Objective To evaluate the effect of comprehensive experiments on multiple trauma emergency rescue in intensive training before nursing practice. Methods 772 students were divided into groups, 16 to 18 students in each group,each team distributed teaching notes, designed experiment scheme toget her, selected and played roles, undertook tasks, practiced independently before the class,then performed comprehensive training in class. Results 94.8% of the nursing students and 100.0% of the training teachers supported this method of comprehensive experiments in intensive training. Conclusions Nursing comprehensive experiments can shorten the gap between the clinical practice and class teaching, improve the students' professional ability and general quality. It is a popular education mode on intensive training before clinical practice.

Objective Methodsof meta-analysis was used to investigate the clinical characteristics, related factors of ocular diseases caused by Tamoxifen.MethodsThe literature and key words in the literature search strategy were used to search the literatures related to the toxicity of tamoxifen in the treatment of breast cancer from 1980 to 2016.Refer to the literature, and extract the data information, use revman 5.1.7 statistical analysis.Results Tamoxifen was taken after t unilateral breast cancer resection by the patient,a sharp decline in visual acuity was found at the third month of taking Tamoxifen, and then the hospital diagnosed it was neuropapillitis.The analysis results show that the ocular toxicity of Tamoxifen was generally appeared after taking 1month to 100months.The most common eye diseases that result in Tamoxifen were macular edema and macular crystallization, although the cure rate was high, but if not treated ocular disease in time, blindness rate was high too.Ocular toxicity may be positive correlated with the cumulative dose of Tamoxifen and Tamoxifen concentration.The incidence rate may also positive correlated with age.Adverse reactions may be related to the metabolic rate, eye disease history and so on.Conclusion The clinical treatment of breast cancer treated with Tamoxifen, should pay attention to the ocular toxicity, replace drugs timely when there is any ADR that could not be tolerate.

Objective To analyze the normal hepatic contrast perfusion blocked by ultrasound excited microbubble cavitation using the visual scoring method. Methods Twenty-four healthy New Zealand rabbits were divided into the microbubbles group (MB + US), the simple ultrasound group (US) and the sham group. The MB + US group was insonated by US and intravenous injection of lipid microbubbles. Microbubble was replaced by saline in the US group and sham US exposure was used in the sham group. US contrast liver perfusion imaging was performed before and 0 min,15 min,30 min,45 min,60 min,24 h after treatment in each group. Results The visual perfusion scores of each group before treatment were no statistical difference ( P >0. 05). The visual score of pre-treatment significantly higher than that of post 0 min, 15 min in the MB+ US group ( P<0. 05), but no difference with post 30 min,45 min,60 min and 24 h ( P >0. 05). There were no statistical significance between all the time points of the US and the sham groups. Conclusions Ultrasound excited microbubble cavitation can temporarily and significantly interrupt liver blood perfusion in the visual score analysis.

Objective To explore the relations of the doctor-patient relationship to psychological security and stress.Methods Totally 430 operation patients were selected and followed-up.A survey was performed using the Security Questionnaire (SQ),the Patient Doctor Relationship Questionnaire 13-Item Version (PDRQ-13),the Hospital Stress Rating Scale (HSRS) Results The average score of SQ was lower than medium value in operation patients.The SQ scores of operation patients with emergency operation were 39.50±10.51,lower than those of selective operation which were 49.02±10.37 and limited operation which were 47.67±10.29 (P ＜ 0.05).The SQ scores of operation patients who didn't provided themselves were 37.33±10.10,lower than those of basically which were 40.10±10.83 and partly provided for themselves which were 43.50±10.51 (P＜ 0.05).The SQ scores of operation patients in severe group according severity of illness were 37.13±10.40,lower than those of them in mild group which were 39.19±10.24 and moderate group which were 41.38±10.01 (P＜ 0.01).The SQ scores of post-operation patients were 44.32±9.96,higher than post-operation patients which were 40.36±10.81 (P ＜ 0.01).The lack of comforts (LC),lack of information (LI) and risks of serious disease (RSD) scores of post-operation patients were 49.23±30.62,30.46±21.42,52.84±31.22,lower than those of post-operation patients which were 52.37±32.06,35.25±20.14,80.12±33.18 (P ＜ 0.05).The path analysis showed that the regression relationship between SQ scores and PDRQ scores,RSD scores was established (β=0.40,-0.26,P ＜ 0.01),and the PDRQ-13 scores was a mediator between the scores of LC,LI,RSD and the SQ scores (β=0.40,P＜0.01).The PDRQ-13 scores was a adjustor between the RSD scores and the SQ scores (β=-0.34,P ＜ 0.01).Conclusions The operation patients have a low level of the sense of security which is statistically significant with surgical types,the ability to care for themselves and severity of illness.The sense of security of post-operation patients were higher than those of pre-operation patients.The recognition of physician-patient relationship may be play a mediating and adjusting role between the sense of security and stress.The surgical stress affect patient security and physician-patient relationship.

Objective To investigate the effect of microbubble (MB) contrast agents impacted by different parameters such as acoustic pressure, frequency, duration of exposure, and MB concentration under flowing condition. Methods A capillary flow mimic model was set up for observation and analysis of MB displacement and aggregation under stereomicroscope. Results The displacement and aggregation of ultrasonic occurred significantly at the frequency of 2.0 MHz than 1.0 MHz and 0.5 MHz. Under low acoustic pressure, MBs were not visually disrupted but the flow slowed down. The aggregation and deflection applying to MB was stronger in the tube happened at the MB concentration of 7×10~7/ml than 7×10~5/ml, but did not when the concentration rose to 7×10~9/ml because of the high viscosity. The ultrasound exposure time could not affect significantly in displacement and MB aggregation. Conclusion MB contrast agents can be manipulated under some ultrasound parameters. It is expected to be physically modulated in blood vessels, in order to increase targeted adhesions for many therapeutic purposes.

Objective To investigate the role of nitric oxide (NO) in the protective effects of morphine postconditioning against ischemia-reperfusion (I/R)-induced myocardial apoptoais. Methods Sixty pathogen-free SD rats were randomly divided into 4 groups ( n = 15 each) : group Ⅰ sham operation (S) ; group Ⅱ I/R; group Ⅲ morphine postconditioning ( M ) and group Ⅳ M + L-NAME ( non-selective NOS inhibitor). The animals were anesthetized with intraperitoneal pentobarbital 60 mg/kg, tracheostomized and mechanically ventilated. ECG was monitored. Right carotid artery was cannulated for BP monitoring and left jugular vein was cannulated for drug and fluid administration. Myocardial ischemia was induced by 45 min occlusion of left anterior descending coronary artery (LAD) followed by 120 min reperfusion. In group S LAD was exposed but not occluded; in group M morphine 1.25 mg/kg was injected iv over 5 min from 3 min before reperfuaion to 2 min of repeffuaion and in group M + L-NAME L-NAME 10 mg/kg was injected iv at 20 min before myocardial ischemia. Hemodynamic changes were monitored. The animals were killed at the end of 120 min reperfusion and their hearts removed. Myocardial apoptosis was determined by TUNEL technique. The expression of Akt phosphorylation was assessed by Western blotting. The NO content in myocardium was measured by a chemiluminescence detector.Results A large number of TUNEL positive cells (18.4 ± 1.1 ) % were observed in group I/R. Morphine postconditioning exerted a significant anti-apoptotic effect. The number of TUNEL positive cells was reduced to (10.8 ± 1.2)%. The myocardial eNOS phosphorylation expression and NO content were significantly increased in group M as compared with group I/R. The anti-apoptofie effect and increased NO production were significantly reversed by L-NAME. However, pretreatment with L-NAME did not inhibit the phosphorylation of eNOS in group L + M. Conclusion In vivo, morphine postconditioning can significantly reduce I/R-induced myocardial apoptosis through phosphorylation of eNOS and increase in NO production.

Objective To investigate the effect of morphine postconditioning on myocardial ischemiarepedusion(I/R)injury and the role of PI3K/Akt signaling pathway in the effect.Methods Seventy male SD rats weighing 280-330 g aged 16-17 weeks Were randomly divided into 5 groups(n=14 each):group Ⅰ sham operation(S);group Ⅱ I/R;group Ⅲ morphine postconditioning(M);group Ⅳ morphine postconditioning+ wortmannin(W+M);groupV wortmannin(W).Myocardial I/R injury wa.g produced by occlusion of anterior descending branch of left coronary artery for 45 min followed by 120 min reperfusion.In group M and W+M (groupⅢ,Ⅳ)morphine 1.25 mCkg was given iv at 3 min before and 2 min after reperfusion.In group W+M and W(groupⅣ,Ⅴ)wortmannin(a specific PDK inhibitor)15μ/gkg Was given iv at 20 min before ischemia. The animals were sacrificed at the end of 120 min repedusion for assessment of ischemic and infarct area and determination of total and phosphorylated Akt expression in myocardium by Western blot.Results There were no significant differences in the size of ischemic area and total Akt expression among the 5 groups. The infarct area was significantly smaller in group M than in group I/R. The were no significant differenees in the size of infarct area between group 1/R, W + M and W (group Ⅱ , Ⅳ,Ⅴ ). The phosphorylated Akt expression was significantly upregulated in group I/R and M as compared with group S, and was significantly higher in group M than in group I/R.Conclusion The PI3K/Akt signaling pathway activation is involved in the protective effect of morphine posteondifioning on myocardium against I/R injury.

Objective To study the effect of ERK signalling pathway and aldose reduetase(AR)on the transforming growth factor-β1(TGF-β1)-induced expression of fibronectin (FN)in nondiabetic nephropathy. Methods Human mesangial cells(HMCs)were cultured and transfected with pCDNA3-AR and AR gene silencing with small interfering RNA(siRNA).The AR expression in the HMCs was examined by real-time PCR and Western blotting was used to detect the protein expression of AR and FN. Inhibitors of AR and ERK signalling pathway were co-cultured with HMCs, then TGF-β1 was added and Western blotting was used to analyze the protein expression of FN. Results The expression of AR, FN and p-ERK was up-regulated by TGF-β1. AR was increased by 1.8-fold, FN was increased by 1.9-fold (P＜0.05), and p-ERK was increased by 5.l-fold after stimulation with TGF-β1 (P＜0.01). HMCs transfected with AR showed stronger protein expression of FN, more than 3.6-fold in the protein level of FN was observed in HMCs (P＜0.05). The HMCs of knockdown AR gene by siRNA showed decreased expression of AR,FN and p-ERK, the level of AR mRNA in HMCs transfected with AR siRNA was 10% of the level in untransfected cells or cells transfected with control siRNA (P＜0.01). Transfection with AR siRNA attenuated TGF-β1-induced FN production, more than 70% decrease in the protein level of FN and p-ERK was observed in HMCs with AR-siRNA (P＜0.01). Conclusions AR can regulate the expression of FN with the stimulation of TGF-β1, as AR gene is one of the responsive genes of TGF-β1, which may be associated with the activation of ERK signalling pathways induced by TCF-β1.

Objective To study the detection rate of contrast-enhanced ultrasound (CEUS) with different perfusion methods on rabbit VX2 small hepatocellular carcinoma less than 10.0 mm. Methods VX2 tumor cells were inoculated into the subcutaneous tissue of New Zealand rabbit′s thigh. Then the plant tumor were cut into small blocks under sterile conditions and transplanted into hepatic parenchyma in 30 New Zealand rabbits. The contrast media was injected through peripheral vein by single and double perfusion methods. The detection rate of two methods were compared. Results There were 41 hepatocellular carcinoma lesions in the 30 rabbits. There were 15 lesions with size between 3.0 mm and 5.0 mm, and 26 lesions between 5.0 mm and 10.0 mm in diameter. On CEUS, the VX2 tumor presented fast-in and fast-out pattern. In arterial phase, the lesion was enhanced rapidly. In portal venous phase, contrast began to wash out from the carcinoma. In delay phase, the enhancement of lesion was signiifcantly lower than the surrounding normal liver parenchyma. A total of 32 lesions were detected by single perfusion method, including 7 lesions ranging 3.0-5.0 mm and 25 lesions ranging 5.0-10.0 mm. A total of 39 lesions were detected by double perfusion method, including 13 lesions ranging 3.0-5.0 mm and 26 lesions ranging 5.0-10.0 mm. The detection rate of micro-hepatocellular carcinoma by single and double perfusion method was 78% and 95% respectively. The difference was statistically signiifcant (χ2=5.150, P=0.023). The detection rate of 3.0-5.0 mm lesions by single and double perfusion method was 47%and 87%, respectively. The difference was statistically signiifcant ( χ2=5.400, P=0.025). The detection rate of 5.0-10.0 mm lesions by single and double perfusion method was 96% and 100%, respectively. There was no statistically signiifcant difference (χ2=1.020, P=0.500). Conclusion The double perfusion method greatly promotes the detection of micro hepatocellular carcinoma, especially for the lesions less than 5.0 mm in diameter.

BACKGROUND:In recent years, with the in-depth research on thecharacteristics and functions of stem cells,stem cell research has become a hot research targeting thetreatment of a variety of diseases.OBJECTIVE:To summarize the research progress of human amnioticmesenchymal stem cells in the treatment of acute lung injury.METHODS:The PubMed and CNKI databases were searched by computerfor relevant literatures published from January 2000 to January 2017. The key words were mesenchymal stem cells, acute lung injury in Chinese and English,respectively.RESULTS AND CONCLUSION:As an important member of adult stem cells, human amniotic mesenchymal stem cells not only have the advantages and characteristics of most other stem cells, but also have unique advantages, such as these cells can be extracted from a vast of sources, require only non-invasive operations, and involve no violation of ethics. Human amniotic mesenchymal stem cells can be driven by inflammation reaction and homing to the damaged tissue, and be activated by inflammatory factors to secrete a variety of cytokines in a paracrine fashion, which inhibit neutrophils, macrophages and other immune cell migration and inhibit dendritic cell maturity, and reduce the proliferation of NK cells, B lymphocytes and T lymphocytes, and up-regulate anti-inflammatory cytokines and down-regulate proinflammatory cytokines, and alleviate alveolar inflammatory injury through anti-oxidation and anti-apoptotic processes. Human amniotic mesenchymal stem cells can also assist in the repair or homing to the damaged tissue to directionally differentiate to replace the apoptotic and necrotic cells. All of these characteristics of human amniotic mesenchymal stem cells provide new insight into the treatment of acute lung injury. As acute lung injury is caused by many pathogenic factors and its pathophysiological process is very complicated, human amniotic mesenchymal stem cell transplantation in the treatment of acute lung injury has many issues to be resolved.