Objective To investigate and analyze the clinical learning environment and professional identity among undergraduate nursing students, and discuss the relationship between two variable, so as to provide basis for ensuring the stability of the nursing staff. Methods 288 undergraduate nursing students who were practicing in Tianjin 3A grade hospital were evaluated using questionnaires about clinical learning environment and professional identity. The correlation analysis was performed between two variable. Besides, multiple regression analysis was used to identify factors that affect the nursing students′ professional identity. Results The total score of 288 nursing students′clinical learning environment and their professional identity was (3.44±0.66) points and (3.65±0.55) points respectively, which were at the middle level. The score of clinical learning environmental was positively correlated with professional identity score (P<0.01). The result of multiple regression analysis showed that professional selectivity had influence on nursing students′ professional identity. With controlling the demographic variables, undergraduate nursing students′ clinical learning environment could explain 58.2% of professional identity. Conclusions Undergraduate nursing students′ clinical learning environment and professional identity are at the middle level. Hospitals should pay more attention to the relationship that clinical learning environment have influence on undergraduate nursing students′professional identity.Measures should be taken to ensure the stability of the high-quality nursing personnel.

Objective To explore the related mechanism of clinical nurses′career growth from three aspects such as organization, family and oneself. Methods Totally 480 clinical registered nurses from eight tertiary first- class hospitals of Tianjin City were investigated with the Proactive Personality Scale, Psychological Safety Climate Scale, Work- Family Support Scale,Career Growth Scale by convenient sampling method. Results Latent interaction structural equation modeling (SEM) showed that family support and work support both had a positive effect on career growth, whose path coefficient were 0.42 and 0.26 respectively, P<0.01, but the interaction was inapparent, P>0.05. Hierarchical regression analyses showed that proactive personality had a negative effect on the relationship of work support and career growth whose regression coefficient was -0.148, P<0.01, and psychological safety climate had a positive effect on the relationship of work support and career growth whose regression coefficient was 0.178, P<0.05. Conclusions In order to promote clinical nurses′career growth, the construction of nurse team and improve quality of nursing, hospital and nurse managers should construct a favorable work atmosphere, provide more support, attach importance to the effect of individual personality on career growth and help nurse deal with work and family well.

Objective To investigate the expression and significance of S100A4 protein and Ecadherin in coloreetal carcinoma. Methods S-P immunohistochemical method was used to detect the expression of S100A4 and E-cadherin in 87cases with colorectal carcinoma and 87 cases with adjacent colorectal tissue, and the expression of S100A4 and E--cadherin were analyzed with relation to clinicopathologic factors and post-operative five-year survival. Results There was no expression for S100A4 protein in glandular epithelium of adjacent colorectal tissues. The positive expression rate of S100A4 was 64.4 %(56/87) in colorectal carcinoma. There was a significant difference between eolorectal carcinoma and adjacent group(P ＜0.01). The expression of S100A4 was positively correlated with the clinical stages, lymph node metastasis and five-year survival (P ＜0.05), but not with other clinicopathalagic factors (P ＞0.05). There was 100 % expression for E-cadherin in adjacent colorectal tissues. The positive expression rate of Ecadherin was 62.1%(54187) in colorectal carcinoma. There was a significant difference between colorectal carcinoma and adjacent group (P ＜0.01). The expression of E-cadherin was positively correlated with the clinical stages, lymph node metastasis, tumor site and five-year survival (P ＜0.05), hut not with other clinicopathologic factors (P ＞0.05). The expression of S100A4 was negatively correlated to E-cadherin in colorectal carcinoma without statistical meaning(r =-0.087, P ＞0.05). Conclusion S100A4 and E-cadherin are closely related with colorectal cancer invasion, metastasis and prognosis; S100A4 might be an important predictor of the clinicopathologic features and prognosis of eolorectal carcinoma.

Objective To assess the accuracy (ACC),sensitivity (SEN),and specificity (SPE) of dose-volume histogram (DVH) parameters in predicting the radiation pneumonitis (RP) using receiver operating characteristic (ROC) curve.Methods Complete clinical data of 118 non-small cell lung cancer patients treated with three-dimensional conformal and intensity-modulated radiotherapy plus chemotherapy were included.Chi-square and logistic regression were retrospectively applied to analyze the correlations between DVH parameters [relative lung volume received ≥ 5 Gy (V5),10 Gy (V10),13 Gy(V13),20 Gy (V20) and 30 Gy (V30) and mean lung dose (MLD)] and grade 2 (and above) RP defined by the National Cancer Institute Common Terminology Criteria for Adverse Events,version 3.0.ROC curve was adopted to investigate the predictive ACC,SEN and SPE of potential DVH parameters associated with RP.Results Total lungs V5,V10,V13,V20 and MLD were all correlated to the development of RP (x2 =4.786,5.771,6.366,7.367 and 6.945,P ＜ 0.05) according to univariate analysis.However,total lungs V30,patient characteristics (age,sex,KPS,tumor location,pathology) and treatment factors (prescription dose,radiotherapy technique,chemotherapy method and timing) were not contributors to RP.Logistic regression showed that V20 of both lungs remains tight by associated with RP (x2 =10.96,OR =4.16,95％ CI 1.40 ～ 12.36,P ＜0.05),although significant colinearity was found between V20 and other DVH parameters (r =0.767-0.902,P ＜0.05).ROC curve confirmed that V20 of both lungs could act as a predictor for RP (Z =2.038,P ＜ 0.05).The predictive ACC,SEN,and SPE were 0.645 (95％ CI0.498-0.793),0.650 (95％ CI0.408-0.864),and 0.674 (95％ CI0.571-0.765),respectively.However,the positive predictive value was only 28.9％.Conclusions V20 of both lungs was correlated to the development of RP.It could act as a predictor for RP though the predictability is limited.

Objective To investigate whether baicalein inhibits the proliferation, cell cycle of and pseudopod formation in A431, a skin squamous cell carcinoma cell line, by suppressing the expression of ezrin protein. Methods A431 cells were grouped to be transfected with ezrin-targeting siRNA (siRNA group), treated with baicalein of 5, 10, 20, 40 μmol/L, respectively (baicalein group), or remain untreated (control group). After additional culture, wound healing assay and Transwell assay were performed to observe the migration and invasion of A431 cells, RT-PCR to detect the mRNA expression of ezrin in A431 cells, Western blot and immunoflu-orescence to measure the expression of ezrin protein and its phosphorylation. The pseudopod formation in A431 cells was observed by using scanning electron microscopy. Results After 24-hour culture, wound healing assay displayed that the percent wound closure was 13.3 ± 1.7, 7.6 ±1.6 and 5.9 ± 1.3, respectively, in A431 cells treated with baicalein of 5, 10, 20μmol/L, significantly lower than that in untreated A431 cells (16.3 ± 2.3, all P < 0.01), and the inhibition of baicalein on the migration of A431 cells was concentration-dependent. In the Transwell assay, a significant decrease was observed in the number of A431 cells per high power field permeating through the artificial basement membrane in the groups treated with baicalein of 5, 10, 20 μmol/L for 48 hours compared with the control group (46.5 ± 3.8, 34.3 ± 3.4, 25.3 ± 2.3 vs 56.3 ± 3.8, all P < 0.01), whereas no significant difference was noted between these baicalein-treated groups and siRNA-transfected group (28.3 ± 2.1, all P > 0.05). RT-PCR analysis showed that the mRNA expression of ezrin in baicalein-treated A431 cells significantly decreased compared with that in untreated cells (all P< 0.01), but showed no difference from that in siRNA group (P > 0.05). A statistical difference was also observed in the expression of ezrin and phosphorylated ezrin protein between baicalein-treated A431 cells and untreated cells (all P< 0.05), but not between 40 μmol/L baicalein-treated A431 cells and siRNA-transfected cells (P> 0.05). Furthermore, the suppression of baicalein on ezrin protein and mRNA expression was concentration dependent. The number of pseudopod per cell was significantly lower in 20 μmol/L baicalein-treated A431 cells and siRNA-transfected cells than that in untreated A431 cells (5.3 ± 1.9, 4.5 ± 2.8 vs 22.6 ± 2.8, both P < 0.01), while no significant difference was observed between the former two groups of cells (P > 0.05); the length of pseudopodia also reduced in baicalein-treated cells. Conclusions Baicalein may inhibit the proliferation and invasion of A431 cells by directly or indirectly suppressing the expression of ezrin and phosphorylated ezrin, which in turn contributes to the effect of baicalein against tumor proliferation and metastasis.

A 6-azido-β-cyclodextrin was synthesized and derivatized with p-nitrophenyl isocyanate as chiral ligand. Following that the ligand was chemically bonded to mesoporous SBA-15 via a ‘Click Chemistry ’ reaction of the azido group with alkynyl group. A new p-nitrophenylcarbamoylatedβ-cyclodextrin bonded SBA-15 chiral stationary phase ( NPCSP ) for HPLC was obtained. The new stationary phase was first used to enantioseparate propranolol in human plasma under the polar organic solvent mode. The effects of methanol content , additive concentration of glacial acetic acid/triethylamine in mobile phase and the temperature on the enantioseparation were studied. The optimal chromatographic conditions were as follows: mobile phase was acetonitrile/methanol/glacial acetic acid/triethylamine (90:10:1. 25:2. 25, V/V), temperature 288 K, flow rate of 0. 5 mL/min, injection volume of 20 μL, detection wavelength at 290 nm. The resolution was 2. 04 with a short run time (< 15 min) under the above conditions. The composition of propranolol in plasma was quantitatively measured by HPLC-MS selected ion monitoring mode ( [ M +H ]+ m/z 260 . 10 ) with hydrochlorothiazide as internal standard. And linear range was 2. 5-250 μg/L and with a good linear relationship. The detection limit was 1 μg/L according to S/N=3. The experimental results showed that the chiral stationary phase exhibited excellent chiral separation ability to propranolol and the analysis method for propranolol in plasma was sensitive, accurate, simple and fast, which could be used for the determination of propranolol in plasma and pharmacokinetic studies.

Objective To investigate the influence of work-family support,self-efficacy and psychological safety climate on nurses' career growth,and to establish a model of this influence.Methods Totally 382 registered nurses were recruited from four third level and grade A hospitals in Tianjin.They were investigated with Career Growth Scale (CGS),Work-Family Support Scale (WFSS),General Self-Efficacy Scale (GSES) and Psychological Safety Climate (PSC).Results The total effect of work-family support on nurses career growth was 0.562 with the 95％ confidence interval at 0.502-0.641;Indirect effect was 0.121 with the 95％ confidence interval at 0.065-0.207,both of the effects were statistically significant.The effect of work-family support-psychological security atmosphere-self-efficacy and career growth path accounted for 45.1％ of the total indirect effect with 95％ confidence interval at 0.197-0.201;the effect of work-family support-self-efficacy and career growth path accounted for 54.9％ of the total indirect effect with 95％ confidence interval at 0.066-0.068,the intermediary effect were established.Conclusions This study established a structural equation model connecting work-family support,self-efficacy,psychological security atmosphere,career growth and enucleate their internal connection.The administrators of nurses should provide nurses with support on both work and life,and help nurse with their career growth through increases of self-efficacy and psychological safety climate.

Two patients who developed typical skin eruptions 24 hours after consumption of shiitake mushrooms are reported.Case 1:a 56-year-old woman suddenly developed widespread itching eruptions one day after intake of shiitake mushrooms.On examination,there were erythematous and edematous linear streaks (flagellate erythema) over the neck,trunk and limbs.Case 2:a 60-year-old man presented with edematous flagellate erythema over the trunk and limbs for four days.He reported intake of shiitake mushroom several days prior to the presentation.Pathological examination revealed focal parakeratosis,intracellular and intercellular edema in the prickle cell layer,severe edema of papillary dermis,evident widening of interfibrous spaces,dilation and congestion of capillaries in the superficial dermis with a mixed perivascular infiltrate of massive lymphocytes and sparse neutrophils.Both patients were diagnosed with shiitake dermatitis,and treated with prednisone and antihistamines.The lesions subsided after 3 and 4 days of treatment in patient 1 and 2 respectively.

Objective To explore the effects of over-expression high-mobility-group A2(HMGA2) on proliferation and cell cycle in primary cultured human growth hormone-secreting pituitary tumor cells .Methods The protein expression of HMGA2 in growth hormone-secreting pituitary tumor cells transfected by HMGA2 overexpression plasmid (transfection group) were detected by Western blot .The effects of the HMGA2 overexpression on cell proliferation ,cell cycle were measured by (cell counting kit-8 , CCK-8) assay and flow cytometry respectively .Results HMGA2 protein of transfection group was higher than the blank load transfection group(tranfectied with pcDNA3 .1 plasmid) after 24 h (P<0 .05) .To compare with the blank load transfection group , cells overexpression of HMGA2 could drastically increase the ability of proliferation at 24 ,48 ,72 ,96 h and increase the S phase rati-o of cell cycle and decrease the G1 phase ratio of cell cycle ,the difference was statistically significant (P<0 .05) .Conclusion Over-expression of HMGA2 increases pituitary tumor cells proliferation ability and promote cells G 1 phase progress .

Objective To observe the clinical curative effect of selective bronchial arterial embolization for severe hemoptysis.Methods Thirty-eight hospitalized patients with severe hemoptysis was enrolled in this study.Of which 31 patients were recurrent hemoptysis,27 patients were with bronchiectasis,4 patients were with bronchial lung cysts,4 patients had unknown causes,3 patients were with tuberculosis.All patients were diagnosed by chest imaging examination,fiber bronchoscopy,bronchial arteriography,and they were all treated by selective bronchial arterial embolization.Results The most times of embolization was 3,and bronchial arterial imaging were performed for vascular malformation.After having bronchial arterial embolization,35 patients were immediately released of bleeding.Postoperative 24 h,8 patients had hemoptysis again,of which 1 case was performed with conservative treatment and subsequently had pneumonectomy,5 patients had effective conservative treatment,2 cases were performed embolization again after failed conservative treatments.Hemoptysis completely disappeared within 1 week.The total effective rate was 97.4％(37/38).Patients were followed up for 1 year,of which 13 patients relapsed again,11 patients'annual and each time's quantity of hemoptysis reduced 50％.Two patients had pneumonectomy after a number of embolization.The total effective rate was 94.7％ (36/38).After treatment,3 patients had mild chest pain in short time,2 patients had shoulder pain,3 patients had chest tightness,and 3 patients had subcutaneous passive congestion.After being treated for short-term,these symptoms disappeared eventually.Conclusion Selective bronchial arterial embolization for the treatment of acute or recurrent severe hemoptysis is very effective,and can avoid the risk of surgery.It is effective for recurrent cases and worthy of clinical application.