Background and purpose: Mel-18 is one of the mammalian polycomb group members. A number of related researches have implied that Mel-18 may play a role in human tumorigenesis.In this study, we measured the expression of Mel-18 in gastric carcinoma cells in vivo to explore the expression and clinical significance of Mel-18 in gastric carcinoma. Methods: Real time RT-PCR was used to detect the expression of Mel-18 in cancer tissue and corresponding normal tissue in 52 cases of gastric carcinoma. The association between Mel-18 expression and the clinicopathological parameters of the tumors was analyzed. Results: The analysis revealed that there was significantly decreased expression of Mel-18 in 18 (34.62%)carcinoma tissues in comparison with para-cancer normal tissue. There was no correlation between Mel-18 expression and clinicopathological parameters, such as age, gender, tumor size and histological differentiation (P>0.05).The decrease of Mel-18 expression was significantly negatively correlated with lymph node metastasis and clinical stage (P<0.05). The expression levels of Mel-18 evaluated by the ratios of gene expression were 1.357,0.453,0.183 and 0.170 in stage Ⅰ, Ⅱ,Ⅲ and Ⅳ gastric carcinoma, respectively. They were 0.634 and 0.210 in patients without lymph node metastasis and in patients with lymph node metastasis, respectively. Expression of Mel-18,lymph node metastasis, and clinical stage were significant covariates, respectively (P<0.05). Conclusion: Our results showed that Mel-18 might play a crucial role in tumorigenesis and progression of gastric carcinoma. It is possible that Mel-18 could be used as one of the biomarkers for predicting the prognosis of gastric carcinoma.

0.05).The decrease of Mel-18 expression was signifi cantly negatively correlated with lymph node metastasis and clinical stage(P

Objective To partially purify the toxic factor secreted by A. corymbifera and to analyze the mechanism of A. corymbifera-induced human umbilical vein endothelial cell (HUVEC) apoptosis. Methods Glycoprotein secreted by A. corymbifera was purified by Con A Lectin chromatography. The influence of different protein fractions on HUVEC apoptosis was determined by flow eytometer. Both denaturing and nondenaturing deglycosylation of purified glycoprotein was performed and the ability of the protein moiety and carbohydrate moiety to induce HUVEC apoptosis was evaluated respectively. Activation of related caspases during A. corymbifera-induced apoptosis was analyzed by Western blot. The role of caspase-8 and -9 in HUVEC apoptosis was investigated using caspase inhibitors. Caspase inhibitors were used to stop the suppression of HUVEC viability by XTT assay. Results Flow cytometric analysis shows the total protein as well as the glycoprotein fraction of A. corymbifera may induce HUVEC apoptosis in a dose dependent manner. In contrast, similar activity was not observed in the non-glycoprotein fraction. Neither deglycosylated protein nor carbohydrate moiety is able to induce HUVEC apoptosis alone. In the apoptotic signaling pathway, caspase9, caspase-3 and cytochrome C were activated significantly, except caspase-8. Moreover, caspase-9 inhibitor, instead of caspase-8 inhibitor, completely abrogates A. corymbifera-induced HUVEC apoptosis. Caspase9 and caspase-3 inhibitors completely waived the suppression of HUVEC viability by A. corymbifera. Conclusion Glycoprotein secreted by A. corymbifera is associated with HUVEC apoptosis. Intact glycoprotein is essential for the apoptotic progress. Intrinsic apoptotic signaling pathway mediates A. corymbifera-induced HUVEC apoptosis.

Objective To analyze the influence of Absidia corymbifera on cell activity of human umbilical vein endothelial cells (HUVEC) as well as the related mechanism. Methods Time course analy sis of the influence of A. corymbifera on cell viability of HUVEC was determined by cell counting after Trypan blue staining. Apoptosis of HUVEC induced by A. corymbifera was observed under fluorescence microscope after treatment with apoptosis detection kit. Time course analysis of HUVEC apoptosis induced by A. corymbifera was detected by flow cytometry quantitatively. Effect of caspase-3 inhibitor on A. corymbifera associated apoptosis was also evaluated at the same time. Activation of caspase-3 inside HUVEC was detected by Western blot. Results A. corymbifera inhibited cell viability of HUVEC in a time-dependent manner by Trypan blue staining. After 12 hours' co-culture, A. corymbifera began to show suppression on cell viability (P =0. 001 ). Fluorescence microscope observation revealed A. corymbifera induced apoptosis of HUVEC instead of necrosis. Flow cytometry analysis showed A. corymbifera induced apoptosis of HUVEC in a time-dependent manner. A. corymbifera began to show obvious effect on apoptosis after 12 h co-culture (P =0.0036). Moreover, A. corymbifera-associated apoptosis was almost abrogated completely by caspase-3 inhibitor. Western blot analysis demonstrated that A. corymbifera triggered the activation of caspase-3 inside HUVEC in a timedependent fashion. Conclusion A. corymbifera induces apoptosis of HUVEC in vitro. Such apoptotic signal is transmitted through caspase cascade reaction.

Traditional teaching approach is a method which lack of overall quality cultivation among students. However, the teaching approach which is combined with counter examples can stimulate their study interests, enhance critical thinking ability and promote theory-practice combination. Counter-example teaching approach has been applied in nursing education in these years and It plays an active role in improving nursing educational quality. This paper aims to provide reference to formulate a scheme of cultivating all-round developed nurses through summarizing the advantages and disadvantages, and application process of counter-example teaching approach used in nursing education.

Objective To discuss the effects of SBAR (situation-background-assessmedicine-recommendation) communication in patient hand-over from pediatric emergency ward. Methods SBAR communication mode has been applied in hand-over in the Emergency Department of Children's Hospital of Shanghai from November 2016. The incidence of nursing adverse events, writing error or omission rate of nursing documents and medical staff's satisfaction were compared between before and after intervention, which were from September to October 2016 and from November to December 2016. Results After the implementation of SBAR, the incidence of nursing adverse events was 4.9%, the writing error or omission rate of nursing documents was 3.1%, which were all lower than those of the control group, and the differences were statistically significant (χ2=9.141,10.794;P<0.01). After the implementation, the satisfaction rates on the comprehesiveness, language rationality and the focus of the disease were 95.0%, 97.5% and 95.0%, which were all higher than those of the control group, and the differences were statistically significant (χ2=8.029, 12.131, 4.675; P< 0.05). Conclusions After the SBAR communication mode being applied in patient hand-off in Pediatric Emergency Department, adverse events due to poor communication decreased; nursing documents became more normative; and the satisfaction rate of medical staff involved in hand-over increased. It is therefore worthy of further improving and making wider use of this type of communication.

Objective To investigate the expression of miR-143-3p and ATG2B in serum of patients with bladder cancer and their relationship with clinicopathology,prognosis and survival of patients.Methods Eighty-eight patients who underwent radical bladder cancer surgery in our hospital from January 2017 to January 2019 were regarded as the research group,and 80 volunteers who underwent physical examination in our hospital were included as the control group.Quantitative real-time PCR(qRT-PCR)method was performed to detect the levels of miR-143-3p and ATG2B;The predictive value of miR-143-3p and ATG2B for bladder cancer was evaluated by ROC curve.Draw survival curve using Kaplan Meier method;The prognostic factors of bladder cancer patients were analyzed by Cox regression.Results The expression level of miR-143-3p in the serum of bladder cancer patients was lower than that in the control group(0.68±0.12 vs.0.87±0.26),and the expression level of ATG2B was higher(1.02±0.30 vs.0.61±0.18)(P＜0.05);the expression level of miR-143-3p in serum of postoperative patients was higher than that before operation(0.77±0.23 vs.0.68±0.12),and the expression level of ATG2B was lower than that before operation(0.85±0.26 vs.1.02±0.30)(P＜0.05);The study group showed a negative correlation between miR-143-3p and ATG2B expression(r=-0.454,r=-0.407,P＜0.01);The AUC of miR-143-3p in the diagnosis of bladder cancer was 0.846(95％CI:0.783-0.897),the sensitivity and specificity were 79.55％and 78.75％respectively;The AUC of ATG2B in the diagnosis of bladder cancer was 0.883(95％CI:0.824-0.927),the sensitivity and specificity were 78.41％and 81.25％respectively;The AUC for the diagnosis of bladder cancer was 0.939(95％CI:0.891-0.970),the sensitivity and specificity were 87.50％and 88.75％,respectively.The 3-year survival rate of the miR-143-3p low expression group was 34.88％(15/43)lower than that of the high expression group 77.78％(35/45),and the 3-year survival rate of the ATG2B high expression group was 40.91％(18/44)lower than that of the low expression group 72.73％(32/44).The differences were statistically significant(Log rank x2=18.055,8.658,P=0.000,0.003).Lymph node metastasis,distant metastasis,tumor pathological grade,TNM stage,miR-143-3p,ATG2B are all factors influencing the survival of bladder cancer patients.Conclusion The serum expression of miR-143-3p in patients with bladder cancer is low,and the expression of ATG2B is high,and the expressions of the two are closely related to the clinicopathological characteristics and prognosis of patients with bladder cancer.

To report a case of cutaneous and subcutaneous coinfection caused by Lichtheimia corymbifera and Candida parapsilosis.A 67-year-old female peasant consulted about proliferative granuloma developing on her left forearm after topical application of a Chinese herbal drug and splint fixation for the treatment of suspected fracture of the wrist.Direct microscopic examination showed gram positive budding yeast cells in lesion secretions.Pathological study with periodic acid-Schiff (PAS) and gormori methenamine silver (GMS) staining revealed broad non-separate hyphae in the corneum and dermis.Fungal culture of lesional tissue at 35℃ grew both mould and yeast.The mould was identified as Lichtheimia corymbifera based on morphological findings and sequences of the internal transcribed space (ITS) 1-4 regions.Thermal tolerance study revealed that the isolate grew fast at 37℃ but slowly at 40℃.Under a scanning electron microscope,the acrogenous sporangia were pear-shaped with conical sporangiophores originating from the top of stolon,which were among but not opposite to the rhizoids.The yeast was identified as Candida parapsilosis by Chromagar test and D1/D2 region sequencing.As antimicrobial susceptibility test indicated,the Lichtheimia corymbifera isolate was most sensitive to terbinafine and itraconazole.The proteolytic activity of Lichtheimia corymbifera was higher than that of Candida parapsilosis.The granuloma completely subsided after surgical resection and 6-week treatment with oral itraconazole 200 mg twice a day.No recurrence was observed during a 4-year follow-up.

Objective:To build the evaluation index system of traditiond Chinese medicine(TCM) service capacity in county-level TCM hospitals, for references to improve the TCM service capability in China.Methods:Based on the " structure-process-result" evaluation model, a preliminary screening index system for the evaluation of TCM service capacity in county-level TCM hospitals was established by analyzing relevant literature and policies; Two rounds of Delphi expert consultation were made to screen the evaluation indexes; The combination weighting method based on both expert scoring method and entropy weight method was used to determine the index weight.Results:The evaluation index system of TCM service capacity of county-level TCM hospitals was finally incorporated into 3 first-level indicators, 9 second-level indicators and 33 third-level indicators. The top five third-level indicators in terms of comprehensive weight were the person time of TCM preventive care in the year(12.02%), the person time of manual reduction diagnosis and treatment(9.03%), the person time of acupuncture and moxibustion(6.55%), the proportion of income from inpatient TCM services in medical income(5.87%) and the person time of massage(5.34%).Conclusions:From the perspective of the whole process of TCM service, the evaluation index system of TCM service capacity of county-level TCM hospitals reflectd the health service capacity of county-level TCM hospitals, highlighted the characteristics of TCM.

Objective:To explore the application of linkage teaching model between hospitals and colleges based on integration of theory and practice in the course of pediatric nursing skills.Methods:Two undergraduate classes of pediatric nursing in a college in 2017 were selected as the experimental group and the control group by random sampling. The experimental group adopted the combined teaching method of colleges and hospitals based on the integration of truth and practice, while the control group adopted the traditional teaching method. The results of skill operation assessment were compared between the two groups, and the results were evaluated by the self-designed teaching effect evaluation questionnaire.Results:The results of the combined nursing skills teaching in colleges and universities were higher in the experimental group (91.24±3.01) than that in the control group (87.33±2.96), the difference was statistically significant ( t value was 5.027, P<0.05). The evaluation score of teaching effect of the experimental group was 62.61 ± 2.94, which was significantly higher than that of the control group (49.67 ± 7.79) ( t value was 7.965, P<0.05). Conclusions:The combined teaching mode of colleges and hospitals based on the integration of theory and practice is beneficial to improve students′ comprehensive quality and learning effect, further shorten the gap between college theory and clinical practice, and is an effective form of pediatric nursing education.