目的 在尿毒症甲状旁腺腺瘤形成行甲状旁腺切除术(parathyroidectomy,PTX)的患者中,探讨异常增高的甲状旁腺激素水平与营养状态之间的关系.方法 回顾性分析2015年9月～2020年7月在青岛大学附属医院行PTX的患者118例,分析手术前1周及手术后半年透析前全段甲状旁腺激素(iPTH)、血钙、血磷、碱性磷酸酶及体质量指数、血白蛋白等营养相关的临床指标,采用主观全面营养评估法(sub-jective global assessment,SGA)及Edmonton衰弱评分量表对患者行营养评估.结果 iPTH(Z=-7.940、P＜0.001)、血钙(Z=-9.101、P＜0.001)、血磷(Z=-8.396、P＜0.001)、碱性磷酸酶(Z=-8.367、P＜0.001)、血白蛋白(Z=-7.940、P＜0.001)、前白蛋白(Z=-5.102、P＜0.001)、体质量指数(Z=-7.341、P＜0.001)等指标手术前后存在统计学差异.SGA评分及Edmonton评分显示术后营养不良及衰弱状态改善.手术前iPTH水平与体质量指数(r=-0.272、P=0.003)、血白蛋白(r=-0.630、P＜0.001)、前白蛋白(r=-0.165、P=0.020)及SGA评分(r=-0.781、P＜0.001)呈负相关,与Edmonton评分(r=0.611、P＜0.001)呈正相关.结论 尿毒症继发性甲状旁腺腺瘤甲状旁腺切除的患者手术前后营养状况差异显著,手术后患者iPTH显著降低,营养相关指标显著改善,衰弱状态显著纠正.

Using literature search, questionnaire survey, field interview and data analysis, this paper constructs the competency model of higher vocational student cadres. Through the questionnaire survey of 22 related students and teachers, 34 competency items are summarized. After two preliminary tests, the Questionnaire on Competency of Student Cadres for Higher Vocational Students is formed, which consists of 30 items. By using exploratory factor analysis and confirmatory factor analysis, the competency characteristics of student cadres for higher vocational students are obtained, namely including competency structure model of student cadres includes nine factors: reliability, responsibility, interpersonal relationship, leadership, team accomplishment, self-management, service orientation and enterprising consciousness.

目的 研究妊娠糖尿病(gestational diabetes mellitus,GDM)患者胎盘脂蛋白酯酶(lipoprotein lipase,LPL)基因Hind片段多态性与新生儿发生胰岛素抵抗(insulin resistance,IR)的关系.方法 收集2018年4月～2020年4月84例GDM患者作为观察组,另纳入同期84例健康孕妇作为对照组.比较两组孕妇LPL多态性分布,比较两组新生儿血糖(FPG,HbA1c及2h PG)和血脂(TC,TG,HDL-C及LDL-C)指标水平,计算胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)值.分析胎盘LPL多态性与子代胰岛素抵抗的关系.结果 观察组H+H+基因型48例,H+H-基因型24例,H-H-基因型12例.对照组H+H+基因型32例,H+H-基因型38例,H-H-基因型14例,两组孕妇胎盘LPL基因型分布比较,差异有统计学意义(χ2=6.52,P<0.05).GDM不同基因型患者所生新生儿TC,TG,HDL-C,LDL-C及HOMA-IR水平差异均有统计学意义(F=5.29～16.33,均P<0.05).多元逐步回归分析结果显示胎盘LPL多态性是新生儿HOMA-IR的重要影响因素(t=2.86,P<0.05).结论 胎盘LPL多态性与GDM发病有关,H+H+基因型产妇子代发生胰岛素抵抗的风险更高.

目的:探讨叙事护理对1型糖尿病患儿焦虑、抑郁及血糖的影响.方法:选择2017年6月—2019年6月收治住院的61例1型糖尿病患儿为研究对象,采用随机数字表法将患儿分为对照组30例与观察组31例.对照组采用常规护理方法,观察组在常规护理基础上采用叙事护理进行干预.观察两组患儿焦虑、抑郁及血糖的控制情况.结果:干预后观察组焦虑、抑郁、空腹血糖、餐后2 h血糖及糖化血红蛋白均低于对照组(P<0.01).结论:叙事护理能缓解1型糖尿病患儿焦虑、抑郁情绪,促进其自我管理,改善空腹血糖、餐后2h血糖以及糖化血红蛋白.

针对网络安全问题,为了提升网络数据信息的安全性,通过采用北京智芯微电子科技有限公司自主研发的高速安全芯片SC1038,实现了一种基于单芯片的高集成高可靠性的高速PCIe加密卡设计.SC1038高速安全芯片将算法、PCIe接口和MCU的功能集中到一颗芯片内,芯片支持SM1、SM2、SM3、SM4和SM7国密安全算法,同时支持DES、RSA和SHA国际安全算法,并且芯片内部具有4个独立的真随机源.芯片和上位机之间通过PCIe接口进行通讯,并包含一个基于ARC EM6结构的高性能32位处理器,用于实现PCIe通讯和算法的控制.实测结果表明,该PCIe加密卡解决方案能实现高速算法加解密运算,通过PCIe接口能达到Gbps级的算法吞吐率,具有良好的应用前景.

Objective To study the expression change of forkhead box protein M1 (FoxM1)and NIMA-related kinase 2 (Nek2) in kidney cancer tissues and its clinical significance.Methods Twenty-five kidney cancer patients who underwent surgical removal of kidney cancer and adjacent tissues were randomly chosen.The specimens were diagnosed by pathology.The expression changes of FoxM1 and Nek2 were detected by Western blot and immunohistochemical method.Results The expression level of FoxM1 in kidney cancer tissues was significantly higher than that in adjacent tissues (P ＜ 0.05),the expression level of Nek2 in kidney cancer tissues was also significantly higher than that in adjacent tissues (P ＜0.05).The expression of FoxM1 and Nek2 in kidney cancer tissues was positively correlated (r =0.915,P ＜ 0.05).Conclusions The expression level of FoxM1 and Nek2 increases significantly in kidney cancer tissues,which may lead to the development and progression of kidney cancer.FoxM1 and Nek2 may be beneficial to the diagnosis and prognosis of kidney cancer.

As a new method of learning, the mobile platform is playing an increasingly important role in English learning. In order to fit in with the construction requirements of the English mobile learning platform, it is obliged to carry out methods of positive studies on English audio segmentation. In this study, the author makes a brief analysis on English audio segmentation based on threshold value and energy sequence, provides the basic process of English audio segmentation, and carries out a discussion on key technical points of the scheme, which including windowing process, audio feature extraction and dual threshold. In the end, the author makes a research on the operation of English audio segmentation, aiming at drawing more attentions to this study.

Objective To compare the clinical efficacy of plating versus non-plating following ulnar oblique osteotomy in the treatment of obsolete Monteggia fractures in children.Methods Clinical data of 33 patients were reviewed who had been treated for obsolete Monteggia fracture in our department from January 2001 to June 2011.They were 23 males and 10 females,aged from 4 to 13 years (average,8.1 years).According to the Bado classification,23 cases were type Ⅰ,4 type Ⅱ and 6 type Ⅲ.Ulnar oblique osteotomy was performed in all the 33 cases to extend the ulna lengthways,but their subsequent fixation was different.In the non-plating group (17 cases),after reduction of the radial head,a supplementary transfixation of the radius was performed with a Kirschner wire through the capitellum,and the excised ulna was free of fixation.In the plating group (16 cases),after transfixation of the radius with a Kirschner wire through the capitellum,plating was performed of the excised ulna.Both groups were immobilized in a plaster cast after surgery.The 2 groups were compared with respect to healing time for the ulnar osteotomy and the Mackay scoring for postoperative elbow function.The 2 groups were comparable with no significant difference in the general data (P ＞ 0.05).Results Follow-ups for an average of 1.5 years (from 10 months to 3 years) revealed no incision infection and ulnar healing in all the patients.The average ulnar healing time for the non-plating group (7.2 ± 1.1 weeks) was significantly shorter than for the plating group (8.5 ± 1.8 weeks) (P ＜ 0.05).In the non-plating group,l0 cases were rated as excellent,5 good and 2 poor; in the plating group,11 cases were rated as excellent,4 good and one poor.In either of the 2 groups,3 cases reported residual pain in elbow motion.The non-plating group reported one case of dislocation of the capitellum.Conclusion Non-plating after ulnar osteotomy may be used as a treatment of obsolete Monteggia fractures in children,because it has advantages of less invasion to the ulnar blood supply,shortened operation time and healing time.

Flanders interaction analysis system was used to investigate the characteristics of demonstrative skills in the course of pathology for higher vocational students and undergraduate students.The most frequent demonstration skills used for higher vocational students were indicative PowerPoint(36.21%),vivid pictures(7.99%) and amplified pictures(7.47%);while the less frequent demonstration skills were mapping the keywords on the blackboard(1.69%),paralleling the key points(1.75%) and demonstration with pictures(1.82%).The demonstration skills such as demonstration with pictures,contrasting pictures,paralleling the key points,problem-based learning,vivid pictures,highlighting keywords,writing keywords on the blackboard,case based study and demonstration with actual samples were more frequently used for higher vocational students than undergraduate students(P<0.05);while indicative PPT was less frequently used for higher vocational students(P<0.01).The teachers should choose proper demonstration skills based on the characteristics of higher vocational students.

Graduate education is an important aspect of personnel training in Guangdong Pharmaceutical University.In order to improve the ability to do research and innovative thinking of graduate students of basic medicine,we should inspire students to pay enough attention to the disciplinary frontier with dynamic examples and cultivate students' scientific humanism during the course of the theory teaching and scientific research.We should also focus on both the quality and practicality of education of graduate students with the attention to overlapping disciplines and cooperation among universities to improve the graduate student's quality and their research ability.

Objective To investigate the P-selectin and platelet count in the evaluation,prediction of severity and prognosis of patients with severe infection and its clinical significance.Methods Eighty patients in RICU of the first affiliated hospital of Zhengzhou university for severe respiratory infections from September 2011 to September 2012 were divided into SIRS group(group A) and non-SIRS group of 40 patients (group B) according to the criteria for the diagnosis of system inflammatory response syndrome (SIRS) in the ACCM/SCCM1991 Chicago conference.Forty cases of healthy persons were chosen as control group (group C).The test results of P-selectin and platelet count were compared among the three groups,then the test result of P-selectin and platelet count between survival group and the death group according to the prognosis of group A were compared.Results The plasma level of P-selectin of group A was higher than that of group B and group C,but the platelet count was lower,the difference was significant.The level of P-selectin of the death group was significantly higher than that of the survival group,but the platelet count was significantly lower.Conclusions The test result of P-selectin and platelet count can be used as important indicators to evaluate the prognosis and severity of the patients with severe infection.

Objective To explore the effects of the combination teaching method of case presentation,model demonstration and system teaching in Nursing Pathology.Methods Students in two classes were selected as the experimental group and the control group,respectively.Case presentation,model demonstration and system teaching combination mode was used in the experimental group;the traditional teaching method was used in the control group.The performance of case analysis and critical thinking abilities of students were compared between the two groups.Results The performance of case analysis and critical thinking abilities in the experimental group were significantly higher than the control group(P0.01).Conclusion The combination teaching of case presentation,model demonstration and system teaching can improve students' abilities of case analysis and critical thinking,and has the important meaning for improving the comprehensive abilities of nursing students.

Objective To study the relationship between serum fibroblast growth factor-23(FGF-23) and cardiovascular calcification in patients with end-stage renal disease(ESRD). Methods A total of 60 ESRD patients were included in this study,the calcification of their abdominal aortas and cardiac valves was qualitatively assessed by both lateral-position plain radiography of abdomen and echocardiography,and FGF-23 by enzyme-linked immunosorbent assay(ELISA).A routine laboratory test was done for detection of serum creatinine(Scr),calcium(Ca),phosphorus(P),alkaline phosphotase(ALP),total cholesterol(TC),hemoglobin(HB),and immunoreactive parathyroid hormone(iPTH) was detected by electrochemilluminescence method.Forty individuals who joined physical examination were served as controls. Results The levels of FGF-23 in ESRD patients were higher than that in the control,the difference was significant(t=7.50,P0.01).A correlation analysis indicated that serum FGF-23 level was positively correlated with Scr,P,iPTH and ALP(r=0.411-0.675,P0.01),and not correlated with serum Ca,TC,TG,and HB(r=-0.113——0.012,P0.05).Serum FGF-23 was higher in ESRD patients with cardiovascular calcification than those without(t=5.40,P0.01). Conclusion The rising of serum FGF-23 in ESRD patients is closely related with occurrence and development of cardiovascular calcification.

Objective To study the value of D-dimer on evaluating the severity and prognosis of CAP.Methods A total of 207 CAP patients hospitalized in the first affiliated hospital of Zhengzhou university from March 2010 to March 2012 were enrolled in this study.Meanwhile,39 healthy individuals were served as controls.CAP patients were divided into groups according to different severity assessment criteria.The variance of D-dimer was compared among the groups.Results The mean D-dimer levels were different significantly among the different pneumonia severity index groups.The D-dimer levels were higher in severe group than those in non-severe group and higher in fatal group than those in non-fatal group.Conclusions D-dimer levels are correlated with the severity and the prognosis of CAP,and Ddimer level could predict prognosis in patients with CAP.

Objective Objective To strengthen the management and reduce the wrongly grounding rate of medical records.Methods Employing the action program of the Quality Control Circle(QCC),through its steps of PDCA(Plan,Do,Check& Action) to carry out QCC activity.Comparing the wrongly grounding rate before and after the QCC management in a certain given period and evaluating the improvement extent.Results The results shows that the wrongly grounding rate dropped by 1.23%,from 1.27% to 0.02%.Conclusions The application of QCC decreased the wrongly grounding rate of medical records,improved the ability on discovering and resolving the problems of the staff in medial record office,and enhanced the consciousness of participating in the department management of the working staff.

目的 观察尿酸性肾病大鼠肾脏血小板反应蛋白-1(TSP-1)和缺氧诱导因子-1α(HIF-1α)的表达及缬沙坦对其影响,探讨缬沙坦对尿酸性肾病大鼠肾间质纤维化的干预机制.方法 选取雄性健康Wistar大鼠36只为研究对象,适应性喂养1周后,采用随机数字表法分为正常组、模型组和缬沙坦组,每组12只.采用酵母和腺嘌呤建立尿酸性肾病模型,造模同时给予缬沙坦干预.于入组3周和5周时观察3组大鼠血尿酸(UA)、血肌酐(Scr)及肾脏病理变化,采用免疫组织化学法和逆转录聚合酶链反应(RT-PCR)法检测肾脏TSP-1和HIF-1α的表达.结果 3组大鼠3周和5周时测得的体质量、UA、Scr水平比较,差异均有统计学意义(P＜0.05).模型组和缬沙坦组大鼠3周、5周时的体质量低于正常组大鼠,UA、Scr水平高于正常组大鼠,差异均有统计学意义(P＜0.05);模型组大鼠3周和5周时的体质量低于缬沙坦组,Scr水平高于缬沙坦组,差异均有统计学意义(P＜0.01).3组大鼠3周和5周时RT-PCR测得的TSP-1 mRNA、HIF-1α mRNA表达量比较,差异均有统计学意义(P＜0.05).模型组和缬沙坦组3周和5周时TSP-1 mRNA、HIF-1α mRNA的表达量均高于正常组(P＜0.01),模型组3周和5周时TSP-1 mRNA、HIF-1α mRNA的表达量亦均高于缬沙坦组,差异有统计学意义(P＜0.05).模型组大鼠3周和5周时肾组织TSP-1 mRNA与HIF-1α mRNA的表达分别呈正相关(r值分别为0.821和0.736,P＜0.05).结论 尿酸性肾病的发展存在缺氧状态;缬沙坦可能通过下调TSP-1及HIF-1α的表达改善肾脏纤维化程度.

In order to get C-Fos gene sequence of proto-oncogene in Rongchang pig for analysis and utilization the total RNA was extracted from the testis of Rongchang pigs.We used RT-PCR to get the C-Fos gene and sequenced it after TA cloning.The length of the obtained C-fos gene in Rongchang swine is 1 143 bp,encoding 381 amino acids.Homologous comparisons between C-Fos gene sequences in Sus scrofa,Equus caballus,Bos taurus,Ovis aries,Felis catus,Ailuropoda melanoleuca,Homo sapiens,Pan paniscus,Macaca mulatta,Rattus norvegicus,Mus musculus,Oryctolagus of GenBank indicate that the homology is up to 99.47% between Rongchang swine and wild boar and there are greater species difference between Rongchang pig and other species.

With the single-row four-point contact ball slewing bearing as an example,and with its minimum volume as the objective function,and bearing capacity and rolling race stress as constraints,the mathematical model is built in the paper.The diameter parameters of the rolling race center and rolling element for slewing bearing of the lorry crane are optimized.In addition,the design method available for such slewing bearings is put forward in the paper.It provides references for developing the industrial standard regarding the slewing bearing of the lorry crane.

According to the current field theory,the large-scale grounding grid control differential equation can be changed into the boundary element integral equation by using the boundary element method and discrete the integral equation,then get the diffusion current and the boundary node voltage by solving linear equations.In this paper,the principle and processing technology is introduced;and the grounding resistance is calculated based on Matlab;at the same time the grounding grid contact voltage,step voltage and the ground potential distribution are directly reflected in vertical two layer medium demarcation.The calculation results for practical example show that this method is effective and can be utilized in practice.