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2018 Vol. 48, No. 8 Published: 2018-08-25   547 Prediction and analysis of B cell epitopes of type HPV58 E6 protein YE Xiaoxian, MAO Shanshan, SONG Yiling, WANG Lude, JIANG Pengfei, ZHU Shanli, ZHANG Lifang Objective: To predict and analyze the B cell linear epitopes of the high-risk human papillomavirus HPV 58 E6 protein and its structure. Methods: E6 protein sequences retrieved from the Swissprot protein database provided by the Swiss Institute of bioinformatics were analyzed using computer aided bioinformatics software, and Expasy Server analysis was used to predict physicochemical properties, secondary structure, three-dimensional structure of E6 protein. DNASTAR software was used to further analyze its hydrophilicity, flexibility, surface probability, antigenicity and polarity and other characteristics. Combined with the amino acid antigen index calculation method, the average antigen index (AI) was calculated, and according to the AI size, the potential peptide of B cell linear epitopes of HPV 58 E6 protein was predicted and analyzed by homology matching. Results: The B cell linear epitopes of HPV58 E6 protein may be located at the following peptide position: N-terminal 8-15 (KPRTLHDL), 27-44 (ELKCVECKKTLQRSEVYD), 108-127 (RPLCPQEKKRHVDLNKRFHN), 141-147 (RPRRRQT) peptide and its surrounding. The homology analysis showed that peptide 27-44 and 141-147 are possible linear epitopes of B cells, which are unique sequences of cell type HPV58 E6 B epitopes. The homology match between peptide 8-15 and HPV33 type E6 protein was 100%. The peptide 108-127 matches HPV33 type E6 and HPV9 E6 protein being 100% homologous. Conclusion: 27-44, 141-147 peptide are the potential dominant epitopes of B protein of HPV58 type E6. 2018 Vol. 48 (8): 547-551 [Abstract] ( 890 ) HTML (1 KB)  PDF (1596 KB)  ( 903 ) 552 The mechanism of FPR2 in suppressing the proliferation, migration and invasion of human extravillous trophoblastic cells Zhao Shenzhi, HUANG Xianping, XIANG Huiqiu, LIAO Tingting, CHEN Jiajia, XU Zhangye Objective: To explore the preliminary mechanism and effect of FPR2 on the proliferation, migration and invasion of human extravillous trophoblastic cells (TEV-1). Methods: Overexpression of FPR2 RNA was constructed and transfected into human TEV-1 cells. MTT assay, transwell assay and scarification test were used to detect the cell proliferation, migration and invasion. RT-PCR and Western blot was used to detect the expression of NF-ĸB and MMP9 mRNA and protein. Results: Over-expression of FPR2 significantly increased the expression levels of FPR2 mRNA and protein in TEV-1 cells (P<0.001), indicating that the transfection was successful. Over-expression of FPR2 gene significantly inhibited the proliferation, invasion (P<0.01) and migration of TEV-1 cells (P<0.05). Over-expression of FPR2 gene significantly decreased the mRNA and protein levels of NF-ĸB and MMP9 in TEV-1 cells (P<0.001). Conclusion: These findings indicated that over-expression of FPR2 gene may perturb proliferation, migration and invasion through NF-ĸB/MMP9 pathway in TEV-1 cells. 2018 Vol. 48 (8): 552-556 [Abstract] ( 784 ) HTML (1 KB)  PDF (1686 KB)  ( 794 ) 557 Correlation between human cytomegalovirus infection and Kawasaki disease YU Lili, LU Jiacheng, XUE Xiangyang, QIU Huixian, WU Rongzhou, CHU Maoping Objective: To investigate the human cytomegalovirus (HCMV) antibody levels in peripheral blood in children with Kawasaki disease (KD) and its correlation with the clinical characteristics of KD. Methods: Two hundred and thirty three children with KD, 113 healthy children and 143 children with fever were collected for retrospective analysis from the Second Affliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from March 2005 to December 2013. Then 58 KD children, 40 healthy children and 40 children with fever were collected for verification analysis. The relationship between clinical characteristics, laboratory indexes and HCMV infection in KD children was analyzed. Results: Retrospective analysis showed that the HCMV IgM positive rate of KD children was lower than fever children (P<0.05), but had no statistical difference from healthy children (P>0.05). The HCMV IgM positive rate of healthy children was also lower than fever children (P<0.05). And there were no statistical difference in IgG positive rate, IgM and IgG antibody titer level among three groups. The verification analysis found that IgM, IgG positive rate and IgM antibody titer level were not statistically different among three groups (P>0.05). But the IgG antibody titer level of KD children was higher than healthy children and fever children (P<0.05). The realation between HCMV infection and clinical features of KD children showed that the incidence of coronary artery injury in HCMV IgM positive children with KD was obviously higher than that of HCMV IgM negative children (P<0.05). There was no difference in the incidence of coronary artery injury in children with HCMV IgG positive and HCMV IgG negative. Conclusion: There is no correlation between HCMV infection and the occurrence of KD. However, HCMV infection may be associated with the progression of coronary artery lesion in KD children. 2018 Vol. 48 (8): 557-562 [Abstract] ( 834 ) HTML (1 KB)  PDF (1267 KB)  ( 985 ) 563 The circRNA expression profile in the tissue of liver fibrosis mice ZHOU Yuping, LYU Xueyou, QU Hui, ZHU Linwen, YE Guoliang, GUO Junming Objective: To study the expression profile of circular RNA (circRNA) in hepatic tissues in a liver fibrosis model. Methods: The classic CCl4 mouse liver fibrosis model was established alongside a normal control group. The high-throughput circRNA microarray technique was used to compare the changes of circRNA expression profiles in the liver of the two groups. The target circRNA was selected according to the principle of high expression difference and good consistency between samples, RT-qPCR was used to verify its expression in liver tissue, and  bioinformatics software was used to predict microRNA (miRNAs) which may be regulated by it. Results: There were 69 circRNAs differentially expressed (P<0.05) in liver tissues between the normal group and the model group, with the difference being more than 2 times. Among them, one was up-regulated by more than 4 times in the model group and five were down-regulated by more than 4 times. RT-qPCR experiments confirmed that the five circRNA trends were consistent with the microarray results. Four of them were statistically different (P<0.05). Bioinformatics analysis combined with literature retrieval showed that mmu_circ_42398, mmu_circ_42397 could combine with miR-338-3p, while mmu_circ_34116 could combine with miR-141-5p in their participation in the pathogenesis of liver fibrosis. Conclusion: The circRNA expression profile in liver fibrosis tissues shows significant changes and circRNA may be involved in the pathogenesis of liver fibrosis. 2018 Vol. 48 (8): 563-566 [Abstract] ( 738 ) HTML (1 KB)  PDF (1630 KB)  ( 919 ) 567 The expression of TLR4 and epithelial-mesenchymal transition-related markers in intrahepatic biliary epithelial cells of patients with primary biliary cholangitis LIU Donghong, LIN Feng, YANG Zaixing, ZHANG Zhencheng, ZHONG Renqian, LIANG Yan Objective: To explore the expression levels of Toll-like receptor 4 (TLR4) and epithelial-mesenchymal transition (EMT)-related markers in intrahepatic biliary epithelial cells (IBEC) and their association in patients with primary biliary cholangitis (PBC). Methods: Immunohistochemistry assay was used to detect the expression levels of TLR4 and EMT-related markers (E-cadherin and vimentin) in IBEC from liver tissues of 11 PBC patients and 5 healthy controls (donors for liver transplantation) from Shanghai Changzheng Hospital. The correlations between TLR4, EMT and PBC fibrosis progression were analyzed. Results: No expression of TLR4 was observed in IBEC of healthy individuals, while significant expression was found in PBC patients. The positive ratios of TLR4 in PBC patients were 28.6%, 41.6%, 64.0% and 73.1% in stage 1, 2, 3 and 4, respectively. The differences were statistically significant between stages except for stage 1 vs. 2 and stage 3 vs. 4 (P<0.01). The expression level of E-cadherin was significantly decreased in IBEC of PBC patients, compared with that of healthy individuals. The positive ratios of E-cadherin were 84.0%, 8.1%, 23.0% and 19.0% respectively in stage 1, 2, 3 and 4 in PBC patients. The differences were statistically significant between groups except for healthy group vs. stage 1 and stage 3 vs. 4 (P<0.01). There was no expression of vimentin in IBEC of healthy individuals, while significant expression in PBC patients. The positive ratios of vimentin were 30.0%, 40.1%, 73.7% and 77.0%, respectively in stage 1, 2, 3 and 4 in PBC patients. There were statistically significant differences between stages except stage 1 vs. 2 and stage 3 vs. 4 (P<0.01). The positive ratio of TLR4 in IBEC had significant negative correlation with that of E-cadherin (r=-0.927, P<0.001), but positively related to that of vimentin (r=0.918, P<0.001). Additionally, the positive ratio of E-cadherin had also significant negative association with that of vimentin (r= -0.918, P<0.001). Conclusion: The expression of TLR4 is increased and EMT occurs in IBEC of PBC patients. Furthermore, TLR4 is closely associated with EMT and both of them show close correlation with PBC fibrosis progression. 2018 Vol. 48 (8): 567-571 [Abstract] ( 676 ) HTML (1 KB)  PDF (1647 KB)  ( 880 ) 572 The establishment of high/low invasion liver cancer stem cells model and identification of its biological properties LI Yuncheng, ZENG Fang, DING Xianjun, LI Shibo Objective: To establish high/low invasion liver cancer stem cells (H/L-ILCSCs) model from human liver cancer cell line HCCLM3, and compare their biological properties with HCCLM3 and HL-7702 cells. Methods: ①Transwell immigration assay was used to separate high/low immigration HCCLM3 cells, then the high/low invasion HCCLM3 cells were isolated from high/low immigration HCCLM3 cells by Transwell invasion assay. ②H/L-ILCSCs were isolated from CD133+ high/low invasion HCCLM3 cells using magnetic activated cell sorting. ③The expression of cancer stem cell markers CD133+, CD90+ and CD44+ were detected in H-ILCSCs, L-ILCSCs, HCCLM3 and HL-7702 cells. ④The proliferation, invasion, clonal sphere formation and tumorigenicity were investigated by CCK-8 assay, Transwell invasion assay, monoclonal sphere formation and transplanted tumor formation assay in nude mice in H-ILCSCs, L-ILCSCs, HCCLM3 and HL-7702 cells. Results: High expression levels of cancer stem cell markers CD133+, CD90+ and CD44+ in H-ILCSCs, but high expression levels of CD133+ and low expression levels of CD90+ and CD44+ in L-ILCSCs. The abilities of proliferation, invasion, clonal sphere formation and tumorigenicity in L-ILCSCs, HCCLM3 and HL-7702 cells were lower than in H-ILCSCs. The abilities of proliferation and invasion in L-ILCSCs were lower than in HCCLM3 cells. Besides, stem cell spheres and nude mouse transplanted tumor couldn’t be established in L-ILCSCs cells. Conclusion: H/L-ILCSCs can be isolated and expanded from HCCLM3 cells, and both cells exhibit distinct biological properties. 2018 Vol. 48 (8): 572-576，581 [Abstract] ( 642 ) HTML (1 KB)  PDF (1571 KB)  ( 816 ) 577 Effect of melatonin on expression of α-SMA and E-cadherin in mice with bleomycin-induced pulmonary fibrosis HU Qingqing, ZHOU Enmin, Jin Ke, DU Yong, QIAN Yan, WENG Huachun Objective: To investigate the effect of melatonin on expression of α-SMA and E-cadherin in  mice with bleomycin induced pulmonary fibrosis and its mechanism. Methods: Mice pulmonary fibrosis model was made by intratracheal injection of bleomycin (5.0 mg/kg) and randomly divided as model group and melatonin group. After 4 weeks, the mice were sacrificed and lung tissue extracted. HE staining was used to evaluate the morphological changes and the oxidative stress kit was used to detect the activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA). The levels of inflammatory cytokines IL-6 and TNF-α in lung tissues were measured by RT-PCR. The expression of α-SMA and E-cadherin in lung tissue was detected by immunohistochemistry. The expression of α-SMA and E-cadherin mRNA in lung tissue was detected by RT-PCR. Western blot was used to detect the expression of α-SMA and E-cadherin in lung tissue. Results: Compared with the model group, the SOD expression in the melatonin group was significantly increased (P<0.05), and the MDA expression was significantly decreased (P<0.05); the expression of TNF-α and IL-6 in the lung tissue was significantly decreased (P<0.05). Immunohistochemistry results showed that the expression of α-SMA protein in the lung tissue of melatonin group was significantly reduced (P<0.05), and E-cadherin protein expression was significantly increased (P<0.05); RT-PCR experiment results showed that the expression of α-SMA mRNA in the lungs of melatonin mice was significantly decreased (P<0.05), and E-cadherin mRNA expression was significantly increased (P<0.05). Western blot results showed that the expression of α-SMA protein in lung tissue of melatonin mice was significantly decreased (P<0.05), and E-cadherin protein expression was significantly increased (P<0.05). Conclusion: Melatonin can inhibit the expression of α-SMA protein, reduce the expression of E-cadherin, and delay the progression of pulmonary fibrosis by reducing the levels of oxidative stress and inflammatory factors. 2018 Vol. 48 (8): 577-581 [Abstract] ( 671 ) HTML (1 KB)  PDF (1629 KB)  ( 901 ) 582 Correlation between peak temperature and prognosis in sepsis patients from intensive care unit MAO Xiaoqiang, LOU Bingheng, CUI Yiming Objective: To explore the correlation between temperature and prognosis in sepsis patients. Methods: The clinical data of 176 cases of sepsis patients admitted to intensive care unit of Quzhou People’ Hospital during January 2013 to May 2017 were retrospectively analyzed. They were divided into 4 groups according to the highest body temperature (MAXICU) recorded during ICU stay: ≤37.4 ℃ group, 37.5-38.4 ℃ group, 38.5-39.4 ℃ group, ≥39.5 ℃ group and all their clinical data were recorded. The relationship between the temperature in each group and 28-mortality was analyzed by Cox regression; the survival rates was calculated using the Kaplan-Meier method and the differences in each group were assessed by log-rank test. Multivariate Cox proportional hazard regression analysis was used to analyze the risk factors of 28-mortality in patients with sepsis. Finally, multivariate dummy variable test was performed. Results: Of the four groups, the 28-day death occurred in 80 cases, with a mortality rate of 45.4%. The median survival time of ≤37.4 ℃ group, 37.5-38.4 ℃ group, 38.5-39.4 ℃ group and 38.5-39.4 ℃ group was 28 days, 13 days, 28 days and 28 days respectively, which involved 16 cases, 39 cases, 17 cases and 8 cases of respectively. Kaplan-Meier survival curve analysis showed the mortality rate between the four groups within 28 days after entering into ICU was statistically different (χ2 log-rank=16.377, P=0.001). Log-rank method was used to compare between groups. The survival distribution was statistically different between 38.5-39.4 ℃ group and 37.5-38.4 ℃ group (P<0.001). Significant difference also existed between ≥39.5 ℃ group and 37.5-38.4 ℃ group (P=0.013), but there’s no statistical difference between ≤37.4 ℃ group and 37.5-38.4 ℃ group (P>0.05) in the survival distribution. The maximum temperature taken in ICU (37.5-38.4 ℃ group, ≤37.4 ℃ group, 38.5-39.4 ℃ group, ≥39.5 ℃ group), acute physiology and chronic health evaluation (APACHE II) score, the use of blood products, international normalized ratio level (INR), PaCO2, age, gender were used as the independent variables and the 28-day mortality after patients entered ICU as the dependent variable to perform the single factor Cox regression and multi-factor Cox regression. Single factor Cox regression analysis showed that the maximum body temperature after entering ICU (HR=0.722, 95%CI=0.562-0.927, P=0.011), APACHE II score (HR=1.057, 95%CI=1.031-1.084, P<0.001), use of blood products (HR= 1.650, 95%CI=1.061-2.566, P=0.026), the level of INR (HR=2.179, 95%CI=1.054-4.509, P=0.036), PaCO2 level (HR=0.978, 95%CI=0.961-0.995, P=0.01) were the risk factors of the death in sepsis patients within 28 days after ICU. Multivariate COX regression analysis showed that the body temperature was still the independent risk factor that affected the patient’s death within 28 days after entering the ICU (P=0.045). Further multivariate dummy variable test for temperature was performed. The 37.5-38.4 ℃ group was taken as the control group (dummy variable), the MAXICU=38.5-39.4 ℃ was the independent protective factor of the 28-day mortality for the septic patients in ICU, the 28-day mortality risk was 41.2% as much as the control group (95%CI=0.221-0.771, P=0.005), but there was no obvious correlation between MAXICU=36.5-37.4 ℃, MAXICU≥39.5 ℃ and the 28-day mortality in ICU (HR=0.930, 95%CI=0.448-1.930, P=0.846; HR=0.560, 95%CI=0.237-1.323, P=0.186). Conclusion: MAXICU=38.5-39.4 ℃ may reduce the mortality of septic patients in ICU. 2018 Vol. 48 (8): 582-586 [Abstract] ( 713 ) HTML (1 KB)  PDF (1310 KB)  ( 868 ) 587 Diagnostic value of autofluorescence laryngoscopy in early laryngeal cancer and its precursor lesions#br# WU Xianmin, PENG Jianhua, LI He, CHEN Jun, CHEN Xiaoyun Objective: To study the diagnostic value of autologous fluorescence laryngoscope for early laryngeal carcinoma and precancerous lesions. Methods: A total of 122 patients, who were suspected with early laryngeal cancer or precancerous lesion and treated at the First Affiliated Hospital of Wenzhou Medical University from July 2014 to July 2016, were examined by both white light and autofluorescence laryngoscopy. The sensitivity and specificity of the two methods were compared based on histopathological diagnosis. Results: The histopathological diagnosis of high and low risk lesions were 95 and 27 respectively. There were 82 and 66 high-risk lesions detected by autofluorescence laryngoscope and ordinary white laryngoscope respectively. The sensitivity of autologous fluorescence laryngoscope and ordinary white laryngoscope was 86.3% and 69.5% (P=0.005) respectively, and the specificity was 51.9% and 63.0% respectively (P=0.409). Twenty cases of early laryngeal cancer or precancerous lesions which had been missed by ordinary white light laryngoscope were detected by autologous fluorescence laryngoscope. Precancerous lesions or precancerous lesions appeared to be surrounded by green fluorescence under autologous fluorescence laryngoscope. Conclusion: Autologous fluorescence laryngoscope is helpful for early diagnosis of laryngeal carcinoma and provides guidance for biopsy and surgical resection of laryngeal carcinoma. 2018 Vol. 48 (8): 587-590 [Abstract] ( 799 ) HTML (1 KB)  PDF (1441 KB)  ( 970 ) 591 A comparison between different anesthesia protocols in gastroscopy procedure GUO Jiantao, Ye Qianqian, YE Keping, YE Qigang, WANG Wenwei, Lin Han Objective: To assess the advantages and security of three different anesthesia protocols including propofol-sufentanil, propofol-lidocaine aerosol and sufentanil in the outpatient’s gastroscopy procedure. Methods: A total of 240 patients scheduled for gastroscopic examination in Huangyan Hospital Affiliated to Wenzhou Medical University from April 2016 to December 2016 were prospectively randomized into propofol-sufentanil group (PS group), propofol-lidocaine aerosol group (PL group) and sufentanil group (S group). The vital signs (HR, MAP, SpO2) in each group were recorded before anesthesia (T0), before intubation (T1), immediately after intubation (T2) and 5 min after completion of the gastroscopy procedure (T3). The consumption of propofol, the recovery time and adverse effects like body movement, gag reflex, and dizziness were recorded. Results: The dosage of propofol in group PL was significantly lower than in PS group (P<0.01). Compared with PS group, the incidence of body movement in PL group was significantly lower (P<0.05), and the incidence of pharyngeal reflex in PL group and S group was significantly lower (P<0.05). The incidence of tachycardia and hypotension in S group was significantly lower compared with PS group (P<0.05). The recovery time of PL group after the procedure was significantly shorter compared with PS group (P<0.01). Compared with MAP at T0, MAP at T1, T2 and T3 in PS group was lowered (P<0.05) and MAP at T2 in PL group was lowered. Among all the three groups, the MAP level at T1 in S group was highest (P<0.05). At T2 and T3, the level of MAP gradually increased with PS group, PL group and S group (P<0.05). Compared with HR at T0 and T1, HR was increased at T2 in S group (P<0.05). Conclusion: Administration of propofol-lidocaine aerosol and sufentanil in sedation and analgesia can be a feasible anesthesia scheme due to its safety and effectiveness. 2018 Vol. 48 (8): 591-594，599 [Abstract] ( 860 ) HTML (1 KB)  PDF (1292 KB)  ( 1155 ) 595 Comparative study of small incision tightrope system and clavicular hook plate in the treatment of acromioclavicular joint dislocation HU Wei, LEI Tao, TANG Jun, CHEN Long, HONG Jianjun Objective: To compare the clinical efficacy of small incision tightrope system and AO hook plate in the treatment of Rockwood type III acute shoulder dislocation. Methods: From January 2014 to December 2016, 69 cases of Rockwood type III acromioclavicular joint dislocation  were treated in the Orthopedics Department of the Second Affiliated Hospital, Wenzhou Medical University. Among them, 30 cases were treated with small incision tightrope system and 39 with AO clavicle hook plate. The indexes of their postoperative imaging results, clinical outcomes and complications during operation and hospitalization between the two groups of patients were compared and analyzed. Results: Compared with the clavicle hook plate group, the operation time of the small incision tightrope plate group was the same (P>0.05), but the average blood loss was less and the length of incision was shorter (P<0.05). There was no significant difference (P>0.05) between the two groups in the beak lock distance. The incidence rate of shoulder pain in the small incision tightrope plate group was lower than that of the clavicle hook plate group, and there was no significant difference between the two groups in the Constant function of the shoulder joint (P>0.05). Dislocation occurred in 3 cases of small incision tightrope plate group. In clavicle hook plate group, postoperative complications occurred including skin irritation, wound infection and nerve injury. Conclusion: The overall efficacy of small incision tightrope plate in the treatment of Rockwood type III acromioclavicular joint dislocation is comparable to the clavicle hook plate. However, small incision tightrope plate has advantages in terms of minimal invasive surgery, low incidence rate in postoperative shoulder pain and shoulder joint activity limit, and less complications as well. 2018 Vol. 48 (8): 595-599 [Abstract] ( 614 ) HTML (1 KB)  PDF (1363 KB)  ( 904 ) 600 The value of large crescent in prognosis of patients with IgA nephropathy ZHENG Shouhao, HUANG Zhaoxing Objective: To assess the value of large crescent in the prognosis of IgA nephropathy (IgAN). Methods: A retrospective analysis of 132 patients admitted into the First Affiliated Hospital of Wenzhou Medical University from January 2008 to February 2017 who were diagnosed by renal biopsy as primary IgAN and contained at least 1 crescents (the crescent volume accounting for more than 50% of the Bowman’s capsule, the same below) was performed. According to the proportion of glomerular crescents in the total number of glomeruli, the subjects were divided into control group with crescent proportion less than 15% and trial group with crescent proportion higher than 15%. The prognosis of the two groups was compared. Multivariate Cox proportional hazard regression analysis was used to analyze the risk factors of renal end point event (Scr doubled compared to the baseline values or had end-stage renal disease). Results: In 132 patients with IgAN, the median large crescent ratio was 8.33% (5.00%, 14.09%). The median follow-up time was 22 (12, 38) months. Compared with the control group, the average age of the patients in the trial group was older, and the level of mean arterial pressure was higher (P<0.05); the level of urinary protein and serum creatinine were higher (P<0.01); the ratio of large crescent and over moderate tubulo-interstitial lesion was higher (P<0.01). Compared with the control group, the usage rate of cytotoxic drugs in the trial group was higher, while the usage rate of RAS inhibitors was lower (P<0.05). Altogether 10 cases entered into end point events, of which 3 out of 100 were in control group, and 7 out of 32 in trail group. There was statistical differences in the incidence of end point events between the two groups (log rank χ2=21.474, P<0.001). Multiple factor stepwise Cox regression analysis results showed that the proportion of large crescents higher than 15% was an independent factor affecting the renal survival (HR=8.133, 95%CI=1.220-54.219, P<0.05). Conclusion: Large crescentic glomerular ratio above 15% may be related with negative renal outcomes of the patients with IgAN. 2018 Vol. 48 (8): 600-605 [Abstract] ( 777 ) HTML (1 KB)  PDF (1291 KB)  ( 731 ) 611 The influence of total improvement position on the comfort of the patients with abdominal surgery Zheng Fengyan, Cao Qian, Zhang Liqing, Gu Didan, Zhang Weijian Objective: To investigate the influence of total improvement position on the comfort of the patients with abdominal surgery. Methods: A total of 200 patients who underwent laparotomy from January to December 2016 were randomly divided into observation group and control group, with 100 cases in each group. Patients in the observation group used a modified type to improve the supine position according to the demand in pre-operative preparation room, intra-operation, and anesthesia resuscitation room, while the control group used the traditional supine position. The Kolcaba general comfort questionnaire (GCQ) was used to evaluate the comfort and satisfaction of the patients during the whole period of modified posture. Results: There was no significant difference between the overall score of the observation group (61.11±10.15) and the overall score of the control group (60.35±10.31) before the intervention. After adjusting for postures with adjustable postures, the overall comfort scores of the observation group at various time points after the operation (Time 1: 70.19±11.93; Time 2: 74.59± 10.85; Time 3: 85.12±11.09) and scores in all dimensions significantly higher than the postoperative scores in the control group (Time 1: 58.30±11.55; Time 2: 64.11±11.26; Time 3: 71.79±11.55), showing statistical differences (P<0.01). Conclusion: The use of adjustable posture can improve the comfort of patients who underwent general anesthesia for abdominal surgery and improve the quality of operating room care. 2018 Vol. 48 (8): 611-614 [Abstract] ( 695 ) HTML (1 KB)  PDF (1282 KB)  ( 800 ) 615 Application of scenario simulation teaching method in improving the competency of nursing interns YU Yueting, HU Pinglang, SHU Meichun, LIN Yichang Objective: To explore the application of scenario simulation teaching method in improving the clinical competency of nursing interns. Methods: Nursing students were divided as the control group with the routine teaching method and the observation group with the situational simulation teaching method based on the conventional teaching method in their clinical practice, and then the differences in their knowledge dimension, behavior dimension and the attitude dimension were compared between the two groups by the end of one round of practice. Results: There was no significant difference in knowledge dimension between the two groups (P>0.05), but the observation group was significantly better than the control group in behavior dimension and attitude dimension (P<0.05). Conclusion: Scenario simulation teaching method can significantly improve the behavior dimension and attitude dimension of nursing interns, and help improve the job competency of nursing students. 2018 Vol. 48 (8): 615-617 [Abstract] ( 836 ) HTML (1 KB)  PDF (1249 KB)  ( 841 )

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