教师在教学实践的过程中，既要让学生能够在高职专科相关课程学习的基础上有本质的提高，符合本科教学的要 求，又要注意避免重复教学，使得学生出现厌烦的情绪。为了更好地应对“互联网+教育”大趋势的发展，以及克 服护理专业“专接本”学生的工学矛盾，我们利用信息化教学模式改变传统的教学模式，不仅有效地解决了这些问 题，而且取得了较好的教学效果。

针对护理专业"专接本"教学中出现的部分学生适应性转换困难、工学矛盾突出、教学内容存在交叉重复或衔接不够以及考核评价方式单一等问题,泰州职业技术学院采取新生入学专业教育时,明确学历提升目标规划;合理调整教学进度,提前融入社会大自考;整合教学内容,促进"专"与"本"科的深度衔接;优化教学设计,适应接本学生的特点;改革教学评价,打造多方参与的科学评价体系等教改措施.实践证明,"专接本"教育教学模式的改革既可以提高学生的学习效果,又可以提升教师的教学能力和学校的知名度以及用人单位的认可度.

本研究按照随机抽取的原则,抽取护理专业的班级进行意义记忆渗透教学,其短期效应良好.为研究其对学生是否会产生长远影响,选择前期研究中实验组和对照组的学生作为研究对象,以非货币收益作为研究切入点,通过问卷调查、访谈等研究方法和手段,探索意义记忆渗透教育对毕业生在社会、家庭、个人三个方面的作用和影响,其统计结果发现:实验组新闻观看时长较对照组长;社会新闻关注度、政治活动参与度高于实验组;实验组与父母、亲友联系次数多于对照组,对工作满意度较对照组高,学历提升的愿望强烈.总之,意义记忆渗透教学在护理专业毕业生非货币收益方面起到积极作用.

目的：以某职业技术学院为例，调查我院高职护理类现代学徒制班级毕业生和传统班级毕业生的就业现状，并探讨如何 进一步完善适应就业新形势的人才培养模式改革。方法 收集我院就业指导中心在学生毕业当年办理报到证时统一提供 的各项就业相关数据，使用描述统计等方法进行整理分析。结果：近四年我院护理专业（含助产）毕业生的就业率为 97.2%，现代学徒制班级学员在三级医院就业人数百分比显著高于其它传统班级学员（P＜0.05）。结论：我院现行的高 职护理人才培养模式基本能适应社会需求，“现代学徒制”班级学员的就业方向与同期传统班级学员存在差异。“现 代学徒制”这种创新型人才培养模式也面临新的挑战，还需进一步深化教育改革，充分发挥其示范引领效应。

Coronary artery disease (CAD) is one of the main causes of hospitalization worldwide and has high morbidity. MicroRNAs (miRNAs) play an important role in the pathogenesis of cardiovascular diseases. miR-451 is a special miRNA that is involved in many cancers' development. At present, there is no research about miR-451 in coronary heart disease. In this study, we aimed to identify the action mechanism of miR-451 in coronary heart disease and human umbilical vein endothelial cells (HUVECs). In this study, we found that miR-451 is up-regulated in the peripheral blood of patients with coronary heart disease. Moreover, TargetScan and dual-luciferase reporter gene assay results showed that VEGFA is a direct target gene of miR-451. C (CCK-8) and flow cytometry assay results showed that miR-451 mimic significantly inhibits cell proliferation and promotes apoptosis in HUVECs. Moreover, we found that the role of miR-451 in HUVECs is associated with the PI3K-Akt-mTOR pathway. Taken together, the data indicates that miR-451 might be a novel bio-marker for coronary heart disease.

目的:观察质膜型唾液酸酶(human plasma membrane-associated sialidase,Neu3)对前列腺癌荷瘤小鼠恶病质的影响.方法:应用真核细胞转染技术,转染前列腺癌PC-3、LNCaP细胞.转染后,利用倒置显微镜观察细胞形态变化;利用MTT实验观察细胞增殖变化;划痕实验观察细胞迁移能力的变化.通过显微外科手术建立原位肿瘤模型,随机分为4组,Mock组、AS组、pGCsi-Scramble组及pGCsi-Neu3组,每组6只小鼠,利用减毒沙门氏菌作为运载体,监测Neu3对裸鼠进食量、体重等恶病质指标的影响;利用IL-6小鼠ELISA试剂盒检测小鼠血清IL-6.结果:PC-3细胞和LNCaP细胞转染pGCsi-Neu3质粒后细胞透光性下降,伪足减少,细胞增殖能力下降,迁移能力下降,与Mock组及pGCsi-Scramble组相比,有统计学意义(P<0.01).动态监测前列腺癌荷瘤小鼠体重和摄食量数据显示:Mock组、AS组和pGCsi-Scramble组,小鼠体重逐渐减轻,摄食量减小,试验结束时,与pGCsi-Neu3组相比体重、摄食量差异明显,有统计学意义(P<0.01).pGCsi-Neu3组小鼠血清IL-6水平明显低于Mock组、AS组和pGCsi-Scramble组,有统计学意义(P<0.01).结论:下调Neu3表达,在体内具有良好的延缓恶病质发生、发展作用,其可能机制是Neu3的表达水平下降抑制了前列腺癌PC-3、LNCaP细胞增殖和迁移,IL-6表达下降,食欲增加.Neu3可能成为治疗癌性恶病质新靶点.

《药物不良反应杂志》2017年第2期刊登了《头孢西丁和复方甘草口服溶液联用致双硫仑反应》一文,该文报道1例患者因肺部感染给予头孢西丁2g静脉滴注,输注结束后1. 5 h患者因咳嗽自行服用复方甘草口服溶液10 ml,约10 min后出现胸闷、呼吸困难、面部潮红、多汗,四肢乏力和皮疹,考虑发生双硫仑反应.读后获益匪浅,但亦觉得该文中有以下问题值得提出商榷.

目的 探究和厚朴酚对神经胶质瘤细胞凋亡的作用及组织因子途径抑制剂因子TFPI-2在其中的分子机制.方法 在体外培养神经胶质瘤细胞系U87b,使用不同浓度(0、40、80μM)的和厚朴酚处理神经胶质瘤细胞,利用流式细胞术检测细胞凋亡情况,利用western blot检测TFPI-2、BAX、BCL-2、Cleaved caspase3的蛋白表达情况.利用siRNA沉默U87细胞中TFPI-2的表达,进一步确定TFPI-2的作用.结果 40μM和厚朴酚处理诱导的U87细胞凋亡率(26.3±0.55)％明显高于对照组(4.8±0.22)％,P<0.001);相比于对照组(4.8±0.22)％,80μM和厚朴酚[(79.1±0.31)％,P<0.001]同样也显著增加细胞凋亡;和厚朴酚成浓度依赖性增加U87细胞内凋亡相关基因BAX/BCL-2比值、Cleaved caspase3的表达以及TFPI-2的蛋白表达;和厚朴酚+siT-FP1-2组的细胞凋亡率(12.7±0.29)％明显低于和厚朴酚+NC组细胞凋亡率[(57.2±0.55)％,P<0.001];TFPI-2沉默能明显抑制促凋亡蛋白BAX、Cleaved caspase3的表达水平,并促进抑凋亡蛋白BCL-2的表达.结论 和厚朴酚可以通过诱导U87神经胶质瘤细胞中TFPI-2高表达,进而促进细胞凋亡的发生.

目的 探讨微信随访延伸护理服务对早产儿行为智能发育的影响.方法 将2014年1月到2017年12月期间在我院住院的129例早产儿分为试验组(66例)和对照组(63例).两组在住院期间均给予常规的育儿指导及常见病预防指导,出院时叮嘱家属按规定的时间到医院进行康复治疗.试验组出院时添加早产儿专责护士的微信群,对照组患儿未添加早产儿专责护士的微信群.两组患儿在6个月、12个月常规儿保门诊随访时,均接受智能测试,并根据随访情况遵医嘱接受早产儿行为智能发育康复训练.结果 试验组患儿家属的随访率明显高于对照组,差异有显著性意义(P＜0.05);通过早发现问题,并及时针对问题有效地实施早期康复训练,12个月后患儿在适应性、大运动、精细运动3个方面与对照组相比,差异有显著性意义(P＜0.05),而在语言和社会交往2个方面与对照组相比,无明显差异(P＞0.05).结论 微信随访延伸护理结合定期康复服务可明显提高患儿家属的遵医随访率,加强护士对患儿家属的延续性护理指导,可以促进患儿的行为智能发育,尤其是患儿在适应性、大运动、精细运动3个方面的功能发育.

为进一步整合教学资源,缓解供求矛盾,提高教学效果,深化教改教研,促进健康宣教,服务地方发展,我院拟建立人体生命科学馆.通过科学设计、精心布局、配套信息化平台、建立健全管理体系等措施逐步完成我院人体生命科学馆的建设规划,使其充分发挥在教学、科研和社会服务等方面的应用潜力.

目的 研究大豆异黄酮(SI)对压力负荷性大鼠心肌肥厚的保护作用及其作用机制.方法 采用主动脉弓缩窄法制备大鼠心肌肥厚模型,造模后将大鼠分为假手术组(Sham组)、主动脉缩窄模型组(TAC组)、溶剂对照组(TAC+placebo组)和SI治疗组(TAC+SI组);4周后处死大鼠,测量大鼠全心质量指数(HW/BW)和左心室质量指数(LVW/TL);左心室组织切片Masson染色和HE染色后观察胶原沉积和心肌细胞形态;免疫共沉淀法测定TLR4和MyD88的交互情况.结果 模型组大鼠的HW/BW和LVW/TL的值显著升高(t=4.344,P=0.012 2和t=8.762,P=0.000 9,n=6);胶原沉积增多,心肌细胞直径增大,TLR4和MyD88的交互增加(t=16.07,P=0.003 9,n=6);SI能显著减轻心脏质量指数(t=3.432,P=0.026 5和t=5.738,P=0.105 0,n=6),使得心肌细胞横截面积减小,同时能明显抑制TLR4和MyD88的交互(t=13.88,P=0.005 1,n=6).结论 SI对主动脉缩窄所致心肌肥厚具有一定的保护作用,其机制与降低TLR4和MyD88的交互,抑制压力负荷激活的TLR4/MyD88信号通路有关.

[目的]探讨组织因子(tissue factor,TF)、组织因子途径抑制物-1(tissue factor pathway inhibitor-1,TFPI-1)和TFPI-2的检测在神经胶质瘤患者诊疗中的意义.[方法]采用酶联免疫吸附法(ELISA)测定45例神经胶质瘤患者及42例健康对照者血浆中的TF、TFPI-1及TFPI-2表达情况.[结果]神经胶质瘤患者血浆中的TF、TFPI-1及TFPI-2的水平分别为105.50±37.61pg/ml、39.21±7.5 1ng/ml、11.16±3.96ng/ml,高于健康对照组的82.13±23.45pg/ml、28.16±5.60ng/ml、7.10±3.07ng/ml (P=0.02、0.01、0.01);且高级别胶质瘤组患者血浆中的TF水平(117.33±31.19pg/ml)显著高于低级别胶质瘤患者(95.23±27.69pg/ml,P=0.03),但其TFPI-2的水平(7.96±2.99ng/ml)低于低级别胶质瘤组(13.78±3.53ng/ml,P=0.01),两组TFPI-1水平差异无统计学意义.[结论] TF、TFPI-1及TFPI-2在神经胶质瘤患者血浆中的水平明显高于健康人群,随着神经胶质瘤的恶性程度的增高,血浆TFPI-2的水平反而降低.

To investigate the cAMP-regulated transcriptional co-activator 3 (CRTC3) polymorphism and its significance in the acute coronary syndrome patients. In total, 248 patients with acute coronary syndrome admitted to Taizhou People's Hospital between March 2016 and October 2016 were included in this study. Eighty-eight age- and gender-matched healthy individuals received physical examination in our hospital served as normal control. Single nucleotide polymorphism (SNP) analysis of CRTC3 (rs3862434 and rs11635252) was evaluated using PCR amplification. For the SNP of CRTC3, significant differences were identified in rs3862434 (AA/AG) and rs11635252 (TT/CT/CC) between the 2 groups (P < .05). Statistical increase was noticed in the high density lipoprotein cholesterol (HDL-C) in those with AG phenotype compared with those with AA phenotype in those with rs3862434. Significant decrease was identified in the total cholesterol (TC), triglyceride (TG), and weight in those with CC phenotype compared with those with CT phenotype among the cases with rs11635252 (P < .05). CRTC3 polymorphism was associated with the onset of acute coronary syndrome in Han Chinese patients, which may be related to the imbalance of the lipid metabolism.

目的:研究17β-雌二醇(17β-estradiol,E2)对体外机械牵拉诱导心肌细胞integrin β1/FAK/p38 MAPK信号转导的影响.方法:以机械牵拉刺激体外培养的新生大鼠心肌细胞,建立心肌细胞肥大模型,采用免疫共沉淀方法检测integrin β1和FAK的结合情况,Western blot方法检测FAK和p38 MAPK磷酸化水平的变化.结果:机械牵拉心肌细胞24 h后,integrin β1和FAK的结合显著增加,FAK和p38 MAPK磷酸化水平亦明显增强.100 nmol/L E2预处理30 min可明显减轻机械牵拉诱导的心肌细胞integrin β1和FAK的结合增加,抑制FAK和p38 MAPK磷酸化的水平增强,该效应可被雌激素受体非特异性拮抗剂ICI182780逆转.结论:100 nmol/L的E2能够抑制机械牵拉诱导心肌细胞肥大发生发展过程中integrin β1对其下游FAK招募结合增加,降低FAK及p38MAPK的磷酸化活性,提示E2与雌激素受体结合后通过抑制integrin β1/FAK/p38 MAPK信号转导途径的激活,从而发挥心血管保护作用.

[目的]了解养老护理员的培训满意度,探讨培训对策.[方法]采用访谈及问卷调查,评估泰州市不同层次养老机构491名养老护理员的一般现状及对培训满意度的反馈,探讨地方高职院校参与提升养老护理员素养的培训对策.[结果]泰州市养老护理员队伍存在年龄结构偏大、医护相关的专业学历背景缺乏、大多为半路改行跨业的“新员工”,职业规划缺乏等现象.学员对此次培训的满意度评分为4.36分±0.64分,其中得分率较高的维度为培训的师资与培训内容,得分率较低的维度为培训环境.[结论]应通过深化教学改革,完善教育体系,加强校企合作,促进资源共享,积极改善服务,传达人文关怀等培训对策,以提高培训效果,提升养老护理员的专业素养.

现代学徒制改革是校企合作、工学结合的纽带和桥梁.泰州职业技术学院护理专业与泰州市人民医院合作办学,积极探索基于现代学徒制的院校合作高职护理人才培养模式改革,初步形成"1+1+1"人才培养方案,在产教融合、校企合作实践中迈出了关键一步,结合这几年教学实践进行总结和展望.

Objective: To evaluate the efficacy of systemic glucocorticoid (steroid) combined with high dose inhaled steroid in the treatment of children with acute laryngitis. Methods: A total of 78 children with acute laryngitis were randomly divided into study group(n=40) and control group(n=38) between November 2016 and April 2017. In addition to routine treatment of anti infection and symptomatic treatment, Dexamethasone injection(0.3-0.5 mg/kg, 1-3 d, according to the patient's condition) was provided to each group. In addition to the treatment mentioned above, the study group were assigned to receive 1.0 mg Budesonide suspension for inhalation, oxygen-driven atomizing inhalation, every/30 minutes, 2 times in a row, after that every 12 hours. The improvement of inspiratory dyspnea, hoarseness, barking cough and wheezing of both groups was evaluated at 30 min, 1 h, 2 h, 6 h, 12 h, 24 h and 72 h after treatment.Sigmaplot 11.5 software was used to analyze the data. Results: No significant difference was detected in terms of inspiratory dyspnea, hoarseness, barking cough or stridor score before treatment between the two groups(P>0.05). Compared with those before treatment, symptoms of inspiratory dyspnea, hoarseness, barking cough and stridor score of both groups improved markedly at 12 h and 24 h after treatment(P<0.05). While there was no significant difference regarding inspiratory dyspnea, hoarseness, barking cough or stridor score at each time point after treatment between the two groups(P>0.05). The effective rate was 92.50% and 92.11% in study group and control group, respectively, and no significant difference was noted (P>0.05). Conclusion: Compared with single systemic glucocorticoid, systemic glucocorticoids combined with inhaled steroid possessed similar efficacy in treating acute laryngitis and relieving laryngeal obstruction of children.

Objective To explore the application effect of nursing humanistic care teaching model in Health Evaluation. Methods A total of 258 nursing students from 2014 to 2016 were selected as the study objects, and were randomly divided into experimental group and control group, 129 cases of each group. The experimental group adopted the permeable nursing humanistic care teaching mode in the Health Evaluation teaching, while the control group adopted the traditional teaching method. At the end of the course, statistical analysis was carried out on the course assessment scores of the two groups, and humanistic care ability scale of nursing students was adopted to evaluate their nursing hu-manistic care ability. Results The humanistic care ability score of the experimental group was higher than that of the control group (P<0.05). But the traditional course examination, two groups of student achievement comparison, the difference had no statistical significance (P>0.05). Conclusion Adopting the teaching mode of nursing humanistic care can significantly improve nursing students'humanistic care ability without affecting their professional knowledge and skills.