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In order to improve the teaching competence of clinical teachers in standardized nursing training and ensure the teaching quality of the training, since 2014, Chongqing Municipal Health and Family Planning Commission has held a unified training course for teachers in a standardized training base for new nurses in the city annually, and formulated a teacher training system; on the basis of fully considering the study needs of clinical teachers, the course of "taking teaching competence as the direction and improving clinical teaching ability as the core" has been set up, and the training teachers are evaluated by various ways. At the end of the training, the satisfaction survey on the training effect has been carried out, and the participants are satisfied with the contents and methods of the teaching. Higher satisfaction can improve the teaching competence of teachers.
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Objective:To evaluate the value of vasoactive-inotropic Score (VIS) at different time points in predicting the 28-day mortality of patients with septic shock, so as to reduce the risk of death and improve the prognosis of patients.Methods:This experiment was a single-center retrospective cohort study. The clinical data of 275 adult patients with septic shock who were treated with vasoactive drugs in the intensive care unit of the Affiliated Hospital of Xuzhou Medical University from February 2016 to February 2020 were collected. According to the 28-day survival condition, all recruited patients were divided into the death group and the survival group, and the maximum vasoactive-inotropic score of all patients at the first 24 h and the second 24 h were calculated, which were expressed as VIS max24 and VIS max48. Multivariate logistic regression analysis was used to find the independent risk factors that influencing the prognosis. The receiver operating characteristic curve was used to analyze the predictive value of VIS. Results:There was no significant difference between the death group and the survival group in the characteristics including age, sex, weight, infection sites, blood culture results, cardiac arrest, hormone use, and 24 h rehydration volume ( P>0.05). APACHE II score, basic lactic acid, and lactic acid after 24 h of treatment were increased significantly in the death group ( P<0.05). VIS max24 could accurately predict the 28-day mortality (AUC=0.953, 95% CI: 0.924-0.982), which were more efficent compared to VIS max48 (AUC=0.919, 95% CI: 0.881-0.957), basic lactic acid (AUC=0.937, 95% CI: 0.900-0.966) and APACHEⅡ score (AUC=0.865, 95% CI: 0.818-0.913). Conclusion:VIS max24 can more accurate predict the 28-day mortality in patients with septic shock.
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Clinical data of a 33-year-old rheumatoid arthritis patient accompanied with pregnancy and lactation-associated osteoporosis(PLO) was retrospectively reviewed.The patient had two pregnancies within three years,and bone pain occurred during lactation of the second pregnancy after 2 months of delivery.Dual-energy X-ray (DEXA) showed decreased bone density,while thoracolumbar spine and pelvic X-ray film suggested osteoporosis.Her rheumatoid arthritis was stable and previous treatment did not include glucocorticoids.Other causes of metabolic bone diseases were excluded and the diagnosis of PLO was confirmed.The breastfeeding was stopped;calcium,active vitamin D,alendronate sodium were administrated,and the treatment was effective.Domestic and international literature from January 2000 to January 2019 was searched and no cases of PLO accompanied with rheumatoid arthritis were reported.There were only 100 cases of PLO retrieved in the literature,including 19 cases of PLO in China reported by four articles.It is suggested that PLO should be considered in RA patients presenting with arthragia during the lactation,in addition to relapse of disease.Awareness of PLO should be increased in physicians,especially rheumatologists,and anti-osteoporosis therapy is effective in patients with PLO.
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Objective@#To investigate the correlation between the frequency and function of early plasmacytoid dendritic cells (pDC) and the treatment response in patients with HBeAg-positive chronic hepatitis B receiving entecavir (ETV).@*Methods@#Patients with HBeAg-positive chronic hepatitis B were enrolled. Antiviral therapy with ETV, serum serological markerso hepatitis B virs (HBV) infection and liver function (HBV DNA load, HBsAg/anti-HBs, HBeAg and anti-HBe levels, and ALT levels) were monitored every three months before and during treatment; the efficacy of ETV was assessed by changes in the level of HBV DNA. Peripheral venous blood was collected before treatment, at 12 weeks and 24 weeks, respectively. Flow cytometry was used to detect the frequency of peripheral blood pDC and the surface co-stimulatory molecule CD86. The baseline and early treatment (12 weeks and 24 weeks) pDC frequency and functional changes were analyzed.@*Results@#Of the 100 patients with chronic hepatitis B, 45 patients received ETV treatment and 48 weeks of follow-up. Within 48 weeks of ETV treatment, HBsAg levels decreased by 0.53±0.78 log IU/mL; HBeAg decreased by 816.61S/CO, and HBeAg seroconversion occurred in 4 cases; HBV DNA content decreased by 6.04±1.12 log IU/mL, in 33 cases (73%) the HBV DNA became undetectable, in 43 cases ALT kept normal continuously for more than 3 months. In the early stage of ETV treatment, pDC% increased significantly, CD86+ pDC%, CD86MFI and CD86ABC showed no significant changes. In ETV-treated HBV DNA responders, pDC% increased significantly, CD86+ pDC%, CD86MFI and CD86ABC showed no significant changes; HBV DNA non-responders had a significant increase in pDC%, but CD86+ pDC% decreased significantly, and CD86MFI and CD86ABC showed no significant changes. The decrease in HBsAg and HBeAg levels in ETV treated patients was not significantly associated with early pDC%, CD86+ pDC%, CD86MFI and CD86ABC changes.@*Conclusions@#ETV treatment can directly inhibit the replication of HBV DNA, but does not enhance the function of immune cells.
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Objective@#To investigate the baseline characteristics of HBeAg-positive chronic hepatitis B patients with poor response to entecavir (ETV).@*Methods@#A retrospective study of 70 patients who were partial virologic responders to ETV in Beijing Ditan Hospital from January 2016 to January 2019 was conducted. Data of HBeAg quantification, HBV DNA quantification, value of alanine amimnotransferase (ALT), total bilirubin (TBIL), albumin (ALB), and creatinine (Cre) levels at baseline and follow-up point were collected. According to HBV DNA level after 48 weeks, patients were divided into high response group (2 log10 IU/ml≤HBV DNA≤3 log10 IU/ml) and low response group (HBV DNA>3 log10 IU/m). The independent sample t test was used to compare the measurement data between the two groups; the χ2 test was used to compare the categorical data between the two groups.@*Results@#There were significant differences in the level of TBIL between the two groups before initiating the antiviral treatment (P<0.05). The difference of HBV DNA quantification and TBIL decline degree at 12 weeks were statistically significant (P<0.05). Comparison of HBV DNA quantification, ALT level, ALT decline degree and TBIL decline degree at 24 weeks were also statistically significant (P< 0.05).@*Conclusions@#Baseline TBIL levels, HBV DNA levels and ALT decline degree after 24 weeks are influencing factors that affect the efficiency of antiviral response.
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Objective@#To explore the effect of combining graduate education of Master of Nursing Specialist with standardized training in a college in Chongqing.@*Methods@#Cluster sampling was used to select 25 of the class of 2015 nursing degree graduates who had participated in the standardized training of nurses, and 18 of the class of 2018 nursing degree graduates who had not participated in the standardized training of nurses. The core competencies of nurses for the grade 2015 and 2018 was investigated. In addition, the satisfaction of grade 2015 students was investigated, and the training effect and existing problems of the "Double Track In One" clinical practice training mode were analyzed in combination with the standardized training results of nurses.At the same time, the "Double Track In One" clinical practice training mode was described.@*Results@#The total score of the core competence of nurses of grade 2015 was 108.40±20.47, and the total score of the core competence of nurses of grade 2018 was 128.68±26.83. The score of the students of grade 2015 was higher than that of the students of grade 2018 in clinical ability, critical thinking and scientific research ability, interpersonal relationship, leadership, ethics and legal practice, and the difference was statistically significant (t=-3.05, P < 0.05). The total score of the satisfaction survey was 88.12±12.44, which was at a medium level.@*Conclusion@#Chongqing Medical University has conducted the clinical practice training of "Double Track In One" for Master of Nursing Specialist, which has achieved good results and effectively improved the core competence of nurses for nursing graduate students, providing a good reference for further promoting the link between nursing graduate education and professional qualification.
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Objective To evaluate the imaging features of nigrosome-1 in Parkinson's disease (PD) with a 3 T scanner by susceptibility weighted imaging (SWI),and to explore its clinical relevance.Methods Thirty-two patients with primary PD diagnosed by neurologists were collected.Healthy controls matched to their age and gender were recruited during the same period (n=20).All subjects underwent routine brain magnetic resonance imaging (MRI) and sensitive weighted imaging (SWI).The SWI images of the subjects were evaluated to evaluate nigrosome-1 by blinded investigators.Then,the correlation between imaging features and clinical data was analyzed.Results In the PD group,21 cases of bilateral "absent swallow-tail sign",five cases of bilateral "indecisive swallow-tail sign",five cases of "absent swallow-tail sign" on one side and "indecisive swallow-tail sign" on the other side,and one case of bilateral "clear swallow-tail sign" were found.The course of the "absent swallow-tail sign" group (56 (54) months) was significantly longer than the "non-absent swallow-tail sign" group (18 (18) months;U=-2.47,P=0.01).The Hoehn-Yahr stage was significantly higher in the "absent swallow-tail sign" group (2.0 (0.5)) than in the "non-absent swallow-tail sign" group (1.5 (0.5),U=-2.21,P=0.03).There was also a statistically significant difference in the Unified Parkinson's Disease Rating Scale score (24 (8),13 (14)) between the two groups (U=-2.91,P=0.01).However,there were no statistically significant differences between the two groups in the Hamilton Depression Scale score (5 (2) vs 5 (7),U=-0.10,P=0.94) and the Hamilton Anxiety Scale score (3.0 (2.5) vs 3.0 (3.0),U=-0.02,P=1.00).Conclusion The images of nigrosome-1 by SWI are closely related to the severity of the condition and motor symptoms of patients with PD,which can reflect the severity of the disease.
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Objective To explore the effect of combining graduate education of Master of Nursing Specialist with standardized training in a college in Chongqing. Methods Cluster sampling was used to select 25 of the class of 2015 nursing degree graduates who had participated in the standardized training of nurses, and 18 of the class of 2018 nursing degree graduates who had not participated in the standardized training of nurses. The core competencies of nurses for the grade 2015 and 2018 was investigated. In addition, the satisfaction of grade 2015 students was investigated, and the training effect and existing problems of the "Double Track In One" clinical practice training mode were analyzed in combination with the standardized training results of nurses.At the same time, the "Double Track In One" clinical practice training mode was described. Results The total score of the core competence of nurses of grade 2015 was 108.40±20.47, and the total score of the core competence of nurses of grade 2018 was 128.68±26.83. The score of the students of grade 2015 was higher than that of the students of grade 2018 in clinical ability, critical thinking and scientific research ability, interpersonal relationship, leadership, ethics and legal practice, and the difference was statistically significant (t=-3.05, P < 0.05). The total score of the satisfaction survey was 88.12 ± 12.44, which was at a medium level. Conclusion Chongqing Medical University has conducted the clinical practice training of "Double Track In One" for Master of Nursing Specialist, which has achieved good results and effectively improved the core competence of nurses for nursing graduate students, providing a good reference for further promoting the link between nursing graduate education and professional qualification.
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Objective To investigate the effect of Osthole on memory function of sleep deprivation(SD) mice. Methods Forty-eight male mice were randomly divided into 4 groups;normal control group(NC group ), large platform control group(TC group),sleep deprivation group(M group)and Osthole group(Ost group). The model of SD in mice was estabished by using improved multi platform method. The ability of learning and memory was tested by using Morris water maze test and pathological changes of hippocampal neurons in mice were observed by HE staining. The serum,hippcampus malondialdehyde(MDA)contents and superoxide dismutase(SOD)activity, so as the hippocampus No content,were detected. Results Compared with NC group and TC group,the escape la-tency of M group increased significiantly and the number of crossing platform decreased significantly. There were in-creased levels hippocampus tissue,serum MDA level,hippocampal SOD activity and NO content. After supplemen-tation of Osthole,the escape latency significantly shortened in mice. The number of crossing platform was increased while the contents of MDA both in hippocampus and serum were decreased,and the SOD activity in hippocampus re-turned to normal. However,the level of NO in hippocampus was not decreased. Conclusion Osthole can protect the memory function of SD mice by reducing the the damage of hippocampal neurons through antioxidant stress.
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Objective To investigate the relationships between the C6 glioma haemodynamic response and basal blood perfusion parameters.Methods Ten Wistar rats with C6 gliomas implanted subcutaneously have undergone Carbogen-induced steady state free precession functional MRI (SSFP fMRI)examination,followed dynamic contrast enhancement MRI (DCE-MRI)examination in the normal air breathing.For each glioma,5 regions of interest(ROI)were drawed randomly on SSFP fMRI images,and the percentage of signal change(PSC)of each ROI was calculated with the analysis of functional neuroimages (AFNI)software.The dynamic signal intensity of ROI in DCE-MRI on the same space and location was fitted by Hoffmann model in R language software,thus to obtain basal blood perfusion parameters (Akep and kel).Distribution-free and small-sample-size-oriented permutation test was used to investigate the relationships between PSC and basal blood perfusion parameters.Results 50 ROI were drawed randomly from 10 glioma. There were no statistically relationship between PSC and Akep,or between PSC and kel (F=0.629 8,P=0.431 3;F=1.859,P=0.179 1).Conclusion The glioma basal blood perfusion could not predict the PSC of SSFP fMRI.
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@#Objective To observe the effects of mirror therapy (MT) combined with functional electrical stimulation (FES) on motor of lower extremities, walking ability and activities of daily living for subacute stroke patients. Methods From July, 2016 to December, 2017, 38 subacute stroke patients were randomly divided into treatment group (n=20) and control group (n=18). All the patients received routine rehabilitation. The control group accepted FES, and the treatment group accepted FES and MT, for eight weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Categories (FAC) and modified Barthel Index (MBI) before and after treatment. Results Both groups improved in the scores of FMA-LE and MBI, and grade of FAC after treatment (Z>3.002, t>7.985, P<0.01), and the scores of FMA-LE improved more in the treatment group than in the control group (Z=-2.037, P<0.05). There was no difference between two groups in the scores of MBI and grade of FAC (t=-1.044, Z=-1.287, P>0.05). Conclusion The addition of MT on FES may further improve the lower extremities motor function, but not enough to improve their walking and activities of daily living in subacute stroke patients.
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Objective To evaluate antimicrobial effect and mechanism of meropenem in the model of PA infection by C.elegans.Methods To evaluate drug effects of PA infection with caenorhabditis elegans by different concentrations of culture medium, determinate the lethal rate of C.elegans.Western blot detected mitogen activated protein kinase ( Mitogen-activated protein kinase MAPK ) activity change, and PCR detected antimicrobial peptide genes expression in C.elegans after PA infection,the effect of meropenem on MAPK activity change and antimicrobial peptide genes expression.Results Compared with the control group (OP-50), the death rate of C.elegans in PA infection group changed significantly (P<0.01). Meropenem showed protective effect after C.elegans infection ( P <0.01 ) .Detection of MAPK kinase activity showed that PA infection caused PMK-1 kinase activation, further study showed that antibiotics meropenem did not affect the activation of PMK-1 kinase (no significant difference).C.elegans antimicrobial peptide gene Lys-1, clec-85, F55G11.7, K08D8.5 activity increased in PA infection (P<0.01).Meropenem promoted the expression of the antimicrobial peptide gene increased (P<0.01),with synergistic effects.Conclusion Our results show that a C.elegans pathogenicity model can be applied screening drug susceptible to pathogens infection quickly and easily.