Objective:To investigate the application effect of the Living Lab concept combined with the teaching model of case-based study (CBS) and reference-induced self-education (RISE) in thoracic surgery nursing teaching.Methods:A total of 132 nursing students who participated in 11 rounds of training (12 nursing students per round) in Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University were included in the study, and according to the teaching method, they were divided into control group and observation group, with 66 nursing students in each group. The students in the control group received routine teaching, and those in the observation group received the Living Lab concept combined with CBS-RISE teaching. Assessment results were compared between the two groups, and the critical thinking ability and degree of satisfaction with teaching were evaluated for both groups. SPSS 22.0 was used to perform the t test. Results:Compared with the control group, the observation group had significantly higher objective question score (48.82±4.21 vs. 46.73±4.54, P<0.05), subjective question score (33.12±3.86 vs. 31.59±3.47, P<0.05), and total score (81.02±7.57 vs. 76.34±7.91, P<0.05). After training, compared with the control group, the observation group had significantly higher total score and scores of the dimensions such as truth seeking, open mindedness, analyticity, systematicity, self-confidence, inquisitiveness, and cognitive maturity ( P<0.05). The observation group also had a higher degree of satisfaction with teaching methods, teaching contents, and teachers compared with the control group ( P<0.05). Conclusion:In thoracic surgery nursing teaching, the application of the Living Lab concept and CBS-RISE can improve the assessment results of nursing students and enhance their critical thinking ability, with a high degree of teaching satisfaction among nursing students.

Objective To explore the relationship between carbohydrate sulfotransferase 6(CHST6)expression level and prognosis in glioma patients and construct prognosis model by using bioinformatics method.Methods To analyze the difference of CHST6 expression in glioma.The median CHST6 expression was divided into high and low expression groups.The prognostic differences between the groups were analyzed.The expression level of CHST6 and different clinical features were analyzed by Cox regression,and the prediction and improvement model was established,and the validity improvement was compared with the control model.Results A total of 1204 medical records were included in TCGA and CGGA databases.CHST6 was significantly up-regulated in glioma samples(TCGA vs.GTEx,Z= 2.457,P＜0.001;CGGA vs.GTEx,Z=4.800,P＜0.001),and was an independent prognostic factor for glioma together with age,WHO grade,IDH mutation status,and 1p19q co-deletion(Cox analysis β=0.02,SE=0.01,HR=1.02,95%CI:1.01～1.04,P=0.01;C-Index 0.885,95%CI:0.862～0.908),has higher predictive validity than the control model(Improved model vs.Control model:TCGA d=0.036±0.004,SE=0.002,P=0.007;CGGA d=0.087±0.004,SE=0.002,P=0.001).Conclusion The high expression of CHST6 may be a predictor of poor prognosis and abnormal immune function in glioma patients.

OBJECTIVE：To st udy the improvement effects and its mechan ism of alisol B 23-acetate on glycolipid metabolism disorder in obesity model mice. METHODS ：The mice was given high-fat diet for 10 weeks to induce obesity model. Model mice were randomly divided into model group ，orlistat group （positive control ，15.6 mg/kg）， alisol B 23-acetate low-dose ， medium-dose and high-dose groups （7.5，15，30 mg/kg），with 10 mice in each group. Another 10 mice fed with normal diet were set as normal group. The mice in normal group and model group were given water intragastrically ，and administration groups were given the corresponding drugs intragastrically ，with the volume of 20 mL/kg，once a day ，for consecutive 4 weeks. After last medication，body weight ，waist circumference ，body fat ，muscle and body fluid mass were measured ；the serum levels of blood lipids indicators （TC，TG，HDL-C，LDL-C）and blood glucose were determined. The levels of PPAR-γ，NF-κB and IL-6 in liver tissue as well as serum level of TNF-α were determined by ELISA. The pathomorphological changes of visceral fat and liver tissue in mice were observed by HE staining. RESULTS ：Compared with normal group ，body weight ，waist circumference ，body fat and body fluid mass were significantly increased in model group （P＜0.01）；serum levels of TC ，TG，HDL-C，blood glucose and TNF-α，the levels of PPAR-γ，NF-κB and IL-6 in liver tissue were increased significantly （P＜0.05 or P＜0.01）；the structure of adipocytes was ruptured ，the volume of adipocytes was increased ，accompanied by inflammatory cell infiltration ；a large number of liver cells were edema ，and cytoplasm was loose and light stained，accompanied by fatty degeneration. Compared with model group ，the body weight ，body fat and body fluid mass as well as serum le vels of TG and TNF-α in alisol B 23-acetate groups were significantly reduced （P＜0.01）；the levels of TC and blood glucose in serum ，IL-6 in liver tissue were significantly decreased in alisol B 23-acetate medium-dose and high-dose groups （P＜0.05 or P＜0.01），and the level of PPAR-γ in liver tissue was increased significantly（P＜0.05 or P＜0.01）； the waist circumference and NF-κB levels in liver tissue in alisol B 23-acetate high-dose group were decreased significantly （P＜ 0.01）；serum level of HDL-C in alisol B 23-acetate medium-dose group were decreased significantly （P＜0.01）；the adipocytes were closely arranged and small in size ；the hepatocytes were mild to moderate swelling ，a small amount of cytoplasm was loose ， light stained or vacuolated ，and a small number of hepatocytes were accompanied by steatosis and small focal infiltration of inflammatory cells. CONCLUSIONS ：Alisol B 23-acetate can improve the disorder of glucose and lipid metabolism in obesity model mice ，and its mechanism may be related to the regulation of PPAR-γ，NF-κB，IL-6 levels in liver tissue and TNF-α levels in serum.

With the development of science and technology,medical simulation has been applied extensively.The application of simulation technique in teaching hospitals has become a new choice in modern medical education.As the most basic and important clinical ability,airway management has become a popular training program in China's teaching hospitals.This paper summarizes the current situation of the simulation training of airway management in teaching hospitals at home and abroad,concludesthe existing problems in the simulation teaching of airway management of teaching hospitals in China,such as narrow range of training objects,lack of professional teaching staff,unscientific curriculum design and outdated training model,etc.Then puts forward the countermeasures of expanding the training coverage,establishing the professional teaching team,designing the curriculum design of science,and introducing advanced simulation equipment to improve the quality of simulated teaching.

The immune system is a complex system involving multiple organs,and it is vulnerable to age,gender,environment and other factors.For a variation normal physiological range,it is a great challenge to evaluate drug-induced immunotoxicity in preclinical safety study.Histomorphologic assessment of the immune system is a recognized cornerstone in the identification of immunotoxicity at present.In this paper,the principles of pathological evaluation for immune system,and pathological evaluation for important immune organs including thymus,spleen,lymph nodes are discussed briefly,so that it is intended to assist toxicity pathologists in the accurate and consistent characterization of intended and unintended drug-induced alterations of the immune system.

Toxicological pathology is a morphological elucidatet ion of tissue damage caused by drug toxicity,including damage type,location,severity grade and prognosis.It provides objective and accurate data to support preclinical drug safety evaluation.Therefore,toxicological pathology plays an important role in drug safety evaluation,and the pathologic data or conclusion often determines the termination or continuation in many drug development projects.In this paper,the characteristic of toxicological pathology,standardized management,the development of new techniques including in situ hybridization,laser scanning cytometry and laser capture microdissection,and related problems in pathology are discussed briefly.

Objective Based on the international standard cardio-pulmonary resuscitation curriculum, the aim of the study is to investigate the effectiveness and importance of the layered cardio-pulmonary resuscitation emergency training. Method A total of 219 trainee including clinical medical personnel , auxiliary medical personnel and medical staff with standardized training were enrolled . Training included watching course video, team practice and class discussion, and the theoretical score and operation marks before and after layered cardio-pulmonary resuscitation training were compared. Theoretical score were compared by paired T-test, and operation pass ratio was determined byχ2 analy-sis. Results The pre- and post-training theoretical score of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 66.60±7.82 vs. 88.60±6.37;61.60± 7.44 vs. 86.90±5.80;73.45±6.83 vs. 94.75±5.04 respectively. The pre- and post-training operation pass ratio of marks of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 31.1%/85.2%;32.0%/90.7%;59.0%/96.4% respectively. Conclusion There are differences in both the theory and operation results of medical personnel at different levels before and after the training of cardiopulmonary resuscitation. The more targeted and layered training is much effective in cardio-pulmonary resuscitation emergency training.

Objective To improve the clinical skill training courses in order to meet the new challenges and different requirements. Methods Totally 327 clinical physicians of different levels in 36 departments were enrolled and 286 physicians were randomly surveyed with the questionnaire , including subjects' general characteristics, participation rate, training courses and training model. Results Among the trainees, most of them were attending physician and resident physician, and their participation rate was 88.5%(77/87) and 90.0% (172/191) respectively. The most popular and well acknowledged training courses were emergency treatment course such as AHA basic/advanced life support course. Training model like ‘group class, one topic, one hour’ was well accepted by 84.1%(275/324) physicians and course time of 16:30-17:30 was preferred by 65.5% (214/327) physicians. Conclusions A series of most popular and significant training courses are developed. More important-ly, physicians' real need and new expectation to the training course are well recognized, which is im-portant to plan the further training program and courses.

BACKGROUND: Since there are only cell axons of neurons in peripheral cells, the study on neural stem cells (NSCs) is almost focused on neuronal cells, for which, the study on repair of peripheral nerve may be based on some experiences in NSCs.OBJECTIVE: To observe the repair of peripheral nerve after graft of autologus bone marrow derived NSCs in the injured area. To observe whether the grafted NSCs were survived and migrated in spinal cord as differentiated neurons in the injured area of peripheral nerve or not.DESIGN: Observed controlled experiment was designed.SETTING: Institute of Neurological Medicine of Zhujiang Hospital affiliated to Southern Medical UniversityMATERIALS: Eight New Zealand big white rabbits were employed, of clean grade, mass weighted varied from 1.5 to 2.5 kg and of either sex.METHODS: The experiment was performed in Institute of Neurological Medicine of Zhujiang Hospital affiliated to Southern Medical University collected from New Zealand big white rabbits for culture and differentiation was prepared. Sciatic neural injured area of one side was randomized as graft side. Physiological saline, collagen matrix and cellular embedding solution were infused up to 0.01 mL (containing stem cells 1×1010L-1). Another side was taken as the control, in which, collagen matrix suspension 0.01 mL was infused. Peffusion and fixation were followed 3 months after graft and auto-graft was performed in the injured peripheral nerve. The materials were collected for observation from graft area, spinal cord area, injured area on the opposite side and normal neural area.MAIN OUTCOME MEASURES: Morphology of nerve fibers and neuronal cells in NSC graft area, spinal cord area and non-graft area on opposite injury side.RESULTS: The density and continuity of nerve fibers grown in graft area were higher remarkably than non-graft area on opposite side and more Schwann cells were seen under optic microscope. With amplified ×400 visual field, Ranvier's node of spinal nerve fiber was visible. In addition,mucous matrix and few fibroblasts were seen also in the space of nerve fibers. The survived neuronal cells were no visible in graft area, spinal cord area and non-graft area of sciatic injury on the opposite side.CONCLUSION: Graft of autologus bone-marrow derived neural stem cells in defect area of peripheral area benefits repair of nerve fibers. But the neural stem cells cannot survive as neurons in graft area of peripheral nerve, spinal cord area and the defect control on the opposite side.

Objective To study the HLA-DRB1 genotype and their r elation with HBV infection among Han patients in shanxi area. Methods HLA-DRB1 genotyping was conducted in 54 patients HBV infection and 108 health controls, as well as 32 asymtomatic HBsAg carriers by using polymerase ch ain reaction/sequence specific primer (PCR-SSP) method. All the patients, asy mtomatic HBsAg carriers, and healthy subjects were inhabitants of Shan'xi area o f Han nationality. The association between HLA-DRB1 genotype and different repl ication of HBV were also studied. Results DRB1*04,DRB1*09,DRB 1*12, DRB1*15 were the most common genotypes in the Shan'xi Han inbabitants wit h the frequency of 16.2%,12.5%,11.6% and 13.4% respectively. Compared to 108 healthy controls, the allele frequency of HLA-DRB1*03 was 11.1% in HBV patien ts versus 3.7% in healthy controls, with odds ratio=3.57 and Pc=0.014 ( P