Genomic Staging of Multifocal Lung Squamous Cell Carcinomas Is Independent of the Comprehensive Morphologic Assessment.

INTRODUCTION: Morphologic and molecular data for staging of multifocal lung squamous cell carcinomas (LSCCs) are limited. In this study, whole exome sequencing (WES) was used as the gold standard to determine whether multifocal LSCC represented separate primary lung cancers (SPLCs) or intrapulmonary metastases (IPMs). Genomic profiles were compared with the comprehensive morphologic assessment. METHODS: WES was performed on 20 tumor pairs of multifocal LSCC and matched normal lymph nodes using the Illumina NovaSeq6000 S4-Xp (Illumina, San Diego, CA). WES clonal and subclonal analysis data were compared with histologic assessment by 16 thoracic pathologists. In addition, the immune gene profiling of the study cases was characterized by the HTG EdgeSeq Precision Immuno-Oncology Panel. RESULTS: By WES data, 11 cases were classified as SPLC and seven cases as IPM. Two cases were technically suboptimal. Analysis revealed marked genomic and immunogenic heterogeneity, but immune gene expression profiles highly correlated with mutation profiles. Tumors classified as IPM have a large number of shared mutations (ranging from 33.5% to 80.7%). The agreement between individual morphologic assessments for each case and WES was 58.3%. One case was unanimously interpreted morphologically as IPM and was in agreement with WES. In a further 17 cases, the number of pathologists whose morphologic interpretation was in agreement with WES ranged from two (one case) to 15 pathologists (one case) per case. Pathologists showed a fair interobserver agreement in the morphologic staging of multiple LSCCs, with an overall kappa of 0.232. CONCLUSIONS: Staging of multifocal LSCC based on morphologic assessment is unreliable. Comprehensive genomic analyses should be adopted for the staging of multifocal LSCC.

Dietary supplement of fermented grass forage regulates growth performance, antioxidant capacity, and immune response of broiler chickens.

The current study aimed to determine the effects of different levels of fermented Juncao grass (FG) on growth parameters, blood constituents, immunity, and antioxidative properties of broilers. A total of 240 (21-d-old) broiler chicks were randomly distributed to four dietary treatments of sixty birds, with six replicate pens and ten birds in each. Fermented grass was added to the basal diet at four levels with 0, 5, 10, and 15% FG. The results revealed that broilers fed 5% FG had significantly higher (P < 0.05) final body weight (FBW), average daily gain (WG) and average daily feed intake (ADFI). The best conversion ratio (FCR) was recorded for broilers supplemented with 5% FG compared to the group supplemented with 15% FG (P < 0.05). Increasing FG % decreased (P < 0.05) anti-inflammatory cytokines IL-4, IL-6, and IL-10. However, FG increased (P < 0.05) proinflammatory cytokines IFN-γ, IL-1, IL-2, IL-12, and TNF-α (P < 0.05). Moreover, IgA, IgG, and IgM levels increased (P < 0.05) with increasing FG %. In addition, increasing FG % in broiler rations significantly increased (P < 0.05) serum antioxidant levels of T-AOC, GSH-PX, SOD, CAT, NO and GSH, but decreased (P < 0.05) MDA levels compared to the control group. Conclusively, fermented Juncao grass would be considered a novel herbal feed additive for improving broiler performance, immunity, antioxidant, and health status. Nevertheless, further research at the molecular level is needed to quantify the effects of these herbal components on cellular and humoral immune functions in broiler chickens.

Metabolic properties, gene functions, and biosafety analysis reveal the action of three rhizospheric plant growth-promoting bacteria of Jujuncao (Pennisetum giganteum).

This study aimed to identify the specific genes associated with plant growth promotion and cadmium tolerance in three bacteria strains associated with Pennisetum giganteum as well as to determine their biosafety levels in their potential use as biofertilizers for promoting plant growth and phytoremediation activities. The plant growth-promoting (PGP) abilities of Enterobacter cloacae strain RCB980 (A3), Klebsiella pneumonia strain kpa (A4), and Klebsiella sp. strain XT-2 (A7) were determined by a growth promotion trial and through testing for PGP traits such as 1-aminocyclopropane-1-carboxylic acid (ACC) deaminase enzyme production, phosphorus solubilization, siderophore synthesis, and indole-3 acetic acid (IAA) production. The genes that potentially contribute to the beneficial activities of these three strains were identified through an analysis of their genomes. To establish the biosafety of the candidate PGPB, a pathological study was undertaken whereby 20 Kunming mice were injected intraperitoneally to study and analyze the effects of the strains on growth and lung paraffin sections of the mice. The strains had no obvious toxicity effect on the tested mice and were therefore not considered as highly virulent strains. These strains are thus considered non-toxic, safe, and highly recommended for use in environmental remediation strategies and agricultural production.

Comparative Study of PD-L1 Expression in Different Sites of Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#The expression of programmed cell death ligand 1 (PD-L1) as a biomarker for immunotherapy in non-small cell lung cancer (NSCLC) is routinely detected in clinical pathology department. However, the spatial heterogeneity of PD-L1 expression in intrapulmonary tumors and extrapulmonary metastases is still a challenge for the clinical testing. This study aims to explore the differences of PD-L1 expression in test samples obtaining from different sites of NSCLC. This study may contribute to the detection strategy of PD-L1 in patients with advanced lung cancer.@*METHODS@#One hundred and thirty-one cases of consecutively detected PD-L1 (22c3 assay, Dako) staining in metastatic NSCLC and 972 cases of non-paired intrapulmonary NSCLC were collected. The discrepancies of tumor proportion score (TPS) of PD-L1 expression in intrapulmonary samples and extrapulmonary metastatic samples of different sites were compared.@*RESULTS@#The positive expression rate of PD-L1 in extrapulmonary metastatic NSCLC (TPS ≥ 1%) was 61.83%, and the TPS was significantly higher than that in intrapulmonary tumors (P=0.03). The PD-L1 scores of the specimens obtained from different sites were significantly different (P=0.007). The positive rates of PD-L1 in liver and adrenal metastases were 85.71% and 77.78% respectively, and their TPS were significantly higher than that of the intrapulmonary samples (P<0.05). The positive rates of PD-L1 in lymph node, bone, brain, soft tissue, and pleural metastases was 40.00%-66.67%, with no significant differences compared to intrapulmonary tumors. The analysis of histological subtype and sample type showed that the PD-L1 score of extrapulmonary samples of adenocarcinoma subtype or surgical specimen was significantly higher than that of intrapulmonary tumors. The analysis of clinicopathological parameters showed that the PD-L1 positive expression or high expression were significantly correlated with male patients, smoking history, and epidermal growth factor receptor (EGFR) wild type.@*CONCLUSIONS@#The expression of PD-L1 in metastatic NSCLC is generally higher than that in intrapulmonary tumor, and the positive rate of PD-L1 expression was discrepant in different sites of specimen. The differences of PD-L1 score between extrapulmonary metastatic samples and intrapulmonary samples may be associated with different metastatic sites, histological subtype, and specimen type.

The clinical nursing teaching effect of self-made simple gastric simulation in electric gastric lavage / 中国实用护理杂志

Objective:To explore the effect of self-made simple gastric simulation in nursing clinical teaching of machine gastric lavage.Methods:A total of 90 subjects were selected from the four-year nursing undergraduates of Dalian Medical University from July 2018 to December 2019 by the convenience sampling method. According to the chronological order, they were divided into the control group and the experimental group by different teaching modes with 45 cases in each group.Control group from July 2018 to March 2019 received the traditional teaching mode, experimental group from April 2019 to December 2019 received the self-made simple simulation of the stomach in gastric lavage machine surgery nursing clinical teaching pattern.After the internship, teaching quality was evaluated by gastric lavage machine theory and operation of nursing students, and the teaching effect of nursing students' satisfaction questionnaire was investigated.Results:The theoretical and operational scores of the students were (86.89±3.79), (91.33±2.15) points in the experimental group,and (74.64±7.78), (76.84±5.71) points in the control group, the differences between the two groups were statistically significant ( t values were 9.48, 15.92, P<0.01). Students to stimulate interest in learning, students participate in the trial group, ability, improve the learning initiative, increase the clinical thinking ability, empathy and compassion, deepen nursing connotation, like teachers teaching form seven dimensions of satisfaction score were (4.26±0.53), (4.18 ±0.57), (4.16±0.55), (4.21±0.51), (4.13±0.54), (4.06±0.59), (4.24±0.54) points in the experimental group, and (2.66±0.92), (2.61±0.85), (2.35±0.83), (2.72±0.89), (2.45±0.81), (2.70±0.89), (2.59±0.86) points in the control group, the differences between the two groups were statistically significant ( t values were 8.55-11.99, P<0.01). Conclusions:The clinical teaching application model of self-made simple gastric simulation in machine gastric lavage can significantly improve the quality and satisfaction of clinical nursing teaching.

Design of Radial Artery Simulation Platform Based on Waveform Drive / 中国医疗器械杂志

In order to obtain the three-dimensional pulse information and blood pressure waveform needed in the study, a radial artery simulation platform with programmable controlled injection pump as the core was constructed by using the circulation theory of human cardiovascular system and pulse wave formation mechanism. Gaussian function model was selected to synthesize multi-type pulse wave to program and drive the platform. The three-dimensional pulse information and blood pressure waveform of the simulated radial artery were collected by binocular visual pulse detection system and pressure transmitter respectively, and the platform stability and repeatability were tested by Pearson correlation. The experimental results show that the radial artery simulation platform is stable, reliable and repeatable, and can generate multiple types of three-dimensional pulse information and blood pressure waveform at the simulated radial artery. The platform is simple in structure, low in cost, and produces many types of pulsating flow. It provides an experimental research platform for revealing the relationship between the three-dimensional pulse information of radial artery and the change of pressure inside the vessel, as well as the prediction of blood pressure waveform from the three-dimensional pulse information.

Chinese Experts Consensus on Immune Checkpoint Inhibitors for Non-small Cell Lung Cancer (2019 version) / 中国肺癌杂志

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer, most NSCLC patients are at advanced stage at the time of diagnosis. For patients without sensitive driven-oncogene mutations, chemotherapy is still the main treatment at present, the overall prognosis is poor. Improving outcomes and obtaining long-term survival are the most urgent needs of patients with advanced NSCLC. In recent years, immunotherapy has developed rapidly. Immune checkpoint inhibitors (ICIs), especially targeting programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1), have made a breakthrough in the treatment of NSCLC, beneficial to patients' survival and changed the treatment pattern for NSCLC. It shows more and more important role in the treatment of NSCLC. Led by NSCLC expert committee of Chinese society of clinical oncology (CSCO), relevant experts in this field were organized. On the basis of referring to domestic and foreign literature, systematically evaluating the results of Chinese and foreign clinical trials, and combining the experiences of the experts, the experts group reached an agreement to develop this consensus. It will guide domestic counterparts for better application of ICIs to treat NSCLC.

Application and evaluation in clinical dispensing of self-made-dispensing-ampoule Car / 中国实用护理杂志

Objective@#To evaluate the application of self-made-dispensing-ampoule car in the medicine dispensing for venous transfusion.@*Methods@#The self-made-dispensing-ampoule car made based on the ergonomics is a temporary carrier device for medical waste in the need of the whole process of dispensing process. The overall exterior is made of 304 stainless steel, separated into 2 layers. The Upper layer has a frame with integral medicine glass hole made of stainless steel, which can be dismantled from the upper layer. The medicine glasses are small empty medicine bottles used to hold the dispensed medicine; while the lower layer is a slide platform which can put on 3 medical waste classification boxes. The bottom has universal wheels with brakes to help the car move and stop. To focus on 42 emergency department nurses using the device, to analyze their error rate of medicine dispensing, the dispensing time for the same batch of patients with same dosages and shuttle time from dispensing car to buffer room to pour medical waste and compare the data the year before and the year using the device.@*Results@#After using it, the dispensing error occurrence rate and nurses dispensing time and shuttle times of pouring waste were 0.31 ‱ (3/97 785), (70.08±3.28) min/time, two times, which were all obviously lower than 1.95‱ (18/92 095), (110.04±6.91) min/time, 30 times without using it (χ2=11.64, 204.16, t=71.70, all P<0.01).@*Conclusion@#Using the dispensing ampoule car can optimize the dispensing process in dispensing of venous transfusion, ensure patients with safe venous transfusion, raise the efficiency of nurses saving time and efforts.

The relationship between left ventricular myocardial strain and different stages of cardiac dysfunction in spontaneously hypertensive rats evaluated by two-dimensional strain echocardiography / 中华超声影像学杂志

Objective@#To investigate the relationship between multi-dimensional myocardial strain and global cardiac function in different stages of cardiac dysfunction in spontaneously hypertensive rats (SHR) by two-dimensional strain echocardiography.@*Methods@#According to cardiac function measurements, SHR of 28 to 102 weeks were divided into 3 groups: Normal group[Group A, normal left ventricular ejection fraction(LVEF) and left ventricular end-diastolic pressure(LVEDP), n=13], diastolic dysfunction group (Group B, normal LVEF but increased LVEDP, n=24), and systolic dysfunction group (Group C, decreased LVEF and increased LVEDP, n=17), with WKY rats at similar weeks of age as controls (group a, n=7; group b, n=12; and group c, n=16). Morphological parameters of left ventricular were measured by echocardiography. Using EchoPac workstation, systolic peak longitudinal strain, circumferential and radial strain were calculated at the left ventricular middle levels. Extracellular collagen content was observed histologically.@*Results@#Left atrial dimension increased in group B and larger in group C, and dilated left ventricular and thickened wall were only found in group C. Systolic peak longitudinal strain of group B was significantly lower than group A and group a(all P<0.05), and deteriorated in group C(P<0.05), while systolic peak circumferential and radial strain and LVEF were only significantly decreased in group C (all P<0.05), while there was no significant difference between Group A and Group B(all P>0.05). Collagen content in endocardial and mid-layer myocardium increased in group B and C, and increased epicardial collagen occurred in group C. Systolic peak longitudinal strain, circumferential and radial strain were correlated positively with LVEF(r=0.65, 0.80, 0.80, all P<0.01).@*Conclusions@#In SHR, systolic peak longitudinal strain obtained by echocardiography is decreased in the period of diastolic dysfunction, while the damage of systolic peak circumferential and radial strain leads to the systolic dysfunction.

The relationship between left ventricular myocardial strain and different stages of cardiac dysfunction in spontaneously hypertensive rats evaluated by two‐dimensional strain echocardiography / 中华超声影像学杂志

Objective To investigate the relationship between multi‐dimensional myocardial strain and global cardiac function in different stages of cardiac dysfunction in spontaneously hypertensive rats ( SHR ) by two‐dimensional strain echocardiography . MethodsAccording to cardiac function measurements ,SHR of 28 to 102 weeks were divided into 3 groups :Normal group[ Group A , normal left ventricular ejection fraction( LVEF) and left ventricular end‐diastolic pressure( LVEDP) , n ＝13] ,diastolic dysfunction group ( Group B , normal LVEF but increased LVEDP , n ＝24) ,and systolic dysfunction group ( Group C ,decreased LVEF and increased LVEDP , n ＝ 17 ) ,with WKY rats at similar weeks of age as controls ( group a , n ＝ 7 ;group b , n ＝ 12 ; and group c , n ＝ 16 ) . Morphological parameters of left ventricular were measured by echocardiography . Using EchoPac workstation ,systolic peak longitudinal strain ,circumferential and radial strain were calculated at the left ventricular middle levels . Extracellular collagen content was observed histologically . Results Left atrial dimension increased in group B and larger in group C ,and dilated left ventricular and thickened wall were only found in group C .Systolic peak longitudinal strain of group B was significantly lower than group A and group a ( all P ＜ 0 .05 ) ,and deteriorated in group C( P ＜ 0 .05 ) ,while systolic peak circumferential and radial strain and LVEF were only significantly decreased in group C ( all P＜ 0 .05 ) ,w hile there was no significant difference between Group A and Group B( all P ＞0 .05) . Collagen content in endocardial and mid‐layer myocardium increased in group B and C , and increased epicardial collagen occurred in group C . Systolic peak longitudinal strain , circumferential and radial strain were correlated positively with LVEF( r ＝0 .65 ,0 .80 ,0 .80 ,all P ＜0 .01) . Conclusions In SHR ,systolic peak longitudinal strain obtained by echocardiography is decreased in the period of diastolic dysfunction ,w hile the damage of systolic peak circumferential and radial strain leads to the systolic dysfunction .

Application and evaluation in clinical dispensing of self-made-dispensing-ampoule Car / 中国实用护理杂志

Objective To evaluate the application of self-made-dispensing-ampoule car in the medicine dispensing for venous transfusion. Methods The self-made-dispensing-ampoule car made based on the ergonomics is a temporary carrier device for medical waste in the need of the whole process of dispensing process. The overall exterior is made of 304 stainless steel, separated into 2 layers. The Upper layer has a frame with integral medicine glass hole made of stainless steel, which can be dismantled from the upper layer. The medicine glasses are small empty medicine bottles used to hold the dispensed medicine; while the lower layer is a slide platform which can put on 3 medical waste classification boxes. The bottom has universal wheels with brakes to help the car move and stop. To focus on 42 emergency department nurses using the device, to analyze their error rate of medicine dispensing, the dispensing time for the same batch of patients with same dosages and shuttle time from dispensing car to buffer room to pour medical waste and compare the data the year before and the year using the device. Results After using it, the dispensing error occurrence rate and nurses dispensing time and shuttle times of pouring waste were 0.31?(3/97 785) , (70.08±3.28) min/time, two times, which were all obviously lower than 1.95? (18/92 095) , (110.04 ± 6.91) min/time, 30 times without using it ( χ2=11.64, 204.16, t=71.70, all P< 0.01) . Conclusion Using the dispensing ampoule car can optimize the dispensing process in dispensing of venous transfusion, ensure patients with safe venous transfusion, raise the efficiency of nurses saving time and efforts.

The correlation study of ground glass opacity and lepidic growth pattern component in stage I lung invasive adenocarcinoma / 中华肿瘤杂志

Objective@#To investigate the correlation between Ground Glass Opacity (GGO) component proportion and quantitative classification of lepidic growth pattern in pathological stage Ⅰpulmonary adenocarcinoma.@*Methods@#Pathological and HRCT data of 183 stage Ⅰ invasive adenocarcinoma patients from January 2005 to December 2012 were retrospectively reviewed. The proportion of GGO was calculated from diameter and volume.The correlation between GGO component proportion and lepidic growth pattern in pathological were analyzed by Spearman correlation.@*Results@#Among 183 patients, the proportion of GGO component calculated by maximum diameter method and three-dimensional computerized quantification was 0.43±0.35 and 0.20±0.18, respectively. The percentage of lepidic growth pattern component using semi-quantitative analysis of pathological sections was 0.29±0.25.The proportion of GGO by diameter and three-dimensional computerized quantification was significantly correlated with the percentage of lepidic growth pattern component (r=0.599, P< 0.001; r=0.620, P<0.001).@*Conclusions@#There was a positive correlation between the content of lepidic growth pattern and the content of GGO in the small adenocarcinoma. Three-dimensional computerized quantification was a better method in preoperational evaluation.

Investigation on Current Situation of Workplace Violence the Intern Experienced and Their Professional Identity / 中国医学伦理学

Objective:To understand the current situation of hospital violence medical students experienced during the internship period and their professional identity.Method:With the method of cluster sampling,a questionnaire survey was conducted among 500 medical students from a medical college in Ganzhou,to understand the characteristics of hospital violence and compare the difference between the medical students who experienced violence and those not.Results:The effective recovery rate of questionnaire was 90.8％,of which 61.4％ of medical students had witnessed hospital violence,8.1％ of students had experienced hospital violence;the hospital violence that medical students experienced were characterized by low frequency and emotional violence.The overall score of personal identity was (117.05 ± 19.65),was in a medium level.Among the comparison of personal identity between the medical students who had experienced violence and those not,there was a significant difference in occupational cognition dimension (P ＜ 0.01),but there was no significant difference in the total score and other four dimensions (P ＞ 0.05).Conclusion:We should pay attention to the current situation of hospital violence that students experienced and their professional attitude,carry out targeted training and psychological counseling to improve their ability to respond to hospital violence and enhance their professional identity.

Evaluation of the effect of modified method of fixation and withdrawal of needles in intravenous infusion / 中国实用护理杂志

Objective To evaluate the effects of modified method of fixation and withdrawal of needles in intravenous infusion.Methods The modified method of two-step fixation and withdrawal of needles was adopted in emergency transfusion room of our hospital from September 2013.In January 2015,during every day's low peak period 12:00-14:00,246 emergency transfusion patients were chosen and divided into the traditional group (122 cases,using three-step fixation and withdrawal of needles) and the modified group (124 cases,using two-step fixation and withdrawal of needles) according to transfusion order.The pain degree caused by withdrawal of needles using Numeric Rating Scale (NRS),time consumption of fixation and withdrawal of needles and rate of adhesive pastes abscission was assessed by nurses and compared between two groups.Results The incidence of pain in the modified group was lower than that of the traditional group [48.39％ (60/124) vs.81.97％ (100/122)],x2=30.49,P＜0.05.The time consumption of fixation and withdrawal of needles in the modified group was shorter than that of the control group [(7.55 ±2.01) seconds vs.(10.88 ±2.72) seconds;(2.44 ±0.84) seconds vs.(11.55 ± 4.62) seconds],Z=8.70,13.55,P＜0.05.Therate of adhesive pastes abscission in the modified group was lower than that of the control group [4.0％(5/124) vs.18.9％ (23/122)],x2 =13.39,P＜0.05.All the difference between two groups was statistically significant.Conclusions The modified method of fixation and withdrawal of needles can relieve the pain caused by withdrawal of needles.Nurses can operate easily,adhesive pastes is fixed sturdily,which is popular among nurses and patients.

Three-dimensional computerized quantification for lung invasive adenocarcinoma with different histopathological subtypes in clinical stage Ⅰ / 中华放射学杂志

Objective To study three-dimensional computerized quantification for clinical stage Ⅰ lung invasive adenocarcinoma with different histopathological subtypes.Methods Pathological and HRCT data of 273 patients within clinical stage Ⅰ lung invasive adenocarcinoma underwent surgery from January 2005 to December 2012 were retrospectively collected.The proportion of ground glass opacity component and solid component in tumor were calculated by three-dimensional computerized quantification.All specimens were classified into 3 grades (grade 1 as the lepidic pattern of invasive adenocarcinoma,grade 2 acinar or papillary patterns,grade 3 micropapillary or solid patterns).The proportion of different components among different histopathological grades was evaluated by Kruskal-Wallis test.The correlation between components in tumor and histopathologic subtypes grade were evaluated by Spearman correlation.Results In 273 patients,49(17.9％) were assessed as grade 1,208(76.2％) grade 2,and 16(5.9％) grade 3.The proportion of ground glass opacity component and solid component in grade 1,grade 2,and grade 3 were 18.40％ (10.00％-33.45％),6.55％ (2.00％-18.00％),1.70％ (0.20％-3.85％) and 29.80％ (11.75％-47.35％),66.60％ (35.40％-83.85％),88.50％ (75.28％-93.60％),respectively.Significant differences among different histopathological grades were observed(x2=37.74,47.73,P＜0.01).The proportion of ground glass opacity component was negative correlation with histopathologic grade(r=-0.37,P＜0.01),while the proportion of solid component was positive correlation with histopathologie grade(r=0.42,P＜0.01).Conclusion Three-dimensional computerized quantification for lung invasive adenocarcinoma may predict histopathological grade.

The application and effect evaluation of medical bottle opener box in clinical pharmacy / 中国实用护理杂志

Objective To explore the application of medical bottle opener box (authorized patent for utility model) in nurses dispensing operations of opening the plastic bottle cap. Methods Put five self-made medical bottle opener box sample into the hospital emergency department for use. The nurses were divided into control group and experimental group according to the different way of open bottle caps; both groups were 33 nurses who did not turn out of emergency department 2 years nurses for a common object of study. The control group was the 33 nurses adopting the method of unarmed open medicine plastic bottle cap from April 2013 to March 2014. The experimental group was the 33 nurses with medical bottle opener box to open medicine plastic bottle caps from March 2014 to March 2015. The method of comparing two groups was to compare the nurse hands skin wear parts and wear symptoms for opening bottle caps, and make the nurses′satisfaction survey. Results For two groups, the nurse hands skin wear parts were in right hand, index finger and thumb;the number of nurses with finger thick skin in experimental group was lower than that in control group [21.2%(7/33) vs. 78.8%(26/33)], and there was significant difference,χ2=21.87, P<0.05.The number of pain [12.1%(4/33) vs. 54.5%(18/33)] and peeling [15.2%(5/33) vs.69.7%(23/33)] in experimental group were lower than those in control group, and there were significant differences, χ2=13.36, 20.09, P < 0.05. The experimental group eliminated the blisters and scratches, avoided hand bleeding trauma. The nurses′overall satisfaction in experimental group was 93.9% (31/33), and 63.6% (21/33) in control group,and there was significant difference, χ2=9.06, P<0.05. Conclusions Nurses using medical bottle opener box when opening the medicine bottle cap can relieve and reduce occupational injury on the finger skin of nurses, improve the nurse hand skin comfort, provide convenient operation safety, it is worth promoting.

Comparative analysis of the correlation between HRCT image features and histopathologic characteristics of cyst-like lung adenocarcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the high resolution CT (HRCT) features of cyst-like lung adenocarcinoma, explore the correlation between HRCT image features and histopathological characteristics, and observe the pathological basis of air-containing space.</p><p><b>METHODS</b>HRCT and histopathologic findings of cyst-like lung adenocarcinoma in 86 patients were investigated retrospectively. The image features of both tumor and air-containing space were analyzed. All surgically resected specimens were reviewed. The pathological analysis included histologic subtype, differentiation degree, and the pathological basis of air-containing space formation. The correlation between HRCT image features and histopathologic grades was analyzed.</p><p><b>RESULTS</b>On HRCT, intratumoral necrosis was detected in 17 cases (19.8%), air-containing space with septa in 40 cases (46.5%), wall nodule in the air-containing space in 16 cases (18.6%), mixed thick and thin walls of air-containing space in 49 cases (57.0%). Air-containing space and its wall were observed in 63 cases on histological specimens, among which destruction of the alveolar wall by tumor cells might be the pathological basis of air-containing space in 42 (66.7%) cases. Differences of tumor attenuation (P = 0.030), intratumoral necrosis (P = 0.003) and proportion of thin-wall in air-containing space (P = 0.014) among different histopathologic grades were significant. The proportion of thin-wall in air-containing space was negatively correlated with histological grade (r = 0.267, P = 0.015). Differences of tumor contour (P = 0.002), tumor attenuation (P = 0.006), intratumoral necrosis (P < 0.001), septa in air-containing space (P = 0.016) and proportion of thin-wall in the air-containing space (P = 0.005) among different differentiation degrees were significant. The proportion of thin-wall in air-containing space was positively correlated with differentiation degree (r = 0.266, P = 0.013).</p><p><b>CONCLUSIONS</b>On HRCT, cyst-like lung adenocarcinoma may manifest as an air-containing space with septa and mixed thin and thick walls, whereas wall nodule of air-containing space and intratumoral necrosis are not common. There is a certain correlation of HRCT manifestation with pathological subtype grading and tumor differentiation. Analysis of HRCT image features is helpful in prediction of the histopathologic grading and histological differentiation degree of the tumors. Destruction of the alveolar structure by tumor cells may be the main pathological basis of air-containing space formation in cyst-liked lung adenocarcinoma.</p>

Application of 2010 edition cardiopulmonary resuscitation clinical nursing teaching pathway combined with OSCE Application in Teaching / 中国实用护理杂志

Objective To explore the application of 2010 edition cardiopulmonary resuscitation clinical nursing teaching pathway combined with OSCE mode in teaching and assessment,and improve clinical emergency response capabilities.Methods 99 target school undergraduate nursing students were selected as research objects,and were randomly divided into the traditional group (50 students) and the combination group(49 students).The traditional group adopted the traditional CPR teaching and assessment methods,the combination group took the 2010 version of CPR pathway and OSCE clinical nursing teaching mo de.The mastery of CPR was compared between two groups.Results The mastery of cardiopulmonary resuscitation skills of the combination group was significantly better than that of the traditional group.Conclusions Implementation of the combination of 2010 version of the CPR and the OSCE clinical nursing teaching pathway mode can effectively promote the mastery of CPR skills by students,effectively improve the first-aid skills and adaptability of students.

An experimental research on implicit and explicit suicide attitude of college students / 中华行为医学与脑科学杂志

Objective To investigate the relationship of college students'explicit and implicit attitudes to suicide and the feasibility of applying B-IAT to measure their suicide attitude.Methods Explicit suicide attitude was primarily investigated by suicide attitude questionnaire (SAQ),and implicit attitudes experimental study was carried out by suicide brief implicit association test (B-IAT).The subjects of this study included 50 college students,and it was used within-subject design.Results ①Each dimension values of explicit suicide attitude was from 2.5 to 3.5,indicating that the subject~ explicit suicide attitude dominated by neutral or contradictory.②The mean of B-IAT was 0.43,indicating that the subjects' implicit suicide attitude was prone to negative.③College students' suicide explicit and implicit attitudes were statistically no significant correlation,indicating that students implicit suicide attitudes was independent of explicit attitudes.Conclusion It is feasible to measure explicit suicide attitudes by B-IAT.College students' implicit suicide attitudes is independent of explicit attitudes.The results from simple IAT may be more accurately reflects the subjects' true attitudes towards suicide.

Clinical and pathological analysis collision carcinoma: report of 7 patients / 中华外科杂志

<p><b>OBJECTIVE</b>To study the epidemiological, pathological, clinical features and therapy of collision carcinoma.</p><p><b>METHODS</b>Seven patients were studied retrospectively against the background of the literature from 1980 to 2001, including the incidence, age of onset, sex ratio, predilection sites, clinical signs, pathological features and therapies.</p><p><b>RESULTS</b>Collision carcinoma is rare, but more common in males than in females. The peak onset age is more than 65 years. It is found frequently in the stomach, liver, uterine, esophagogastric junction, and lung. Without special clinical features, it is difficult to diagnose. Pathological findings are the only way to make a correct diagnosis before operation. Operation is the major therapy, assisted by chemotherapy or/and radiotherapy when necessary. Collision carcinoma represents a coexistence of two adjacent but histologically different malignant neoplasmas without histological admixture in an organ.</p><p><b>CONCLUSIONS</b>Collision carcinoma is rare but composed of mosaics of two malignant tumours. The clinical features of collision carcinoma need further investigation.</p>