Objective: To build a relationship model of perceived academic self-efficacy, learning stress, and learning burnout of high school students. Methods: 674 high school students were surveyed with Learning Stress Scale of High School Students, The Perceived Academic Self -efficacy Scale, Scale of Learning Burnout of High School Students. Results: Learning stress had a direct effect on a low level of learning efficacy, perceived alienation to teacher and physical exhaustion (The direct effect value were -0.22,0.12,0.27). At the same time, perceived basic ability and perceived control partially mediated the impact of learning stress on the low level of learning efficacy, perceived alienation to teacher and physical exhaustion (the mediated effect value were -0.155 and-0.264, 0.066 and 0.299, 0.089 and 0.233). Perceived basic ability and perceived control fully mediated the relationship between learning stress and emotional exhaustion (the mediated effect value were 0.033 and 0.387). Conclusion: The students with a higher level of stress reported suffering more learning burnout than those with a lower level of stress, and vice versa.

Objective To explore the MRI appearances of heterotopic gray matter. Methods The appearances of MRI of heterotopic gray matter(n=12) confirmed were analyzed retrospectively. Results In the 12 cases,3 lesions were nodular,9 lesions were lamellar. MRI can clearly show the lesions. On T1-WIs and T2-WIs,these lesions appeared isointense to the normal gray matter. 2 lesions associated with arachnoid cyst,2 lesions with schizencephaly and 1 lesion with dysgenesis of the corpus callosum and lipoma of midline. During contrast on MRI(n=5) ,all lesions show unenhancement. Conclusion The MRI have characteristics in diagnosis of heterotopic gray matter and is the best method.

Purpose To explore the association between ultrasound contrast agent injection volume as well as regurgitation and tubal patency. Methods SonoVue contrast agent was used for 515 cases of infertility transvaginal four-dimensional ultrasound imaging hysterosalpingography, recorded the amount of contrast agent injection, regurgitation, and compared contrast agent injection volume and regurgitation in different patency. Results The ultrasound contrast agent injection volume between bilateral patency with bilateral passable and one side patency one side passable as well as one side patency one side barrier, between one side patency one side passable and one side patency one side barrier had no significant difference (U=1467.0-4843.0, P>0.05);and it had statistical difference between any other two conditions (U=273.5-6160.0, P<0.05). The regurgitation between bilateral passable and bilateral barrier, one side passable one side barrier, between bilateral barrier and one side patency one side barrier, one side passable one side barrier, between one side patency one side passable and one side patency one side barrier had no statistical difference (U=949.5-6378.5, P>0.05), and it had statistical difference between any other two conditions (U=919.5-5126.5, P<0.05). Conclusion Ultrasound contrast agent injection volume and regurgitation in hysterosalpingography are associated with tubal patency, which can be used as objective indexes for assessing tubal patency, and provide basis for tubal patency.

Based on comprehensive vocational ability,this article analyzed lesson presentation of nursing pharmacology by introducing the nature and function of this course,design idea,curriculum goal,curriculum content,curriculum implementation and curriculum evaluation.Through this activity,higher vocational teachers may change the comprehension of curriculum and improve the quality of teaching.

Comparison of rCBF SPECT imaging and clinical visual function of 12 cases with complete homonymous hemianopia (CHH) were taken before and after a course of oriented dynamic color photic stimulation (ODCPS ). It was suggested that ODCPS in patients with CHH was an effective met hod for increasing visual field and improving visual function. Cerebral metabolic patterns of increasing rCBF reflected the mechanism of ODCPS effecting the patients with CHH. The rgtinal- midbrain-occipital visual path way may play an important role in mediating the increase of visual field and restoration of visual function.

Objective To investigate whether amniocentesis may increase the risk for mother-tochild transmission of hepatitis B virus (HBV).Methods Totally 40 children born to HBV-infected mothers who had amniocentesis performed in Nanjing Drum Tower Hospital, Nanjing University Medical School from January 2010 to December 2013, were followed up and screened for HBV markers.Amniotic fluid samples were collected and stored at-80 ℃ were tested for HBV markers.Among the 40 carrier mothers, three (7.5％) were hepatitis B e antigen (HBeAg)-positive.Relevant data such as antiviral history, administration of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG) in infants were collected.Chi-square test or Fisher's exact test was used for statistical analysis.Results The mothers were 21-41 years old, with a mean age of (31.5±5.5) years at the time of amniocentesis and mean gestational age of (21.2± 1.6) weeks (18.4-24.9 weeks).Indications for amniocentesis were mainly abnormal maternal serum alpha-fetoprotein levels (65.0％, 26/40)and maternal age over 35 years (10.0％, 4/40).None of the mothers received antiviral therapy and 14 (35.0％)underwent transplacental amniocentesis.Among 28 cases who had a store of amniotic fluid sample and were followed-up, one (7.1％) was positive for both hepatitis B surface antigen (HBsAg) and HBV DNA, and another was positive for HBsAg only.The average age of 40 children at follow-up was (2.0± 1.0) years (seven months to four years old), among which 23 were boys and 17 were girls.All of them received hepatitis B vaccine and HBIG.Positive rate of HBsAg and HBV DNA in HBeAg(+) mothers are higher than those in HBeAg(-) mothers [4.7％(2/43) vs 3/5, x2=14.705;0/43 vs 2/5, x2=17.948;both P ＜ 0.05].Thirty-seven children born to HBsAg(+)/HBeAg(-) mothers were negative for both HBsAg and hepatitis B core antibody (anti-HBc), and the other three born to HBsAg(+)/HBeAg(+) mothers were also negative for HBsAg and anti-HBc.Additionally, the positive rate of hepatitis B surface antibody in children was 90.0％ (36/40).Conclusions For those HBsAg(+)/HBeAg(-) mothers, amniocentesis does not elevate the risk for mother-to-child transmission of HBV, even performed transplacentally.However, further studies are needed for HBeAg-positive mothers.HBsAg or HBV DNA positive in amniotic fluid should be diagnosed as intrauterine infection of HBV.

Objective To investigate the value of the adaptive statistical iterative reconstruction (ASIR) algorithm for reducing the radiation dose and optimizing the image quality in the low-dose spectral CT scanning in GSl (Gemstone spectral imaging) of the liver.Methods A total of 60 patients who underwent hepatic spectral CT scanning in GSI were enrolled in this study.The patients were randomly divided into two groups according to priority with 30 cases per group.Low-dose spectral CT scanning was used for group A, and images were reconstructed by ASIR 0 and 50％ , marked as A1 and A2.Group B was scanned with conventional dose of spectral CT, and images were reconstructed by Filtered back projection (FBP).Effective doses (E) for each group were calculated.Image quality was assessed by two radiologists, and the radiation doses were compared between groups A and B.Results All image quality of each group were good enough for clinical diagnosis.E for group A and B were (3.2 ±0.2) and (5.8 ± 0.2) mSv, respectively.There was statistical difference with image noise between group A and B(Z =-6.784,P ＜ 0.05).The image noise, SNR and CNR had statistical differences between group A and B (F =24.013, 15.646, 8.285, P ＜0.05).Compared with group A1, the image noise was lower, and the SNR and CNR were higher in groups A2 and B(P ＜ 0.05).There were no statistical differences of image noise, SNR and CNR between groups A2 and B (P ＞ 0.05).There were no statistical differences of the image quality score between groups A1, A2 and B (F =102.38,105.768, P ＜ 0.05).Conclusions ASIR combined with low-dose spectral CT scanning was helpful to reduce radiation dose and could obtain better image quality in hepatic CT examination.

Objective To access the diagnostic accuracy and clinical value of transvaginal real time three-dimensional hysterosalpingo-contrast sonography (RT-3D-HyCoSy) in evaluating the fallopian tube patency.Methods 428 infertile women were under went transvaginal RT-3D-HyCoSy and 32 of them were underwent laparoscopically salpingoraphy to evaluate the fallopian tube patency.Results 846 fallopian tubeswere studied by RT-3D-HyCoSy,271 of them were unobstructed,202 of them were obstructed,373 of them were partially passable.Compared with laparoscopically salpingography,sensitivity,specificity,positive predictive value and negative predictive value of transvaginal RT-3D HyCoSy were 84.0％,100％,87.5％ and 90.9％,respectively.The transvagianl RT-3D HyCoSy and the laparoscopy with a Cohen's Kappa was 0.788.Conclusions Transvagianl RT-3D HyCoSy could dynamic show the visualization of the course from uterus to distal tubal and the both ovary consecutively.It has more advantage in assessing the patency of tubal and distal tubal function.

Objective To investigate the effects of comprehensive psychological intervention on psychological and biochemical indexes of servicemen in three degree combat readiness. Methods 189 servicemen in three degree combat readiness were randomly divided into the study group and the control group by squad. Beyond the same exercise and education as the control group, the study group received the comprehensive psychological intervention in the course. They were all assessed with Self-rating Depression Scale (SDS) ,self-rating anxiety scale (SAS) ,and simplified coping style questionnaire (SCSQ) at the day entering three degree combat readiness (prereadiness) and the next day after the mission (post-readiness). The serum concentrations of superoxide dismutase ( SOD), malondialdehyde ( MDA), cortisol ( COR), and aldosterone (ALD) were determined to evaluate biochemical indexes at the same time. Results Compared with the control group after the combat readiness, the total scores of SDS( (42.1 ± 9.3 ) vs (49.2 ± 10.3 ) ) and SAS( (43.8 ± 7.2) vs (50.6 ± 10.2), P＜ 0. 01 ) were lower, the score of the positive coping style ( ( 21.2 ± 6.4) vs ( 18.2 ± 5.4), P ＜ 0. 05 ) was higher in the study group.Meanwhile,the levels of MDA( (2.6 ±0.51 ) μmol/L) ,COR( (252.5 ±52.4) ng/ml) ,and ALD ( (97.5 ±24.4) pg/ml) were lower ( P ＜ 0. 01 ), the activity of SOD ( ( 1551 ± 354 ) U/gHb) was higher ( P ＜ 0. 01 ) after the combat readiness. In the control group post-readiness, the total scores of SDS (49.2 ± 10.3) and SAS (50.6± 10.2) ,the levels of MDA ( (2.9 ±0.35 ) μmol/L) ,COR( (333.8 ±62.6) ng/ml) ,and ALD( ( 123.8 ±29.6)pg/ml ) increased significantly (P＜0.01), the score of the positive coping style ( 18.2 ± 5.4) and the activity of SOD ( 1302 ± 352 ) U/gHb decreased significantly ( P ＜ 0. 01 ). The total scores of SDS, SAS were negatively related to the level of SOD ( r= -0. 142, -0. 119, P＜0. 0lor 0.05) ,and positively related to COR ( r=0. 156,0. 159, P＜0. 01 ) and ALD ( r=0.151,0.156, P＜0. 01 ). The score of positive coping style was positively related to the level of SOD ( r=0. 141, P＜0. 01 ) ,and negatively related to COR and ALD ( r= -0. 152, -0. 155, P＜ 0. 01 ). Conclusion Comprehensive psychological intervention could effectively improve the psychological and biochemical indexes,reduce the stress level of servicemen in three degree combat readiness.

Objective To investigate use of oral antihypertensive drugs among community hypertensive patients in Shanghai and find out factors related to their unreasonable use to direct their clinical use. Methods Seven hundred and three hypertensive patients were surveyed with questionnaire by stratified cluster sampling at three neighborhoods and one village of Dahua community, Baoshan district, Shanghai during April to June 2009 to understand their use of antihypertensive agents, including kinds and forms of drugs, rationale of drug use. Results Five hundred and eighty-two (82. 8% ) of 703 hypertensive patients interviewed were using antihypertensive drugs, 271 (38. 5% ) of them used only one kind of non-compound antihypertensive drug, 182 (25.9%) used one kind of compound agent, 311 (53.4%) used two or more kinds of drugs in combination, including 117 patients ( 16. 8% ) used two kinds of agents combined and 12 patients ( 1.6% ) used three kinds of agents combined. Two hundred and sixty-six (47.5%) patients took orally calcium-channel blockers and 205 ( 35.2% ) used compound agents. Conclusions Frequency of combined use of two or more kinds of antihypertensive agents is reasonable and significantly higher than that of use of one kind of drug at Dahua community in Shanghai. Calcium channel blocker plays a predominant role in treatment for hypertension, non-long-acting compound agents are used in a higher proportion. But,guidelines for hypertension prevention and treatment are not so well complied with in local hypertensive patients. So, it is suggested that training for community physicians and management for standard use of antihypertensive agents at community should be strengthened further.