of IFN-γ, IL-4, IL-6 in the plasma of HBV chronic patients.To acknowledge the correlation between the immune function of T-cell with chronic hepatitis B virus.Methods The expression levels of IFN-γ, IL-4, IL-6 in the plasma were determined by ELISA in 42 cases of chronic hepatitis B (CHB group), 30 cases of cirrhosis (LC group), 30 cases of primary liver cancer (HCC group) and 30 cases of health control (NC group).Combine with the load of HBV DNA, HBeAg and ALT, the expression levels of IFN-γ, IL-4, IL-6 were re-analysed.Results The expression levels of IFN-γ, IL-4 and IL-6 in the researched groups were statistically significantly different.The expression levels of IFN-γ, IL-4, IL-6 in CHB, LC and HCC groups were higher than NC group with significance.The expression level of IL-4 in the CHB group was higher than LC and HCC groups with significance.The expression level of IL-6 in the HCC group was higher than CHB and LC groups with significance.Compared with the control group, the ratio of IFN-γ/IL-4 in CHB, LC and HCC groups were decreased with significance.There was significantly positive correlation between the expression level of IL-4 with the load of HBV DNA (r=0.757, P＜0.001).The expression level of IFN-γhad negative correlation between the load of HBV DNA (r=-0.786, P＜0.001) with the level of ALT (r=-0.713, P＜0.001) with significance.There was no significant correlation between HBeAg with the cytokines in the serum of patients with chronic HBV.Conclusion The results showed the immune function of T-cell play important role in chronic HBV patients.That would provide a good basis on CHB treatment.The expression levels of IL-6 were higher in HCC group with significance, which provided the direction for the deep study of liver cancer.

Objective To retrieve,assess and summarize the best evidence on breast milk expression of premature infants' mothers in maternal separation so as to provide high-quality evidence for medical staff to carry out breast feeding guide. Methods Guidelines,systematic reviews,recommended practices and evidence summaries were retrieved in the UpToDate,WHO,Academy of Breastfeeding Medicine(ABM), Cochrane Library,Joanna Briggs Institute Library,Registered Nurses' Association of Ontario(RNAO), National Guideline Clearinghouse(NGC),PubMed,Embase,Chinese Biological Medicine,Chinese National Knowledge Infrastructure,WanFang data,VIP and the evidence-based nursing database of Fudan University from January 2008 to December 2018. Results A total of 7 literatures were included,two guidelines,one clinical decision,two systematic reviews and two evidence summaries. A total of 19 evidences were gathered in 7 aspects,such as training for medical staff,parents' education,selection of breast pump,preparation before expression,operational skills of breast expression,measures for increasing lactation and expression effects monitor. Conclusions Clinical medical staff should lay down the individualized nursing measures for maternal women to ensure breast milk collected as soon as possible,gain enough breast milk and fill the bill of growth and development of premature infants.

Objective:To explore the quality improvement in the organization structure and management model of the integrated community child health services.Methods:This was a qualitative study, including two parts: cause analysis and service improvement suggestions. In the analysis part the data mining was conducted to identify valuable patterns and relationships in the comprehensive child health services. Semi-structured interviews were conducted with 12 relevant department heads and health workers of the comprehensive child health service team at Gumei Community Health Service Center in December 2023, and the causes of the key problems were explored. In the service improvement part, focus group discussions were held to propose suggestions, then improvement measures were formulated to address the identified problems.Results:Through data mining and semi-structured interviews, the key problems were identified: information isolation among multiple departments and lack of coordination mechanism in the comprehensive child health service team. A team organizational structure based on the "three definite" principle was established. The organizational structure should include the pediatric family doctor team, general practitioner management team and departments of pediatrics, maternal and child health care, immunization and child rehabilitation; the management model should include a cross-department resource and information sharing mechanism, the pediatric family doctor model, optimization and integration of physical space, and enhancement of publicity activities for the comprehensive child health services.Conclusion:Based on the analysis in Gumei health service center, this study identified key problems in community integrated child health services, and proposes the quality improvement measure in the organizational structure and management model of the service team.

Nonalcoholic fatty liver disease (NAFLD) is a clinical syndrome characterized by hepatic steatosis and fat deposition in hepatocytes in the absence of significant alcohol use. A growing number of studies have shown significant dysregulation of intestinal microbiota in patients with chronic liver disease and cirrhosis. Small intestinal bacterial overgrowth (SIBO) is a clinical syndrome induced by excessive bacteria in small intestine. This article reviewed the correlation between SIBO and NAFLD, as well as the effect of probiotics on treatment of NAFLD.