In this study, a new model of "Internet + PACD (namely, theoretical presentation, assimilatin, clinicopathological diagnosis and discussion)" was put forward in the online and offline course construction of surgical diagnostic pathology. and the teaching effect of this teaching model was evaluated through the performance evaluation and questionnaire survey. The results showed that the teaching model of "Internet + PACD" could not only significantly improve the performance of professional courses of students majoring in pathology, but also enhance their learning interest, confidence, competition and cooperation consciousness, which has been affirmed and recognized by students.

The construction of Internet plus and big data pathology medical alliance platform is based on the Clinical Pathological Diagnosis Center of Qiqihar Medical University, on the basis of the digital pathological cloud platform provided by Jiangfeng biological assistance, relying on the medical development plan of Qi Medical Pathology diagnosis Center, cultivating the development concept of high, fine and sharp innovative pathological talents, and absorbing the leading figures of pathological diagnosis in various departments in China. From that, the real-time supervision and control of the diagnostic quality of Primary Pathological Diagnostic Unit can be established, the real-time, timely and accurate all-round training of Basic Pathological Diagnostic Technicians can be realized, and the level of basic pathological diagnosis can be quickly improved. A new training mode for pathology talents can perfectly fit with the big data medicine and artificial intelligence.

Objective:To investigate the current status of multiple leadership styles of head nurses and affective domain ability of nurses, and to explore the influence of multiple leadership styles of head nurses on affective domain ability of clinical nurses.Methods:From June and August 2019, we selected 380 clinical nurses in the Second People's Hospital of Liaocheng with the method of cross-sectional survey and convenience sampling. All nurses were investigated with the General Information Questionnaire, Multifactor Leadership Questionnaire (MLQ) and Nurse Affective Domain Ability Scale. We analyzed the influence of multiple leadership styles of head nurses on affective domain ability of clinical nurses. In this study, a total of 380 questionnaires were distributed and 372 valid questionnaires were recovered with a valid recovery rate of 97.9%.Results:Among 372 clinical nurses, the total score of perceived MLQ of head nurses was (86.30±18.59) and the item average score was (2.70±0.58) ; the total score of the Nurse Affective Domain Ability Scale and the item average score were (97.67±13.35) and (3.91±0.53) respectively. Univariate analysis showed that there were statistical differences in the total score of Nurse Affective Domain Ability Scale among nurses with different nursing ages, professional titles and educational levels ( P<0.05) . Pearson correlation analysis indicated that the total score of MLQ of head nurses had a positive correlation with the total score of the Nurse Affective Domain Ability Scale of nurses with a statistical difference ( r=0.364, P<0.05) . Hierarchical regression analysis showed that nursing ages and transformative leadership style had a predictive effect on clinical nurses' affective domain ability. Conclusions:Head nurses adopt a transformative leadership style to enhance clinical nurses' affective domain ability, so that they devote themselves to nursing work with full enthusiasm and stabilize the development of the nursing talent team.

Objective To investigate the protective effect of Honokiol on the airway inflammation induced by particulate matter 2.5(PM2.5)in the asthmatic mice and its mechanism.Methods Fifty male specific pathogen free (SPF)Balb/c mice were randomly divided into 5 groups.Group A:normal control group;group B:asthmatic model group;group C:PM2.5 exposure asthmatic group;group D:TAK -242 group;group E:Honokiol group. Asthmatic mouse models were established by ovalbumin(OVA)sensitization and challenge.On days 0 and 7,the mice in B-E groups were injected intraperitoneally with injection 100 mg/L OVA and aluminum hydroxide for sensitization;on days 14 to 21,10 g/L OVA solution was given 30 min per day to challenge.During challenge phrase,the mice in C -E groups received intratracheal injection of PM2.5,every other day,4 times totally.On this basis,the mice in group D re-ceived TAK-242 intraperitoneal injection,and the mice in group E received honokiol intragastric administration.Group A was given saline instead of OVA.Animals were sacrificed 24 h after the final inhalation challenge,and the bronchoal-veolar lavage fluid(BALF)of the left lung was used for differential inflammatory cell counts.The expressions of Toll-like receptors 4(TLR4)and nuclear factor(NF)-κB at mRNA level were detected by real-time quantitative PCR. Flow cytometry analysis was performed to measure the levels of Th17 and Treg cells.Results Compared with group A,mice in group B and group C expressed more serious disorders of bronchial epithelial cells,alveolar wall congestion and edema,increased mucus secretion in the airway and infiltration of inflammatory cells in the lung,and those in group C were more obvious than those of group B and group E significantly reduced respiratory inflammation;compared with group A[(4.15 ± 1.35)×108/L,0.012 0 ± 0.002 3],the total number of inflammatory cell counts[(16.79 ± 5.62)×108/L and(24.58 ± 13.46)×108/L],eosinophils proportions(0.113 8 ± 0.022 3 and 0.197 8 ± 0.084 9)in group B and group C,were significantly higher,and the differences were statistically significant(all P<0.05);The total number of inflammatory cell counts and eosinophils proportion in group E(8.56 ± 3.28)×108/L and 0.041 5 ± 0.013 5)were significantly lower than those in group C,and the differences were statistically significant(all P <0.05);The expressions of TLR4 mRNA and NF-κB mRNA in group B and C(1.85 ± 0.56,1.82 ± 0.28 and 2.97 ± 0.41,2.83 ± 0.32)were significantly higher,and the differences were statistically significant(all P <0.05);The expressions of TLR4 mRNA and NF-κB mRNA in group E(1.60 ± 0.28,1.54 ± 0.25)was significantly lower than those in group C,and the differences were statistically significant(all P<0.05);the expressions of Th17 in group B and C[(2.89 ± 0.61)% and(4.96 ± 0.27)%]were significantly higher than those of group A[(1.03 ± 0.35)%] (all P<0.05);The expression of Th17 in group E[(1.83 ± 0.23)%]was significantly lower than that of group C,and the differences were statistically significant(P<0.05);the expressions of Treg in group B and C[(4.96 ± 0.35)%and(2.27 ± 0.41)%]were significantly lower than those of group A[(7.37 ± 0.56)%],and the differences were sta-tistically significant(all P<0.05);The expression of Treg in group E was significantly increased[(6.45 ± 0.38)%] compared with that in group C,and the difference were statistically significant(P<0.05);and those of group D and E were improved remarkably.Conclusions Honokiol can relieve PM2.5 exposure of asthmatic airway inflammation through down-regulating the expression of TLR4 and NF-κB and Th17 and regulating the balance of Th17 and Treg cells.

Vessel identification and dissection are the key processes of laparoscopic complete mesocolic excision (CME). Vascular injury will lead to complications such as prolonged operative time, intraoperative hemorrhage and ischemia of anastomotic stoma. Superior mesenteric artery (SMA), superior mesenteric vein(SMV), gastrointestinal trunk, left colic artery(LCA), sigmoid artery and marginal vessels in the mesentery have been found with possibility of heteromorphosis, which requires better operative techniques. Surgeons should recognize those vessel heteromorphosis carefully during operations and adjust strategies to avoid intraoperative hemorrhage. Preoperative abdominal computed tomography angiography(CTA) with three-dimensional reconstruction can find vessel heteromorphosis within surgical area before operation. Adequate dissection of veins instead of violent separation will decrease intraoperative bleeding and be helpful for dealing with the potential hemorrhage. When intraoperative hemorrhage occurs, surgeons need to control the bleeding by simple compression or vascular clips depending on the different situations. When the bleeding can not be stopped by laparoscopic operation, surgeons should turn to open surgery without hesitation.
Colonic Neoplasms ; surgery ; Dissection ; Hemorrhage ; prevention & control ; Humans ; Laparoscopy ; Mesenteric Artery, Inferior ; Mesenteric Veins ; Mesocolon ; surgery

Objective:To investigate the mechanisms of IL-1β promoted lung cancer cells proliferation. Methods: The“Transwell? Inserts” system was used to coculture lung cancer cells A549,NCI-H520 with macrophages. BrdU ELISA used to measure the effect of macrophages promoted lung cancer cells proliferation. Expression of mRNA of IL-1β in A549 and NCI-H520 cells were analysed by Real-time PCR analysis. IL-1β was responsible for macrophage-promoted lung cancer cells growth, IL-1β neutralizing antibody was added. The autophagy marker Beclin1 protein was detected by Western blot. Results:The BrdU ELISA assay showed that after coincubation with macrophages in the proportion of 1:0. 5,the OD value of A549 increased from(0. 41±0. 06)to(1. 13±0. 10). There was statistical significance(P<0. 05). It also showed that the growth of the A549 cell was dependent on the macrophage number (P<0. 05). The OD value variability of NCI-H520 cells was as same as A549 cell upon cocultured with macrophages. Real-time PCR results showed that the expression of IL-1β mRNA in macrophages was remarkably enhanced in a time dependent manner upon coincubated with lung cancer cell,and the expression level was higher than lung cancer cells. Addition of IL-1β neutralizing antibody markedly inhibited macrophage-promoted lung cancer cells proliferation. The OD value of these two cells were decreased from ( 3. 63 ± 0. 33) to (1. 46±0. 18),from (2. 94±0. 38) to (1. 53±0. 20),respectively (P<0. 05). After treatment with IL-1β,the expression of Beclin1 was significantly inhibited in tumor cells. Conclusion:Over-expression of IL-1βfrom macrophages and lung cancer cells is re-sponsible for proliferation of tumor cells in coculture condition. Inhibition of autophagy in tumor cells may be the important mechanisms of IL-1β promotes lung cancer cells proliferation.

Objective To amplify the higA gene from the Mycobacterium tuberculosis,and to analyze the structure and function of their encoded proteins by using bioinformatics.Methods Total DNA was extracted from Mycobacterium tuberculosis.PCR of higA was performed and the products were sequenced.The biological features of the higA protein including,its physical and chemical properties,signal peptide,spatial structure and epitopes were analyzed by using software online.Results The PCR products of higA were 450 bp in length,which were consistent with the expected size.The higA protein consisted of 149 amino acids and had the following characteristics:a theoretical isoelectric point of 7.93,a fat-soluble factor of 94.30,and instability coefficient of 36.57.The higA protein had no signal peptide,containing 10 phosphorylation sites and multiple potential epitopes.Conclusion Mycobacterium tuberculosis higA gene can be amplified by PCR and the characteristics of higA protein is identified.

To explore the pathogenicity of VEG strain Toxoplasma gondii oocysts on China Kunming mice,T.gondii oocysts of ＜ 1 and 102-108 were chosen to feed the mice orally.And the modified agglutination test (MAT),H&E and IHC were used to check the infection of mice.The infection rate,the survival rate of mice,and number of cysts in brain were analyzed.Results showed that 100％ of the mice fed with ≥102 oocysts were infected,the minimum lethal dose was 102 oocysts and the 100％ lethal dose was 108 oocysts.The time of death in acute infection was 7 DPI to 14 DPI.T.gondii cysts formation rate was 32.14％ (9/28),and the number of cysts was 9 to 857 per mouse.The survival rate of infected mice was 67.44％ (29/43),and the longest survival time was more than 390 DPI.Accordingly,the virulence of T.gondii VEG strain is medium,and has a higher cysts formation rate.

Objective To investigate the anti-inflammatory and immunosuppressive effects of honokiol in a mouse model of particulate matter ( PM ) 2.5-induced asthma .Methods Female SPF BALB/c mice were randomly divided into five groups:normal saline group (group A), ovalbumin (OVA)-sensitized group ( group B), PM2.5-exposed+OVA-sensitized group ( group C), dexamethasone-treated group (group D) and honokiol-treated group (group E).All mice except those in group A were sensitized and challenged with OVA, and the mice in groups C, D and E were exposed to PM2.5 every two days since the first challenge.Samples of lung sections were stained with hematoxylin and eosin (HE) to observe in-flammatory infiltration.Bronchoalveolar lavage fluid (BALF) and PBMCs were collected from each mouse . Expression of RORγt and Foxp3 at mRNA level was detected by quantitative real-time PCR.Flow cytometry analysis was performed to measure the percentages of Th 17 and Treg cells.ELISA was performed to measure the levels of IFN-γ, IL-10 and IL-17 in the supernatants of cell culture .Results Compared with group B , group C showed an enhanced expression of RORγt at mRNA level, increased IL-17 level and up-regulated percentage of Th17 cells (all P<0.05), but a suppressed expression of Foxp3 at mRNA level, decreased IL-10 level and down-regulated percentage of Th17 cells (all P<0.05).No significant difference in the per-centage of Th1 cells or in the expression of Th 1-related cytokines was observed .The expression of RORγt at mRNA level, IL-17 level and the percentage of Th 17 cells were decreased in PM2.5-exposed mice upon honokiol intervention (all P<0.05), while the expression of Foxp3 at mRNA level, IL-10 level and the per-centage of Treg cells were increased after honokiol intervention (all P<0.05).Honokiol had similar efficacy to dexamethasone in the treatment of asthma .Conclusion Honokiol can alleviate airway inflammation in mice with PM2.5 exposure-induced asthma through regulating the percentages of Th 17 and Treg cells.

With the aging of the Chinese population, it seems obvious that the number of elderly patients with the disease of colorectal carcinoma grows significantly. Meanwhile, no evidence-based practical guideline for the treatment of colorectal carcinoma are available in this particular age group. Therefore, the concept of integrative management has been brought up by the Colorectal Cancer Center of the Second Affiliated Hospital of Zhejiang University, which combines the processes of surgery, perioperative rehabilitation and adjuvant chemotherapy together. In this way, the cooperation and complementarity between different clinical departments could cooperate and complete tasks together to integrate the treatment processes into a cohesive one. To achieve the goal of integrative management, the project is divided into horizontal and vertical aspects. The horizontal integration means the cooperation between different clinical departments, which is also known as multi-discipline treatment (MDT). The vertical integration reflects the completeness of the entire treatment under the goal of consistency, strictness and job separation, which could also be explained as the clinical pathway. Furthermore, this review stresses on the integrative strategy of both clinical and biochemical indexes rehabilitation, as well as the operation and postoperative adjuvant chemotherapy which has been put in execution several years by the Colorectal Cancer Center of the Second Affiliated Hospital of Zhejiang University.
Aged ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; surgery ; therapy ; Critical Pathways ; Humans ; Integrative Medicine ; Postoperative Period ; Risk Factors