High-risk human papillomavirus types are associated with most of cervical cancer cases. To explore the mechanism by which human papillomavirus 16 infections interferes with the progression and immune evasion of cervical cancer by acting on T helper 9 cells cytokines. Cervical cancer cells were obtained from China Center for Type Culture Collection. Cells were cultured in Roswell Park Memorial Institute Medium-1640. Through wound healing test and transwell analysis, the effect of interleukin-9 on the movement, migration and invasion of cancer cells was evaluated. The expression of epithelial-mesenchymal transition markers and programmed death-ligand 1 and programmed cell death protein 1 messenger ribonucleic acid was detected. Human papillomavirus 16 and interleukin-9 receptor had higher expression in cervical cancer tumor tissue than normal group. The proliferation of cervical cancer cells was inhibited in interleukin-9 transfection group compared with the cervical cancer group. Interleukin-9 transfection group reduced N-cadherin and vimentin expression, and increased E-cadherin expression. Interleukin-9 inhibition group increased N-cadherin and vimentin expression and decreased E-cadherin expression. Interleukin-9 transfection group reduced programmed death-ligand 1 and programmed cell death protein 1 expression, while interleukin-9 inhibition group increased programmed death-ligand 1 and programmed cell death protein 1 expression. These cytokines can limit tumor proliferation, movement, migration and invasion. They induce the up-regulation of E-cadherin expression in cervical cells and inhibit programmed death-ligand 1 and programmed cell death protein 1 expression, thereby expressing tumor antigens.

目的:以促进农村医疗卫生水平为前提,构建乡村医学专业《妇产科学》课程标准,验证可行性,优化高职乡村医生《妇产科学》课程教学.方法:设立对照组和实验组,实验组采取新课程标准教学,对两组学生知识、能力、素质进行评价,验证本课程标准的可行性.结果:统计学方法采用SPSS16.0统计软件,①理论知识成绩x2检验,x2=17.17,x2＞x20.01(2),P＜0.01;②实践技能成绩x2检验,x2=17.52,x2＞x20.01(2),P＜0.01;③素质认知程度t检验,实验组学生素质认知程度高于对照组(P＜0.

本文从“三教”改革背景出发，对妇产科护理教学与思政元素融合问题进行研究。研究中结合“三教”改革核心内 涵对融合带来的必要性及融合现状，从教师、教学及教材、教法几方面展开讨论，希望为妇产科护理教学与思政元素融合提供有 益的参考。

Immediate management of children's epilepsy is essential before the patient arrives to the hospital. The purpose of this study was to compare the efficacy of intranasal midazolam vs. rectal diazepam in the management of acute pediatric seizures. In this cross-sectional study, 68 patients having acute seizure were evaluated for response to treatment after receiving intra-nasal midazolam (34 patients) or rectal diazepam (34 patients). Patents were assessed by physicians at the arrival to emergency department for history taking and examination. Blood samples were assessed for valproate, phenobarbital and phenytoin levels in serum to determine previous use of antiepileptic drugs. Seizure duration and response time to treatment were evaluated along with health care utilization and were compared between study groups, by the statistical package for the social sciences software. Mean age of study participants, sex disturbance, age at onset of a seizure, type of seizure and prehospital time had not any significant differences between two groups (p>0.05). The mean response time to diazepam was 8.0±4.9 min and 6.3±2.2 min for midazolam; which had a significant difference between groups (0.001). Linear regression of serum antiepileptic drug levels in association of response time in each group was not significant in all case (p>0.05), expect the lamotrigine serum level in midazolam group (p=0.029). Intranasal midazolam was seen to have a better effect than rectal diazepam in the management and treatment of acute seizures in children; while antiepileptic drugs monitoring want helpful in assessing the absolute effect.

INTRODUCTION:Postoperative facial numbness is the main complication of radiofrequency thermocoagulation in treating trigeminal neuralgia, which could seriously affect the surgical efficacy. This problem is expected to be resolved by coblation technique. AIM:To compare the long-term efficacy and safety of coblation and percutaneous trigeminal radiofrequency thermocoagulation (PT-RFT) under fluoroscopic guidance in the treatment of trigeminal neuralgia (TN). MATERIAL AND METHODS:A case-control prospective study was carried out. Patients with TN were randomly scheduled to receive coblation or PT-RFT. Both surgical procedures were performed under fluoroscopic guidance. The data, including the degree of pain, pain relief and complications, were recorded during follow-up evaluation, which was performed on the first day and at the end of the first month, third month, sixth month and first year after surgery. RESULTS:A total of 50 patients were enrolled in this study, with 25 patients in each group. The visual analog scale (VAS) scores in both groups at each time point after surgery were significantly lower compared with before surgery (p < 0.05). There were no significant differences in VAS scores or pain relief between the two groups at any time point after surgery (p > 0.05). However, patients in the PT-RFT group exhibited greater facial numbness after surgery (p < 0.05). For other complications, there were no significant differences between the two groups (p > 0.05). CONCLUSIONS:Coblation and PT-RFT showed similar effectiveness in reducing pain; however, coblation was associated with a lower rate of postoperative facial numbness. Therefore, coblation may be a better treatment option for TN.

目的:本课探索提高高职助产专业学生的岗位胜任能力的教学方法,开展院校合作与网络教学相结合的教学,验证可行性,优化高职助产专业人才培养模式.方法:设立实验组和对照组,实验组采取本研究的教学模式,学习结束,通过对两组学生岗位胜任力进行评价,验证本教学方法的可行性.结果:统计学方法采用SPSS16.0统计软件,对实验组与对照组岗位胜任力进行理论知识成绩和实践技能成绩的χ2检验:①理论知识成绩χ2=16.83,χ2>χ20.01(2),P<0.01;②实践技能成绩的χ2检验,χ2=21.675,χ2>χ20.01(2),P<0.01.结果表明实验组与对照组其教学效果存在显著性差别,表明实验组的教学效果优于对照组.结论:本课题组开展院校合作教学与网络教学结合的教学研究可以提高高职助产专业学生的岗位胜任力,本教学模式值得推广应用.

细胞凋亡机制及过程较为复杂,但其又有重要的维持机体稳定性的作用,当细胞凋亡受到抑制时,可发展为恶性肿瘤.凋亡抑制蛋白(inhibitor of apoptosos protein, )家族有8 个成员[1],可有效抑制细胞凋亡.Livin(又称 KIAP,ML-IAP)是IAP 家族中的新成员.它的出现为恶性肿瘤的研究提供新思路,因而成为研究热点.

随着“二孩政策”全面推行,势必会影响临床护理.儿科所接收的病例具有特殊性,进而对临床护理提出了更高的要求,这就需要儿科护士具备熟练的专业技术,高超的护理操作,方可胜任儿科护理工作.儿科护士作为儿科护理工作的主体,是影响儿科护理服务水平的重要因素,因此,强调儿科护士专业稳定性,具有重要意义.

目的: 研究分析PBL在儿科教学中的应用价值与教学方法.方法: 选取2015年10月-2016年10月期间我院儿科实习的临床医学专业学生62名,按照单盲、平行的原则将这62名学生均分为对照组和观察组,对照组的31例学生接受传统教学,观察在的31例学生接受PBL教学,观察比较两组学生的教学效果.结果: 观察组学生的理论知识评分、技能操作评分以及综合考核评分均明显优于对照组;观察组教学满意度96.77％明显高于对照组87.10％.(P<0.05)具有统计学意义.结论: PBL在儿科教学中的应用价值高,能够提升教学质量,同时还能提升学生的教学满意度,值得推广.

以护理专业三年制高职学生为研究对象,对人才培养目标、课程体系、教学方法等进行改革,构建并实施"增加人文—强化外语—加强实践—核心课程国际化"的护理专业国际化特色课程体系,建立以合作办学为桥梁、以就业为导向、工学结合的护理专业国际化特色人才培养模式,提高学生国际就业竞争力,让学生高质量就业.

探讨思连康联合锌制剂治疗小儿迁延性腹泻的临床效果及对患儿血清指标的影响.选取我院收治的120例迁延性腹泻患儿(收治时间2014年1月至2015年1月),根据患儿治疗方法分为治疗组和对照组各60例,对照组采用基础治疗+锌制剂,治疗组加用思连康治疗,连续治疗10d,对比两组的临床效果.结果显示,接受治疗前,治疗组和对照组患儿的血清IL-6、IL-8、hs-CRP、NO、SOD的水平差异无统计学意义(p＞0.05).接受治疗后,治疗组患儿的血清IL-6、IL-8、hs-CRP、NO的水平均显著的低于对照组(p＜0.05),治疗组患儿的血清SOD的水平均高于对照组(p＜0.05);治疗组患儿的大便性状恢复正常、大便次数恢复正常、腹痛消失时间、腹胀消失时间均显著优于对照组患儿,差异具有统计学意义(p＜0.05).接受治疗10d后,治疗组痊愈率70.00％、显效率21.67％、有效率6.67％、无效1.67％,对照组痊愈率50.00％、显效率35.00％、有效率10.00％、无效5.00％,两组比较差异具有统计学意义(p＜0.05).思连康联合锌制剂治疗小儿迁延性腹泻能显著的减轻患儿炎症反应程度、恢复内环境的稳定、促进临床症状的缓解,提高治疗效果.

目的 探讨研究儿科病例讨论教学模式的应用与价值.方法 选择2015级100名学生作为对象,采用抽签的方式,分为两组,一组为对照组,一组为实验组,每组50名.对照组,传统教学模式,实验组,采用病例讨论教学模式,比较2种教学模式的教学效果.结果 比较理论考试及见习考试成绩,实验组显著高于对照组,经数据分析,差异明显,有统计学意义(P<0.05).另外,调查学生对教学的满意程度,实验组,满意度为94％(47/50),对照组,为82％(41/50),组间对比,差异有统计学意义(P<0.05).结论 儿科教学中,病例讨论教学模式应用价值高,值得推广.

目的:探讨儿科教学中循证医学的应用与意义.方法:选择我学院2015级临床儿科医学专业100名专科生,作为此次研究的对象,通过电脑随机的方式,平分为两组,即常规组与研究组,两组分别有50例.常规组采用传统教学模式,研究组采用循证医学模式.结果:研究组实践能力考核、理论成绩考核分数均显著高于常规组,有统计学意义(p<0.05).结论:通过循证医学模式指导儿科教学,临床意义十分重大,不仅可以培养学生实践能力,而且还能帮助学生进一步巩固理论知识,值得临床重视,可推广.

Objective To evaluate the efficacy and safety of ozoned autohemotherapy (O 3-AHT)in adjuvant therapy of men with primary hypertension. Methods Sixty male patients with primary hypertension treated at Xuanwu Hospital Capital Medical University from January 2014 to January 2015 were randomly divided into experiment group and control group by random number table method,each group had 30 cases. The control group orally took levamlodipine at a dose of 5 mg,once per day. Based on that of the control group,adjuvant therapy of O 3-AHT (concentration:20 mg/ L,once per two days,ten times a course of treatment courses)was given to the experiment group. The systolic blood pressure (SBP)and heart rate (HR)before treatment (T 0 ),3 months after the first course of treatment (T 1 ),3 months after the second course of treatment (T 2 ),3 months after the third course of treatment (T 3 )were recorded;the oral status and grades of satisfaction index (PSI)scores of T 3 were recorded. The incidence of adverse events during the treatment was recorded. Results There was no significant difference in age and course of disease (P > 0. 05). There was significant difference in SBP between two groups (P < 0. 05). There was significant difference in SBP at different time points (P < 0. 05). The treatment method and time had interactive effects on SBP (P < 0. 05). There was no significant difference in HR between two groups (P > 0. 05),there was no significant difference in HR at different time points (P > 0. 05). The treatment method and time had no interactive effects on HR (P > 0. 05). The status of taking medicine orally and grades of PSI scores of the experiment group were significantly better than those of the control group (P < 0. 05). None of the patients in the two groups had severe hypotension,cardiovascular and cerebrovascular accident, hemolysis,allergies and other adverse reactions. Conclusion O 3-AHT shows obvious curative effect and high safety in adjuvant therapy of men with primary hypertension.

1国外情况<br>　　率先着手进行护理成本概念及护理成本构成研究工作的是上个世纪50年代的美国。之后，开始对不同患者的护理成本核算进行分类测量，并确定出核算项目和基本方法。80年代起，美、德、日等国开始从成本价格、护理供需、效益分析、保险等方面，从价值补偿和价值增值两个维度，对配置合理的护理资源进行了大量研究，积累了大量的经验。90年代初，护理经济学研究的发展速度加快，范围广，内容多，注重从不同工作量测算系统下进行成本比较研究和成本效益研究，并纳入医疗机构体系的经济学评价指标，以指导决策和选择。如对重症老年护理单元的建立分析、患者健康教育的成本分析等；在不同的护理方式下，按照不同种类的患者康复成本来计算，如脑卒中、创伤性脑损伤等护理成本分析等；21世纪以来，随着护理成本研究的角度越来越广泛和创新，与临床护理工作结合也越来越紧密，如Patel等[1]对中风患者的护理成本与不同健康水平的护理者之间的关系进行了阐述；Grivelli等[2]在家庭护理成本方面进行了大量资料的收集和比对等；Lipman等[3]在家庭护理成本方面也进行了研究，并集中在了新生儿家庭群体。

Objective To investigate the long - term efficacy and safety of CT guided sphenopalatine ganglion radiofrequency thermocoagulation in the treatment of sphenopalatine neuralgia( SPN). Methods The study enrolled 8 SPN&nbsp;patients who received CT guided sphenopalatine ganglion radiofrequency thermocoagulation in the Department of Pain Management,Xuanwu Hospital Capital Medical University from October 2005 to May 2014. Telephone follow - up was conducted on patients from October 2005 to December 2015,lasting for 19 - 122 months with(55. 4 ± 12. 8)months on average. NRS and VAS of patients before surgery were recorded,and NRS,VAS and pain relief status were recorded 3 days,1 month,3 months, 6 months,1 year,2 years,3 years,5 years,7 years and 10 years after surgery,and postoperative reactions were observed (including visual impairment,facial hematoma,intracranial infection,postural hypotension and syncope). Results The 3 days pain relief rate was 100. 0% after surgery. All the patients completed follow - up,and 1 month,3 months,6 months,1 year,3 years,5 years,7 years and 10 years pain relief rates were all 100. 0% after surgery;2 years pain relief rate was 87. 5%after surgery;one(12. 5% )patient who had relapse 16 months after surgery had pain controlled after the oral administration of tramadol hydrochloride sustained - release tablets and prepared to take CT guided sphenopalatine ganglion radiofrequency thermocoagulation again. Before surgery,the NRS and VAS of the 8 patients were(8. 4 ± 1. 4)and 0;3 days after surgery,the NRS and VAS of the 8 patients were(0. 3 ± 0. 7)and(2. 6 ± 5. 6);1 month,3 months,6 months and 12 months after surgery,the VAS was(1. 5 ± 1. 3),(1. 1 ± 1. 1),(0. 5 ± 0. 9) and 0 respectively and the NRS was all 0;2 years after surgery,the NRS and VAS of 6 patients were both 0;3 years and 5 years after surgery,the NRS of 4 patients was 0 and(0. 5 ± 1. 0 )respectively,and VAS was all 0;7 years after surgery,NRS and VAS of 2 patients were both 0;10 years after surgery,the NRS and VAS of 1 patient were 2 and 0 respectively. After surgery,patients did not have serve adverse reactions, such as visual impairment,facial hematoma,intracranial infection,postural hypotension and syncope. Conclusion CT guided sphenopalatine ganglion radiofrequency thermocoagulation for SPN can make pain relief which lasts for a long time,thus it is a safe and effective mini - invasive therapy.

Objective To investigate the clinical efficacy and safety of the infiltration of nasal mucosa with lidocaine in the treatment of nasal interal neuralgia related to acute upper respiratory tract infection. Methods From October 2014 to December 2015,we enrolled 40 patients with nasal interal neuralgia related to acute upper respiratory tract infection who accorded with the inclusion and exclusion criteria from Xuanwu Hospital Capital Medical University as research subjects. Using random number table method,we divided the patients into two groups:lidocaine group(group A)and 0. 9% sodium chloride solution&nbsp;(group B),and each group had 20 patients. Group A and group B received infiltration of nasal mucosa with 1% lidocaine and 0. 9% sodium chloride solution respectively every 1 - 3 minutes for 5 - 10 times with 3 - 5 minutes per time. The VAS scores of general pain,nasal pain and ocular pain before treatment,immediately after first treatment,and on day 1,4 and 7 were recorded;the numbers of patients with obvious(≥50% )remission of general pain,nasal pain and ocular pain and obvious (≥50% )decrease in nasal mucus immediately after treatment and 7 days after treatment,times of treatment,VAS score of satisfaction and adverse reactions such as dizziness and drowsiness were recorded. Results The interaction was identified between treatment and time on VAS scores of general pain,nasal pain and ocular pain(P < 0. 05). Main effects of treatment and time on VAS scores of general pain,nasal pain and ocular pain were significant(P < 0. 05). Group A was lower than group B in VAS scores of general pain and ocular pain on day 4 after treatment(P < 0. 05). Group A had lower VAS scores of general pain, nasal pain and ocular pain immediately after treatment and on day 1,4 and 7 after treatment than those before treatment(P <0. 05);group B had lower VAS scores of general pain,nasal pain and ocular pain on day 4 and 7 after treatment than those before treatment and immediately after treatment(P < 0. 05). Group A had higher number of patients with obvious remission in general pain,nasal pain and ocular pain than group B( P < 0. 05);the two groups were not significantly different in the numbers of patients with obvious decrease in nasal mucus immediately after treatment,obvious remission of general pain,nasal pain and ocular pain and obvious decrease in nasal mucus on day 7 after treatment(P > 0. 05). Group A had higher numbers of patients with obvious decrease in nasal mucus on day 7 after treatment than those immediately after treatment(P < 0. 05);group B had higher numbers of patients with obvious remission in general pain,nasal pain and ocular pain and obvious decrease in nasal mucus on day 7 after treatment than those immediately after treatment(P < 0. 05). Group A had more treatment times than group B(P < 0. 05). Group A was higher than group B in VAS score of satisfaction( P < 0. 05). No adverse reactions such as dizziness and drowsiness occurred in both groups. Conclusion The infiltration of nasal mucosa with 1% lidocaine is a safe and effective method to relieve nasal interal neuralgia related to acute upper respiratory tract infection.

Objective To observe the efficacy and safety of repetitive transcranial magnetic stimulation( rTMS)in treating idiopathic trigeminal neuralgia( ITN). Methods From December 2013 to December 2014,the study enrolled 40 patients who were definitely diagnosed with ITN in the Department of Pain Management,Xuanwu Hospital Capital Medical University. Using random number table method,the patients were divided into gabapentin group and rTMS group,20 in each group. General data of the patients were recorded, including gender, age, duration of disease, lesion side and lesion branch. The VAS score and the number of patients with VSA score < 4 were recorded before treatment,in week 2(T1),week 5 (T2),month 1(T3),month 3(T4)and month 6(T5)after treatment. The dosages of gabapentin and the pain remission rate at T1, T2, T3, T4 and T5 were recorded, and adverse reactions such as somnolence and dizziness at T5 were also observed. Results The two groups were not significantly different in gender,age,duration of disease,lesion side and lesion&nbsp;branch( P > 0. 05 ) . One patient in gabapentin group terminated treatment and was excluded from the study due to the ineffectiveness of gabapentin. There was no interaction between treatment method and treatment time for VAS score(P > 0. 05);treatment method had no marked main effect on VAS score(P > 0. 05);treatment time had marked main effect on VAS score(P< 0. 05). The two groups were not significantly different in VAS score at different time points(P > 0. 05). The two groups had lower VAS scores at T1,T2,T3,T4 and T5 than those before treatment(P < 0. 05). Before treatment,there were no patients with VAS score < 4 in the two groups. After treatment,the two groups were not significantly different in the incidence of VAS score< 4 at different time points(P > 0. 05). The two groups of patients were significantly different in the dosage of gabapentin at different time points after treatment(P < 0. 05). The two groups were not significantly different in pain remission rate at different time points after treatment( P > 0. 05). rTMS group was lower than gabapentin group in the incidence rates of dizziness and somnolence after treatment(P < 0. 05). Conclusion rTMS can effectively relieve idiopathic trigeminal neuralgia,and it is a safe and effective method of noninvasive physical therapy.

细胞凋亡()，即为细胞的程序性死亡( P ro-grammed cell death，)，是机体为有效维持自身动态平衡由基因控制的细胞自主性死亡方式。细胞凋亡的运行过程较为复杂，凋亡抑制蛋白( inhibitor of apoptosos protein，)可有效阻断所需的半胱氨酸--天冬氨酸蛋白酶类()的水解活性，进而抑制细胞凋亡，与肿瘤的发生发展密切相关。当前所发现的在人体内存在的成员有8个，包括X－染色体连锁的抑制凋亡的蛋白( XI-AP/ILP－1)；神经元性抑制凋亡的蛋白()；细胞抑制凋亡的蛋白－1()；细胞抑制凋亡的蛋白－2()；多重泛素结合酶()；()；()以及()[1]。 X－染色体连锁的凋亡抑制蛋白(XIAP)是由Peter等学者于1996年运用PCR技术和Southern 杂交克隆出来的一种具有抗凋亡作用的蛋白，其紧密结合凋亡启动因子及效应因子与，调节受体信号传导，抑制细胞凋亡，是IAP s家族中最有效的caspase抑制剂[2]。 XIAP存在于多种正常组织中，但在多种恶性肿瘤中表达水平明显增高。国内外很多学者利用不同的技术，在多种恶性肿瘤组织中发现了XIAP的高表达，说明XIAP在肿瘤的发生和发展过程中有着重要的作用。