Application of task-based teaching method combined with formative evaluation in nursing teaching / 中华医学教育探索杂志

Objective:To evaluate the application effect of task-based teaching combined with formative evaluation in the teaching of Nursing Research. Methods:A total of 56 nursing students from Batch 2016 were selected as the research objects. The task-based teaching method and formative evaluation were applied in the teaching of Nursing Research to guide the students to participate in and complete the whole nursing research process. The changes of students' autonomous learning ability, learning behavior and innovation ability before and after the course were investigated by questionnaires, so as to evaluate the teaching effect. SPSS 24.0 was used for t test and chi-square test. Results:There were significant differences in the scores of students' independent learning ability before the course (90.43±9.45) and that after the course (94.73±9.64) ( t=-11.87, P<0.05), especially in the aspects of information ability, learning and cooperation ability ( P<0.05). There were significant differences in the score of students' innovation ability before the course (73.64±10.12) and that after the course (77.34±12.31) ( t=-3.05, P<0.05), especially in the aspects of innovative thinking ability and innovative practice ability ( P<0.05). In addition, the students' learning behavior also changed significantly, which was manifested in the increased action of preview, review and questioning. Conclusion:Task-based teaching method combined with formative evaluation can improve students' autonomous learning ability, learning behavior and innovation ability.

Causes and management for male urethral stricture / 中南大学学报(医学版)

Objective:To explore the etiology of male urethral stricture,analyze the therapeutic strategies of urethral stricture,and summarize the complicated cases.Methods:The data of 183 patients with urethral stricture were retrospectively analyzed,including etiology,obstruction site,stricture length,therapeutic strategy,and related complications.Results:The mean age was 49.7 years,the average course was 64.7 months,and the constituent ratio of51 to 65 years old patients was 38.8％ (71/183).The traumatic injury of patients accounted for 52.4％ (96/183),in which the pelvic fracture accounted for 35.5％ (65/183) and the straddle injury accounted for 16.9％ (31/183).There were 54 cases of iatrogenic injury (29.5％).The posterior urethral stricture accounted for 45.9％ (84/183),followed by the anterior urethral stricture (44.8％,82/183) and the stenosis (6.6％,12/183).A total of 99 patients (54.1％) received the end to end anastomosis,and 40 (21.9％) were treated with intracavitary surgery,such as endoscopic holmium laser,cold knife incision,endoscopic electroknife scar removal,balloon dilation,and urethral dilation.In the patients over 65-years old,the urethral stricture rate was 14.8％ and the complication rate (70.4％) for transurethral resection of the prostate (TURP) was significantly higher than that of all samples (P＜ 0.01).Conclusion:Both the etiology of male urethral stricture and the treatment strategy have changed and the incidence of traumatic and iatrogenic urethral stricture has increased in recent 3 years.The main treatment of urethral stricture has been transformed from endoscopic surgery into urethroplasty.

Transurethral seminal vesiculoscopy in the treatment of refractory hemospermia / 中华泌尿外科杂志

Objective To discuss the clinical effects of transurethral seminal vesiculoscopy in refractory hemospermia caused by seminal vesicle diseases.Methods The clinical data of 50 patients suffered from refractory hemospermia caused by seminal vesicle gland diseases were retrospectively analyzed from February 2012 to February 2014.Patients' age varied from 25 to 54 years old,mean (39.2 ± 9.2) years.The course of disease was (7.44 ± 2.6) months.There were 24 seminal vesiculitis,10 seminal ducts obstruction disease,and 16 seminal vesicle calculi disease.According to patients' priority,the patients were divided into surgical treatment group and conservative treatment group.In surgical group,there were 38 patients with age of (38.9 ± 8.8) years old,and the course of disease was (7.5 ± 2.5) months.There were 18 seminal vesiculitis,8 seminal ducts obstruction,and 12 seminal vesicle calculi.Whereas in conservative treatment group,there were 12 patients,with age of (40.2 ± 10.5) years old,and the course of disease was (7.3 ±2.9) months.Among them,there were 6 seminal vesiculitis,2 seminal ducts obstruction,and 4 seminal vesicle calculi.There was no significant difference between the two groups in patients age,course of disease and constitution of disease.The clinical data derived from the two treatment groups including the white blood cell counts (WBC) and red blood cell counts (RBC) in the seminal fluid,hematospermia rate,quality of life score,cure rate and improvement rate before and after the treatment were analysed.Results 1,3,6 months and 1 year after treatment,all observation indexes in the two groups had been ameliorated and had significant difference compared with those before treatment including WBC and RBC in the seminal fluid,hematospermia rate and quality of life score.No operative complications occurred in conservative treatment group.While a patient in surgical treatment group suffered from infection and recovered after levofloxacin treatment for a day.Six months after two kinds of treatment,in surgical treatment group,the cure rate was 55.2％,and the improvement rate was 36.8％.In the meanwhile,in conservative treatment group,the cure rate and the improvement rate were both 25.0％.A year after two different treatment,in surgical treatment group,the cure rate was 60.5％,the improvement rate was 34.2％.However,in conservative treatment group,the cure rate and improvement rate were both 8.3％.The effective rate of surgical group was much higher than that of conservative treatment group and the difference were significant.Conclusions Both transurethral seminal vesiculoscopy and conservative treatment have certain effects in relieving hemospermia.The transurethral seminal vesiculoscopy has obvious advantages over conservative treatment in improving the clinical effects of hemospermia after long duration.It could be used as a good supplement when medication fail.

Anti-cicatricial and anti-restenosis effect of verapamil on anterior urethral stricture: A randomized controlled clinical trial / 中南大学学报(医学版)

To evaluate the anti-cicatricial and anti-restenosis effect of verapamil on anterior urethral stricture.
 Methods: A total of 32 patients received anterior urethral stricture were enrolled in this study. They were divided into 4 blocks according to the duration of previous urethral operations and dilations. Every block was further randomly divided into an experimental group and a control group. Experimental groups received 2 mL injection of verapamil around the anastomosis site of urethra before and after the surgery (2, 4, 6, 8, and 10 weeks after the surgery), while the control groups only received the anastomosis surgery. After surgery, maximal urinary flow rate (Qmax) was examined for all patients once the catheter was removed. In addition, they were also conducted palpation of urethral scar range. The sum of long transverse diameters of urethral scar was measured, and the narrowest urethral inner diameter was examined. The Qmax was rechecked and the urethral scar range was assessed by penis color Doppler elastography after 12 weeks of surgery. The above 4 indexes were used to evaluate the inhibitory effect of verapamil on urethral scar.
 Results: The length of palpated urethral scar in the Block 1 to 4 of the experimental groups was (22.75±1.03), (21.25±0.25), (20.75±1.03), and (20.0±0.58) mm, respectively; and those in the control groups (26.00±0.82), (24.5±1.04), (25.75±1.65), and (28.25±1.75) mm, respectively. The Qmax rates in the Block 1 to 4 of the experimental groups were (11.85±0.77), (11.33±0.81), (10.23±0.26), and (10.35±0.17) mL/s, respectively; and those in the control groups were (10.85±0.39), (10.50±0.76), (10.53±1.00), (12.60±0.39) mL/s, respectively. The Qmax rates in the Block 1 to 4 of the experimental groups were (11.73±0.87), (10.65±0.25), (10.23±0.19), and (10.35±0.29) mL/s, respectively; and those in the control groups were (8.05±0.28), (7.73±0.68), (7.53±0.92), and (9.60±0.32) mL/s, respectively. The narrowest diameters of urethral in the Block 1 to 4 of the experimental groups were (9.00±0.58), (7.50±2.89), (7.00±0.10), and (7.00±0.41) mm, respectively; and those in the control groups were (5.50±0.29), (5.00±0.41), (4.75±0.48), and (6.75±0.48) mm, respectively. The ultrasound strain ratio in the Block 1 to 4 of the experimental groups were 6.10±0.22, 6.10±0.17, 5.10±0.16, and 6.90±0.19, respectively; and those in the control groups were 8.00±0.25, 10.60±0.29, 11.30±0.16, and 8.90±0.33, respectively. Compared with the control groups, the experimental groups displayed smaller urethral scar range, less severe scarring, improved Qmax rates and wider inner diameters (all P<0.05).
 Conclusion: Urethral regional injection of verapamil intraoperatively or postoperatively can prevent overgrowth of urethral scar tissues after the transperineal anastomosis surgery, and reduce the tendency of postoperative restenosis of anterior urethral stricture.

Effect of calcium channel blockers on primary cultured human urethra scar fibroblasts / 中南大学学报(医学版)

To investigate effects of verapamil on primary cultured human urethral scar fibroblasts (USFs) and to provide basis for protecting the formation of urethra scar.
 Methods: The cell proliferation was evaluated with the cell counting kit (CCK)-8 method after USFs were incubated various verapamil concentrations (50, 100, 150, 200, or 250 μmol/L) or solvent for 12, 24, or 48 h. The protein level of matrix metalloproteinase (MMP) was evaluated with ELISA after cells were incubated with verapamil (100 μmol/L) or solvent (control cells) for 24 h.
 Results: The proliferation of USFs was obviously suppressed after verapamil treatment, which was in a dose-dependent and time-dependent manner. Meanwhile, the protein levels of MMP-2 and MMP-9 in the verapamil treatment group increased obviously compared with those of the control groups (P<0.05).
 Conclusion: Calcium channel blockers may prevent the excessive formation of urethra scar by inhibiting the proliferation of urethral scar fibroblasts and enhancing the activity of MMP.

Analysis of influential factors for prostate biopsy and establishment of logistic regression model for prostate cancer / 中南大学学报(医学版)

OBJECTIVE@#To establish logistic regression model for prostate cancer and provide basis for prostate biopsy.
@*METHODS@#A total of 117 cases of prostate biopsy were retrospectively analyzed in chronological sequence. All cases were assigned into a model group (n=78) and a validation group (n=39). Logistic regression model was established and its value was estimated by receiver operating characteristic (ROC) curve. 
@*RESULTS@#Digital rectal examination(DRE), transrectal ultrasound(TRUS), MRI, prostate-specific antigen density (PSAD), and free PSA/total PSA (fPSA/tPSA) were the influential factors for prostate biopsy (P<0.01). The established logistic regression model for prostate cancer by regression coefficient was: logit P=-2.362+2.561×DRE+1.747×TRUS+2.901×MRI+1.126×PSAD-
2.569×fPSA/tPSA and area under curve was 0.907. When the cutoff aimed at 0.12, the sensitivity and specificity were 81.80% and 89.30%, respectively.
@*CONCLUSION@#Logistic regression model for prostate cancer can provide sufficient basis for prostate biopsy. Prostate biopsy should be performed when P value is more than 0.12.

A preliminary study on mechanisms for urinary system disorders before and after ketamine withdrawal in rats / 中南大学学报(医学版)

OBJECTIVE@#To explore the mechanisms for urinary system disorders before and after ketamine withdrawal in rats and to evaluate the recovery degree of the urinary system damage after ketamine withdrawal.@*METHODS@#Fifteen male healthy Sprague-Dawley rats were randomly divided into 3 groups: A control group, an experimental group, and a withdrawal group. The rats in the control group were given normal saline. The rats in the experimental group were given ketamine 30 mg/(kg.day) for 30 days. The rats in the withdrawal group were treated as the experimental group except for drug withdrawal for 2 weeks. In the experimental period, we randomly selected 1 rat of kidney, ureter, and bladder from each group to perform HE staining. The bladder tissues in each group were used to detect mRNA expression by quantitative real-time polymerase chain reaction (qRT-PCR).@*RESULTS@#1) The behavior of ketamine-injected rats was obviously changed, but the weight of ketamine-induced rats was not changed. 2) As compared with the control group, the experimental and withdrawal groups showed infiltration of mononuclear inflammatory cells in the kidney tissues, the thinner epithelium of bladder and infiltration of submucosal mononuclear inflammatory cells under the optical microscope. 3) As compared with the control group, the expression of H1R mRNA was increased in the experimental group (P<0.05). As compared with the experimental group, H1R mRNA expression was significantly decreased in the withdrawal group (P<0.05).@*CONCLUSION@#Ketamine abuse could induce behavior changes in rats. The infiltration of mononuclear inflammatory cells in kidney and bladder, the thinner bladder epithelial layer, and the increased H1R gene mRNA expression in bladder might be an important pathogenesis of KAUD. Ketamine withdrawal may effectively reverse the pathogenic process of KAUD.

Therapeutic effect of regular urethral dilatation on patients with postoperative urethral stricture / 中南大学学报(医学版)

Objective: To determine the therapeutic effect of regular urethral dilatation on patients with postoperative urethral stricture. Methods: A total of 142 patients underwent urethral stricture. The unimproved patients after the surgery were divided into a reoperation group and a regular urethral dilatation group. All the patients were followed up for 1-3 months, and the curative effect was compared. Results: Of the 142 patients, 42 had no improvement and 27 of them had reoperation, and symptoms in 21 were improved. Another 15 patients received regular urethral dilatation, and 5 improved. hTere was signiifcant difference between the 2 groups (P<0.01). Conclusion: Regular urethral dilatation has some effect on postoperative patients, but no obvious effect on patients with dissatisifed operation for urethral stricture or restenosis.

Ketamine induces apoptosis of human uroepithelial SV-HUC-1 cells / 中南大学学报(医学版)

Objective:To determine the effect of ketamine on the apoptosis of human uroepithelial cells (SV-HUC-1) and the pathogenesis of ketamine-associated cystitis. Methods:SV-HUC-1 cells were cultured under various concentrations of ketamine and different time. Flow cytometry was used to analyze the rate of cell apoptosis. hTe protein levels of Bax, Bcl-2, pro-caspase-3, and cleaved caspase-3 were detected by Western blot. Results:Compared with the control group, the apoptotic rate of ketamine cultured SV-HUC-1 cells increased. hTe expression of Bax increased, Bcl-2 expression decreased, and Bax/Bcl-2 in the ketamine cultured SV-HUC-1 cells was signiifcantly higher. hTe protein level of pro-caspase-3 was signiifcantly lower, and that of cleaved caspase-3 was signiifcantly higher than that in the control group (P<0.05), positively correlated with the dose of ketamine and time of culture (P<0.05). Conclusion:Ketamine can induce the apoptosis of SV-HUC-1 cells in a dose and time dependent manner.

Diagnosis and treatment of ketamine-associated cystitis：A report of 3 cases and literature review / 中南大学学报(医学版)

Objective:To determine the diagnosis, treatment, and pathogenesis of ketamine-associated cystitis. Methods:Clinical data from 3 patients with ketamine-associated cystitis were analyzed retrospectively and discussed in light of relevant literature. Results:In the 3 cases, 2 presented severe lower urinary tract symptoms, including frequency, urgency, dysuria, urge incontinence, and painful haematuria. Urinalysis and urine culture were negative. Imaging examination demonstrated thickening of the bladder wall and a small capacity. Inflammatory changes in the bladder mucosa were observed by cystoscopy and biopsies. After cessation of ketamine use, with the addition of steroids or hydrodistension, the symptoms in the 3 patients improved. The symptoms recurred in 2 patients, as 1 was exposed to ketamine again and 1 had severe bladder contraction after for 3-4 month follow-up. Conclusion:Ketamine-associated cystitis is a new urinary system inlfammatory damage. Its etiology and treatment methods are not clear. early abstinence from ketamine use and early treatment are crucial for patients with ketamine-associated cystitis to avoid irreversible damage.

Investigation and analysis of attitudes of nursing students in higher vocational towards death / 中华医学教育探索杂志

Objective To investigate and analyze the attitudes of higher vocational nursing students toward death and the related effect factors.Methods Totally 324 nursing students in a higher vocational school in Shaanxi province were investigated with death attitude profile-revised scale.Contents of investigation included physical and mental health status,family members' attitude towards death,family form and ranking,religion,presence of suicidal thoughts,exposure to mass media reports about death,reading books about death,death fear,death escape,natural acceptance,approach acceptance,avoidance acceptance,etc.SPSS 16.0 was used for data entry and statistic analysis,mean and standard deviation for statistical description,t test and variance analysis for statistical inference.Results ①Higher vocational nursing students got the highest average score (3.93 ± 0.55) in the dimension of natural acceptance.②In the dimension of avoidance acceptance,the scores of nursing students with excellent and good physical and mental health were significantly lower than those of students with general physical and mental health (F=4.80,P=0.009) ; the scores of nursing students in single parent family were significantly higher than those of students in other family forms (F=4.59,P=0.004) ; the scores of nursing students with suicidal thoughts were significantly higher than those of students without (t=-4.77,P=0.000).In the dimension of death avoidance,the scores of nursing students whose family discussed death openly were significantly lower than those of students whose family never done so (F=6.88,P=0.001).In the dimension of natural acceptance,the scores of nursing students with religious beliefs were significantly lower than those of students without (t=2.52,P=0.012) ; the scores of nursing students who gained information of death from mass media were significantly higher than those of nursing students who never done so.(t=-3.85,P=0.000),which was the same in the dimension of approach acceptance (t=-3.48,P=0.001).Conclusions The majority of higher vocational nursing students can naturally accept death reality.Attitude of higher vocational nursing students toward death are influenced by physical and mental health,discussing death in family,family form,religious belief,suicidal thought and news or report about death from the mass media.

Screening of membrane antigen differentially expressed in androgen-dependent prostate cancer and androgen-independent prostate cancer / 中南大学学报(医学版)

OBJECTIVE@#To determine the screening of the expression of membrane proteins in androgen-dependent prostate cancer (ADPC) and androgen-independent prostate cancer (AIPC) and to explore the mechanism of membrane proteins in these two cancers.@*METHODS@#Serum samples were collected from 3 patients with ADPC and another 3 patients with AIPC. The serum was incubated with ADPC cell line LNCaP and/or AIPC cell line PC-3 and detected by immunoprecipitation and Western blot. Differentially expressed proteins between ADPC and AIPC identified by mass spectrometry were compared and their expression level and location were analyzed by immunofluorescence.@*RESULTS@#Altogether 11 membrane proteins were identifited, such as the Neural-Cadherin precursor, ER60 precursor, Claudin-4, and so on. Immunofluorescence revealed that the expression level of Claudin-4 in PC-3 cells was higher than in LNCaP cells.@*CONCLUSION@#We can use the screening method to study membrane proteins in prostate cancer. Claudin-4 may play an important role in the pathogenesis and the development of AIPC.

Chylous leakage after retroperitoneoscopic upper-pole heminephrectomy for duplex kidney / 中南大学学报(医学版)

OBJECTIVE@#To discuss management of chylous leakage after retroperitoneoscopic upper-pole heminephrectomy for duplex kidney.@*METHODS@#Between November 2004 and Februar y 2011, 39 patients underwent retroperitoneoscopic upper-pole heminephrectomy for duplex kidney, of these 5 patients had chylous leakage. The ages of the patients ranged from 32 to 60 years (mean 42). All the patients were treated conservatively, and the therapeutic effects were observed.@*RESULTS@#Delayed chylous leakage in 5 patients occurred 5-31 days after surgery, and leakage occurred in 4 of the same 5 patients during the first 2 post-operative years. Chylous leakage after retroperitoneoscopic upper-pole heminephrectomy for duplex kidney preferentially occurred at the left side of duplex kidney. All the patients healed under conservative treatment.@*CONCLUSION@#Chylous leakage typically occurs after left retroperitoneoscopic upper-pole heminephrectomy for duplex kidney, and can be prevented by improving surgical technique; it can be completely relieved by conservative management with satisfactory results.

Primary testicular non-Hodgkin's lymphoma / 中华泌尿外科杂志

Objective To summarize the clinical presentation, pathology features, and treat-ment principle for primary testicular non-Hodgkin's lymphoma. Methods Twelve patients were di-agnosed with primary testicular lymphoma. The mean age was 62 years (36-78). Of the patients, unilateral primary testicular tumors were found in 11 cases and bilateral tumors were found in 1 case. All cases had swollen testes, 3 cases had mild pain and 1 had low-grade fever. Ultrasonic examination detected solid mass in all 12 cases. CT scan revealed retroperitoneal enlarged lymph nodes in 3 cases. Nine patients were diagnosed with disease of stage Ⅰ E, 2 of stage Ⅱ E, and 1 of stage Ⅲ E. All of the patients underwent radical orchiectomies. Postoperative treatment included: CHOP chemotherapy for 10 cases, radiotherapy after chemotherapy for 5 cases, and surgery alone for 2 cases. Results Post-operative pathology results were non-Hodgkin's lymphoma in all cases. One patient lost in follow up, one died within 2 years because of other disease. The 1, 3 and 5 year actual survival rates were 82% (9/11) ,40%(4/10),20% (2/10), respectively. The relapsed organs included contralateral testis(3/ 11), central nervous system(3/11), liver(1/11)and retroperitoneal lymph node(1/11). Conclusions The prognosis of the primary testicular non-Hodgkin's lymphoma is very poor. Chemotherapy must be used after surgery for any stage. Stage Ⅰ E and Ⅱ E patient should be treated by surgery combined with radiotherapy and chemotherapy. Contralateral testis should be irradiated prophylactically. Pa-tients beyond stage Ⅱ E should accept chemotherapy after surgery and radiotherapy according to the patient's status.

Treatment of renal calyceal stricture and atresia through antegrade percutaneous nephrostomy by Holmi-um laser / 中华泌尿外科杂志

Objective To evaluate the clinical efficacy and safety of Holmium laser in the treat ment of calyceal stricture and atresia through antegrade percutaneous nephrostomy. Methods Ante grade percutaneous nephrostomy was performed in 68 patients with calyceal stricture and atresiathrough a rigid 8/9.8 F ureteroscope. The stricture and atresia was incised in a linear fashion by theHolmium laser with a 550 mm fiber. After completion of the incision,a double J ureteral stent wasplaced for 6-8 weeks and nephrostomy tube was kept for 7 days thereafter. Patients were then fol lowed up with IVU and/or ultrasound at 3-6 month intervals. Results The mean operative timewas 90 min,ranged from 80 to 120 min. The mean postoperative hospital stay was 8 d(7-9d). Hy dronephrosis was significantly improved in 38 cases in an average follow up of 9 months (4-26 months). Repeated laser incision was performed to 4 treatment failures and all turned out to be suc cessful. Conclusions The Holmium laser treatment through antegrade percutaneous nephrostomyfor calyceal stricture and atresia has characteristics of minimal invasion,short hospital stay,good effi cacy in short term and repeated cases. This procedure to be used as the first choice for patients withgood renal function and mild hydronephrosis,especially accompanied with renal calculus.

Knowledge,attitude and related factors associate with HIV/AIDS among female prisoners in Shaanxi province / 中国艾滋病性病

Objective To investigate the knowledge,attitude and related factors associated with HIV/AIDS among female prisoners in Shaanxi province.Method A cross-sectional survey with questionnaire was conducted in 837 female prisoners.Results Of the studied female prisoners 94% had heard of HIV/AIDS.The rate of correct answer on basic knowledge about AIDS was 19.8%-87.3%.The rate of correct answer on the transmission route was 11.6%-87.6%.The rate of correct answer on non-transmission route was 23.4%-48.6%.The rate of correct answer on prevention was 36.7%-57.5%.Of them 46.6%-55.7% were afraid of AIDS,and 26.6%-90.0% had prdjudice and stigma to HIV/AIDS and PLWHA(people living with HIV/AIDS).The factors affecting HIV/AIDS related knowledge included marriage status,career,education background and number of family members.The factors affecting attitude included age and education background.Conclusion The studied female prisoners have wide but superficial knowledge about HIV/AIDS and have expressed over fear for HIV/AIDS.They also cannot tolerate AIDS patients.