Objective To explore the application of Mini-CEX oriented by nurses'core competencies in the clinical teaching of intern nursing students.Methods A total of 50 students,interning in the First Affiliated Hospital of Kunming Medical University from January 1,2023 to April 30,2024,were randomly divided into experimental group and control group,with 25 students in each group.The control group was taught by traditional clinical teaching methods,and the experimental group by Mini-CEX.The data indicators of the two groups of intern nursing students were analyzed and compared at entry into and exit from the department,respectively.Results The scores of the two groups were higher than those at entry into the department(P<0.05),and the intern nursing students in the experimental group had excellent scores in nursing consultation,nursing examination,nursing diagnosis,nursing measures,humanistic care,organizational effectiveness,health consultation,and overall evaluation,and the scores were higher than those of the control group(P<0.05).The improvement in all the scores was also better than that of the control group(P<0.05).Conclusion Mini-CEX,which is oriented to the nurse'core competencies of nurses,can improve the clinical nursing abilities of intern nursing students and enhance the cultivation effect of clinical practice skills.

Aim To investigate the effeot of Shenqi Fuzheng injection on the prevention of immune myocarditis induced by anti-PD-1 antibody by reducing the production of inflammatory factors and the expression of myocardial injury markers. Methods Thirty-two maie PD-1 humanized mice with C57BL/6 genetic background were randomly divided into control group, myocarditis model group, anti-PD-1 antibody group and Shenqi Fuzheng injection group (n = 8). Except the control group, mice in other groups were intraperitoneally injected with myocardial myosin heavy chain peptide (5 mg • kg

Objective:To summarize the clinical manifestations and gene mutation features of patients with nucleotide excision repair (NER) disorders.Methods:A retrospective analysis was made on clinical data of patients with NER disorders who were admitted to the Chinese People′s Liberation Army General Hospital from October 2008 to February 2022 and diagnosed in the Outpatient Department of Beijing Children′s Hospital, Capital Medical University from October 2015 to February 2022.Literature on previously reported Chinese patients with NER disorders was reviewed.Results:(1)A total of 16 patients with NER disorders were enrolled, including 6 males and 10 females.The onset age was 7.5 (4.0, 12.0) months and the age at diagnosis was 42.0 (21.5, 77.0) months.There were 3 types of NER disorders: Cockayne syndrome (CS) in 13 cases, Xeroderma Pigmentosum (XP) in 2 cases and Cerebro-Oculo-Facio-Skeletal syndrome (COFS) in 1 case.Four disease-causing genes were detected: CSA gene in 11 cases, CSB gene in 3 cases, XPG gene in 1 case, and XPD gene in 1 case.The first symptoms of the 16 patients were photosensitivity and developmental delay, and neurological symptoms were observed in all the 3 NER disorder types.XP and CS patients had skin symptoms.CS patients presented typical facial features, visual and auditory impairment, microcephaly and changes in neuroimaging features.COFS patients showed intrauterine growth retardation.(2)Results of literature review: a total of 96 Chinese patients reported were retrieved, involving 6 disease types, including CS in 45 cases, XP in 44 cases, trichothiodystrophy in 4 cases, COFS in 1 case, XP-CS in 1 case, and ultraviolet sensitive syndrome in 1 case.Nine mutated genes were identified: CSA in 33 cases, XPA in 15 cases, CSB in 13 cases, XPV in 10 cases, XPC in 9 cases, XPG in 7 cases, XPD in 7 cases, XPF in 1 case, and MPLKIP in 1 case.The common symptoms were growth failure (62 cases), skin photosensitivity (61 cases), typical facial features (52 cases), mental retardation (49 cases) and microcephaly (48 cases). Among 36 cases had imaging data 33 cases(91.7%)had calcification of basal nucleus or globus pallidus.Three cases had intrauterine growth retardation and microcephaly during pregnancy. Conclusions:Patients with such prenatal manifestations as intrauterine growth retardation and microcephaly or with typical symptoms like skin photosensitivity, typical facial features, growth failure, mental retardation, hypertonia, and calcifications of basal ganglia should be suspected of NER disorders.Early genetic testing is recommended to confirm the diagnosis.

ObjectiveTo explore the sensory processing characteristics of preschool children with autism spectrum disorder （ASD）， and to provide a theoretical basis for early screening and intervention training of ASD. MethodsA total of 215 preschool children with ASD and170 typically developed （TD） children were investigated with a basic situation questionnaire and sensory processing measure （SPM）. The two groups were stratified according to age and gender， and the differences of scores in sensory domains were compared to analyze the sensory processing characteristics of preschool children with ASD. ResultsThe scores of social participation， vision， hearing， touch， taste and smell， body awareness， balance and motion， planning and ideas， and total sensory system in children with ASD were all higher than those in children with TD （all P<0.01）. The highest degree of abnormality was found in hearing and the lowest degree in taste and smell in children with ASD. The results of Spearman correlation analysis showed that in the 4-year-old and 5-year-old children with ASD， the scores of vision （r_s=-0.200， P= 0.033） and hearing （r_s=-0.194， P=0.040） decreased with age. There was no correlation between the scores of other developmental quotients and age （all P>0.05）. Boys and girls with ASD had higher scores in all developmental quotients than TD children （P<0.01）. However， there was no significant gender difference in any developmental quotients of ASD children （all P>0.05）. ConclusionSensory processing abnormalities are common in preschool children with ASD， which are different from those of TD children in multiple sensory domains. Sensory processing abnormalities may be used as an indicator for early screening of ASD， and it is necessary to conduct corresponding intervention training for sensory processing abnormalities in children with ASD.

ObjectiveTo investigate a foodborne disease outbreak and identify the pathogenic factors in order to prevent the occurrence of similar incidents. MethodsEpidemiological study， on-site food hygiene investigation， and laboratory testing were used to analyze the cause of outbreak in Company A. ResultsA total of 24 confirmed cases were screened out. The major clinical symptoms were diarrhea （100.0%）， stomachache （100.0%）， and vomiting （41.7%）. Samples from 24 patients were tested positive for Vibrio parahaemolyticus， and were homologous by Pulsed field gel electrophoresis （PFGE） phylogenetic study. According to the result of case-control study， eating glass noodles salad at the dinner and supper on July 16th， 2019 was the risk factor （OR=15.71，95%CI：1.90‒129.71）. ConclusionThis foodborne disease outbreak was caused by glass noodles salad cross contaminated with Vibrio parahaemolyticus.

Objective:To study the predictive value of combining alpha-feto protein (AFP) with contrast-enhanced MRI imaging features in predicting incidence of microvascular invasion (MVI) in patients with hepatocellular carcinoma.Methods:The data of 206 patients with hepatocellular carcinoma treated at Tianjin Medical University Cancer Institute and Hospital from January 2017 to April 2019 were retrospectively analyzed. There were 179 males and 27 females, with an average age of 58.7 years. The roles of preoperative MRI imaging features and clinical data on predicting the incidence of MVI in patients with hepatocellular carcinoma were evaluated by univariate and multivariate logistic regression analyses. Multivariable regression analysis was then used to plot a nomogram.Results:There were 86 patients (41.7%) with MVI positivity and 120 patients (58.3%) with MVI negativity. Multivariate logistic regression analysis showed that AFP >400 μg/L ( OR=3.318, 95% CI: 1.243-8.855, P=0.017), two-trait predictor of venous invasion (TTPVI) ( OR=13.111, 95% CI: 6.797-28.119, P<0.001), diffusion weighted imaging/T 2 weighted imaging (DWI/T 2WI) mismatch ( OR=17.233, 95% CI: 4.731-44.490, P<0.001), and rim enhancement( OR=5.665, 95% CI: 2.579-18.152, P=0.013) predicted increased risks of MVI in patients with hepatocellular carcinoma. The constructed nomogram directly predicted the risk of MVI in these patients. Conclusions:AFP>400 μg/L, TTPVI, DWI/T 2WI mismatch and rim enhancement were independent risk factors in predicting MVI in patients with hepatocellular carcinoma. This predictive model of MVI which was based on multivariate logistic regression analysis was helpful to clinicians in making individualized treatment plans for patients with hepatocellular carcinoma.

Objective: To investigate the prognostic value of chest computed tomography (CT) characteristics in crizotinib-treated pa-tients with advanced non-small cell lung cancer (NSCLC). Methods: Forty-seven patients with advanced ALK-rearranged NSCLC who re-ceived crizotinib treatment from January 2014 to March 2017 were enrolled in this retrospective study. Pre-treatment CT characteris-tics were evaluated. Patients were followed up after crizotinib treatment, and the best overall response and progression-free survival (PFS) were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). Results: The median PFS of all patients was 10 months. There was no association between CT characteristics and response. In univariate analysis, large tumor size (P=0.009), central type (P=0.002), consolidation of surrounding lung tissue (P=0.002), pleural effusion (P=0.001), and lymphangitic carcino-matosis (P=0.019) suggested a poor prognosis. Multivariate Cox regression analysis showed that location (hazard ratio, 3.219; 95% con-fidence interval: 1.517-6.833; P=0.002) was an independent prognostic predictor. Conclusions: Pre-treatment CT characteristics are useful in predicting the PFS of crizotinib-treated patients with advanced NSCLC harboring ALK rearrangement.

To investigate the correlation between magnetic resonance imaging (MRI) features and tumor risk grade of gas-trointestinal stromal tumors (GISTs). Methods: Between September 2007 to December 2017, 54 patients who underwent MRI and were pathologically diagnosed in Tianjin Medical University Cancer Institute and Hospital were retrospectively reviewed. We analyzed MRI features including the size, location, shape, boundary, and growth pattern of the tumor; cystic necrosis; metastasis; T1WI and T2WI signal intensities; enhancement signal intensity-time (SIT) curve pattern; and average apparent diffusion coefficient (ADC) val-ues. The MRI features were compared with the tumor risk grade. Results: Of the 54 cases, 16 were of low-risk grade, 13 were of inter-mediate-risk grade, and 25 were of high-risk grade. Statistical analysis showed that tumor size, location, shape, boundary, cystic necro-sis, signal intensity, and average ADC values were correlated with tumor risk grade (P<0.05). However, tumor growth pattern, metasta-sis, and enhancement SIT curve pattern were not correlated with tumor risk grade (P>0.05). GISTs with higher aggressive features were more likely to have larger size, irregular shape, unclear boundary, cystic necrosis, heterogeneous signal intensity, and lower ADC values on MRI. Conclusions: MRI has the potential to predict the risk grade of GISTs before surgery, thereby guiding clinical manage-ment, and evaluating prognosis.

Objective To compare the efficacy and safety of solitaire stent thrombectomy versus intravenous thrombolysis for treatment of elderly stroke patients with acute vertebrobasilar occlusion.Methods Clinical data of 76 patients with acute vertebrobasilar occlusion at the neurology department of Anyang People's Hospital from May 2014 to July 2017 were retrospectively analyzed.Patients were divided into two groups:solitaire stent thrombectomy group (n =30)and intravenous thrombolysis group (n =46).Recanalization rates,score improvement rate in National Institutes of Health Stroke Scale (NHISS)after 24 hours of treatment,symptomatic intracranial hemorrhage rate and mortality at 90 days after treatment were compared between the two groups.Results The recanalization rate,NIHSS score improvement rate at 24 hours after treatment and the improvement rate of Modified Rankin Scale(mRS)score at 90 days after treatment were significantly higher in the solitaire stent thrombectomy group than in the intravenous thrombolysis group[86.7％ (26/30)vs.45.7％(21/46),66.7％(20/30)vs.34.8％(16/46),53.3％ (16/30)vs.23.9％(11/46),x2 =6.543,3.900 and 3.761,P =0.012,0.041 and 0.046,respectively].No significant difference in incidence of intracranial hemorrhage was found between the two groups [6.7 ％ (2/30) vs.19.6 ％ (9/46),x2=0.813,P=0.357].The mortality at 90 days after treatment were significantly lower in the solitaire stent thrombectomy group than in the intravenous thrombolysis group [0.0％ (0/30)vs.30.4％ (14/46),P =0.017].Conclusions Solitaire stent thrombectomy versus intravenous thrombolysis has better efficacy and higher safety in treating acute stroke due to vertebrobasilar occlusion in elderly patients.

Objective To compare clinical characteristics between acute exacerbated chronic obstructive pulmonary disease (AECOPD) patients with chronic bronchitis phenotype and emphysema phenotype.Methods A total of 73 AECOPD patients with chronic bronchitis phenotype and 82 AECOPD patients with emphysema phenotype in Tibet Chengdu Branch Hospital,West China Hospital,Sichuan University from January 2014 to November 2016 were selected.All patients had completed lung function tests,basic information collection,modified medical research council dyspnea scale (MMRC),and COPD assessment test (CAT).The serum samples were collected to detect C-reactive protein (CRP).The clinical characteristics,lung function,complications and systemic inflammation between the two groups were compared.Results There was no difference in body mass index (BMI),CAT score,serum CRP level and length of hospital stay between the AECOPD patients with chronic bronchitis phenotype and emphysema phenotype (P＞0.05).Compared with AECOPD patients with chronic bronchitis phenotype,the AECOPD patients with emphysema phenotype have longer smoking history,higher MMRC score,and more severe lung function impairment (P＜0.05).Conclusion AECOPD patients with chronic bronchitis phenotype and emphysema phenotype have different clinical characteristics,those with emphysema phenotype have more severe dyspnea and lung function impairment.