Objective:Based on the theory of demand analysis theory, to build teaching resources of human physiology course and explore its application effect.Methods:The three-year nursing junior college students of Batch 2018 were selected as the research objects. According to the principle of randomization, the students were divided into the observation group (97 cases) and control group (99 cases). Students in the observation group used integrated teaching resources from the perspective of demand analysis, while students in the control group used traditional curriculum resources. After the end of the course, the differences between the two groups of students' theoretical and practical assessment results and teaching experience were compared SPSS 20.0 was used for t test. Results:The results of theoretical [(73.67±8.76) vs. (70.48±8.36)] and practical skills [(84.41±4.83) vs. (83.63±4.27)] in the observation group were significantly different from those in the control group ( P<0.05). The overall scores of 9 teaching effect sub-items, such as learning awareness of inquiry, independent learning ability and critical thinking ability, were significantly higher than those of the control group ( P<0.01). Conclusion:The construction of human physiology teaching resources based on demand analysis theory can improve the effectiveness and pertinence of resource construction, and the effective use of resources in teaching can significantly improve the teaching effect, stimulate students' subjective initiative, cultivate their comprehensive ability and improve classroom efficiency.

Objective:The Qinzhi Zhudan formula(QZZD)exhibits a prominent therapeutic effect in the treatment of vascular dementia(VaD).This study combined a network pharmacology approach and experimental validation to identify the underlying biological mechanism of QZZD against VaD.Methods:Male Wistar rats received bilateral common carotid artery occlusion(BCCAO)surgery,and after 4 weeks of intragastric administration of QZZD,the therapeutic effect was assessed using the Morris water maze test and cerebral blood flow(CBF)assessment.Hematoxylin and eosin staining,Nissl staining,and electron microscopy were used to measure the histopathological changes in the neurons of rats.The effect of QZZD treatment on hippocampal neurotransmitters was assessed by high-performance liquid chromatography with electrochemical detection and liquid chromatography mass spectrometry.Immunofluorescence was used to observe VaD-induced microglia activation.The inflammatory cytokine levels were assessed by enzyme linked immunosorbent assay.Western blot was used to examine the TNFR1-mediated TNF pathway,which was screened out by network pharmacology analysis.Results:QZZD treatment alleviated pathological changes and neuronal damage in VaD rats and atten-uated their cognitive impairment.In addition,QZZD increased CBF and the expression of acetylcholine and 5-hydroxytryptamine in the hippocampal region.Notably,QZZD inhibited microglial activation and the expression of IL-6 and TNF-a.Network pharmacology and western blot indicated that QZZD inhibited the levels of TNFR1,NF-KBp65,p-ERK,TNF-α,and IL-6,which are related to the TNFR1-mediated TNF signaling pathway.Conclusion:QZZD clearly improved learning and memory function,reduced brain pathological damage,elevated CBF and hippocampal neurotransmitter levels,and alleviated neuroinflammation of VaD rats partly by inhibiting the TNFR1-mediated TNF pathway,indicating its potential value in the clinical therapy of VaD.

Objective:To respond to the national requirements on the construction of research integrity, and improve the capacity building of research integrity at hospitals.Methods:Dealing with research integrity problems identified at hospital before 2018, measurements that include " policy and procedures development, standardization of the management of scientific research activities, and optimizing the scientific and technological evaluation system" were adopted to promote the construction of research integrity. Such corrective activities were monitored to summarize experiences and lessons for the continuing improvement of research integrity construction.Results:Both " heteronomy" and " self-discipline" of research integrity have been sublimated simultaneously, at the same time, a tailored research integrity management system with the characteristics of local hospitals has been established.Conclusions:Updating institutional policy and procedures, taking paper management as a priority, as well as research integrity training, these measurements played important roles in promoting the research integrity capacity building at hospitals.

OBJECTIVE：To prepare supersaturated system of lip ophilic aci clovir（ACV）prodrug，and to increase the cutaneous bioavailability of ACV. METHODS ：Three prodrugs of ACV were synthesized by anhydride acylation ，i.e. aciclovir acetate （ACV-Ace），butyrate（ACV-But）and hexanoate （ACV-Hex）. The structures of ACV and three ACV prodrugs were confirmed by 1H-NMR and HRESI-MS ；the concentrations of ACV and three ACV prodrugs were determined by UPLC-triple quadrupole tandem mass spectrometry ，and saturated solubility of them in different volume fractions of propylene glycol-water solution was calculated. The compound with the greatest potential of form supersaturated system was screened out. The supersaturated system of that compound was prepared by co-solvent method. The effect of hydroxypropyl methylcellulose E 3 （HPMC E 3） on its physical stability was observed by light microscope. Vertical Franz diffusion cells were used to study the effects of degree of supersaturation （DS）and HPMC E 3 on the deposited amount of drug in the excised porcine skin after using the supersaturated system for 1 h. The distribution of ACV in the excised porcine skin was determined by frozen slicing stratified quantitative method after using the supersaturated system and marketed aciclovir cream for 1 h. RESULTS ：Three ACV prodrugs were successfully synthesized. The established quantification methods met the requirements of biological sample analysis. Among all of the three ACV prodrugs ， ACV-Hex showed the lowest saturated solubility in water [ （0.5±0.0）mmol/L] a nd the highest saturated solubility in propylene glycol [（53.4 ± 14.2）mmol/L]，which made it potentially feasible to form supersaturated system with high DS. In 10％propylene glycol-water system ，the addition of HPMC E 3 163.com enabled ACV-Hex supersaturated systems ，with DS no morethan 4，to maintain physical stability within 1 h. The total deposited amount （ACV + ACV-Hex ） in skin after the application of ACV-Hex supersaturated system with DS of 4 for 1 h was higher than that after the application of ACV-Hex supersaturated system with DS less than 4 or without HPMC E 3. In addition ，the concentration of ACV in the basal epidermis （skin thickness was 100-160 mm）by supersaturated system was significantly higher than that of the marketed aciclovir cream （P＜0.05）. CONCLUSIONS：ACV-Hex，the lipophilic prodrug of ACV ，can form stable supersaturated system with DS of 4 in 10％ propylene glycol-water system in the presence of HPMC E 3. High concentration of ACV could be accumulated in the basal epidermis after the skin was exposed to supersaturated system for 1 h，which may be valuable for local treatment skin infection of herpes simplex virus .

Objective To determine the expression level of MicroRNA-15b in premenopausal endometrial carcinoma and analyze its relationship with pathological parameters. Methods From March 2016 to June 2018, 64 cases of premenopausal endometrial carcinoma tissues and 28 cases of premenopausal normal endometrial tissues that were surgically resected and examined in Shaanxi People′s Hospital were collected. The expression of microrna- 15b was detected by reverse transcription polymerase chain reaction (rt-pcr), and the relationship between the expression level of microrna-15b and the pathological parameters of premenopausal endometrial carcinoma was analyzed. Results The relative expression level of microrna-15b in premenopausal endometrial cancer (1.38 ± 0.28) was lower than that in normal endometrial tissue (2.55 ± 0.36), and the difference was statistically significant (P<0.05). MicroRNA-15b expression level in premenopausal endometrial carcinoma tissue of Ⅲ period, infiltration depth 1/2 or more muscle layer, lymph node metastasis, ER negative and negative PR was significantly lower than that of stage Ⅰ ～ Ⅱ, < 1/2 muscularis infiltration depth, no lymph node metastasis, and positive ER and PR(P < 0.05). However, there was no significant difference in the expression level of microrna-15b in premenopausal endometrial cancer tissues with different ages, pathological types and pathological grades (P>0.05). Conclusions The expression of MicroRNA-15b in premenopausal endometrial carcinoma is low, and it is closely related to pathological stage, depth of invasion, lymph node metastasis and hormone receptor. Up-regulation of microRNA-15b expression may become a new treatment direction for premenopausal endometrial cancer.

Objective: To investigate the clinical features of childhood epilepsy with occipital paroxysms. Methods: The clinical data of 33 children admitted to our hospital from 2015 to 2019 were retrospectively analyzed. Results: The children were divided into three groups: idiopathic group (n=20), structural group (n=10) and genetic group (n=3). Among the structural etiology group, there were 1 case of megagyrus malformation, 1 case of focal cortical dysplasia type Ⅱ (FCDⅡ), 1 case of gestational age infant with enlarged ventricle, and 7 cases of perinatal ischemic-hypoxic encephalopathy (HIE). In the genetic group, there were 1 case of PCDH19 gene mutation, 1 case of cyclin-dependent kinase like 5 (CDKL5) deficiency disorder and 1 case of Wolf-Hirschhorn syndrome. All three groups had ocular motor symptoms and secondary motor symptoms. Compared with the structural group, patients of the idiopathic group had more autonomic symptoms, less visual symptoms, longer ictal duration, less episodes, less abnormal background rhythm, and more epileptic discharges in the frontal lobe or Rolandic area. The genetic group had frequent seizures and the CDKL5 deficiency disorder patient had slowed background and spasms. Compared with the other two groups, patients of the idiopathic group had fewer MRI abnormalities, better seizure control effect, and better prognosis. Conclusions There are many causes of childhood epilepsy with occipital paroxysms. The idiopathic group accounts for a large proportion. The visual symptoms and autonomic symptoms are different between groups. Background abnormalities are detected more often in the structural group and the genetic group, which is also helpful for differential diagnosis. The treatment options and prognosis of different groups vary greatly. The overall therapeutic effect and prognosis of the idiopathic group are better than those of the structural group and the genetic group.

Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults,and to provide evidences for clinical management.Methods The data of clinical manifestations,laboratory examinations,chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed.The chi-square test was used for the categorical variables,and the rank sum test was used for the continuous variables of non-normal distribution.Results Compared with patients in HAdV55,those in HAdV7 group displayed more diarrhea (12.1％ [26/214] vs 2.6％ [6/235],x2 =15.583),more laryngeal lymphatic follicles (33.2％ [71/214] vs 17.9％ [42/235],x2 =23.566),more tonsil enlargement (56.5％ [121/214] vs 20.0％ [47/235],x2 =63.870) with secretions (33.2％ [71/214] vs 11.5％ [27/235],x2 =30.878),more leukocytosis (24.8％ [53/214] vs 14.0％ [33/235],x2 =8.318),more monocytosis (78.0％ [167/214] vs 52.8％ [124/235],x2 =31.364),more thrombocytosis (7.1％ [15/212] vs 3.8％ [9/235],x2 =5.835),more elevated level of C-reactive protein (80.8％ [97/120] vs 64.3％ [137/213],x2 =10.020),more abnormalities of liver function (alamne aminotransferase [ALT]:13.5％ [28/207] vs 5.6％ [13/232],x2 =8.111) and myocardial enzymes (creatine kinase [CK]:37.6％ [77/205] vs 26.4％ [61/231],x2 =6.246),creatine kinase isoenzymes ([CK-MB]:35.6％ [73/205] vs 11.1％ [24/216],x2 =35.600),and all the differences were statistically significant (all P ＜ 0.05,0.01).Compared with patients in HAdV7 group,those in HAdV55 group displayed longer duration of diseases (7 [5]days vs 6[5] days,Z=-2.632),more sore throat (72.8％ [171/235] vs 62.1％ [133/214],x2 =0.016),more headache (62.1％ [146/235] vs 16.4％ [35/214],x2 =97.527),more pharyngeal congestion (93.6％ [220/235]vs 74.8％ [160/214],x2 =30.602),more leukopenia (14.0％ [33/235] vs 24.8％ [53/214],x2 =8.318),and more elevated level of lactate dehydrogenase (12.6％ [29/230] vs 6.3％ [13/205],x2 =4.881),more pneumonia (71.5％ [168/235] vs31.8％ [68/214],x2 =70.846) (all P＜0.05,0.01).Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different.The type 55 infection is more likely to develop to pneumonia,while the type 7 infection has wider tissue tropism.

Objective To study the preoperative ultrasonographic parameters and their relationship with age in symptomatic CAS patients with different curative effects of stenting.Methods Fiftyseven symptomatic CAS patients admitted to our hospital for stenting were divided into young age group (n=7),middle age group (n=25),old age group (n=25) according to their age,and into very good curative effect group (n=18),good curative effect group (n=33) and no curative effect group (n=6) according to their postoperative NIHSS score.The carotid ultrasonographic parameters in different groups were compared and analyzed within 3 days before operation.Results A significant difference was found in the ratio of UPT,maximal ER of plaques,PV of stenosis,PI,resistance index (RI),carotid artery stiffness index (SI),distensibility coefficient (Dc) and compliance coefficient (Cc) in different curative effect groups (P＜0.01).The carotid artery SI was significantly higher in old age group than in young age group and middle age group (P＜0.01).A linear regression equation was established between carotid stiffness and age (y=0.075x-1.537,R2 =0.448,F=44.727,P =0.000).Conclusion The ratio of UPT,maximal ER of plaques,PV of stenosis,PI,RI,carotid artery SI,Dc and Cc are different in patients with different curative effects of stenting,and a linear relationship is found between carotid artery SI and age of patients.

Objective To analyze the clinical characteristics and treatment of children with tuberous sclerosis (TSC) complicated with epilepsy,so as to improve the level of diagnosis and treatment and improve the prognosis of children with TSC.Methods The clinical data of TSC children complicated with epilepsy diagnosed and followed up in Xiangya Hospital of Central South University were collected and analyzed retrospectively.Results Of the 51 children,49 (96.1％) had their first visit because of epileptic seizures.Their electroencephalogram (EEG) showed epileptiform discharges during the epileptic period.The therapeutic effect of vigabatrin on TSC patients with spastic seizures was significantly different from that of antiepileptic drugs alone or in combination.Conclusions Epileptic seizure is the most common reason for first visit and seizure control will affect the prognosis of children to a large extent.Vigabatrin had remarkable effect on TSC patients with spasm seizure,and rapamycin has broad prospects in the treatment of children with TSC.

Objective To observe 100 video-electroencephalogram (EEG)-cases of intellectual disability (ID) children,to analyze their EEG features of different degrees of ID,to explore the relationship between EEG changes and ID.Methods We performed a retrospective analysis of long-range video-EEGs of 100 children with an unexplained reason of ID from July 2016 to May 2018 in the department of pediatrics of Xiangya Hospital of Central South University,sumnarized their EEG manifestations,and compared their differences among different degrees of ID.We carried out x2 test according to the degree of ID,and discussed the relationship between the degree of ID and EEG.Results Among 100 cases of ID children with unexplained pathogenic factor,67 cases (67％) of them were males,33 cases (33 ％) of females,38 cases (38％)of mild ID,27 cases (27％) of moderate ID and 35 cases (35％) of severe ID.The EEG background of ID patients showed fast waves (11％),slow waves (15％),generalized discharges (14％) and focal discharges (36％),etc.Focal sharp and spike-wave were the most common in children with moderate ID,while background changes and multifocal sharp spike wave were more common in severe ID children.Conclusions The EEG background changes in children with severe ID have significant differences than mild and moderate degree ones.The specific features of EEG in mild and moderate degree ones is focal discharges,while multiple discharges in severe ID patients.Changes in the EEG may be related to the extent of intellectual disability.