Objective To investigate the diagnosis and treatment of aggressive fibromatosis after thyroidectomy.Methods One patient who were admitted into our hospital on January 16,2014 were discovered to have left cervical mass at the regular follow-up 8 months after opertaion.The ultrasonic examination showed that there were low echo area of 58 mm ×30 mm in the 3 ~5 muscular layer at the left neck. And it was diagnosed as aggressive fibromatosis through the puncture disease inspection.Whereafter,the patient were readmitted into hospital and recieved radical resection of the tumor on left side of the neck.The clinical,pathological and radiological data of the patient were collect-ed and analyzed so ao to discuss the diagnosis and treatment experience combined with related literatures.Results Postoperative pathologic examination confirmed that it was aggressive fibromatosis.The patient was actively cooperated with perioperative treatment,and the postoperative recovery was good with no local recurrence during the follow-up up to now.Conclusion Early diagnosis and surgical treatment are needed for patients with aggressive fibromatosis after thyroidectomy.

Physiology experiment can effectively stimulate the enthusiasm of the students to explore the scientific truth by providing the opportunity to observe real physiological phenomena,analyze,discuss and solve practical problems.Lab-based learning (LBL) and theory teaching have complementary advantages,promoting each other and can maximize the use of teaching resources.During the process of physiological LBL,training of students' thinking ability by creating problem situation,inspiration and guidance,carrying out exploring experiments can develop students' intelligence,promote innovation,improve the teaching effect.

Objective: To investigate the awareness and identify the influencing factors of sexual knowledge among primary and middle school students in Butuo County, Sichuan Province, so as to provide insights into sex education. Methods: Six primary and middle schools were randomly sampled from 40 primary and middle schools in Butuo County using the cluster sampling method on March and April, 2021, and a class was randomly sampled from each of grades 4 to 6 of primary schools and grades 1 to 3 of junior high schools, with all students from the class as study subjects. Students' demographic features and awareness of sexual knowledge were investigated using self-designed questionnaires, and the factors affecting the awareness of sexual knowledge were identified among primary and middle school students using multivariable linear regression analysis. Results: A total of 980 questionnaires were allocated, and 957 valid questionnaires were recovered, with an effective recovery rate of 97.65%. The respondents included 458 boys ( 47.86% ) and 499 girls ( 52.14% ), and included 908 students with Yi Ethnicity. The respondents included 802 primary school students ( 83.80% ) and 155 junior high school students ( 16.20% ). The awareness of sexual knowledge was 21.94% among the primary and middle school students, and their sexual knowledge was predominantly derived from parents ( 338 students, 35.32% ) and teachers ( 335 students, 35.01% ). The awareness of sexual knowledge was significantly lower in boys than in girls ( 17.69% vs. 25.86%; χ2=8.344, P=0.004 ), and the awareness of sexual knowledge appeared a tendency towards a rise with age ( χ2trend = 63.908, P<0.001 ). Low awareness of sexual knowledge was seen in students with fathers going out for labor ( 19.54% ), mothers going out for labor (11.24%) and living in the countryside ( 14.32% ) ( χ2=7.790, 9.224 and 34.144, all P<0.01 ). Multivariable linear regression analysis showed that students living in the countryside, students’ mothers going out for labor, ages of 12 to 14 years and ages of over 14 years were factors affecting the score of sexual knowledge ( β'=-0.072, 0.341, 0.645 and 0.843, all P<0.05 ). Conclusions The awareness of sexual knowledge is low among primary and middle school students in Butuo County. Health education of sexual knowledge should be emphasized on male students, those living in the countryside and students with mothers going out for labor.

Objective To study the effects of oral rehydration with the solution of pyruvate-glucoseelectrolyte (PGES) by comparison with the bicarbonate-glucose-electrolyte solution (BGES) on resuscitation in rats with lethal hemorrhagic shock.Methods Sixty adult male SD rats with intra-gastric tube,and cannulation of femoral artery and vein were subjected to 45％ total blood volume loss from the femoral artery,and then randomly divided into three groups (n =20 in each group):no fluid resuscitation group (NR),oral fluid resuscitation with the PGES group (PGES) and oral fluid resuscitation with the BGES group (BGES).In NR group,the animals received no fluid replacement or any other treatment.Rats in PGES and BGES groups were infused intra-gastrically with pre-warmed PGES or BGES in volume of 2 times shed blood given at 30 min after hemorrhage and completed within 6 hours.Blood samples in each group were collected from the abdominal aorta before or at 0,1,2,4 h post hemorrhage to detect serum alanine aminotransferase (ALT),creatinine (Cr),creatine phosphate kinase isoenzyme (CK-MB) and intestinal fatty acid binding protein (iFABP).Another 84 rats randomly divided into four groups:NR group (n =24),PGES group (n =24),BGES group (n =24),and no hemorrhage group (NH group,n =12).Rats in the three hemorrhage groups were treated the same as described above,and the rats in NH group underwent the same surgical procedure without hemorrhage were served as the sham group.All these rats were observed for their 24-hour survival rates.Results The 24-hour survival rates of PGES and BGES groups were both significantly higher than the rate of NR group (11/24 vs.1/24,x2 =18.087,P ＜0.01 ; 5/24 vs.1/24,x2 =6.445,P ＜ 0.05) ; the survival rate of PGES group was also significantly higher than that of BGES group (11/24 vs.5/24,x2 =4.02,P ＜ 0.05).All levels of ALT,CK-MB,Cr and iFABP in both the NR group and two oral resuscitation groups at 1 h,2 h and 4 h post hemorrhage were significantly higher than those before the blood loss,respectively (P ＜ 0.01).These biomarkers at 2 h,4 h post hemorrhage were significantly lower in the PGES and BGES groups than those in NR group (P ＜ 0.01) ; the serum levels of ALT,CK-MB,Cr and iFABP were significantly lower in the PGES group than those in the BGES group at 2 h and 4 h post hemorrhage,respectively (P ＜ 0.05).Conclusions Present results demonstrated that the pyruvate-enriched oral re-hydration solution (ORS =PGES) was more effective in preserving the organ function and prolonging the animal survival after resuscitation of lethal hemorrhagic shock in comparison with the bicarbonate-containing ORS (BGES).The oral re-hydration solution (PGES) recommended by the World Hygiene Organization (WHO ORS) may require further improvement in oral resuscitation of shock and the PGES may be recommended as a choice of oral re-hydration salts in the treatment of lethal hemorrhagic shock when intravenous administration is not available.

Thought and consciousness of experimental design were carried in the experimental teaching and the classical physiological experiments were merged. Innovational design and practice were penetrated through the whole experimental class. After consulting literature, designing experi-ments, observing the phenomenon, dealing with the data and summurizing the results, the designers experienced the basic research procedure, got the innovate results, gained the chance to further study and improved the innovative capability.

The application of micro-lectures in higher medical education is still in a stage of exploration.The au-thors applied the micro-lectures with the traditional teaching method in the teaching of physiology, and conducted a questionnaire survey about it.In this article, the authors summarized the developing process, the students’attitude and the video production of micro-lectures, and compared the micro-lecture with traditional teaching method and MOOCS.At last, they gave some suggestions about application of micro-lectures in higher medical college.

Objective To explore the effect of internet + continuing nursing education teaching methodflipped classroomin the teaching of Assessment of Consciousness among junior nurses. Methods A total of 98 nurses who have graduated within two years in the third hospital of Mianyang city in Sichuan province were selected and divided into experimental group and control group by random digits table method with 49 nurses each. The experimental group used flipped classroom teaching method and the control group used the traditional teaching method. After the training, the scores of examination and nurses′ learning satisfaction were analyzed and compared. Results The scores of nurses′ learning satisfaction in the experimental group was (100.35 ± 12.21) points, learning process, learning content, learning result, learning environment, interpersonal relationship of the dimensions were (26.85 ± 3.38), (22.02±3.07), (20.90±3.15), (17.19±2.50), (13.40±1.51) points. The scores of nurses′learning satisfaction in the control group was (86.00±11.63) points, learning process, learning content, learning result, learning environment, interpersonal relationship of the dimensions were (23.63±2.81), (19.67±3.06), (17.76±3.32), (15.20±2.46), (9.74±2.74) points. There were statistical differences between two groups(t=3.46-7.97, all P=0.000). The score of nurses′examination in the experimental group was (78.19±6.11) points,the score of nurses′ examination in the control group was (49.64 ± 14.42) points, and there was statistical difference between two groups(t=10.19, P=0.000). Conclusions Internet+continuing nursing education teaching methodflipped classroomcan improve junior nurses′learning satisfaction and the effect of the training, worthy of further promotion.

Objective To explore the effects of"one kind of high-quality nursing plan for one kind of disease" nursing model on self-efficacy and curative effect of depressive patients with different severity. Methods Totally 120 depressive patients hospitalized in the department of mental health of our hospital from January 2014 to December 2015 were selected as the research object, and they were assigned to the observation group(n=60) and the control group(n=60). Patients in the control group were given routine nursing procedure, while patients in the observation group were given"one kind of high-quality nursing plan for one kind of disease" nursing model. Patients were evaluated by Hamilton depression scale ( HAMD) and general self-efficacy scale ( GSES) at the beginning of hospitalization, 15 d and 30 d after hospitalization. The evaluation results were compared between two groups. Patients in the observation group were divided into 3 groups based on the severity of depression, and the scores of HAMD and GSES at the beginning of hospitalization, 15 d and 30 d after hospitalization were compared among 3 groups ( mild group, moderate group and severe group).Results The GSES score in the observation group at 15 d (t =-2.79,P = 0.01) and 30 d ( t = 2. 60,P = 0.01) after hospitalization was higher than that in the control group; the HAMD score in the observation group at 15 d ( t = 2.19,P = 0.03) and 30 d ( t = 2.60, P = 0.01) after hospitalization was lower than that in the control group;the HAMD score-reducing rate of patients with mild depression ( P < 0. 01) and patients moderate depression ( P = 0.01) in the observation group was significantly higher than that of severe patients.Conclusions "One kind of high-quality nursing plan for one kind of disease" nursing model has significant effect in promoting the rehabilitation of depression and enhancing self-efficacy of depressive patients, especially the patients with mild depression and moderate depression. It also can make the patients more positively faced with the disease, so to obtain good curative effect.

Objective To evaluate the validity and reliability of learning attitude scale among nurses in continuing nursing education in hospital.Methods We designed a nurse learning attitude scale in continuing education on the basis of a learning attitude questionnaire for teacher-training by Jiao Weiting. In July 2015, totally 207 nurses of the Third Hospital of Mianyang who received continuing education in hospital were selected as the research object by cluster sampling method. We investigated their learning attitudes. The reliability of the scale was assessed by Cronbach's α coefficient and test-retest reliability. The validity was assessed by factor analysis and Pearson's correlation.Results The test-retest reliability of the scale were as the following:cogni-tive level (0.82),experience of emotion (0.89),tendency of behavior (0.91),total scale (0.88);Cronbach's α co-efficients were as the following:cognitive level (0.85),experience of emotion (0.94),tendency of behavior (0.83), total scale (0.89). According to the result of Pearson's correlation,the total scale of learning attitude exhibited a positive correlation with cognitive level,experience of emotion and tendency of behavior (P<0.01). Four prin-cipal components were extracted by factor analysis and the constructs of the instrument obtained were consistent with the conceived concept in essence.Conclusions The scale learning attitude could measure the learning attitude of nurses in continuing nursing education with better reliability and validity.