Objective:To investigate the impact of humanistic spirit cultivation on nursing students' ethics cog-nition. Method:Total 364 internship nursing students in 2010 were taken as the control group with the routine clini-cal teaching method, 381 in 2014 as the experimental group, not only a routine clinical teaching method but also to increase of their humanistic spirit culture. Results:Humanity spirit cultivation before and after practice nursing students in medical security system cognition difference is not significant, but in medical optimization, the patients right of informed consent, the life value differences of cognitive and ethical cognitive dimension score was statisti-cally significant ( P<0 . 05 ) . Conclusions:Humanistic spirit culture promote the practice of nursing students to raise the level of moral cognition foundation for humanity quality education and nursing ethics education, should further strengthen the diversification of internship training nursing students humanistic spirit.

Objective To explore the folate receptor mediated (FRD) check and multi-function acetic acid white solution liquid based cervical cytology (TCT) application value in cervical cancer screening.Methods A total of 602 cases of patients was tested with FRD multi-function acetic acid white solution check,and TCT and cervical biopsy pathology examination.With the used of histopathological results as the gold standard,FRD multi-function acetic acid white analysis was compared with the TCT screening inspection results.Results For a total 602 patients with TCT screening,the positive rate was 21.8％ (131/602),including 36 cases of CIN Ⅰ level,41 cases of CIN Ⅱ level,24 cases of CIN Ⅲ level,and 30 cases of cervical invasive carcinoma.For the FRD multifunction white acetate solution screening,its positive rate was 23.8％ (143/602).No statistically significant difference was found between TCT and FRD screening (P ＞ 0.05).The missed diagnosis rate of FRD multi-function white acetate solution screening was 2.6％ in inflammation,and 21.1％ in cervical invasive cancer,and 3.8 ％ in CIN.The missed diagnosis rate of TCT screening was 7.2％ in inflammation,5.3％ in CIN Ⅰ,4.9％ in CIN Ⅱ,and 58.6％ in CIN Ⅲ]; whereas,its detection coincidence rate was 100％ in squamous cells carcinoma (SCC) and adenocarcinoma (AC).FRD multi-function acetic acid white solution screening had a sensitivity 80.92％,specificity 92.14％,positive predictive value 74.13％,and negative predictive value 95.59％.TCT examination had a sensitivity 90.84％,specificity 90.23％,positive predictive value 72.12％,and negative predictive value 97.25％.No significant difference was found between FRD and TCT methods (P ＞ 0.05).Conclusions FRD and TCT methods were both efficient in screening and evaluation for cervical lesions and cervical cancer.Because FRD method is limited in the deep tube for examination of cervical lesions; it cannot completely replace the TCT examination.However,FRD method is reliable,economic,and simple operation; it is suitable for primary hospitals census of cervical cancer

Objective To investigate the effects of ketamine and propofol on cardiovascular system and cognitive function in the patients with depression during the modified electroconvulsive therapy (MECT). Methods A total of 60 patients with depression treated by MECT were randomly divided into 2 groups. Induced anesthesia with ketamine and propofol were performed respectively during MECT. The course of treatment was 8 times. The mean arterial pressure(MAP)was recorded before therapy and at 5 min after MECT.Depression and the cognitive function were evaluated by using the Hamilton Depression Scale(HAMD)and the Wisconsin Card Sorting Test(WCST)before treatment and 1 day after treatment. Results There was no significant difference in MAP between the two groups after MECT(P > 0.05). The HAMD scores of the two groups were lower than those before treatment(P<0.05). In the total number of errors and the number of random errors,there was no significant difference between two groups (P > 0.05). But in completing classification of WCST ,the ketamine group was better than the propofol group(P<0.05). Conclusion Propofol has no obvious influence on the cognition function and little influence on MAP,so it could be the first choice of anaesthetic for the induction of MECT.

Objective To investigate the clinicopathological significances of LDHA/mutant p53 co-expres-sion in gliomas. Methods According to the 2016 WHO CNS,archived 68 gliomas were collected and analyzed retrospectively. The co-expression of LDHA/mutant p53 was detected by immunohistochemical staining. Results High expression of LDHA alone was always found in high grade gliomas(48.5%). Mutant p53 high expression was usually observed in glioblastomas (26.5%). There was a close relationship between co-expression of LDHA/mutant p53 in glioblastoma(27.9%,P = 0.005),or gliomas with high histological grading(27.9%,P = 0.002). Conclusions Co-expression of LDHA/mutant p53 in tumor cells might be a specific immunohistochemical pheno-type of gliomas,and may help for distinguishing glioblastoma and other high grade gliomas from low grade gliomas.

Objective To compare the efficiency of National Early Warning Score (NEWS),Chronic Respiratory Early Warning Score(CREWS) and BAP-65(elevated Blood urea nitrogen,Altered mental status,Pulse＞109bpm,age＞65 years)among patients with AECOPD (acute exacerbations of chronic obstructive pulmonary disease).Methods Totally 181 patients with AECOPD were investigated by these three scales,and the efficiency of NEWS,CREWS and BAP-65 was compared.Results The scores of NEWS,CREWS and BAP-65 in the death group were higher than those in the survival group and the general ward group(P＜0.01).Regarding the predicted results of hospital death,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.878,0.836 and 0.774,respectively,and the differences were not statistically significant(P＞0.05);for predicted results of ICU admission,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.826,0.813 and 0.716,respectively,and the differences were not statistically significant (P＞0.05).Conclusion NEWS,CREWS and BAP-65 have satisfied predictive efficiency for prognosis,and NEWS and CREWS are much easier and faster to use.

Objective To analyze iodine nutrition and its correlation with thyroid function in pregnant women.Methods A total of 295 pregnant women were enrolled from Jun.to Oct.2016,and detected for serum levels of thyroid stimulating hormone(TSH),free thyroxine(FT4) and thyroid-peroxidase antibody(TPOAb) by using electrochemiluminescence analysis,and for urinary iodine concentration(UIC) by cold digestion method according to iodine catalytic effect of arsenic-cerium.Results The median of UIC was 174.90 μg/L.The prevalence of iodine deficiency and iodine excess were 40.00% and 7.12% respectively.The prevalence of TPOAb positivity and thyroid dysfunction in the iodine deficiency group and iodine excess group were significantly higher than those of iodine proper group(P<0.05).The levels of TSH and FT4 of iodine excess group were significantly higher than those of iodine proper group(P<0.05).Conclusion The abnormality of iodine nutrition could be common in pregnant women.Monitoring of UIC and thyroid hormones should be highlighted.

Objective:To observe the effects of static 70° head-up tilted standing and of repeated body repositioning on hemodynamics in healthy young and middle-aged persons.Methods:The hemodynamics of 24 middle-aged and 23 younger persons were studied. Both groups were requested to perform static 70° head-up tilted standing and to repeatedly change their body position from 0° to 70° of tilt at a velocity of 1°/second for ten minutes in a random order. Before, between and after each test the subjects rested supine for ten minutes. Hemodynamic variables and blood pressure were recorded non-invasively.Results:The average heart rate (HR) increased significantly in both groups when rising from supine to the testing positions. In 70° tilted standing the average HR of the youth group, 84.0±9.5bpm, was significantly higher than that in the other position and that of the middle-aged group in the same position. The average HR of the middle-aged group in 70° tilted standing was also significantly higher than in the other position. Among the middle-aged group, the average stroke volume (SV) in the testing positions was significantly lower than when resting. Significant differences were observed in the average diastolic blood pressure (DBP) between the testing and rest positions for both groups, with the average DBP of the middle-aged group significantly higher than that of the youth group in all three positions. Among the youth group, the average SV, CO and systolic blood pressure (SBP) of the males were significantly higher than among the females in all of the different body positions.Conclusions:Young persons mainly rely on an increased heart rate to maintain cardiac output while middle-aged participants appear to achieve this through increased peripheral resistance. Repeated position changes have less impact on hemodynamics than 70° inclined standing, making it a safer and more stable training method. However, the long-term effects of such intervention need to be confirmed in further studies.

Objective To explore the effect of dronedaronel on hyperpolarization-activated cyclic-nucleotide-gated(HCN) channel expression by detecting the change of HCN channel mRNA and protein level before and after giving dronedarone in neonatal rat ventricular myocytes.Methods Neonatal rat ventricular myocytes were separated and digested by type Ⅱ collagenase,and then single ventricular myocytes were collected through differential sticking wall separation method.According to the concentrations (0.1,0.5,1.0,5.0,10.0,20.0 μmol/L of dronedaronel for treating myocytes for 48 h) and time(10 μmol/L of dronedaronel for treating myocytes for 1,6,12,24,48 h)the gradient grouping was conducted.The levels of HCN2 and HCN4 channel mRNA and protein level were determined by real-time PCR and Western blot.Results The HCN2 mRNA and HCN4 mRNA expression levels in concentration gradient group and time gradient group were lower than those in the control group(P＜0.05);compared with the control group,the protein level in the 10 umol/L dronedaronel treatment for 12 h group was significantly down-regulated(P＜ 0.01).Conclusion Dronedaronel could inhibit the expression of HCN2/HCN4 channel mRNA and protein,moreover its action shows the concentration dependency and reaches the maximum at 12 h after medication.

Objective: To evaluate the effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension. Methods: The databases of CNKI，Wanfang，VIP，PubMed and the Cochrane Library were researched for the literatures about effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension published from 2011 to 2018. These papers were retrieved and evaluated according to inclusion and exclusion criteria. Stata 12.0 software was used for meta analysis. Results: Eleven out of 880 papers were included into meta analysis. There were 1 174 cases，with 587 cases in the experimental group and 587 cases in the control group. The results of the meta analysis showed that compared with traditional health intervention method，the intervention based on WeChat significantly reduced the level of systolic blood pressure（WMD=14.77，95%CI：11.76-17.77）and diastolic blood pressure（WMD=8.17，95%CI：5.67-10.67）of hypertensive patients. Subgroup analysis showed that the longer the intervention，the better the effects（P<0.05）. Conclusion The intervention based on WeChat is more helpful than traditional health intervention for blood pressure control of patients with essential hypertension.

Objectives To analyze the distribution and drug resistance of pathogenic bacteria in neonatal department,and to provide criteria for rational clinical use of antibiotics. Methods Totally 15,796 specimens ob-tained from neonates were cultured according to the operation specification. The isolated pure strains were identified and their drug susceptibility was tested by VITEK-2 automated microorganism identification system. Results A to-tal of 1,125 strains of bacteria were isolated and the total detection rate was 7.1%. Of the total,742(66.0%)were gram-negative bacteria ,355(31.6%)gram-positive bacteria and 28(2.4%)fungi. K pneumonia was the most fre-quently isolated pathogen in gram-negative bacteria ,and staphylococcus the most frequently isolated pathogen in gram-positive bacteria. G-bacteria were highly resistant to ampicillin ,1st and 2nd generation cephalosporin. The re-sistant rates of K pneumonia,P aeruginosa and A baumannii to imipenem were>24.0%.Among the staphylococ-cus,35.7%were MRSA and 73.3%MRSCN. The antibiotic sensitivities of staphylococcusto vancomycin,Rina thia-zole alkanes and Tigecycline were 100.0%,but those to penicillin,cephalosporin and erythromycin low. Conclu-sion The dominant bacteria isolated from specimens obtained from neonates are gram-negativebacteria ,and they present extensive antibiotic resistance.