Nursing keypal exchange: an effective acculturation strategy to prepare for an international experience

Aim: The aim of this paper is to provide arguments for incorporating keypal exchanges prior to an international exchange. Background: At Rotterdam University of Applied Science in the Netherlands, the Master's in Advanced Nursing Practice Program/Nurse Practitioner Program focuses on the role of the nurse practitioner and places emphasis on internationalization within the curriculum. The students must complete a short‐term immersion experience to the USA during the 2‐year programme. Conclusion: An effective teaching strategy to acculturate students to the American culture, healthcare and nursing system differences was utilized by incorporating keypal communication within the international preparation programme.     

溴脱氧尿嘧啶核苷体外掺入舌癌的初步研究

目的:观察溴脱氧尿嘧啶核苷(BrdU)标记在肿瘤增殖研究中的价值。方法:用80LgPml的BrdU或碘脱氧尿嘧啶核苷(IdU)体外掺入Tca8113细胞或舌癌组织,标本连续切片与增殖细胞核抗原(PCNA)表达比较;相同孵育时间的细胞与流式细胞术(FCM)定量S期细胞数比较。结果:BrdU标记细胞核大浑圆,呈散在或姊妹细胞分布,子代细胞染色稍淡。BrdU或IdU掺入和PCNA表达之间无显著性差异(P>0105)。FCM测定的S期细胞数显著多于 BrdU掺入的细胞数(P<01001)。结论:BrdU标记可用于细胞增殖研究,其应用潜力较大。     

Cx31.1蛋白在舌癌细胞中的表达及其对细胞通讯功能的影响

目的：探讨细胞缝隙连接蛋白（connexin)Cx31.1在人舌鳞癌细胞系Tca8113中的表达及其对细胞间隙连接通讯的影响。方法：应用流式细胞仪及其Lucifer Yellow划痕荧光传输技术,研究六亚甲基二乙酰胺（HMBA）作用对Tca8113细胞Cx31.1蛋白表达,以及细胞生长状态和间隙连接通讯功能的调节作用,结果：Tca8113细胞经HMBA处理后,流式细胞仪分析,C 31.1蛋白表达的阳性细胞计数率由1．7％上升至30．3％,Tca8113细胞生长明显受到抑制,推测细胞间隙连接通讯功能得到部分恢复,结论：HMBA可上调Cx31.1蛋白在Tca8113细胞中的表达,可能命名细胞间隙连接通讯功能得到恢复,并实现对舌癌恶性表型的逆转作用。     

Surgical treatment of squamous cell carcinoma of the base of tongue.

INTRODUCTION: Squamous cell carcinoma (SSC) of the tongue base has historically been shown to be associated with a poor prognosis. We reviewed our experience with primary surgery followed by postoperative radiation therapy (XRT) to determine the impact of our treatment protocols on outcome. METHODS: We retrospectively reviewed the records of all patients presenting to the University of Pittsburgh with previously untreated SSC of the tongue base between 1980-1997. Patients who were treated nonoperatively were excluded from analysis. Surgical excision of the primary was performed with ipsilateral neck dissection. The contralateral neck was dissected when the primary lesion was located in the midline or for clinically positive contralateral neck nodes. Postoperatively, most patients (93%) received XRT to the primary site and neck. Adjuvant chemotherapy was offered if histologic signs of aggressive behavior were identified (multiple nodes or extracapsular spread). RESULTS: Of 87 patients identified, 39 (45%) were initially seen with T1 or T2 tumors. Seventy-nine patients (91%) were initially seen with stage III or IV disease. Contralateral neck dissection was performed in 36 patients (41%). Metastatic disease was demonstrated in 84% of ipsilateral neck nodes and in 47% of contralateral neck nodes. Occult metastases were found in 61% of clinically N0 necks. Local recurrence occurred in 5 patients, regional recurrence occurred in 12 patients, and distant metastases developed in 22 patients. Overall and disease-specific survival rates at 5 years for all patients were 49% and 56%, respectively. The 5 year disease-specific survival rates for stage I, stage II, stage III, and stage IV disease were 100%, 86%, 62%, and 48%. The 5-year disease-specific survival rate was 88% for T1 lesions, 64% for T2 lesions, 58% for T3 lesions, and 30% for T4 lesions (p <.05, log-rank test). CONCLUSIONS: Surgical treatment of SCC of the tongue base is highly effective in achieving local disease control and disease-free survival for early lesions. Because both functional outcome and survival are poor after surgical treatment of advanced lesions, we now offer brachytherapy with XRT or participation in a combined chemoradiation protocol rather than primary surgical therapy to patients with advanced disease. Prospective studies are needed to compare the effect of these organ-preserving therapies with traditional combined surgery and XRT to determine the effect on functional outcome and quality of life.     

肿瘤浸润性T淋巴细胞ζ链异常表达在舌癌预后中的价值

[目的]探讨肿瘤浸润性T淋巴细胞CD3-ζ链异常表达在舌癌预后预测中的价值。[方法]利用免疫组化法检测115例舌癌CD3-ζ链的异常表达,分析方法是寿命表法、Kaplan—Meier法和Speannan相关检验。[结果]CD3-ζ链异常表达（CD3-ζ减少）者占42．61％（49／115）。CD3-ζ链正常表达组患者的3、5年累积生存率分别为84．69％、82．60％,异常表达组为69．23％、66．67％（P=0．0362）,单因素分析提示CD3-ζ链异常表达影响患者预后。CD3-ζ链异常表达与颈淋巴结病理阳性组患者的3、5年累积生存率最低（30．00％、30．00％）,其次分别是CD3-ζ链正常表达与颈淋巴结病理阳性组（66．67％、66．67％）,CD3-ζ链异常表达与颈淋巴结病理阴性组（79.32％、76．14％）患者,而CD3-ζ链正常表达与颈淋巴结病理阴性组患者的3、5年累积生存率最高（87．51％、85．01％）（P=0．0000）。[结论]肿瘤浸润性T淋巴细胞CD3-ζ链异常表达在舌癌预后评价中的有一定价值,结合颈淋巴结病理状态能更加准确地预测患者预后。     

Incorporating learning technologies into undergraduate radiography education

PurposeThis study investigated the impact of integrating podcasts/audio file downloads and use of an electronic voting system (EVS) on a previously traditionally taught module. Both student (direct entry and mature) and staff satisfaction with the modified structure were evaluated.MethodAn interim student evaluation was undertaken during the module, to provide formative data to the module leader about student opinion of the teaching methods and learning technologies. An end of module questionnaire was given to students and staff on the teaching team.ResultsFrom the interim evaluation, given the option of returning to the traditional delivery method, 77.5% of students agreed that the module should continue to run in its blended format. The final evaluation discovered no differences in the behaviour of direct entry students compared to mature students. Both groups accessed the podcasts easily, generally at home, and spent longer studying than if blended learning technologies had not been used. It was discovered that 16% of the mature and 24% of the direct entry students would have preferred lectures to podcasts, although the students were positive about the flexibility offered. Both groups of students were virtually unanimous on the benefits of the EVS to support learning.ConclusionThe researchers concluded that the learning technologies did not create barriers for either student group, and that students' engagement with their learning and level of classroom interactivity were both increased when compared with the previous traditional delivery. The researchers are confident that the described combination of teaching delivery methods is a successful way of allowing small group work to continue with large cohorts.     

Radiation recall reaction with docetaxel administration after accelerated partial breast irradiation with electronic brachytherapy

PurposeAccelerated partial breast irradiation (APBI) offers several advantages over whole breast irradiation. Electronic brachytherapy may further reduce barriers to breast conserving therapy by making APBI more available. However, its toxicity profile is not well characterized.Methods and MaterialsA 60-year-old woman was treated with APBI using Axxent (Xoft, Sunnyvale, CA) electronic brachytherapy. One month after APBI, a cycle of docetaxel and cyclophosphamide was given. Within 3 weeks, the patient developed an ulcerative radiation recall reaction in the skin overlying the lumpectomy cavity. To investigate this toxicity, the skin dose from electronic brachytherapy was compared with the dose that would have been delivered by an iridium-192 (¹⁹²Ir) source. Additionally, a dose equivalent was estimated by adjusting for the increased relative biologic effectiveness (RBE) of low energy photons generated by the electronic source.ResultsUsing electronic brachytherapy, the skin dose was 537 cGy per fraction compared with 470 cGy for an ¹⁹²Ir source. Given an RBE for a 40 kV source of 1.28 compared with ¹⁹²Ir, the equivalent dose at the skin for an electronic source was 687 cGy-equivalents, a 46% increase.ConclusionsWe present a case of an ulcerative radiation recall reaction in a patient receiving APBI with electronic brachytherapy followed by chemotherapy. Our analysis shows that the use of electronic brachytherapy resulted in the deposition of significantly higher equivalent dose at the skin compared with ¹⁹²Ir. These findings suggest that standard guidelines (e.g., surface-to-skin distance) that apply to ¹⁹²Ir-based balloon brachytherapy may not be applicable to electronic brachytherapy.     

Sublingual Gland Resection in Squamous Cell Carcinoma of the Floor of Mouth: is it Necessary?

OBJECTIVES: Little evidence exists to guide surgeons in the management of the sublingual glands (SLG) not macroscopically involved by squamous cell carcinoma of the floor of mouth and oral tongue. This study aims to determine the frequency with which the SLG is invaded, to identify variables predicting for SLG invasion and the morbidity associated with it's resection in entirety. STUDY DESIGN: Retrospective cohort study. METHODS: A review of 164 patients treated for oral cavity cancer at a tertiary institution with a large volume of head and neck malignancy was performed. Demographic data, rates of surgical complications and follow up information was recorded. Pathologic review of resected material in this group yielded 134 specimens in the region of the SLG. A detailed analysis of 63 specimens in which the SLG was included was carried out. RESULTS: The median age was 58 years, mean follow up was 2.2 years, and there were 44 males and 19 females. Seventeen cases (27%) demonstrated histopathological SLG invasion. In patients with SLG involvement, this was evident at the time of surgery in 15 patients (88%). Microscopic SLG invasion, without macroscopic evidence at surgery, was present in only 4.2% of patients undergoing SLG resection. Clinical and pathological T stage (p = 0.023 and 0.005) and tumor thickness (p = 0.015) predicted for SLG invasion. Total SLG resection significantly increased the post-operative wound complication rate from 14% in patients without SLG resection to 25% (p = 0.05). CONCLUSION: Total SLG resection in early stage and thin squamous cell carcinoma of the floor of mouth and oral tongue provides minimal oncologic benefit and is associated with increased perioperative morbidity due to neck wound complications.     

The relationship of body mass index and blood pressure in primary care pediatric patients

OBJECTIVE: To determine whether an association of overweight, or risk of overweight, and blood pressure can be detected in children in the pediatric primary care practice setting. STUDY DESIGN: We examined electronic medical record (EMR) data from primary care practices on 18,618 children age 2 to 19 years. Each child was classified on the basis of age- and sex-specific body mass index (BMI) percentile as normal weight (BMI < 85th percentile), at risk for overweight (BMI > or = 85th and < 95th percentile), or overweight (BMI > or = 95th percentile). BMI Z-score and height Z-score were computed. Systolic and diastolic blood pressures were compared among age-sex-BMI groups. RESULTS: Among children in primary care pediatric practices, 16.7% were at risk of overweight and 20.2% were overweight. With increasing BMI status there was a significant increase in both systolic blood pressure (P < .001) and diastolic blood pressure (P < .001). The association of higher blood pressure with increasing BMI status was present in all age groups. CONCLUSIONS: Clinical data from pediatric primary care practices verify the high prevalence of childhood overweight. The effect of overweight on blood pressure is present in childhood and can be detected even in children as young as 2 to 5 years.     

egfr基因两个重要片段和核基质结合

背景与目的： 探讨舌鳞癌细胞株TCA8113中egfr基因两个重要片段和核基质的关系。材料与方法： 应用免疫组化和Western印迹对TCA8113中表皮生长因子受体 (Epidermal growth factor receptor,EGFR)的表达进行检测,通过PCR扩增了解egfr基因的两个片段与核基质的结合关系。结果：TCA8113不仅表达EGFR,而且,在该细胞株中EGFR基因的两个片段（一个为由829 bp长的编码区片段和110 bp长的内含子构成的939 bp长的片段; 另一个为110 bp长的非编码区片段）均与核基质紧密结合。结论： TCA8113细胞中egfr基因通过这两个片段与核基质紧密结合,并可能通过这种相互作用调控EGFR的表达。 进一步分离和鉴定与egfr基因片段结合的核基质蛋白,并研究它的功能,对了解EGFR与肿瘤发生发展的关系,以及阻断EGFR治疗肿瘤有一定意义。