Objective To explore the status of the English learning among nurses and influencing factors. Method A self-designed questionnaire was used to investigate the status on English learning of 282 clinical nursing from 3 first-class hospitals in Beijing. The influencing factors were analyzed. Results The clinical nurses were in a poor condition and low interest and they had a poor setting for learning English. The influencing factors were found to be their English competency, education level, professional title and medical department (P < 0.05). Conclusions The clinical nurses are at lower level concerning English learning situation, learning interest, settings, learning motivation and a platform for training and practice. Therefore, hospitals should actively enhance their interest in English learning, learning motivation and learning settings and provide them with a platform for English training and practice so that they can increase their nursing professional English level.

Objectve To explore the application of exercise test use in diagnosis of periodic paraly sis.Methods Forty five cases of hypokalemic periodic paralysis were collected,and 40 health persons as control group.Both groups were measured serum potassium,serum creatase and thyroid function tests.All of them were taken exercise test (ET) and observe 50 minutes,measured before and after the test to seek the changes of compound muscle action potentials (CMAP),and its decreased more than 33％ were considered abnormal.The application of exercise test use was analyzed in diagnosis of periodic paralysis.Results In patients with periodic paralysis,the incidence of ET positive was higher than the control subjects (80％ vs 3.3％,P ＜ 0.001).This trend was significant after 20 minutes,such as 30 min[(37.8 ± 13.2)％ vs (6.2±3.2)％,P＜0.01],40min [(40.3 ±17.6)％ vs (3.2±1.9)％,P＜0.01],50min [(45.26 ± 19.9) ％ vs (-5.1 ± 2.6) ％,P ＜ 0.01].Moreover,linear correlation analysis showed that the serum potassium had negative correlation with serum creatase (r =-0.483,P =0.024).ALL of symptoms improved after a week treatment,the ET positive rate was still higher in patients with periodic paralysis than the control subjects (80.0％ vs 71.1％,P =0.824).Conclusions Exercise test was one of the important objective basis in the diagnosis of low potassium type periodic paralysis,and was not affected by treatment and testing time.

Objective To compare the outcome of double Endobutton plate versus clavicular hook plate (CHP) in treatment of Tossy grade Ⅲ acromioclavicular dislocation.Methods A cohort of 82 patients with Tossy grade Ⅲ acromiocavicular dislocation treated between January 2010 and August 2012 were reviewed retrospectively.Based on the treatment choices,the patients were divided into double Endobutton group (36 cases) and CHP group (46 cases).Operative situation,in-hospital parameters,and postoperative visual analogue scale (VAS) of the shoulder,shoulder abduction-rise or anteflexionrise,Constant-Murley shoulder score as well as complications were evaluated.Results There were no statistical differences between the two groups in aspects of operation time,intraoperative blood loss,and length of stay.Mean time to return to work was (13.1 ± 1.4) weeks in double Endobutton group,shorter than (15.5 ±2.6) weeks in CHP group (P ＜0.01).No statistical difference was observed for postoperative complications between the two groups.At postoperative 12 months,VAS was lower in double Endobutton group [(2.1 ± 0.7) points] vs CHP group [(2.9 ± 0.8) points,P ＜ 0.05],but abductionrise and anteflexion-rise were higher in double Endobutton group [(138.6 ± 15.7) °,(140.3 ± 17.6) °] vs CHP group [(91.7 ±8.4)°,(96.7 ± 10.5)°,P＜0.05].Conclusion To treat Tossy grade Ⅲ acromioclavicular dislocation,double Endobutton plate is associated with less shoulder pain,quicker recovery,better shoulder function restoration compared with CHP and there is no need for a second surgery to remove it.

To explore the influence of glucose level of 75 g oral glucose tolerance test ( OGTT ) druing pregnancy on delivery of large for gestational age infants. This research selected 790 cases of patients diagnosed as gestational diabetes mellitus( GDM) , 478 cases of pregnant women diagnosed as normal glucose tolerance( NGT) from Affiliated Hospital of Jining Medical University in 2014 and followed up until they delivered. Single live births were selected, risk factors which had influence on offsprings, birth weight were analysed. GDM group had significantly higher rate of delivering large for gestational age(LGA)infants than that of NGT group(47. 30% vs 31. 30%, P<0. 05). Adjusting for confounding factors, it suggested that 2 h plasma glucose level of 75 g OGTT was an independent risk factor for the delivery of LGA infants, and 1 mmol/L glucose increment in 75 g OGTT 2 h plasma glucose level, mayincreasetheriskofLGAby29%(OR=1.29,95%CI1.05-1.58,P=0.02). The2hplasmaglucoselevelof75 g OGTT is an independent risk factor for delivery of LGA infants.

Objective To evaluate the therapeutic effects and safety of open surgery vs.endovascular procedures for subclavian steal syndrome (SSS).Methods A retrospective analysis was made on 112 patients from July 2005 to July 2014 including 72 undergoing endovascular therapy and 40 cases treated by open bypass surgery.Results There were not difference between endovascular therapy group and surgical group in technical success rate (95.8％ vs.100％,P =0.239),postoperative subclavian artery diameter [(8.3 ± 1.6) mm vs.(8.1 ± 0.7) mm,P =0.374],postoperative suffering/contralateral systolic pressure ratio [(0.95 ±0.12) vs.(0.96 ±0.15),P =0.518].Nor there were the differences in mortality [0(0％) vs.3 (7.5％),P =0.018],postoperative renal dysfunction [2 (2.8％) vs.5 (12.5％),P =0.042],wound inffections [1 (1.4％) vs.4 (10％),P=0.034],duration of operation [(1.5 ±0.32) h vs.(2.7±0.51) h,P=0.027],days in hospital [(5.7±3) dvs.(9.3±3) d,P=0.013].After 1,3,5 years postoperative follow-up the two groups were not significantly different in patency rates,subclavian artery diameter,suffering/contralateral systolic pressure ratio (all P ＞ 0.05).Conclusion For subclavian artery steal syndrome,endovascular treatment is safe,effective and minimally invasive.

Objective To investigate the feasibility, effect and mechanism of chemical bile duct embolization for chemical hepatectomy. Methods Phenol or absolute ethanol plus cyanonacrylate were employed as embolization agents. Histology, Fas and TGF-? 1 measurement were used to evaluate the result. Results Phenol plus cyanonacrylate effectively destroyed and embolized intrahepatic biliary duct, leading to complete disappearance of hepatocytes in the periphery of embolization lobe and thereby achieving the effect of chemical hepatectomy. Expression of Fas and TGF-? 1 in phenol embolism group (88.90?38.10, 185.22?70.39) and ethanol embolism group (72.39?29.51, 163.56?51.75) were higher than those in biliary duct ligated group (26.31?12.07, 74.84?40.73) ( P

Objective To investigate the level of Irisin in polycystic ovarian syndrome ( PCOS) patients and analyze its potential correlation with 25 (OH) vitamin D3 and other metabolic indicators , with an attempt to explore the role of Irisin in PCOS and thus inform the diagnosis and treatment of this condition .Methods Totally 67 PCOS patients presenting in the reproductive infertility center of the First Hospital of Shanxi Medical University from April 2015 to January 2016 were enrolled as the PCOS group;meanwhile, 72 women of child-bearing age from the health check-up center were included as the control group .We measured the height , body mass, waist circumference, abdominal girth, hip circumference, and blood pressure and calculated their body mass index (BMI) and waist-to-hip ratio (WHR).The serum biochemical indicators including Irisin , 25(OH) vitamin D3, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol ( LDL-C ) , fasting plasma glucose ( FPG ) , fasting insulin ( FINS ) , follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TES) , and Homeostatic Model Assessment of Insulin Resistance ( HOMA-IR ) were measured .Results The body mass [ ( 66.074 ± 12.952) kg vs.(57.671 ±8.806) kg, P =0.000], BMI [ (25.340 ±4.149) kg/m2 vs.(22.201 ± 3.585 ) kg/m2 , P=0.003 ] , waist circumference [ ( 88.829 ±12.212 ) cm vs.( 80.550 ±10.343 ) cm, P=0.007], hip circumference [ (100.805 ±8.614 ) cm vs.(92.007 ±9.325 ) cm, P=0.000], WHR (1.279 ±0.082 vs.0.857 ±0.071, P=0.000), diastolic blood pressure [ (78.548 ±8.936) mmHg vs. (73.071 ±10.614) mmHg, P=0.036], TG [ (2.263 ±1.142) mmol/L vs.(1.330 ±1.329) mmol/L, P=0.019], FPG [ (5.128 ±0.392) mmol/L vs.(4.809 ±0.394) mmol/L, P=0.008], FINS [ (13.319 ± 8.122) mU/L vs.(4.921 ±2.028) mU/L, P=0.000], LH [ (8.153 ±2.271) IU/L vs.(3.811 ±2.607) IU/L, P=0.000], TES [ (63.068 ±25.704) ng/dl vs.(34.811 ±11.827) ng/dl, P=0.000] and, HOMA-IR (2.245 ±0.853 vs.1.021 ±0.153, P=0.000) in PCOS group were higher than those in the normal control group.Serum irisin level in PCOS group was significantly elevated when compared with control group [ (831.542 ± 98.484) ng/ml vs.(612.345 ±86.308) ng/ml, P=0.006], while HDL-C [ (1.278 ±0.345) mmol/L vs. (2.493 ±0.262) mmol/L, P=0.011], and 25 (OH) VD3 concentrations [ (17.181 ±5.078) nmol/L vs. (20.823 ±5.305) nmol/L, P=0.009] were decreased significantly .Linear regression analysis showed that iri-sin was positively associated with body mass (r=0.396, P=0.028), BMI (r=0.712, P=0.000), waist circ-umference (r=0.462, P =0.021), hip circumference (r =0.478, P =0.006), WHR (r =0.686, P =0.002), TG (r=0.397, P=0.036) and HOMA-IR (r=0.467, P=0.019) in the PCOS patients and there was a negative correlation between irisin and 25 (OH) VD3 (r=-0.654, P=0.004).Multiple regression analysis in PCOS group with irisin as dependent variable and other anthropometric and biochemical indicators as independent variables revealed that there was linear regression relationship between serum irisin and BMI (β=0.822, P<0.001), TG (β=0.076, P=0.035), and 25 (OH) VD3 levels (β=-0.242, P=0.027). Conclusions Serum Irisin level is increased in PCOS patients and it is correlated with 25 ( OH) vitamin D3 , BMI, HOMA-IR, and TG.Irisin provides a new method for the diagnosis and treatment of PCOS .

Objective To investigate the eftect of radiation dose of dual-source computed tomography (CT) dual energy single-phase enhanced scan in patients with esophageal cancer.Methods The prospective study was conducted.The clinicopathological data of 56 patients with esophageal cancer who were admitted to the Lishui Hospital of Zhejiang University between January 2015 and December 2016 were collected.All the patients were divided into the experimental group (undergoing dual-source CT dual energy single-phase enhanced scan) and control group (undergoing dual-phase CT enhanced scan) bv randomised block method.TNM classification of esophageal cancer (Seventh Edition) published by American Joint Committee on Cancer (AJCC) was used as a standard TNM staging.Two observers independently read films.All the patients underwent radical resection of esophageal cancer or palliative surgery,and then received adjuvant radiochemotherapy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to March 2017.Observation indicators:(1) consistencies of T staging,N staging and M staging;(2) accuracies of T staging,N staging and M staging (pathological results as a gold standard);(3) radiation dose of CT scan;(4) treatment and follow-up situations.The Kappa test was used for evaluating the consistency,κ≥0.75 as a good consistency,0.40≤κ＜0.75 as a normal consistency and κ＜0.40 as a poor consistency.Comparisons of count data and ratio were done by the chi-square test.Comparisons of measurement data were analyzed by the t test.Results A total of 50 patients were enrolled in the study,including 25 in the experimental group and 25 in the control group.(1) Consistencies of T staging,N staging and M staging:all the 50 patients finished successfully CT scans.Two observers considered that consistencies of T staging,N staging and M staging in the 2 groups were normal (κ =0.452,0.618,0.729,P＜0.05).Consistencies of N staging and M staging were superior to T staging.(2) The pathological results were used as a gold standard.Accuracies of T staging,N staging and M staging in the experimental and control groups were 72％,76％ and 88％,84％ and 92％,88％,respectively,with no statistically significant difference between the 2 groups (x2 =0.10,0.37,0.50,P＞0.05).(3) Radiation dose of CT scan:volume CT dose index (CTDIvol),dose length production (DLP) and effective radiation dose (E) were (10.35±2.01) mGy,(400.63± 34.13) mGy · cm,(5.61 ± 0.47) mSv in the experimental group and (3.55 ± 0.60)mGy,(140.66± 10.89) mGy · cm,(1.98±0.17) mSv in the control group,respectively.There were statistically significant differences in CTDIvol and E between the 2 groups (t =16.23,36.30,P＜0.05).(4) Treatment and follow-up situations:of 50 patients,43 patients received treatments,including 32 undergoing radical resection (11 receiving postoperative adjuvant chemotherapy),6 undergoing palliative surgery,3 receiving single radiotherapy and 2 receiving single chemotherapy.Thirty-six of 43 patients were followed up for 3-18 months,with a median time of 6 months.During follow-up,1-year survival rate was 61.1％.Conclusion Dual-source CT dual energy single-phase enhanced scan in patients with esophageal cancer cannot reduce accuracy of TNM staging,but decreased effectively radiation dose.

Cold acclimation can improve freezing tolerance. Here cDNA amplified fragment length polymorphism (cDNA-AFLP) was used to isolate differentially expressed cDNAs and a Pp-LIM only A cDNA was isolated and identified in the cold acclimation of Physcomitrella patens. Real-time RT-PCR indicated it is obviously up-regulated at 6 h, 12 h, 24 h, 48 h and 72 h after cold acclimation. After comparing the cDNA with the gene sequence, seven introns and eight exons were identified in the cDNA. The cDNA putatively encodes a protein of 345 amino acid residues and only contains one LIM domain which has highly similarity with the PDZ/LIM domains of the protein family in animals. We proposed that Pp-LIM only A be a new gene coding for the LIM-domain containing protein and enhance stability of cell membrane via their effects on cytoskeleton during cold acclimation in P. patens.
Acclimatization ; genetics ; physiology ; Amino Acid Sequence ; Amplified Fragment Length Polymorphism Analysis ; Base Sequence ; Bryopsida ; genetics ; physiology ; Cloning, Molecular ; Cold Temperature ; DNA, Complementary ; genetics ; DNA, Plant ; genetics ; Molecular Sequence Data ; Transcription Factors ; genetics

Objective Cryptococcosis is a potential life-threatening systemic mycosis with a heterogeneous susceptible popu-lation which is classified into three groups according to the current guidelines, including AIDS patients, organ transplantation recipients ( OTR) , and non-HIV-infected and non-transplant hosts ( NHNT) .This study aimed to discuss the influence of basic diseases on the clinical features and prognosis of NHNT cryptococcosis patients. Methods Using a retrospective cohort study design, we retrieved the clinical data about 73 NHNT cryptococcosis patients treated in Jinling Hospital.Based on the presence or absence of immunodefi-ciency or infection-increasing complications, we divided the patients into a basic disease group ( n=35) and a non-basic disease group ( n=38) and analyzed their clinical characteristics, chest radiographic features, laboratory results, and clinical outcomes. Results Compared with the non-basic disease group, the basic disease group showed a significantly higher incidence rate of disseminated disea-ses (62.9%vs 21.1%, P<0.01), more cases of patchy consolidation (47.4%vs 16.7%, P<0.05) and mixed lesion (31.6%vs 3.3%, P<0.05) in chest radiography, and a higher mortality (30.0%vs 5.3%, P=0.016). Conclusion Basic diseases have a great impact on the clinical features and prognosis of NHNT cryptococcosis.NHNT patients with basic diseases are susceptible to dis-seminated diseases with severer clinical symptoms and a higher mortality.