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Nursing skill competitions are the wind vane for clinical nursing development, and the teaching concepts, proposition forms, and evaluation systems demonstrated by competitions have a strong reference value for nursing teaching. This article introduces the knowledge selection and integration from nursing-related courses according to the problems and objectives to be solved by drawing on the STEM education concept in comprehensive nursing practical training in the context of integration of competition and education. Realistic problem scenarios can be created with clinical cases as the carrier or main line, and then the Tanner clinical judgment model is used to guide students to conduct a comprehensive analysis of cases, thereby helping students to develop clinical thinking ability and comprehensive practical skills, so as to bridge the gap between the contents learned at school and nursing work in clinical practice and help nursing students adapt to clinical practice as soon as possible.
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Objective:To evaluate the efficacy and safety of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) for rectal cancer with lateral lymph node metastasis (LLNM).Methods:From January 2016 to December 2022, 103 rectal cancer patients with LLNM were enrolled. The patients were divided into SIB-IMRT group (52 cases) and conventional chemoradiotherapy (CRT) group (51 cases) using the random number table method. The dose was 50 Gy for the pelvis with 60 Gy of SIB-IMRT for the LLNM in the SIB-IMRT group. The dose was 50 Gy for the pelvis in the CRT group. The primary endpoint was the lateral recurrence rate. The efficacy and adverse reactions of the two groups were compared.Results:The adverse reactions and surgical complications after neoadjuvant radiotherapy were comparable between the two groups. The response rates of LLNM treatment were 76.9% and 56.9%, respectively, in the two groups ( χ2=4.69, P=0.03). The SIB-IMRT group and CRT group had a local recurrence rate of 7.7% and 25.5% ( χ2=5.92, P=0.015), respectively, and a lateral recurrence rate of 3.8% and 23.5% ( χ2=8.49, P=0.004), respectively. Univariate analysis showed that the SIB-IMRT, short axis of lateral lymph nodes <5 mm after radiotherapy, and negative result in the postoperative lymph node pathological examination were factors associated with lateral recurrence. Multivariable regression analysis demonstrated that the SIB-IMRT ( HR=6.42, 95% CI: 1.40-29.49) and short axis of lateral lymph nodes <5 mm after radiotherapy ( HR=0.17, 95% CI: 0.04-0.66) were independent factors associated with lateral recurrence. The two groups had a 3-year disease-free survival of 73.25% and 62.6% ( P>0.05), respectively, and a 3-year overall survival of 87% and 82.5% ( P>0.05), respectively. Conclusions:The SIB-IMRT is safe and effective for rectal cancer with LLNM. The short axis of lateral lymph nodes <5 mm after neoadjuvant radiotherapy and SIB-IMRT is an independent risk factor for lateral recurrence.
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Objective:To study the application effect of objective structured clinical examination (OSCE)-based situational simulation case teaching on Nursing Fundamentals practical training. Methods:Using convenient sampling method, two undergraduate nursing classes of Batch 2018 in Hubei University of Chinese Medicine were chosen as the study objects. They were divided into observation group with 45 students and control group with 43 students through ball touching method. The control group used traditional teaching method, on this basis, the observation group used OSCE-based situational simulation case teaching. At the end of the semester, the results of theoretical assessment, operational skills assessment, humanistic care, health education achievements of the two groups of nursing students and students’ evaluation of the new teaching method in the observation group. SPSS 22.0 was used for t test. Results:The sores of theoretical assessment, operational skills and humanistic care assessment in the observation group were (81.01±8.53), (92.69±3.87) and (11.73±1.59), and the corresponding sores in control group were (76.94±9.74), (91.21±2.70) and (10.79±1.36). The nursing students in the observation group had significantly higher scores than the control group in above mentioned aspects ( P<0.05). In the observation group, 45 students (100.0%) believed that this teaching method could stimulate learning interest and comprehensively deal with clinical problems, 43 students (95.6%) thought that this teaching method could improve team cooperation ability, only one person (2.2%) did not agree that this teaching method could help to form critical thinking, and 42 students (93.3%) said that the teaching hours of this teaching method could be appropriately increased. Conclusion:The OSCE-based situational simulation case teaching may effectively improve the teaching quality of the nursing students and mobilize their learning activities.
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The National Institutes of Health(NIH)launched the American Clinical and Translational Science fund program in 2006. Since then both NIH and its clinical and translational science centers made useful experiments in community engagement with initial success. By means of literature review, the authors searched the projects and policies for community cooperation in websites of NIH and the American Clinical and Translational Science Center. They also searched PubMed to look for literatures about the American Clinical and Translational Science Center and community engagement. The study found that community engagement is gradually increasing in clinical and translational science; the cooperation is found over the entire process of research projects, which proves conducive to the development of research; advocating community health service can improve not only community health, but also public health and medical services at the same time.
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Objective To explore the effect of the modular teaching for nursing students based on WeChat in the comprehensive training before the practice.Methods The undergraduate students of nursing were randomly divided into 5 classes,among which class 1,2,3 as the control group,and class 4,5 as the experimental group.The control group used the traditional ‘Case Teaching Method',taking the group as a unit to practice the clinical nursing skills individually;while the experimental group took the method which integrated individual nursing skills and practical materials with humanistic qualities in clinical cases.They conducted practical training by dividing the learning module with the ‘representative patients',using WeChat as the learning and exchange platform andbuilding modular training model.After the training,the results were evaluated by the score sheet for integrated skills,a critical-thinking scale and the learning model questionnaire.The data was analyzed by T-Test and Chi-Square inspection.Results All of the nursing students were willing to use WeChat for autonomous learning.The scores of the nursing students in the experimental group were higher than those in control group in the abilities of judgement,communication,operation and introspection.The difference was statistically significant (P＜0.05).In addition to the cognitive maturity,the scores of experimental group were higher than those in control group in the searching for truth,opening mind,abilities of analysis and integration and self-confidence in critical thinking and desire for knowledge,The difference was statistically significant (P＜0.05);Also the proportion of experimental group was higher than the control group in students' attitude to study,knowledge acquisition and practical training mode.The difference was statistically significant (P＜0.05).Conclusion The implementation of nodular teaching mode based on WeChat is beneficial to improve the clinical comprehensive ability of nursing students,and help to train the high quality nursing talents who meet the needs of clinical practice.
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Objective To investigate the clinical value of radiotherapy combined with xeloda monotherapy in the treatment of elderly patients with rectal cancer.Methods 80 elderly patients with rectal cancer were retrospectively collected.The patients were assigned into study group (n=43) or control group (n=37) according to the treatment way.The study group adopted radiotherapy combined with xeloda,while the control group only treated with radiotherapy.The main indicators included major clinical outcomes (3-year survival rate,recurrence rate,progression free survival),and postoperative health related quality of life and major complications of the two groups were observed.Results Compared with the control group,the 3-year recurrence rate of the study group decreased significantly (25.58% vs.48.65%,x2=4.579,P=0.032);the progression free survival was significantly prolonged [(42.58±7.63)months vs.(34.95±6.30)months,t=7.495,P=0.000];the quality of health related life after 1 year increased significantly [(75.50±8.11) vs.(69.76±9.58),t=3.295,P=0.002].There were no significant differences in postoperative major complications (granulocyte reduction,diarrhea,nausea,vomiting,hand foot syndrome and sensory neuropathy) and 3-year survival rate between the two groups (all P>0.05).ConclusionRadiotherapy combined with xeloda chemotherapy helps improve progression free survival and recurrence rate in elderly patients with rectal cancer.
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Objective To investigate the effect of the high mobility group protein 1 (HMGB1), cancer embryonic antigen (CEA) and squamous cell carcinoma antigen ( SCC-Ag) by paclitaxel combined with cisplatin chemotherapy in the treatment of advanced esophageal cancer patients .Methods 43 cases advanced esophageal cancer patients from our hospital were selected and randomly divided into the control group and the experiment group.19 cases in the control group were treated by surgery combined with postoperative chemotherapy , 24 cases in the experimental group were treated with surgery and chemotherapy.The clinical efficacy and high mobility group protein 1 ( HMGB1 ) , cancer embryonic antigen ( CEA ) and squamous cell carcinoma antigen ( SCC-Ag ) levels were compared between the two groups before and after treatment.Results The total effective rate of the experimental group was (91.7%) higher than that of the control group (57.9%), the difference was statistically significant (P <0.05).After treatment, the serum levels of SCC-Ag, CEA and HMGB1 were decreased in the two groups, compared with the control group, the experimental group SCC-Ag, CEA and HMGB1 levels were lower, the difference was statistically significant ( P <0.05 ) .There was no significant difference in adverse reactions between the two groups.Conclusion Paclitaxel combined with cisplatin in the treatment of advanced esophageal cancer patients with good results, presumably with the decrease of serum SCC-Ag, CEA and HMGB1 levels in patients with.
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Objective To investigate healthy status and disease distribution of couples through analysing the results of pre‐preg‐nancy laboratory examination and to explore high risk factors ,in order to provide scientific references for the realization of eugenics . Methods The routine blood test ,serum markers of hepatitis B ,five items(TORCH) examination ,detection of female vaginal secre‐tions were carried out in 8 313 couples planning pregnancy from 2013 to 2014 ,and the results of pre‐pregnancy health examination were analysed and evaluated .Results The thyroid dysfunction accounted for 17 .43% of all women undergoing examination ,which was the most common disease .Among items carried out in all couples ,thalassemia and positive of hepatitis B surface antigen were the most common ,accounted for 10 .20% and 9 .94% respectively .Conclusion The pre‐pregnancy health examination could screen high risk factors ,which is benefit for guiding eugenics and effectively reducing the birth defects and adverse pregnancy and is a sig‐nificant measure for eugenics .
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Objective To investigate the impact of Ang-1 on the septic mice′pulmonary vascular endothelial barrier function and VE-cadherin and its mechanism. Methods 80 BALB/c mice were randomly divided into NS, LPS, LPS+Ang-1, LPS+Ang-1+ Ly and Ang-1 groups (n = 16). Measure VE-cadherin, Ang-2 levels in plasma and lung permeability index (LPI).Test the total VE-cadherin of lung and the phosphorylation of VE-cadherin expression. Results Plasma Ang-2 was higher compared with NS group(P<0.01) except Ang-1 group. In LPS+Ang-1 group and LPS+Ang-1+Ly group, plasma Ang-2 was lower compared with LPS group (P <0.05). In LPS+Ang-1+Ly group, plasma Ang-2 was higher compared with LPS+Ang-1 group (P<0.01). LPI, plasma VE-cadherin and lung phosphorylation of VE-cadherin were the same with the trends of the plasma Ang-2 , but the lung total VE-cadherin showed the opposite tendency. Conclusion Through the PI3K/Akt signal transduction pathway , Ang-1 may regulate septic mice′VE-cadherin , hence the pulmonary vascular endothelial barrier function improved.
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Objective To evaluate the ability to kill human urothelial carcinoma T24 cells selectively in vitro by celecoxib combined with ZD55-IL-24 and explore the effectiveness for this combination use.Methods The EGFP expression of cells was observed by fluorescence microscope.The human umbilical vein endothelial cells (HUVEC) were used as crotrols.The expression of IL-24 mRNA was detected by RT-PCRwhen the cells were transfected by ZD55-EGFP or ZD55-IL-24.After transfected by ZD55-IL-24 and treated by celecoxib,the inhibition effect on cells was measured by MTT assay,and the apoptosis rate was examined by flow cytometry.Results The fluorescence in T24 and HUVEC can be observed 24h after ZD55-EGFP transfection and the fluorescence intensity was increased corresponding with the times.Fluorescence intensity in T24 cells showed higher than that in HUVEC group at the same times.The result of RT-PCR showed that the T24 cells expressed higher level of IL-24 mRNA than HUVEC group at the same time when the cells were transfect by ZD55-IL-24 (P ＜ 0.01).The inhibition rate of ZD55-IL-24 combined with celecoxib group was significantly higher than other groups (P ＜ 0.001).The inhibition rate of T24 cells in each group was significantly higher than HUVEC group (P ＜ 0.01).The flow cytometry results indicated that celecoxib combined with ZD55-IL-24 had the highest apoptosis rate on T24 cells than other single use group.Apoptosis rate of T24 cells showed a higher than HUVEC cells (P ＜ 0.01).Conclusion Celecoxib combined with ZD55-IL-24 can inhibit T24 cells proliferation at a greatest degree and this effect may be contributed to apoptosis.
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ObjectiveTo investigate the effects of isoflurane anesthesia on hippocampus synaptosomes proteome in aged rats.MethodsTwenty-seven 22- month-old SD rats weighing 480-550 g were randomly divided into 2 groups: control group (group C,n =6) and isoflurane group (group Ⅰ,n =21 ).In group C inhaled mixed gas containing 80％ oxygen for 2 h.In group Ⅰ the animals were endotracheal intubated after induction by 3％ isoflurane and inhaled 2％ isoflurane and 80％ oxygen for 2 h.Cognition function was evaluated by Y-maze at 24 h after anesthesia and the total training times were recorded.The total training times ＞ 75 was defined as cognitive dysfuction.In group Ⅰ the animals were divided into cognitive dysfuction group (group ⅠA) and non-cognitive dysfuction group (group IB) according to the results of Y-maze test.The animals were sacrificed and their hippocampi were removed and synaptosomes were extracted for two-dimensional gel electrophoresis.The different protein spots were analyzed by mass chromatographic analysis.ResultsSix rats had cognitive dysfuction (group IA) and another thirteen rats had no cognitive dysfuction (group IB).The total training times were significantly higher in group IA than in groups C and IB( P ＜ 0.05).There was no significant difference in the total training times between groups C and IB (P ＞ 0.05).There were 21 (11/10) different protein spots between groups IB and IA,and 19 (12/7) different protein spots between groups C and IA.Thirty-one protein spots were identified by means of MALDI-TOF-MS.ConclusionThe cognitive dysfuction after isoflurane anesthesia in aged rats may be related to the changes of energy metabolism protein,cytoskeletal structure and regulatory protein in synapse of hippocampus.
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AIM: To determine the antioxidant and the immunoregulatory effects of Centella asiatica extracts. METHODS: Centella asiatica was extracted with alcohol and different organic solvent. The content of polyphenol was determined by Folin-ciocalteau method. The efficacy of the extracts to scavenge the hydroxy radical (OH·), 1,1-diphenyl-2-picryl-hydrazyl radical (DPPH·) and intra-cellular reactive oxygen species (ROS) was measured. Lymphocyte proliferation was assessed to observe the influence of Centella asiatica extracts. RESULTS: (1) Centella asiatica was found to have abundant polyphenol extrated from different phases and in a descending order as follows: ethyl acetate extracts>n-butanol extracts>water extracts>ligarine extracts. (2) Extracts of Centella asiatica exhibited the scavenging efficacy of OH· and DPPH· free radicals, in which the acetic ether extracts showed the significant effect. (3) The acetic ether extracts had significant ability to inhibit the generation of ROS in stimulated lymphocytes. (4) The acetic ether extracts suppressed the lymphocyte proliferation. (5) The active ingredient was identified as flavone. CONCLUSION: Flavones in the Centella asiatica posseses antioxidant activity and effectively inhibits lymphocyte proliferation, showing ability of immunosuppre-ssion.
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Objective To investigate the impact of peritoneal albumin leakage on malnutrition-inflammation-atherosclerosis (MIA) syndrome in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods A cross-sectional study of a cohort of 130 CAPD patients without edema or active infection was performed. In order to identify peritoneal transport characteristics in CAPD patients, a standard peritoneal equilibration test (PET) was carried out. For malnutrition and inflammation, serum albumin and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Mean-carotid artery intima media thickness (IMT) was used to determine atherosclerosis. Residual glomerular filtration rate (rGFR) was defined as the average of 24-hour urinary urea and creatinine clearances. Results Pearson and Spearman correlation analysis showed that peritoneal albumin leakage amount was positively correlated with age, body mass index, night dwell time, blood glucose, 4 h D/P creatinine levels and hs-CRP levels (r=0.204, P<0.05 ;r=0.314, P<0.01; r=0.265, P<0.01; r=0.212, P<0.05; r=0.401, P<0.01; r=0.216, P<0.05); whereas it was negatively correlated with diastolic perssure, serum albumin levels, glucose level of dialyzate and peritoneal Kt/V (r=-0.209, P<0.05; r=-0.123, P<0.05; r=-0.271, P<0.01; r=-0.212, P<0.01). Overall, there was no correlation between peritoneal albumin leakage and IMT. Patients was significantly greater (P<0.01), and there was a positive correlation between peritoneal albumin leakage amount and IMT (r=0.650, P<0.01). Conclusions Peritoneal albumin leakage is significantly associated with peritoneal transport characteristics, malnutrition and inflammatory state in CAPD patients. High peritoneal albumin leakage amount is a risk factor for atherosclerosis in patients with rGFR less than 1 ml·min-1(1.73 m2)-1.
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AIM: To investigate the effects of IL-13 on expression of IL-1? in acute renal ischemia/reperfusion injury. METHODS: Fifty-seven male Wistar rats were randomly divided into 8 group: normal group,sham operation group, ischemia group, ischemia/reperfusion injury group(I/R), normal saline(NS)-treated group 1(C-1), NS-treated group 2(C-2),IL-13-treated group1(T-1)and IL-13-treated group 2(T-2).Rats were subjected to 45 min bilateral renal ischemia followed by reperfusion. rmIL-13 (1.5 ?g/50 g body weight )was injected into the renal arteries through the abdominal aorta before ischemia(T-1) or immediately afterischemia(T-2).The serum level of IL-1? and the renal expression of IL-1? were determined in each group at 24 h post-ischemia. In addition, BUN,Cr and renal histology were also measured. RESULTS: (1)The serum level of IL-1? [C-1to T-1: (27.13?5.51) ng/L to (14.05?3.82) ng/L, P
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Objective To detect the level of Th1 and Th2 type cytokines of peripheral blood CD+3 T lymphocytes in patients with breast cancer, in order to find out the laboratory evidence of tumor immunotherapy. Methods The peripheral blood lymphocytes were stimulated by stimulator in order to enhance expression of cytokines. Specific fluorochrome-conjugated monoclonal antibody combined with antigen. Cytokines were detected by flow cytometry and ELISA. Results Both the cytokines secreted by CD+3 T lymphocytes and serum cytokines showed that the level of Th1 type cytokines such as interferon-?(IFN-?), interleukin-2(IL-2), interleukin-12(IL-12) were significantly lower in patients of breast cancer than those of normal controls. The level of Th2 type cytokines such as interleukin-4(IL-4), interleukin-10(IL-10) were higher in patients of breast cancer than those of normal controls. There was significant difference between them. The level of tumor necrosis factor ? (TNF-?)in patients were significant higher than normal control. Conclusion Th1/Th2 was imbalance in mammary cancer. Th1 type cytokines were inhibited, and Th2 type cytokines were relatively enhanced, so Th1/Th2 shift to Th2. It maybe the mechanism of tumor arising and transferring by immune escaped from immunosurveillance.
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AIM: To explore the effects of uremic serum on proliferation and trans-differentiation of human renal tubular epithelial cells. METHODS: Human renal tubular epithelial cell line (HK-2) was cultured in RPMI-1640 medium. The proliferation effects of uremic serum at different concentrations were evaluated by methylene blue assay (MTT method) and flow cytometry. The positive cells percentage of ?-smooth muscle actin(?-SMA)in different concentration uremic serum medium was also measured by flow cytometry in vitro. RESULTS: Absorbance 490 (A 490) was increased in 5%-20% uremic serum groups compared with that in normal controls with the use of MTT. Cells in G 1 phase were decreased, but proliferation index (PI) was increased in 10%-20% uremic serum groups compared with that in normal controls with the use of flow cytometry. No significant difference of cell proliferation index was found among uremic serum groups. The positive percentage of ?-SMA cells was increased significantly in uremic serum groups compared with that in normal controls, and increased in parallel with the increasing of uremic serum concentration. CONCLUSION: Uremic toxin may accelerate renal tubulointerstitial fibrosis through promoting renal tubular epithelial cell proliferation and trans-differentiation in patients with chronic renal failure.
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Objective:To study the possible role of LPS and IL-13 on IL-12 production of mesangial cells in vitro.Methods:The production of IL-12 in mesangial cells was detected with ELISA kit under following different treatments:①Mesangial cells were cultured with LPS(20 ?g/ml)under different time;②The cells were cultured with different concentrations of LPS for 24 h.For observation of the effect of IL-13 on IL-12 production by mesangial cells,three groups were designed:control group,LPS(10 ?g/ml)group and different concentrations of IL-13 with LPS (10 ?g/ml).ELISA was applied to detect IL-12 in supernatants fluid from mesangial cells cultured for 24 h.The expression of IL-12p40 mRNA by mesangial cells cultured for 20 h was evaluated by RT-PCR.Results:Under basal conditions (no LPS) the production of IL-12 was hardly detected.The levels of IL-12 stimulated by LPS was significantly increased in certain doses,but the levels of IL-12 reduced accompanied with the doses and time increasing of LPS stimulantion.IL-13(1-100 ng/ml) inhibited the protein and mRNA expression of IL-12 in a dose-dependent manner(P