Objective To confirm the deviation between the present charge and real cost of nursing by comparing them between PICC and jugular veins catheter,and the advantages and disadvantages were weighed between them in tumor patients undergoing chemotherapy.Methods The cost of manpower,financial resources or materials for 106 patients with PICC,68 patients with jugular veins catheter were measured,accounted and statistically analyzed with the ladder sharing method for project cost.Comparing the cost between calculation cost and current charging standard,and the cost and clinical application was studied.Results The real cost of PICC was (2259.99±30.99)Yuan and current charging standard was 1532.79 Yuan,the deviation was -727.20 Yuan,and the real cost of jugular veins catheter was (393.86±33.93) Yuan,and current charging standard was 292.13 Yuan,the deviation was -101.73 Yuan.The complication rate was 12％ in PICC,17％ in jugular veins catheter.The real cost of nursing on PICC and jugular veins catheter was higher than current charging standard,and the real cost of single nursing on PICC was 5.74 times higher than jugular veins catheter.The cost remains unchanged with 4～6 course of chemotherapy treatments in a year.Conclusions The advantages of PICC are more than jugular veins catheter,so the preferred choice is PICC,and jugular veins catheter comes secondary.

Objective To learn the overall results of the final test paper in nursing undergraduates of Peking Union Medical College, and to provide the theoretical support for teaching quality assessment of nursing undergraduates.Methods The difficulty coefficient, the discrimination index, the reliability (Cronbach α coefficient) and the degree of coverage were analyzed based on education measurement and education statistical methods.Results The mean total score was 67.8±12.5, ranged from 38 to 95.The difficulty coefficient, the discrimination index and the Cronbach α coefficient were 0.68, 0.30 and 0.71 respectively.The rates of loss score were 33.8% for choice questions, 37.2% for completion questions, 22.5%for true or false questions and 24.8% for calculation questions respectively.Among the total 30 examination questions, the proportions of the most difficult ones, the difficult ones, the moderate ones, the easy ones and the easiest ones were 30.0%,13.3%,20.0%,20.0% and 16.7% respectively.28 examination questions (93.3%) had the best or better discrimination.Conclusions The test paper held the moderate difficulty and the good discrimination, reliability and the degree of coverage.The results of the examination accurately reflect the knowledge and ability of the students.In addition, more attention should be paidto improve the knowledge of nursing undergraduates on the importance of the medical statistics in medical scientific research.

Objective:To investigate the expressions and significance of tyrosine kinase receptor EphA2 and its ligand ephrinA1 in human malignant gliomas and their correlation with tumor angiogenesis. Methods:The expressions of EphA2, ephrinA1, and CD105-stained microvessel density (MVD) were detected via immunohistochemical assay in 62 glioma tissues and 8 normal brain tissues. The correlation between EphA2 and ephrinA1 expression and microvessel counts in the glioma tissues were assessed. Results:Immunohistochemical staining results revealed that variable levels of EphA2 and MVD expression were significantly higher than that of the normal brain samples. Statistical difference was observed in EphA2 and MVD expressions between human gliomas and normal brain samples (P<0.01). The positive rate of EphA2 and MVD expressions was significantly higher in high-grade gliomas (WHO III-IV) than that in low-grade gliomas (WHO I-II) (P<0.01). EphrinA1 was expressed at low levels in most malignant gliomas, and the increased ephrinA1 expression was associated with lower-grade histology. MVD was significantly positively correlated with EphA2 expression (r=0.713, P<0.01) and significantly negatively correlated with ephrinA1 expression (r=-0. 772, P<0.01). EphA2 was significantly negatively correlated with ephrinA1 expression (r=-0.912, P<0.01). Conclusion:Specifically over-expressed EphA2 and its low-expressed ligand ephrinA1 in malignant gliomas may be closely correlated with the invasion and malignant degree of gliomas. Cooperation is involved in the angiogenesis and has an important function in the initiation and progression of gliomas.

Objective To evaluate the efficacy and safety of testa triticum tricum purif for the treatment of functional constipatiofi(FC) in the late middle-aged and elderly patients.Methods This study was designed as a multicenter randomized controlled trial.Patients who met Rome Ⅲ diagnostic criteria of FC were enrolled,with age between 55-85 years old.Those with organic diseases were excluded.The patients were randomly allocated to receive testa triticum tricum purif (3.5 g bid) or polyethylene glycol 4000 powder (PEG4000,10g bid) for 8 weeks,followed by single dose of maintenance therapy for 4 weeks.Follow-up visits were at 4 and 12 weeks after treatment discontinuation.The independent investigators in each center evaluated the constipation symptoms scores.The primary endpoints included rates of significant improvement,improvement and overall improvement at the end of 2,4 and 8 weeks of therapy,which were calculated by the reduction of symptom scores ≥ 75 ％,50％-74％,≥ 25 ％ respectively.Results A total of 127 FC subjects were enrolled from 3 centers,and 122 cases valid for final analysis.The mean age was (69.4 ± 6.9) years old,including 62 cases in testa triticum tricum purif group and 60 cases in PEG4000 group.The demographic data,constipated symptoms scores and proportion of FC subtypes at baseline were comparable.The rates of significant improvement,improvement and overall improvement in testa triticum tricum purif and PEG4000 groups at the end of 2,4 and 8 weeks were 37.70％ (23/61) vs 59.32％(35/59) (P=0.018),57.38％ (35/61)vs74.14％ (43/58) (P=0.054),and64.41％ (38/59)vs 79.31％ (46/58) (P =0.073) respectively.Testa triticum tricum purif therapy significantly improved the proportion of spontaneous bowel movement (SBM) ≥ 3 times/week from 43.55％ (27/62) to 80.33％ (49/61),83.61％ (51/61) and 93.22％ (55/59) at 2,4,and 8 weeks respectively (all P＜0.01),which were comparable with PEG4000 group (all P ＞ 0.05).The proportion of normalized stool forms in study group was significant higher than that of control group at the end of 8 weeks [86.44％ (51/59) vs 67.24％ (39/58),P =0.014].Only one patient complained mild abdominal distension during testa triticum tricum purif therapy.Conclusions The efficacy of testa triticum tricum purif for the treatment of FC in late middle-aged and older patients is comparable with osmotic laxatives PEG4000,which has significant effect on normalization of fecal forms and reliable safety.

Objective To evaluate the efficacy and safety of higenamine hydrochloride(HG) stress echocardiography for diagnosis of coronary artery disease (CAD). Methods The study was designed as prospective,randomized,open-labled,positively controlled and crossover phase II multi-center clinical research.Ninety subjects who were suspected to have CAD were enrolled.HG dosage was titrated at 0.5,1, 2,4 μg.kg -1.min-1every 3 min.Adenosine was injected 140 μg.kg -1.min-1for 6 min with total dosage 0.8 mg/kg.Visual assessment of the left ventricle wall motionand 17-segment model were used for analysis of stress echocardiography.CAD was defined as identifying >50% diameter stenosis in at least one major coronary artery by coronary angiogram.All adverse reaction were recorded. Results For HG group,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 28.9%,89.7%, 57.1%,76.5% and 47.8%,respectively;for adenosine group,they were 26.7%,94.9%,58.3%,85.7%and 47.1%,respectively. There was no significant difference between the two groups( P > 0.05). The diagnostic sensitivities of HG and adenosine echocardiography for single vessel stenosis were 11.1% and 5.6%,respectively( P >0.05).Both HG and adenosine echocardiography have the same sensitivity with 37.5% for double vessel stenosis and 44.4% for triple vessel stenosis.Advers reaction rate was 84.4% in HG group and 92.2% in adenosine group( P >0.05).Conclusions HG stress echocardiography for CAD diagnosis has high specificity,good safety and low sensitivity,which are similar to adenosine echo.

Objective To explore the association of MTHFR C677T polymorphism and birth body mass with the vulnerability of autism in Chinese Han population. Methods Totally 1 505 children with au-tism have been recruited,using the diagnosis and statistical manual,4th revised version ( DSM-IV-R) diag-nostic criteria for autism. And 1 308 healthy control subjects sex matched with the children with autism were enrolled for the study. All the participants were identified the birth body mass ( kg) according to the birth medical recording. All the subjects were examined the MTHFR C677T genotypes,using the polymerase chain reaction- restrict fragment length polymorphism (PCR-RFLP) methods. The frequencies of genotypes,alleles and birth body mass were compared between autism and healthy control groups using the chi-square and other tests. Results The MTHFR C677T (P=0. 004,OR=1. 18,95% CI=1. 02-1. 29),low birth body mass (<2. 5 kg) (P=0. 001,OR=1. 04,95%CI=1. 02-1. 06),and their interactive effects ( P=0. 0001,OR=2. 18,95%CI=1. 44-3. 32) were associated with the vulnerability of autism. Conclusions The MTHFR C677T polymorphism,low birth body mass and their interactive effects might be associated with susceptibility of autism in Chinese Han population.

Child ; Humans ; Muscle Neoplasms ; Sarcoma