As the key of colleges and universities and medical career,the affiliated hospital's clinical department is the core of its development.In the new era,strengthening the mechanism of party branch participating in the decision-making of clin-ical departments is an inevitable requirement for implementing the party's leadership and strengthening hospital management.The Party branch of the affiliated hospital of the university has the"dual"attribute,through the establishment of the"core group"of the party branch to participate in decision-making in the clinical business department,the establishment of an efficient decision-making platform,the construction mechanism of supporting rules of procedure and supervision measures to realize its function,the in-depth analysis of management challenges and the improvement of countermeasures,in order to create a new way and a new mechanism of the party branch decision-making,and promote the deep integration of party building and business.

Objective: To evaluate the effects of the blended learning applied in the course of Medical Nursing of Vocational Colleges. Methods: From March to November of 2018, the Vocational Colleges nursing students of grade 2017 were selected as the research subjects. They were divided into the experimental group (n=120) and the control group (n=150). The experimental group implements the blended teaching mode based on rain classroom, while the control group adopts the traditional classroom teaching mode. This paper evaluated the effect of the blended teaching mode based on rain classroom by using the students′ autonomous learning ability scale, the teaching effect satisfaction scale and the theoretical examination papers. Results: The scores of autonomous learning ability (90.6±8.8) and theoretical examination (48.8±3.5) in the blended teaching mode group based on rain classroom were higher than those in the control group (71.4±9.6,39.6±3.6), with statistical significance (t=21.125,16.942, P<0.05). Nearly 93.3% (112/120) of the students in the experimental group accepted this teaching mode. Conclusions The blended teaching model based on rain classroom can obviously improve the self-learning ability and interest of nursing Medical Nursing of Vocational Colleges, and it is worthy of being promoted.

Objective To explore the effect of hypoxia on the proliferation of human umbilical vein endothelia cell (HUVEC) and its underlying mechanism.Methods HUVEC were incubated at different oxygen concentrations (1％,5％,21％) and at 5％ CO2 at a temperature of 37 ℃ for 24 hours.Proliferation rate was detected by WST-1.The target gene of miR-99a was predicted by bioinformatics and verified by double luciferase reporter assay.MiR-99a mimics,miR-99a siRNA,mTOR siRNA,or mTOR cDNA were transfected in HUVEC by lipofectamine 2000,and then incubated in hypoxia.Mir-99a and mTOR were respectively detected by qRT-PCR and RT-PCR or Western blot.Results The proliferation of HUVEC was obviously decreased under hypoxia (1％ O2) (33.3％ ± 6.5％),as compared with normoxia(21％ 02) (P =0.004).Hypoxia could up-regulate the expression level of miR-99a (1.94 ± 0.24,P =0.001),which further inhibited the proliferation of HUVEC.Bioinformatics and double luciferase reporter assay indicated that mTOR was the target gene of miR-99a.Under hypoxia,the gene and protein level of mTOR were down-regulated by miR-99a.Further research demonstrated that the proliferation of HUVEC was inhibited under hypoxia by miR-99a-mTOR pathway.Conclusions Hypobaric treatment could significantly inhibit the proliferation of HUVEC,which might be associated with miR-99a-mTOR pathway.

Objective To explore the effect of hypoxia on the proliferation of human umbilical vein endothelia cell (HUVEC) and its underlying mechanism.Methods HUVEC were incubated at different oxygen concentrations (1％,5％,21％) and at 5％ CO2 at a temperature of 37 ℃ for 24 hours.Proliferation rate was detected by WST-1.The target gene of miR-99a was predicted by bioinformatics and verified by double luciferase reporter assay.MiR-99a mimics,miR-99a siRNA,mTOR siRNA,or mTOR cDNA were transfected in HUVEC by lipofectamine 2000,and then incubated in hypoxia.Mir-99a and mTOR were respectively detected by qRT-PCR and RT-PCR or Western blot.Results The proliferation of HUVEC was obviously decreased under hypoxia (1％ O2) (33.3％ ± 6.5％),as compared with normoxia(21％ 02) (P =0.004).Hypoxia could up-regulate the expression level of miR-99a (1.94 ± 0.24,P =0.001),which further inhibited the proliferation of HUVEC.Bioinformatics and double luciferase reporter assay indicated that mTOR was the target gene of miR-99a.Under hypoxia,the gene and protein level of mTOR were down-regulated by miR-99a.Further research demonstrated that the proliferation of HUVEC was inhibited under hypoxia by miR-99a-mTOR pathway.Conclusions Hypobaric treatment could significantly inhibit the proliferation of HUVEC,which might be associated with miR-99a-mTOR pathway.

Objective To explore the relationships among psychological empower, role stressors and job burnout in nurses.Methods From February to October of 2014, by random sampling method, 420 nurses from three hospitals of Jinzhou city of Liaoning province were selected and assessed with the psycho-logical empower questionnaires,the job burnout questionnaire,role stressors questionnaire.The data were ana-lyzed using pearson correlation analysis and logical multiple linear regression analysis.Results The average score of job burnout was (59.58±18.30) points, the average score of psychological empower was (38.87±7. 05) points.Job burnout and each dimension were negative correlated with self-determination of the psycho-logical empower ( r=-0.25--0.34, P<0.05) and self-efficacy ( r=-0.08--0.53, P<0.05).The scores of role stressors were positively correlated with the scores of emotional exhaustion( r=0.17-0.43, P<0.05) and cynicism ( r=0.07-0.46, P<0.05) .Multiple regression analysis showed that age(β=-0.104) ,education lev-el(β=-0.237),seniority(β=-0.334),self-determination(β=-0.152),self-efficacy(β=0.127),role am-biguity(β=0.284),role overload(β=0.325) were influencing factors of nursing burnout.Conclusion -Nurses role stressors and psychological empower can predict nurses’ burnout, so nurse managers can in-crease the level of authority to relieve psychological job burnout by reducing caregiver stress source.

Objective To evaluate reliability and validity the Chinese-version of chronic pain acceptance questionnaire-8(CPAQ-8).Methods The reliability and validity of CPAQ-8 was tested in 223 old patients with chronic pain.Result The Chinese-version of CPAQ-8 was (23.79±-5.23),AE was (12.84±4.96),PW was(10.97 ±2.90).Cronbach' s of CPAQ-8 was 0.853,and Guttmann Split-Half Coefficient was 0.843.Two factors were extracted by factor analysis through exploratory factor analysis,whose cumulative contribution was 58.217％.While confirmatory factor analysis showed probability level of the modified model was P=0.322,with indexes as follows: x2/df =1.124,GFI =0.979,AGFI =0,956,TLI =0.069,RMSEA =0.024,NFI =0.960,TLI =0.992,CFI =0.995.Conclusion Reliability and validity of CPAQ-8 were both well.

Objective To investigate the level of self-management behaviors and the quality of life with gastro esophageal reflux disease(GERD) patients,and analyze the correlation between self-management level and quality of life.Methods A total of 372 GERD patients were investigated by using Self-management Behavior Scale and Mos 36-item Short Form (SF-36) Health Survey.Results The level of self-management behaviors in GERD patients was relatively low.The total score of quality of life was (48.75±7.59) and the scores of the level of self-management behaviors was (5.13±0.59).Correlation analysis showed that there was positive correlation between quality of life and self-management behaviors(r=0.423,P＜0.01).Conclusion To promote the patients' health status,nursing staff should take measures to strengthen patient health education on the level of self-management behaviors for GERD patients.

Objective To evaluate the clinical efficacy of propranolol in treating proliferating infantile haemangiomas,and to measure the expression levels of vascular endothelial growth factor-A (VEGF-A) and hypoxiainducible factor 1α (HIF-1α) in sera and urine of patients during the treatment.Methods Thirty infants with proliferating haemangiomas were treated with propranolol at doses of 0.5-2 mg/kg per day.The radius of haemangiomas was measured,and blood and urine samples were obtained from these patients before,and at 4 and 12 weeks after the beginning of treatment.Clinical efficacy was estimated according to a four-graded scale as well as the feedback from parents of these patients.Enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum and urine concentrations of VEGF-A and HIF-1α.Thirty check-up infants collected from the Department of Child Health Care served as the healthy controls.Statistical analysis was done by two-way analysis of variance followed by the least significant difference (LSD) test.Results After 12 weeks of treatment,clinical response was excellent in 2 patients,good in 11,moderate in 14,and poor in 3.The serum levels of VEGF-A and HIF-1α were (268.174 ± 95.056) μg/L and (10.809 ± 1.686) mg/L respectively in the control group,sequentially decreased in the patients from baseline to 4 and 12 weeks after the beginning of treatment (VEGF-A:(385.692 ± 136.146) vs.(264.853 ± 122.12) vs.(211.345 ± 104.035) μg/L; HIF-1α:(31.462 ± 7.458) vs.(21.454 ± 5.489) vs.(12.052 ± 3.623) mg/L).The trend in expression changes of VEGF-A and HIF-1α in urine samples was similar to that in blood samples in these patients.Positive correlation was observed between the expression level of VEGF-A and HIF-1α in sera (r=0.730,P＜ 0.05) and urine (r=0.667,P＜ 0.05) of these patients.Moreover,the levels of serum VEGF-A,urine VEGF-A,serum HIF-1α and urine HIF-1α were all negatively correlated with the time course following propranolol administration (r =-0.390,-0.689,-0.806,-0.683,P ＜ 0.05,0.01,0.05,0.01 respectively).Conclusion Propranolol is effective for the treatment of proliferating infantile haemangiomas,likely by reducing serum and urinary concentrations of VEGF-A and HIF-lα in children.

Objective To identify the availability of video-assisted thoracoscopic thymectomy. Methods Retrospectively analyzed 68 patients with myasthenia gravis who underwent thymectomy including 34 cases of video-assisted thoracoscopic thymectomy and 34 cases of transsternal thymectomy,and the patients were followed up for 16 years. Results Patients of the VATS group were given video-assisted thora-coscopic thymectomy. The mean operative time was (90. 1 ± 15. 0) min,mean blood loss was (45. 0 ± 5. 5) mL,mean chest tube drainage time was (2. 5 ± 1. 2) days and mean postoperative hospital stay was (7. 0 ± 1. 2) days in VATS group,and there was no serious complica-tions and surgical death. The mean operative time was (98. 0 ± 12. 5) min,mean blood loss was (118. 5 ± 17. 5) mL,mean chest tube drain-age time was (4. 5 ± 1. 3) days and mean postoperative hospital stay was (11. 0 ± 2. 5) days in transsternal thymectomy group. 3 patients de-veloped MG crisis. There was no significant difference in mid-and long-term effects between the two groups(P>0. 05). ConclusionVideo-as-sisted thoracoscopic thymectomy for MG is safe and feasible with the advantage of less invasion,less surgical trauma,lower rate of complica-tion,and good curative effect compared with transsternal thymectomy.

Objective To investigate work stress state of nursing home staff and to analyze the influential factors affecting work stress.Methods Stratified random sampling method was adopted to investigate 180 nursing assistants by self-designed questionnaire,Work Stress Scale(WSS),Simplified Coping Style Questionnaire and internal-external locus of control scale investigation.Results Totally 174 valid questionnaires were collected.Variance analysis revealed there were significant differences of age and other factors.Stepwise multiple regression analysis showed five variables entered the equation,including workexpenence education level number of the cared ages work scheduline coping stule and explain 56.7％ of the total variable.Conclusion Nurse managers should pay attention to and improve achievement sense and mental adjustment ability of nursing assistants,to build a well-organized support system to reduce the workload.