Objective:To discusses the professional quality cultivating mode construction for nursing students based on the second classroom as well as its mechanism and effects .To investigate the cognition and evaluation of nursing students on recessive education of the second classroom .Methods:Questionnaire was used in nursing un-dergraduates in three grades .The professional spirit , professional skills , humanity qualities were involved .Re-sults:For professional spirit , 44 .13% agreed for significantly increasefor their professional quality , and 33 . 20%for improved, 6.48%forreduced, or a significant reduction.For professional skills, 51.82%forsig-nificantly increase, 41 .70%for improved, 1 .21%forreduced , or a significant reduction.For humanistic quality, 91.1% of the students thought it significantly increasetheir humanistic quality .In grade 2009 and 2011 , over 50% students thought this quality was improved by the second classroom .Conclusions:Professional quality cultivating mode based on the second classroom makes nursing students 'professional spirit , professional skills, the humanities quality improved , and this cultivating mode received wide recognition and affirmation in the nursing students .

Objective To investigate the efficacy and safety of percutaneous microwave ablation in the treatment of hypersplenism.Methods From March 2007 to May 2011,38 patients with hepatitis B virus caused liver cirrhosis and complicated with hypersplenism received percutaneous microwave ablation treatment for several times.Before percutaneous microwave ablation treatment,the volume of spleen was calculated according to 3D computed tomography (CT) scan.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were also tested.For the first time,1/3 volume of spleen was ablated.If no complication were observed in one week after ablation,then another 1/3 volume of spleen was ablated.Blood routine and liver function test were checked on the 1st,3rd and 5th day after microwave ablation.Blood routine,liver function test and ultrasound were examined on 7th and 14th day after microwave ablation.On the 30th day CT examination was conducted.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were detected at one month,three month and every three month after microwave ablation.The follow up duration was over two years.The t-test was performed for clinical data comparison.Results The mean ratio of ablated spleen was (47 ±5)％ (range 41％ to 57％).Preoperative white blood cell count was (2.46±0.78)× 109/L,which gradually increased after operation and peaked on the 3rd day after operation ((5.34 ± 2.10) × 109/L).Then gradually decreased,which was (3.16 ± 1.02) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t=-3.349,P＜0.01).Preoperative platelet count was (46.58 ± 17.30) × 109/L,which gradually decreased after operation and was lowest on the 3rd day after operation.Then gradually increased,which peaked at 30 days after operation ((101.79 ± 25.80) × 109/L) and then gradually decreased,which was (61.97 ± 15.09) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t＝-4.135,P＜0.01).The inner diameter of portal vein was (14.66±0.88) mm preoperation,which was (13.22±0.64) mm at three month after operation and the difference was statistically significant compared with that of preoperation (t=8.145,P＜0.01).It was (14.64±0.81) mm at six month after operation and the difference was not statistically significant compared with that of preoperation (P＞ 0.05).The major adverse effects were fever,left upper abdominal pain,left shoulder pain,pleural effusion,intraperitoneal hemorrhage and temporary hemoglobinuria which all recovered after symptomatic treatment.No severe complication such as uncontrollable bleeding,splenic abscess,spleen rupture and the surrounding organ injury and treatment related death were observed.Conclusion Percutaneous microwave ablation for several times could safely destroy suitable volume of spleen,increase platelet and white blood cell count,improve portal hypertension and with rare complications,which might be a minimally invasive techniques with clinical application value in the treatment of the hypersplenism.

Medical education should combine clinical professional skills with humanities skills,integrate humanities knowledge into vocational education.Taking 2008 grade seven-year program clinical medicine students in the 2nd affiliated hospital of Harbin Medical University as fostering object,we made researches into students' understanding of doctor-patient relationship before practice and their mastering of skills.Through conducting questionnaire,we got to know the effect of humanities practice skill training for seven-year program clinical medicine students.Meanwhile,we compared students' self evaluation results before and after training,discussed on how to improve medical students' communication skills,cultural skills and the reform direction in an aim to guide students to transit from students to clinical doctor.

Objective To study the mental health condition of occupational female and influencing factors of mental health. Methods 827 occupational females in Dongguan city were investigated using the questionnaires, the contents included the basic personal information, mental health condition and influencing factors of mental health.Results The results showed that there existed higher ratio of mental disorder in people of age over 50 years, post-graduate educational background, monthly income levels of 4001 to 5000 yuan and divorced occupational females.Moreover, the influential factors on mental health of occupational females were correlated with age, culture degree,family population and society. Conclusion We should pay more attention to occupational females and take effective measure to relieve their mental stress. This is the demands of woman as well as society.

The aim of this study is to investigate the critical factor affecting the properties of PLGA microspheres fabricated by a solid-in-oil-in-water (S/O/W) emulsion technique with BSA as a model protein. Prior to encapsulation, the BSA microparticles were fabricated by a modified freezing-induced phase separation method. The microparticles were subsequently encapsulated into PLGA microspheres by S/O/W emulsion method, then Motic BA200 biological microscope, confocal laser scanning microscope, scanning electron microscope were used to observe the structure of S/O/W emulsion and PLGA microspheres. The protein content extracted or released from BSA microspheres was measured by Bradford protein assay method. It was found that NaCl added in the outer aqueous phase effectively suppressed material exchange between the inner and outer phase of S/O/W emulsion. Then, the structure and permeability of obtained microspheres were influenced. As a result, with the increase of NaCl concentration in the outer aqueous phase, the encapsulation efficiency of microspheres significantly increased from 60% to more than 85%, the burst release of microspheres reduced from 70% to 20%, and the particle size decreased from 103 microm to 62 microm. Furthermore, the rehydration of encapsulated protein was also retarded and then integrity of BSA was successfully protected during encapsulation process. In vitro release test showed that BSA released from PLGA microspheres in a sustained manner for more than 30 days.

[Abatract] In order to improve the result of clinical practice for undergraduate students of clinical medicine, combined with the professional characteristics of hematology and teaching syllabus, Hematology Department in the First Affiliated Hospital of Dalian Medical University developed practi-cal teaching content and tried using a variety of teaching methods and teaching means such as multi-media aided teaching, case teaching and simulation teaching method and so on. Besides, multiple station examination was established; teaching feedback and supervision were strengthened. The prac-tice proved that the reform measures were conducive to the cultivation of medical students' practical skills and clinical thinking, which helped to speed up the transformation from the students to the role of doctors.

Objective To establish the screening platform of circulating tumor cells (CTCs) using acridine orange fluo?rescent (AO-F) dyeing method, and to apply it in the screening of peripheral blood CTCs in patients with kidney cancer. Methods Twenty-seven patients with metastatic renal cell carcinoma was included in this study. Primitive tumor cells and kidney cancer cell line 769-P were cultured with different concentrations of fetal bovine serum. Smears were prepared and observed under fluorescence microscopy. The percentage of AO-F positive staining of 769-P cells under 5 random sights was calculated. The sensitivity of AO-F staining to cells was evaluated. The 5 mL morning fasting venous blood was obtained from 10 subjects with healthy check-up. The 1×106 cell suspension was prepared. The logarithmic phase of renal tumor cells was used to prepare tube containing 500, 200, 100, 50 and 10 tumor cell suspension, which were mixed with 1×106 nucleated cells to establish CTCs model of renal cancer. AO-F staining method was used to detect the expression of AO-F positive cells. The correlation between expression of AO-F positive cells and clinical parameters was analyzed. Results The prima?ry cells and cell line 769-P showed similar bright color and morphological characteristics. The percentage of AO-F positive staining in 769-P cells was 93%±3%under 5 random sights. The recovery rates (%) of four groups (500, 200, 100 and 50 tu?mor cell suspension) were 10.2±3.8, 9.2±2.3, 10.8±2.6 and 10.5±1.9, respectively. There were no significant differences in recovery rates between four groups (P>0.05). The group of 10 tumor cell suspension could find AO-F positive staining cells occasionally. Zero case was positive in controls. Nine of 27 patients were positive and the rate was 33.33%. There were no significant statistical differences in AO-F positive rates between gender, age, tumor size, pathological pattern, Furhman stage, metastasis of lung and presence of tumor (P>0.05). Conclusion It is confirmed that the method of CTCs staining with AO-F, which has high specificity and reproducibility, is feasible to detect CTCs and worthy of being studied. There is a certain reference value to predict tumor recurrence and metastasis.

Objective To study the feasibility, safety and clinical application value of LRH, comparing with abdominal radical hysterectomy (ARH) . Methods A total of 80 patients' clinical data were collected to analyze the development of LRH in Yunnan Tumor Hospital while compared with another 40 patients between June 2012 to June 2013 of ARH for some associative indexes. Results The patients were divided into group A and B equally.Compared with Grope A, the time of operation decreased 26.9%, 37.2% has been augment for lymph gland sweeping, the amount of bleeding and intraoperative complication reduced 37.3% and 7.5% in Grope D, respectively, with distinctive difference ( >0.05) .Hospitalization expenses had a small degree reduced but no distinctive difference.The learning curve of LRH was 40 approximately.Comparison between LRH and ARH in the same period showed that LRH was more splendid than ARH in several index.1 case relapsed in 2-48 months follow-up in ARH while no relapse in the other group. Conclusion LRH is safe and feasible and has good prospects in clinical application and deserves clinical generalization because of its advantages such as less trauma,less pains, quick recovery,less scars and aesthetical appearance.

Objective To report the treatment of type A3 distal tibiofibular fractures with the fibular posterolateral approach and minimally invasive percutaneous plate osteosynthesis (MIPPO).Methods We reviewed 61 patients with type A3 distal tibiofibular fracture (observation group) who had been treated with MIPPO and the fibular posterolateral approach from June 2011 to May 2015.Our control group included 78 patients with type A3 distal tibiofibular fracture who had been treated by traditional open reduction and internal fixation from April 2009 to September 2013.Interval between injury and surgery,surgical time,intraoperative bleeding,hospital stay,postoperative complications,X-ray Lane-Sandhu osteotylus score and limb weight-bearing score one year after operation were compared between the 2 groups.Results All the 139 patients were followed up for more than one year.There were significant differences between the 2 groups in terms of interval between injury and surgery (8.0 ± 3.5 h versus 140.7 ± 52.4 h),surgical time (66.2 ± 7.2 min versus 92.1 ±6.6 min),intraoperative bleeding (59.8 ± 12.8 mL versus 209.5 ±50.4 mL),hospital stay (9.4 ± 1.9 d versus 26.1 ± 15.7 d),postoperative complications,X-ray Lane-Sandhu osteotylus score (3.9 ±0.2 points versus 3.0 ±0.6 points) and limb weight-bearing score (3.9 ±0.1 points versus 3.0 ±0.7 points) one year after operation,favoring the observation group(P ＜ 0.001).Conclusions In the treatment of type A3 tibiofibular fractures,MIPPO plus the fibular posterolateral approach is superior to the traditional open reduction and internal fixation because it can benefit fracture healing by shortening the time for preoperative preparation,surgery and hospitalization,and decreasing the amount of intraoperative bleeding and the incidence of postoperative complications.

Objective:To investigate the current situation and influencing factors of home-based self-management ability of patients with schizophrenia and to provide theoretical basis for clinical nursing intervention.Methods:This study is a cross-sectional study. Using the convenient sampling method, a total of 220 patients with schizophrenia who were admitted to Outpatient Department of a Class Ⅲ Grade A Psychiatric hospital in Beijing from June to December 2019 were selected as the research objects. The General Information Questionnaire and Home-based Self-management Scale for Patients with Schizophrenia were used to investigate.Results:In this study, a total of 220 questionnaires were distributed and 207 valid questionnaires were returned. The effective recovery rate was 94.09%. The score of Schizophrenia Self-Management Instrument Scale was (63.51±9.55) , and the scoring rate was 47.58%. Univariate analysis showed that, the scores of Home-based Self-management Scale for Patients with Schizophrenia with different ages, marital status, education levels, working status, household monthly income per capita, living status, economic burden, courses of disease, times of hospitalization, family attitudes and social supports showed statistically significant differences ( P<0.05) . Multivariate analysis showed that, age, marital status, social support and economic burden were the influencing factors of home-based self-management ability of schizophrenia patients ( P<0.05) , accounting for 36.0% of the total variation. Conclusions:The home-based self-management ability of patients with schizophrenia needs to be improved urgently. Medical staff should implement nursing intervention or self-management education according to the different characteristics of patients to effectively improve the self-management ability of patients, promote the recovery of the disease, reduce the recurrence rate and improve quality of life.