Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Humans ; Purpura, Thrombotic Thrombocytopenic ; therapy ; Rituximab

Objective To investigate the evaluation of the employing hospital about nursing undergraduate students,to understand the actual working capacity of graduates and explore the quality requirement and individual needs of nuring undergraduates according to the findings,to improve the quality of nursing undergraduates and personnel training specifications.Methods The self-evaluation questionnaires on nursing undergraduates was used to investigate eight hospitals which accepted three or more graduates of our college by letter investigation.Results The employing hospital had the highest satisfaction degree on the moral character and working attitude,respectively 98.1%and 96.2%;the satisfaction degree of management and research capability was the lowest,respectively 81.0%and 80.0%. Conclusions Overall assessment of the quality of graduates is better,the graduates' clinical competence,interpersonal relations and psychological quality is satisfactory,nursing skills and adaptability should be improved;foreign language,scientific research,administration and management capacity is rehtively weak.In the future,the college should adapt to the reeds of employers in the teaching process,strengthening the training of practical ability and adaptability,using appropriate methods to enhance research and foreign language skills,appropriately adjust training goal of undergraduates.

[Objective] To retrospectively study and discuss the indications,surgical techniques and effect of treating hallux valgus with modified Austin operation-Chevron-Gerbert osteotomy or Chevron-Youngswick osteotomy.[Method]From October 1998 to April 2006,34 patients(62 feet)with hallux valgus were treated with modified Austin operation.The X-ray films of all patients were collected preoperatively,two weeks postoperatively and during the follow-up.The hallux valgus angle(HVA),intermetataral angle(IMA),proximal articular set angle(PASA)and distal articular set angle(DASA)were measured and analyzed on radiogram.[Result]All patients were followed up for 1-8 years(mean 3.6 years).HVA before and after surgery was 33.50??1.02?and 13.6??0.826 respectively.IMA was 16.0??0.837?before and 8.6??1.078 after surgery.AOFAS score was 44.8?5.7 before,and 87.6 4.2 after surgery.Significant difference was found between the results.According to AOFAS rating system,46 feets had a excellent result and 10 feet had a good result and the other 5 feet had a fair result.The rate of excellent or good results was 90.3%.[Conclusion]The modified Austin operation is a good,simple and reliable operation means for treatment of hallux valgus,which especially applies to severe hallux valgus with big PASA.The adductor hallucis or the sesamoid is not necessarily interfered in patients with slight or moderate hallux valgus.

Objectives To help nursing students to adapt to the environment of the job interviews by simulation interview, train the students'psychological quality and the adaptability, give the necessary guidance for seeking job after graduation. Method Five interview groups were composed by 15 nurse executives and interpersonal communication teachers from 4 hospitals, after the simulation interview, the students were surveyed using the self-desigued questionnaire. Results There are 10 items having the most significant influence, 10 items having more obvious influence the last 7items.Conclusion It can improve all aspects'ability of the students effectively through carrying out the simulation interview pertinence, and can help the students find job successfully.

Objective: To prepare the conjugate of supcrantigen (SAg) staphylococcal enterotoxin A (SEA) and monoclonal antibody (McAb) against human hepatocellular carcinoma HAbl8 F(ab' )_(2) fragment and to investigate the anti-human hepatoma effect of peripheral blood mononuclear cells (PBMC) targeted by HAbl8 F(ab' )i-SEA. Methods: McAb HAbl8 was extracted and its F(ab' )_(2) fragment was prepared with papain; the conjugate HAblS F(ab' )_(2)-SEA was prepared with N-succinimidyl-3-(2-pyridyldithio) propionate (SPDP); eveny collected peak after purification was identified with gel chromatography; the activity of antibody in the conjugate was identified with immunohistocheinical ABC method; the anti-hepatoma effect of PBMC targeted by HAbl8 F(ab' )_(2)-SEA was observed with MTT method. Results: The conjugate HAbl8 F(ab' )_(2)-SEA was prepared successfully and it had obvious effect of targeting PBMC to kill hepatoma cells, and this effect is correlated positively with the dose of HAbl8 F(ab')_(2)-SEA. Control groups had no such effect. Conclusion: Targeting therapy of hepatoma with McAb-SAg conjugate might be a kind of hopeful model of hepatoma im-munotherapy.

The incidence of toileting problems is associated with the level of intellectual disability,and more common among the children with severe intellectual disability.This paper would review the classification,prevalence,consequences,origins of toileting problems,and also include the descriptions,assessment and practical considerations of behavioral interventions.

Objective To evaluate the optimal surgical approach for huge liver neopiasms in the caudate lobe.Methods Thirty-three patients with huge liver neplasms（≥10cm) underwent caudate lobectomy at a single tertiary referral center between January 2001 and June 2007.The surgical out-comes of pateints who underwent isolated caudate lobectomy or caudate lobectomy combined with partial hepatectomy were compared.Result Fifteen（45.5％）of 33 patients underwent isolated total or partial caudate lobectomy（group A）,whereas 18（54.5％) had total or partial caudate lobectomy cellular carcinoma (HCC) (51.5％),followed by hemangioma(21.2％),intrahepatic cholangiocarcinoma(9.1％),angiomyolipoma(6.1％),hepatic adenoma (3％),focal nodular hyperplasia(3％),colorectal liver metastases(3％)and sarcoma(3％).The median diameter of the tumour was 12.3 (range,10.2-21)cm.Patients in group A had significantly longer operative time (280 minutes vs.170 minutes),longer length of hospital stay (17 days vs.12 days)and more blood loss(1250 ml vs.670 ml) than patients in group B.There was no perioperative death in the 2 groups of pateints.Complication rates in group A and group B were 26.7％ and 16.7％ respectively.There was no disease-related death in patients with benign lesions.The1-,3- and 5-year disease-free survivals of patients with malignant lesions in group A and group B were 25.9％,0％,0％and 74.3％,46.7％,31.2％,respectively.The 1-,3- and 5-year overrall survivals were 68.6％,19.7％,0％ and 100％,66.5％,41.8％,respecively.Conclusion The approach to caudate lobectomy depends on the size and location of the lesion and the liver functional reserve.For patients with sufficient liver functional reserve,caudate lobectomy combined with partial hepatectomy is preferred because it is technically less demanding.For patienls with marginal liver functional reserve,isolated caudate lobectomy is the only viable surgical option.

ObjectiveTo valuate the three-dimensional CT angiography(3DCTA) in diagnosing blood vessel diseases.MethodsCTA findings of 284 patients confirmed with blood vessel diseases were retrospectively analyzed.They were divided into two groups:141 cases of head and neck and 143 cases of trunk and extremities.Scan was performed with the beam collimation of 0.625 ～ 3.0mm,increment of 0.3 ～ 1.4mm,pitch of 1.0 ～ 1.5,with the gross contrast medium of 1.5 ～ 2.0ml/kg.3D imaging methods included volume rendering(VR),multi-planar reformatting (MPR),curved planar reformatting(CPR),surface shade display(SSD),maximum intensity project(MIP) and virtual endoscopy(VE).The diagnostic results of CTA were compared with those of DSA and/or surgery.ResultsIn this study,3D images of vasculature met the diagnostic criterion.The diagnostic sensitivity,specificity and accuracy of CTA was 97.28％,82.35％ and 96.48％,respectively.The size of artery aneurysm shown with CTA and DSA had no significant difference( P ＞0.05 ),both smaller than that in surgery( P ＜ 0.05 ).Conclusion3DCTA could be used in diagnosing the cardiovascular diseases and compensate the limitation of conventional CT.It had the characteristics of non-invasion,high accuracy and could partly substitute DSA.

Objective To explore the effect of acupoint injection of bone marrow mesenchymal stem cells (BMSCs)on hemodynamics of rat model with acute myocardial infarction(AMI). Methods Sixty Sprague-Dawley (SD)rats were randomly divided into sham group,model group,myocardium injection BMSCs group and acupoint injection BMSCs group(each n=15). The left anterior descending coronary artery(LAD)was ligated to establish a rat model of AMI. After the rat model was successfully established for 72 hours,0.2 ml BMSCs(1×1010/L)were transplanted by a micro-quantity syringe at 6 points in equal amount in the LAD blood-supply area and its periphery in the myocardial injection group,while in the acupoint injection group,0.3 ml BMSCs(1×1010/L)was transplanted at each of the following acupoints:Xinshu,Zhiyang and Tanzhong. Four weeks after AMI,polyethylene tubing was inserted into the right carotid artery to measure the hemodynamics,at the same time animals were sacrificed,and the heart was take out to calculate the heart mass index(HMI)and left ventricular mass index(LVMI). Results One, 3,5 and 4 rats were respectively dead in the sham group,model group,myocardium injection group,and acupoint injection group during the experimental period. Compared with the sham group,the left ventricular systolic pressure (LVSP,mm Hg,1 mm Hg=0.133 kPa),the maximum rate of increase of left ventricular pressure(+dp/dt max, mm Hg/s), the maximum rate of decrease of left ventricular pressure(-dp/dt max,mm Hg/s), the maximum logarithmic change rate of left ventricular pressure〔(dp/dt)?P-1max,s-1〕,HMI(mg/g),LVMI were significantly decreased,and left ventricular end-diastolic pressure(LVEDP,mm Hg),heart rate(HR,bpm)were obviously increased in model group(all P<0.05). Compared with the model group,the LVSP,+dp/dt max,-dp/dt max, (dp/dt)?P-1max, HMI,LVMI were significantly increased in myocardial injection group and acupoint injection group〔LVSP:130.38±14.96,124.36±14.36 vs. 114.36±12.71,+dp/dt max:4707.52±394.36,4597.14±411.05 vs. 3791.43±327.29,-dp/dt max:4075.11±317.89,3938.05±373.76 vs. 3116.32±275.04,(dp/dt)?P-1max:215.26±21.29,197.39±18.96 vs. 155.93±25.14〕,and the LVEDP and HR were significantly decreased(LVEDP:5.15±2.39,5.64±1.96 vs. 10.58±2.49,HR:400.50±42.58,395.55±44.62 vs. 414.51±35.75,all P<0.05). There were no significant differences in above indexes between myocardium injection group and acupoint injection group. Conclusion Acupoint injection of BMSCs can improve the heart function of rat model with AMI.

Objective To evaluate the effect of the gastric signet ring cell cancer(SIG)on the T,N,M stages. Methods Three hundred and fifty-one patients undergoing D2 or greater gastrectomy for gastric cancer were ana lyzed retrospectively.The T,N,M stages of 59 patients with SIG and 161 patients with tubular adenocarcmonla (TUB)were compared using univariate and multivariate analysis.Results The chi-square test showed that there were not significant differences in T,N,M stages between TUB and SIG.Multivariate Logistic regression analysis indicated that SIG Was not a independent factor influencing the T,N.M stage.Conclusion Gastric cancer with SIG has not higher T,N,M stages than that with TUB.