Objective To investigate the assessments from family member and nurse for nursing care needs of critical patients based on the Maslow's hierarchy of needs. Methods Questionnaires regarding nursing care needs of critical patients were designed according to the Maslow′s hierarchy of needs; these questionnaires were performed to family members and nurses, and the results were analyzed. Results There was difference regarding the order of various needs of critical patients between family members and nurses; compared to nurse, family members had significantly higher scores on love and belongingness need [(4.08±0.72) points vs. (3.44±0.63) points, t=5.61, P<0.01], and had obviously lower scores on safety needs [(3.71±0.62) points vs. (3.92±0.69) points, t=2.18, P<0.05]. Conclusions The asymmetry in assessments from family member and nurse for nursing care needs of critical patients exist objectively;during clinical nursing, communication with family members should enhance and provide humanized services and management measures should be adopted to improve family members′satisfaction towards nursing service.

Objective To analyze the reliability and validity of the core competence scale A for military personnel.Methods Three thousand and five hundred healthy soldiers volunteered to complete the core competence scale A for military personnel,and data were analyzed by AMOS7.0 and SPSS16.0 program.Results The confirmatory factor analysis for structure validity of all factors showed that 11 items with higher cross loading should be deleted according to its modified index,thus the revised scale was composed of 7 factors,21 competence components,65 items and one added lie subscale.Furthermore,the theoretical model of the scale was supported by the sample data,and the fit indexes,uch as GFI,AGFI,NFI and CFI of total scale,were all over 0.9,and RMSEA was lower than 0.08.In addition,the standardized factor loadings of all competence components were 0.393-0.791(P

Objective To formulate the Psychological Core Diathesis Scale for Military Personnel(Part B),and examine the reliability and validity of the scale.Methods Following the psychometric principles,a five factors model of general cognitive ability was firstly constructed by theoretic analysis.The items of initial scale were then developed,followed by repetitive revision and screening for the final establishment of the Psychological Core Diathesis Scale for Military Personnel(Part B),which was composed of 5subtests and 25 items.One thousand and two hundred healthy soldiers were chosen by randomized cluster sampling to participate in the measurement,and 1143valid questionnaires were analyzed for item analysis,Cronbach'?coefficients,split-half reliability and construct validity.Four weeks later,50out of the 1143soldiers were retested for evaluation of the test-retest reliability.Another 200soldiers were randomly collected for the measurement of Intelligence Test for Military Personnel(Part B)as well as the Psychological Core Diathesis Scale for Military Personnel(Part B).The correlation between the results obtained from the 2scales was then analyzed.Soldiers were comprehensively evaluated by their squad leader according to uniform standard.Finally,the top soldiers and ordinary soldiers(50each)were selected by 20 squad leaders from the 1143valid subjects,the scores of the 2groups of soldiers on Psychological Core Diathesis Scale for Military Personnel(Part B)were then compared.Results Item analysis indicated that the average difficulty index of subtests ranged from 0.44to 0.80,the discriminatory power from 0.31to 0.50,and the test-retest correlation coefficient between total scale and subtests from 0.6253 to 0.9558(P

Objective To investigate the clinicopathological significance of transforming growth factor-β1 (TGF-β1), transforming growth factor-β1 receptor Ⅱ (TGF-βRⅡ ), Smad4 and Smad7 protein expressions in gastric carcinomas. Methods 109 cases of gastric carcinomas,28 of high grade dysplasia,20 of low grade dysplasia,30 of chronic atrophic gastritis,29 of intestinal metaplasia, and 21 of normal gastric mucosa were selected for the detection of the expression level of TGF-β1,TGF-βRⅡ , Smad4 and Smad7 proteins by immunohistochemistry. Results The expression of TGF-β1,TGF-βRⅡ and Smad7 proteins in gastric carcinomas and dysplasia (high and low grade) were significantly higher than those in chronic atrophic gastritis, intestinal metaplasia and normal gastric mucosa (all P <0. 001 ) ,whereas the expression of Smad4 was significantly increased in high and low grade dysplasia (cytoplas-mic IS :4.89±2.38,5.80±1.54, respectively; nuclear IS: 3.89± 1.52,3.80±1.33, respectively), and decreased in gastric carcinomas (cytoplasmic IS:2.41±2.27,nuclear IS:2.02±2. 14) (P <0.001 ,P <0.001 ,respective-ly). Meanwhile,the expressions of TGF-β1,TGF-βRⅡ and Smad7 were higher in advanced gastric cancer (4.36± 2.66,3.05±1.93,4.84±3.06, respectively) than those in early gastric cancer ( 2.93±1.85,2. 17±1.87, 4. 14±2.46, respectively) ( P < 0.01, P < 0.05, P < 0. 05, respectively ) ; however the expression of Smad4 protein was much higher in early gastric cancer (P < 0. 001 ). The expression of Smad4 protein was significantly correlated with tumor size( P < 0.05 ), lymph node metastasis ( P < 0. 001 ), T stage ( P < 0. 001 ) and chnical stage ( P < 0.001) ,and the expressions of TGF-βRⅡ and Smad4 proteins were correlated with patients' 5-year survival rate (P<0.05 ,P < 0.01 ). TGF-β1 showed the positive correlation with TGF-βRⅡ and Smad7 (r1= 0.45 ,P <0. 05; r2 = 0.49, P <0. 05), but negative correlation with Smad4 ( r = - 0.21,P < 0.05 ). Conclusion TGF-β1, TGF-βR Ⅱ, Smad4 and Smad7 protein may play an important role in the carcinogenesis of gastric carcinoma,and smad4 is the key in TGF-β pathway. Also, the detection of these proteins expression can be a useful marker for predicting the gas-tile cancer invasion,metastasis and patients' prognosis.

Objective To detect the serum expression level of Pokemon and explore its clinical value combines with AFP,AFP-L3 or DCP in hepatocellular carcinoma (HCC).Methods In this study,the serum levels of Pokemon,AFP,AFP-L3 and DCP in 30 patients with HCC,34 patients with benign liver diseases and 30 healthy controls were examined by enzyme-linked immunosorbent assay.Then,the clinical significance of Pokemon expression level was analyzed.In the end,the diagnostic evaluation of four serum biomarker alone detection was used to analyze the sensitivity,specificity,the area under the curve and Youden index in the diagnosis of HCC.Results The serum expression level of Pokemon in patients with HCC was (22.63 ± 6.82) ng/ml,which was significantly higher than that in the group with benign liver diseases and healthy controls [(3.54±1.26)ng/ml,t =8.594,P＜0.001;(1.95 ±0.57)ng/ml,t =10.021,P＜0.001].The expression level of Pokemon in HCC patients was correlated to tumor size (t =2.678,P =0.021) and TNM stag (t =2.578,P =0.034).The serum expression levels of AFP,AFP-L3 and DCP in patients with HCC were (774.56 ± 96.52) ng/ml,(26.37 ± 2.54) ng/ml and (93.49 ± 30.45) mAU/ml,which were significantly higher than those in the group with benign liver diseases [(22.21 ± 3.57) ng/ml,(7.05 ± 2.71) ng/ml,(34.68 ± 10.13) mAU/ml] and healthy controls [(14.65 ± 4.45) ng/ml,(3.84 ± 1.09) ng/ml,(25.87 ± 9.01)mAU/ml,F=58.46,P=0.000;F=12.47,P=0.000;F=23.41,P=0.000].The sensitivity and specificity of Pokemon,AFP,AFP-L3,DCP in the diagnosis of HCC were 84.6％ and 87.5％,52.5％ and 78.9％,95.0％ and 80.0％,77.1％ and 87.5％,respectively.Conclusion The enhanced Pokemon serum level,with its sensitivity and specificity higher than AFP,points out Pokemon may be a potentially useful biomarker to diagnose HCC.

Objective An analytical method for rapid screening and confirmation of multiple pesticide residues in vegetable and fruit was established according to GB 2763-2014 national food safety standard-maximum residue limits for pesticides in food,using ultra performance liquid chromatography-Q-time of flight mass spectrometry (UPLC-Q-TOF-MS).Methods Pesticide residues in vegetable and fruit were screened by comparing the accurate mass,isotope distribution and abundance in the accurate mass database,and confirmed by comparing with the spectra in the spectra library or by the spectral analysis method.Results The method was verified by spiked samples,and all pesticides were detected at the addition level of 10.0 and 50.0 μg/kg.The recovery of 90％ of the pesticides was in the range of 70％-120％,with relative standard deviation (RSD) ≤ 20％ (n =5).The method was applied to screen pesticides in 30 samples of vegetables and fruits.Twenty-seven pesticides were found and 2 samples exceeded the limit.Conclusion The method was sensitive,accurate and reproducible.Hundreds of pesticides in GB 2763-2014 could be screened and confirmed in a short period of time even without standard substance.It could provide an effective method for food safety control.

Chronic inflammatory demyelinating polyneuropathy (CIDP) with positive anti-contactin-associated protein-1 (Caspr1) antibody is a rare autoimmune antibody mediated peripheral neuropathy. A 62-year-old male patient was reported in this article, whose clinical manifestations were subacute onset, abnormal distal limb motor sensation, and increased cerebrospinal fluid protein level. The patient had a good response to plasma exchange. Electromyography of lower limbs showed that motor involvement was dominant, motor conduction velocity slowed down, compound motor active potential (CMAP) and sensory nerve active potential amplitude decreased, and F wave was not elicited; electromyography of upper limbs without symptoms showed that CMAP amplitude of median nerve decreased, and conduction velocity was normal. There are few reports of anti-Caspr1 positive CIDP in the world. The article summarized the characteristics of the patient and reviewed the relevant literature, in order to improve clinicians′ understanding and diagnosis and treatment ability of the disease.

Objective To investigate the relationship between molecular subtypes of breast cancer and postoperative loco-regional recurrence (LR) in early breast cancer patients with 1-3 positive axillary lymph nodes (pN1) and to improve the individualized indications for post-mastectomy radiotherapy (PMRT)in these patients.Methods A total of 547 patients with pT1-2 N1M0 breast cancer,who received mastectomy between December 1998 and December 2009 in Sun Yat-sen University Cancer Center,were retrospectively analyzed.None of them received adjuvant radiotherapy after mastectomy.The patients were divided into luminal A group,luminal B group,HER-2-overexpressing group,and triple-negative group according to the molecular subtypes of breast cancer determined by immunohistochemistry and fluorescence in situ hybridization.The patients in different groups were compared in terms of LR rate (LRR) and LR-free survival (LRFS),and the risk factors for LR were analyzed in combination with clinical and pathological features.The Kaplan-Meier method was adopted to calculate LRR and LRFS;the Logrank test was used for survival difference analysis and univariate prognostic analysis.The Cox proportional hazards model was used for multivariate prognostic analysis.Results The luminal A group,luminal B group,HER-2-overexpressing group,and triple-negative group accounted for 30.0％,48.6％,9.3％,and 12.1％,respectively,of all the patients.The follow-up rate was 97.1％ ;334 patients were followed up for at least 5 years,and 127 were followed up for at least 10 years.Univariate analysis showed that,compared with the luminal A group,the HER-2-overexpressing group and triple-negative group had significantly higher 5-year LRRs (19.0％ vs 5.3％,x2 =4.28,P =0.026; 14.9％ vs 5.3％,x2 =5.02,P =0.015) and significantly lower LRFSs (73.5％ vs 91.1％,x2=7.27,P=0.005;80.6％ vs 91.1％,x2=4.77,P=0.021).Multivariate analysis revealed that HER-2 overexpression,triple-negative phenotype,age of ≤ 35 years,and stage pT2 were poor prognostic factors for survival (LRR and LRFS) (x2 =2.29,2.08,18.22,and 6.86,P =0.020,0.016,0.001,and 0.005;x2 =1.90,1.41,8.58,and 3.94,P=0.006,0.025,0.002,and 0.039).The 10-year LRRs of patients with 0,1,and ≥2 of the above risk factors were 4.3％,14.1％,and 31.9％,respectively (x2 =28.03,P =0.000).Conclusions Molecular subtyping is helpful for individualized evaluation of LR risk in early breast cancer patients with 1-3 positive axillary lymph nodes (pN1).PMRT should be recommended for the patients with 2 or more risk factors for LR.

Objective To investigate the relationship between total homocysteine (tHcy) and carotid intima-media thickness (CIMT) in brain infarction patients. Methods Sixty patients with fasting plasma tHcy levels ≤10μmol/L (non-Hhcy group), 60 patients with fasting plasma tHcy levels>10μmol/L and≤15μmol/L (H1 group), and 60 patients with fast-ing plasma tHcy levels>15μmol/L (H2 group) were chosen in hospitalized patients with acute cerebral infarction. Values of CIMT were detected in three groups of patients. The clinical biochemical indicators including triglyceride (TG), total choles-terol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), folic acid (FA), Vitamin B12 (VitB12) and glycated hemoglobin (HbA1c) were also detected. Results There was signifi-cant difference in CIMT between three groups (P<0.01). The value of CIMT increased in H2 group [0.98(0.90, 1.05)mm] com-pared with that of non-Hhcy group [0.85(0.80, 0.95)mm]. The value of CIMT increased in H2 group compared with H1 group [0.98(0.90, 1.05)mm vs 0.85(0.85, 0.95)mm], P<0.05). There were significant differences in tHcy, FA and VitB12 between three groups. Based on the log-transformed values of CIMT as the dependent variable, multiple stepwise linear regression showed significant associations of the following variables with increased CIMT: increasing age, the history of smoking, the history of diabetes, higher LDL-C and tHcy levels. Conclusion Brain infarction in patients with higher tHcy level often have lower levels of FA and VitB12, and increased CIMT. When the level of tHcy >15 μmol/L, there is more significantly higher level of CIMT. The increased CIMT level was associated with some cerebrovascular risk factors in patients with brain infarction.