Application of "4C" teaching method combined with two-way evaluation method in nursing teaching of gastrointestinal surgery / 中华医学教育探索杂志

Objective:To explore the application effect of "connections, concepts, concrete practice and conclusions (4C)" teaching method combined with two-way evaluation method in nursing teaching of gastrointestinal surgery, so as to provide reference for personnel training and quality control of practice.Methods:A historical controlled study was conducted to prospectively include the nursing interns received by the Department of Gastrointestinal Surgery of the hospital from May 2020 to May 2022 as the subjects of this study. The interns were divided into the control group (64 interns from May 2020 to May 2021) and the research group (93 interns from June 2021 to May 2022) according to the order of admission of nursing interns. The control group was taught by traditional nursing teaching method, while the research group was taught by "4C" teaching method combined with two-way evaluation method. The scores of theoretical knowledge and operation of nursing students in the two groups were compared after 6 weeks of practice. The self-directed learning ability of nursing students in the two groups was compared before and after 6 weeks of practice [Chinese version of self-rating scale of self-directed learning (SRSSDL)]. The evaluation of teaching quality between two groups of nursing students were compared. SPSS 25.0 was used for t-test and Chi-square test. Results:One person in the control group voluntarily quit the internship, and two in the observation group voluntarily quit the internship. Finally, 63 people in the control group and 91 people in the research group entered the study. There was no statistical significant difference between the two groups in baseline data ( P>0.05). At 6 weeks of practice, the scores of theoretical knowledge (87.96±4.62) and operation (92.60±4.25) in the study group were higher than those in the control group [(86.02±4.53) and (88.27±4.31)] ( P<0.05). At 6 weeks of practice, the total scores of learning awareness, learning behavior, learning strategies, learning evaluation, interpersonal skills and self-directed learning ability of the two groups were higher than those before practice, and the study group was higher than the control group ( P<0.05). After 2 weeks, 4 weeks and 6 weeks of practice, the scores of the two groups of nursing students in evaluating the teaching quality of the teachers increased gradually compared with that of the first week of practice ( P<0.05). Conclusion:The "4C" teaching method combined with the two-way evaluation method in the nursing teaching of gastrointestinal surgery can improve the nursing students' theoretical knowledge, practical operation ability and self-directed learning ability, and is conducive to the improvement of teaching quality.

Faecal bacteria transplantation from 2012 to 2021 of nursing in China: a bibliometric analysis / 中国实用护理杂志

Objective:To understand the current status, development trend of nursing fecal bacteria transplantationand comparison with the research in China, and provide guidance and reference for the follow-up research.Methods:The bibliometrics method was used to analyze the contents of fecal bacteria transplantation literatures in Wanfang Data, China National Knowledge Infrastructure, VIP Database from 2012 to 2021.Results:According to the inclusion and exclusion criteria, a total of 881 articles were included, including 54 nursing articles and 827 clinical medicine articles related to faecal bacteria transplantation. Since 2013, the number of publications published in nursing showed a slow increase and then a gradual decline. Jiangsu Province had the largest number of publications (15 articles, 27.8%). Of the 38 papers supported by the foundation, 9 were funded by China Natural Science.Conclusions:Faecal bacteria transplantation in China has developed rapidly in the past ten years, and a series of studies have been formed. However, the depth and breadth of the research on faecal bacteria transplantation in nursing care are insufficient. More researchers should be involved in the later stage, to strengthen cooperation and exchanges between medical staff, formulate related contents of faecal bacteria transplantation with nursing characteristics, and increase the breadth and depth of the content of faecal bacteria transplantation in nursing care.

Simultaneous determination of four kinds of components in Erchen Decoction by UPLC-MS/MS / 国际中医中药杂志

Objective:To develop the UPLC-MS/MS method for the determination of hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid in Erchen Decoction. Methods:The separation was performed on Phenomenex Gemini C18, isocratic elution was carried out with mobile phase consisting of acetonitrile - 2 mmol/L ammonium formate. The mass spectrometer was operated in the positive and negative ionization electrospray (ESI) mode using multiple monitoring (MRM) for analysis of four components. External standard methods fix quantity. The precursor to product ion transitions monitored for hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid were m/z 611.2→303.1, 455.2→407.2, 166.2→148.2 and 821.4→350.9, respectively. Results:Hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid were all analyzed exactly, the linear ranges were 0.010 0-0.400 0, 0.006 3-0.250 0, 0.012 5-0.500 0, 0.002 5-0.100 0 ng, respectively. The r were 0.998 2, 0.998 8, 0.999 4 and 0.999 1, respectively. The recovery rateof the four analytes ranged from 98.45% to 102.60% and the RSD were all below 1.67%. Conclusion:This UPLC-MS/MS method is sensitive, accurate and suitable hwhich could be applied for the determination of hesperidin, oleanolic acid, ephedrine and glycyrrhizic acid in Erchen Decoction.

A case of glycogen storage disease type Ⅰa with gout as the main clinical manifestation / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic etiology of a patient with glycogen accumulation type Ⅰa with gout as the main clinical feature.@*METHODS@#Clinical data of the patient was collected. The patient and her parents were subjected to next generation sequencing (NGS). Suspected pathogenic variation was verified by Sanger sequencing.@*RESULTS@#The patient, a 30-year-old women, mainly manifested hyperuricemia, chronic gouty arthritis, fasting hypoglycemia, hypertriglyceridemia, hyperlactatemia, hepatomegaly, urolithiasis, and gradually developed liver nodules and renal dysfunction. NGS revealed that she has carried c.648G>T (exon 5) and c.260delG (exon 2) compound heterozygous variants of the G6PC gene, which were respectively inherited from her father (phenotypically normal) and mother (with hyperuricemia). The c.260delG variant was unreported previously. Bioinformatic analysis indicated that both variants are pathogenic.@*CONCLUSION@#The compound heterozygous variants of the G6PC gene probably underlay the glycogen storage disease Ⅰa in this patient. G6PC gene mutations should be excluded in young women with hyperuricemia and /or gout.

Reproductive safety of bisphosphonates in women of childbearing age / 中华内分泌代谢杂志

Bisphosphonates ( BPs) are bone resorption inhibitors, which are increasingly used in the treatment of bone metabolic diseases in women of childbearing age. It is unclear whether the use of BPs in women of childbearing age will affect the health of their offspring. This article retrieved 66 reports in the past 40 years by searching on the databases of Pubmed, Embase, Ovid, Medline and so on. A number of reports found that BPs may be responsible for shortening gestational age, increasing spontaneous abortion, and decreasing neonatal birth weight. Three women's offsprings were found to have abnormal blood calcium after birth. Cases of skeletal malformations include two bilateral talipes equinus, one Apert's syndrome and one rickets. However, there have been many reports of no reproductive abnormalities or abnormal blood calcium level. Occasionally, children breast-fed by women who had received BPs have had a transient hypocalcemia. There is currently insufficient evidence to confirm that BPs can cause significant reproductive malformations during pregnancy or pre-pregnancy. However, due to the long-term presence of BPs in the bones, women of childbearing age who have a need for pregnancy should choose to use these drugs with caution.

Assessing the severity of acute pulmonary embolism using CT obstruction index and the relationship between its CT obstruction index and D-dimer levels / 实用放射学杂志

Objective To assess the value of pulmonary artery CT obstruction index for the evaluation of the severity of pulmonary embolism (PE),and to investigate the relation between pulmonary artery CT obstruction index and D-dimer levels.Methods 125 patients were diagnosed as PE by computed tomographic pulmonary angiography (CTPA)and D-dimer.Patients were separated into high-risk group and non-high risk group.CT obstruction index,D-dimer levels,diameter of the pulmonary artery were compared between two groups. Spearman’s rank correlation coefficients were used to assess the correlation between the CT obstruction index and the D-dimer levels,diameter of the pulmonary artery.Results CT congestion index of high-risk PE group was obviously higher than that of the non-high risk group (P=0.000).The diameter of pulmonary artery in high-risk PE group was obviously greater than that of the non-high risk group,the difference was statistically significant (P=0.000).No statistically significant difference was found in D-dimer levels between the two groups (P=0.103).There was no correction with CT congestion index and D-dimer levels(P=0.71).Conclusion The D-dimer levels of serum was a predictor of pulmonary embolism,cannot evaluate the severity of PE.CT obstruction index can reflect the severity of PE in some extent as an indicator of PE,there was no correlation with CT obstruction index and D-dimer levels.

Contrast-enhanced multislice CT features and predominant anatomic distribution of mediastinal malignant lymphoma / 生物医学工程学杂志

The objective of this study was to investigate the specific contrast-enhanced MSCT features and predominant anatomic distribution of mediastinal malignant lymphoma. Contrast-enhanced MSCT in 31 cases of mediastinal malignant lymphomas were retrospectively evaluated by analyzing the features of size, morphology, attenuation and anatomic distribution in accordance to the ATS classification of intrathoracic lymph nodes. Nine cases of Hodgkin Disease (HD) and 22 cases of Non-Hodgkin Disease (NHL) were included. The enlarged nodes were found to be homogeneous (HD 72.7%, NHL 88.9%) and partly homogeneous with necrosis (HD 27.3%, NHL 11.1%). HD involved predominantly the lymph nodes in the areas of 2R (77.8%), 3 (55.6%), 4R (88.9%), 4L (55.6%), 5 (66.7%), 6 (55.6%), 7 (66.7%) and 10R (55.6%), while NHL often involved the areas of 2R (68.2%), 3 (54.5%) 4R (59.1%), 4L (50%), 5 (54.5%), 6 (54.5%), 7 (54.5%) and 8 (50%). The following extranodal organs were involved: pericardium (19.4%), pleura (19.4%), great vessels (6.4%), lung (6.4%), chest wall (3.2%) and breast (3.2%). Mediastinal malignant lymphoma had some characteristic manifestations and predominant anatomic distribution shown on contrast-enhanced MSCT, which can provide imaging evidences for diagnosis and for determining the tumor stage.

Imaging technique and features of the 16-slice detector spiral CT for aortic lesions / 生物医学工程学杂志

The purpose of this study was to describe the 16-slice detector spiral computer tomography (SCT) technique and imaging features of aortic aneurysms. We analyzed 21 patients documented aortic aneurysms, that underwent unenhanced and contrast-enhanced spiral CT with a 16-slice scanner (Sensation 16), and three-dimensional reconstructions were performed for CT scan images. The results showed that: (1) Aortic dissection (11 cases), included the true and false lumen (11 cases, 100%), intimal flaps (11 cases, 100%), intimal tear (9 cases, 81.8%) and thrombosed false lumen (5 cases, 45.5%); (2) Intramural hematoma, unenhanced CT depicted crescent-shaped areas with high attenuation extending along the walls of the aorta, no definable intimal flap, while contrast-enhanced CT showed no enhancement of attenuation in the crescent-shaped areas; (3) True aortic aneurysms (7 cases), CT revealed the size, range, thrombosis and calcification of all aneurysms; (4) Pseudoaneurysms (2 cases), the enhanced part of the inhomogeneous masses beside the aorta connected with the aorta shown on contrast-enhanced CT. Therefore, 16-slice detector SCT axial and three-dimensional images can exactly reveal the pathological and anatomical features of aortic aneurysms, and provide detailed imaging information for clinical therapy.

The MSCT methods and radiological features of aortic diseases / 生物医学工程学杂志

With the advancement of multi-detector spiral computer tomography (MSCT) and Z-axis resolution, CT has progressively been applied in showing the anatomy and disease of vessels; therefore, CTA is increasingly important to the diagnosis of vascular diseases. In this paper we focuses on a review of the progress of MSCT and CTA in diagnosing aortic diseases.

Sectional imaging of coronary atherosclerosis and its clinical application / 生物医学工程学杂志

Although selective coronary angiography is a golden standard for diagnosing coronary artery diseases, it is expensive and may cause a little danger to the patient. With the advancement of space-resolution, time-resolution and various kinds of scan techniques, the sectional image methods such as electron beam CT, multislice spiral CT and magnetic resonance imaging will be prospective non-invasive techniques to diagnose coronary artery and other heart diseases.

Imaging technique and clinical application of 16-slice spiral CT for coronary artery / 生物医学工程学杂志

This study was conducted in pursuit of the optimal imaging technique and for a primary clinical application of 16-slice multislice spiral computed tomography (MSCT) for coronary artery. Unenhanced and contrast-enhanced 16-slice SCT imaging was performed in 38 cases with retrospective electrocardiographic gating. MPR, MIP and VRT reconstruction of enhanced scan images were made in all cases, and CPR, VE reconstruction images were made in some cases. The demonstration of coronary artery was evaluated. The influencing factors of the image quality were analyzed. The results showed that the detection rates of RCA, PDA, LMA, LAD, DB, LCX and LMB were 36 (94.7%), 34 (89.5%), 37 (97.4%), 36 (94.7%), 34 (94.4%), 36 (94.7%), 34 (89.5%) on axial images, respectively, which were higher than those of the arteries on 3D images (P < 0.01). Therefore, 16-slice spiral CT is a reliable and accurate technique to demonstrate coronary artery and its branches, and is a noninvasive method to screen, diagnose and postoperatively evaluate coronary artery diseases. The factors influencing the image quality include the heart rate, the cardiac rhythm, the respiratory movement of patients and the trigger delays of imaging processing.

CT Diagnosis of Rare Liver Tumors / 中国普外基础与临床杂志

Objective To evaluate the role of contrast enhanced CT (CECT) scanning in the diagnosis and treatment planning of some rare liver tumors. Methods We retrospectively reviewed the CECT imaging features of 10 cases with rare tumors of the liver proved by surgical pathology in 8 cases or by liver biopsy in 2 cases, with correlation of relevant clinical manifestations, laboratory results and surgical findings. Results Three cases were histopathologically proved to be benign, and 7 cases were malignant. On CT images, the liver lesions were mixed cystic solid in 5 cases, totally solid in the other 5. Eight cases demonstrated heterogeneous enhancement, while 2 cases of liver lymphoma had no enhancement. The anatomic relationship of tumors to intrahepatic vasculature, the compression and infiltration of neighboring abdominal structures were accurately delineated by CT as compared with findings at operation. Clinical manifestations and laboratory findings were not useful for the qualitative diagnosis of rare liver tumors, except for hepatocellular carcinoma. Conclusion CECT is very useful for the detection of rare liver tumors and the fine depiction of local extent of these tumors. When correlated with clinical and laboratory information, it helps to differentiate rare liver tumors from hepatocellular carcinoma. But its role in the characterization of rare liver tumors is limited.

Portosystemic shunt via the left branch of portal vein for the prevention of encephalopathy following transjugular intrahepatic portosystemic shunt / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine and analyze plasma ammonia concentration difference of the portal vein system and ramifications of rabbits and consequently guide selection of the portal vein in transjugular intrahepatic portosystemic shunt (TIPS) so that reduce shunt-induced hepatic encephalopathic incidence. To evaluate clinical significance of transjugular intrahepatic left branch of portal vein portosystemic shunt (TILPS) and to analyse hemodynamics of both branches of the portal vein and to observe long-term results in the prevention of encephalopathy.</p><p><b>METHODS</b>Blood samples in different portal vein branches of rabbits were collected and the plasma ammonia concentration was assayed and compared. The left branch of portal vein was used as the puncture site to perform TILPS and to keep away from the right branch of portal vein blood that contains nutrition and toxin.</p><p><b>RESULTS</b>Plasma ammonia content was superior in the mesenteric vein and higher than the portal vein branch, the splenic vein, and the vena cava. The right portal vein was above the left. Encephalopathy did not occur in all patients within 3 months. Of the 341 patients undergoing TILPS, encephalopathy occurred in only 5 patients (1.47%) and shunt abnormalities in 19 patients (5.57%) verified by venography during overall follow-up period.</p><p><b>CONCLUSIONS</b>Selective left branch of the portal vein portosystemic shunt can decrease encephalopathy obviously and protect liver function.</p>

Studies on Quantitative Determination of Ingredients in Loratadine Paracetamol Pseudoephedrine Sulfate Sustained-release Tablets by RP-HPLC / 中国药房

OBJECTIVE:To establish a HPLC method for the quantitative determination of loratadine(Lor),paracetamol(Par)and pseudoephedrine sulfate(Pse)in loratadine paracetamol pseudoephedrine sulfate sustained-release tablets(LPPST). METHODS:The HPLC method was carried out on Kromasil-C 18 column(250mm?4.6mm,5?m).The mobile phase consisted of a mixture of methanol-sodium acetate(0.82g in1000ml)(2000∶1000)for paracetamol with detection at243nm.The mo?bile phase consisted of a mixture of acetic acid-methanol-1%(V/V)sodium lauryl sulfate(0.1∶70∶30)for loratadine and pseudoephedrine sulfate with detection at257nm.RESULTS:The calibration curve was linear in the range of13.79～55.18?g/ml for paracetamol(r=0.9999),0.013～0.105mg/ml for loratadine(r=0.9999),0.30～2.37mg/ml for pseudoephedrine sul?fate(r=0.9999).The average recoveries were99.89%(RSD=0.43%),99.69%(RSD=0.20%)and99.57%(RSD=0.10%)for three above-mentioned components respectively(n=6).CONCLUSION:This method is accurate and reliable for the quality control of this compound preparation.

ULTRASTRUCTURAL FEATURES OF THE POSTNATAL DEVELOPMENT OF THE ECTOPLASMIC SPECIALIZATION IN RAT SERTOLI CELLS / 解剖学报

The postnatal development of the ectoplasmic specialization (ES) of Sertoli cells was investigated in the rats from 1st to 8th week after birth and the adult by electron microscopy. At the end of the 1st week. ES is in the beginning of its formation. Some high electron dense materials accumulate in the submembranous regions and short cisternae of endoplasmic reticulum align in these zones. At the end of the 2nd week the short cisternae are fused each other and straight microfilaments bundles appear and are sandwiched between the flattened cisternae and cell membrane. The density of microfilaments is increased in the 3th week and numerous tight junctions appear between adjacent Sertoli cells. The ES is gradually completed in its structure until the 5th week and fully extend and circumscribed around the base of Sertoli cells. Thereafter, there is no more morphological changes. We conclude that the first 5 weeks after birth is the important period for the development of ES of Sertoli cell as well as the blood-testis barrier in rats.

OBSERVATIONS ON THE REORGANIZATION OF THE SEMINIFEROUS TUBULES OF THE RAT TESTIS IN VITRO / 解剖学报

The Sertoli cell-rich or Sertoli-germ cell aggregates of 15-21 day immature rat testis were cultured in serum-free Ham F-12 medium for observation of the reorganization of the seminiferous tubules in vitro. The results showed that after first week of culture, the cell aggregates were spreaded on the bottom of culture dish as a monolayer consisted of Sertoli cells as well as spermatogenic cells. While after second week these monolayer cell cultures rearranged and transformed into cellular cords which connected each other to form a cellular rete. During this time, there were many small cells with long cytoplasmic processes appeared in the cultures. They looked like immature spermatozoon-like cells which were released from the cellular cords and floated in the medium, however no movement was detected. After third week, the cellular cords developed into a solid or tubule-like structures consisted of Sertoli cells and spermatogenie cells in different stages of spermatogenesis.These cultures have been studied by phase-microscopy in vitro, light and electron microscopy on semithin and ultrathin sections. These studies revealed that the Sertoli cells and Sertoli-germ cell aggregates of immature rat testis, in vitro, not only developed into monolayer cell culture as mentioned, but were also able to be further reconstructed, or reorganized, in some extent, to solid and tubule-like structures. The possible significance and mechanism were discussed.

IMMUNOCYTOCHEMICAE LOCALIZATION OF EPIDIDYMAL SPECIFIC PROTEINS IN THE EPIDIDYMIS OF THE RABBIT / 解剖学报

The secretion and localization of epididymal specific proteins ESP-1, ESP-2 were systematically studied by the PAGE-western blot and ABC immunocytochemical technique in the epididymis of the rabbit. The results indicated that ESP-1 and ESP-2 represented the rabbit epididymal specific proteins of 42 kd and 20 kd, respectively. They were immunoeytochemically negative in the testis, heart, liver, spleen, lung, kidney and skeletal muscle of the rabbit as well as testis and epididymis of the rat. However, in the rabbit epididymis, except the initial segment ESP-1 and ESP-2 were started to be positive from caput segment. The ESP-1 was displyed in the supranuclear area of the principle cells, while the ESP-2 was distributed evenly in the whole cytoplasm of it. Subsequently, the most heavy positive reaction was demonstrated in the corpus epididymis and the proximal segment of cauda. In contrast of the caput, the stereocilia of principle cells and lumen sperms of the cauda epididymis were positive also. However, in the distal segment of cauda the positive reaction in cytoplasm of principle cells was gradually decreased and became disappeared completely soon, while the stereocilia of it still remained heavy positive even in that of vas deferens. The epithelium of prostate gland and seminal vesicle were negative. These results indicated that both ESP-1 and ESP-2 were secretory proteins produced mainly in the principle cells of the corpus epididymis. After releasing into the lumen, they took part of epididymal fluid and might bind on the sperm to regulate sperm maturation. The possible physiological significance of ESP-1 and ESP-2 was discussed.

DISTRIBUTION OF MICROTUBULES IN SERTOLI CELL OF RAT TESTIS / 解剖学报

The distribution of microtubules (MTs)in the Sertoli cell of rat testis was studied with indirect immunofluorescence and electron microscopy. We have found that MTs are mainly located in the cytoplasm apical to the nucleus and oriented parallel to the long axis of the Sertoli cell. MTs may extend into the stalks and processes of the cell which embrace different germ cells. With the changes of the architecture of the seminiferous epithelium and the shape of Sertoli cells, there are some regular changes in MTs distribution during the seminifeous epithelium cycle. In stage Ⅰ-Ⅴ, many MTs aggregate around the elongated spermatids and are parallel to their long axis. During stage Ⅶ maturing spermatids are suspended into the lumen by the Sertoli cell processes containing numerous MTs. Some of the MTs conform to the contour of the hook-shaped spermatids heads. After spermiation (stage Ⅶ-Ⅸ), MTs retract from the lumen with the Sertoli cell processes and gather around the spermatids which just start their elongation. These results indicate that the distribution of the MTs in Sertoli cell has close relations with the architecture of the seminiferous epithelium, and the changes of the Sertoli cell shape and the movement of the spermatids.