Bilateral ablation of the cerebral parietal cortex in adult rats was performed. After appropriate days, the tissue surrounding the wound was removed and the brain wound tissue extract (EWTE) was prepared. Newborn rat cerebral cortical neurons were used as a culture model to test the neuronotrophic factors (NTFs) and neuritepromoting factors (NPFs) in EWTE. In order to investigate the origin of above mentioned factors whether related to the macrophages which appeared in the brain wound region at early stage, we designed to culture macrophages and collected the macrophage conditioned medium (M?CM) to measure their NTF and NPF activities for cultured cerebral cortical neurons. On the other hand, we also observed the effect of EWTE and M?CM on PC 12 (phehrmytema) cells and further studied the action of NPFs. Cur experimental results show that EWTE and M?CM contained NTFs and NPFs for cultured cerebral cortical neurons. These factors appeared in EWTE at 4 days post-lesion, with maximal level of their activities reached between 5 and 6 days post-lesion and there was another peak of NPF activity at 9 days post-lesion, until 13 days post-lesion also detected their activities. The NTF activity in M?CM was lower than that in BWTE, in contrast, the NPF activity in M?CM was higher than that in BWTE. There was NPF activity to PC 12 cells in BWTE and M?CM. According to the experimental assays, we suppose that the neurotrophic factors in BWTE mainly come from the macrophages which appear in the lesion site at early stage of injured brain, subsequently, it may relate to the astrocytes. The components of these factors may be complexity and multiplicity that remain to be solved.

Objective To explore the relationship between social support and professional identification among nursing students,and to examine the mediating role of resilience.Methods A total of 650 nursing students were evaluated with Social Support Rating Scale,Professional Identity Questionnaires for Nursing Students and Chinese revision of Connor-Davidson Resilience Scale.Results The scores of nursing students' social support,resilience and professional identification were (38.93±5.30),(66.79±11.93),(57.45±9.95).Professional identification could positively influence their professional identification(r=0.233-0.422,P＜0.01).Resilience mediated the relationship between social support and professional identification,the effect sizes were 52.27％.Conclusions Resilience plays a mediating role between social support and professional identity.It is important to pay attention to social support and resilience and take proper interventions to promote nursing students professional identification.

Objective To examine the psychological resilience and its influencing factors of the nursing students in medical university.Methods A total of 693 nursing students were investigated by using general questionnaire,Chinese version of CD-RISC,Professional Identity Questionnaires of Nursing Students,TCSQ,EPQ and SSRS.Results The average score of CD-RISC was (66.79±11.93),different grade students had significant differences in psychological resilience,resilience scores of nursing students were different in aspect of professional knowledge,occupation expectation and interpersonal satisfaction.Resilience was positively correlated with positive coping,professional identity,social support,extraversion,and negatively correlated with negative coping,neuroticism and psychoticism; Positive coping,professional identity,extraversion and neuroticism could predict 48.6％ of total variation in psychological resilience.Conclusions The resilience average score of nursing students was low.Nursing educators can implement mental intervention according to psychological characteristics of nursing students in different periods by cultivating professional emotion,guiding coping style and shaping healthy personality to promote the resilience and mental health of nursing students.

OBJECTIVE:To provide reference for clinical rational drug use. METHODS:The medical orders of oral tablet in the inpatients collected from our hospital in 2014,and the application of oral tablet splitting was analyzed statistically. RESULTS:There were 220 specifications in total,and 93 tablets were split for use,accounting for 42.27%. Of all split tablets,there were 52 kinds with split mark on surface,accounting for 55.91%. There were 357 602 medical orders of tablet and 15 202 of tablet split-ting,accounting for 4.25%. The top three categories in frequency of splitting were Benserazide tablets,Digoxin and Clonazepam tablet. CONCLUSIONS:To meet the demand of clinical treatment,tablet splitting has its rationality. It is necessary to enhance com-munication among pharmacists,doctors and nurses to weigh the pros and cons before treatment.

OBJECTIVE:To provide reference for informationized construction of outpatient narcotic drug management in the hospital. METHODS:The narcotic drugs management system,which consisted of the hospital information system and the intelli-gent management machine of narcotic drugs were introduced in working procedure and informationized management,and its effects were evaluated. RESULTS:After informationized construction,the recycling of empty ampoules and used patches was included in compulsory management procedure;informationized management would be achieved completely from safety management,prescrib-ing and dispensing property management,prescription management,batch number management,outcoming and incoming manage-ment,five specialmanagement,etc. Compared with traditional dispensing mode,the dispensing time of each prescription was shortened under informationized dispensing mode,decreasing from(174±32.3)s to(128±30.7)s(P<0.05). Pharmacists could communicate with physicians online by the system;drug application,incoming,use,inventory reconciliation,special book for reg-istration and special book of account were all completed by electronic recording and electronic registering;the system could auto-matically complete the report form of prescription information for evaluation. CONCLUSIONS:It is feasible of the informationized mode of outpatient narcotic drug management in our hospital.

Objective To investigate whether correlation exists between quantitative perfusion parameters obtained from dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI) and different prognostic factors or immunohistochemical subtypes of breast cancers. Methods A retrospective analysis of DCE?MRI was performed in 87 breast cancer patients with 91 pathology confirmed breast lesions. All the patients underwent the immunohistochemistry after the operation, 80 breast cancer patients with 84 breast lesions were divided into different subtypes based on the immunohistochemical profiles. All the patients underwent plain MRI and DCE?MRI. The volume transfer constant (Ktrans), rate constant (kep) and volume of EES per unit volume of tissue (Ve) value were calculated. Results of the immunohistochemistry and observation results of the the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor?2 (HER?2) were recorded. Subtypes were also categorized. The degree of the expression of Ki?67 was observed simultaneously. Among the 87 breast cancer patients (with 91 breast lesions), 68 were ER?positive,18 were ER?negative, 60 were PR?positive, 26 were PR?negative;30 were HER?2 positive and 58 were HER?2 negative. Eighty breast cancer patients (with 84 breast lesions) were divided into different subtypes:19 were Luminal A, 49 were Luminal B, 7 were HER?2 positive subtype and 9 were triple negative breast cancer (TNBC). The quantitative perfusion parameters with diffierent expression of the receptors were analyzed through Mann?Whitney U test, the correlation between the degree of the expression of Ki?67 and quantitative perfusion parameters was obtained with Spearman test. Furthermore, the distributions of the perfusion parameters between groups according to immunohistochemical subtype were compared using the Kruskal?Wallis test. Results Ktrans and kep value were higher in tumors with ER?negative and PR?negative than with ER?positive and PR?positive and difference was statistically different ( P<0.05). There was no statistically significance in the quantitative perfusion parameters between HER?2 positive and HER?2 negative (P>0.05). The degree of the expression of Ki?67 was 5%to 90%the mean value was 33%, the median and interquartile range of Ktrans, kep and Ve value was 1.33/min (0.88/min), 2.63/min (2.34/min) and 0.51 (0.22) respectively. There was no significant correlations between the degree of the expression of Ki?67 and Ktrans and kep value (r value was 0.24 and 0.22 respectively, P value was 0.03 and 0.04 respectively), and the degree of the expression of Ki?67 was not associated with Ve (r=0.00, P=0.97). Ktrans value was lower in Luminal A and Luminal B than that in HER?2 positive subtype and TNBC, kep value was lower in Luminal A and Luminal B than that in TNBC, and Ve value in Luminal A, Luminal B and HER?2 positive subtype were higher than that in TNBC, kep value was lower in Luminal B than that in HER?2 positive subtype, statistically significance was seen among them (P<0.05).Triple?negative breast cancer showed the highest kep value (3.99/min) and the lowest Ve value (0.41) than the other subtypes. Conclusion The different subtypes of breast cancer may be predicted to some extent with quantitative perfusion parameters, and there is no correlation between quantitative perfusion parameters and the prognostic factors.

OBJECTIVE To establish a model for chlorpyrifos(CPF)whole-body dynamic inhalation exposure in SD rats and investigate the injury effects after acute exposure by CPF. METHODS By optimizing the aerosol parameters ,the animal acute dynamic inhalation exposure of CPF was established. Absorption sampling-gas phase detecting technology was used to monitor the concentration of CPF in the whole-body dynamic-inhalation exposure cabin by exploring the relationship between the concentration , particle size of CPF aerosol and the CPF inhalation time in the exposure cabin via a particle size detector. Using Bliss method,specific pathogen free SD male rats were allocated to the environment of CPF exposure at different lethal concentrations and time points. The symptoms and deaths of these SD male rats in different groups were recorded within the following 10 d. Based on the median lethal concentra?tion time(LCt50),the values of plasma cholinesterase(ChE)were checked at different time points after being exposed at different doses. RESULTS The mean concentrations of CPF aerosol at nine time points was 160.6 mg · m-3,the relative standard deviation value was 6.9%;the geometrical mean of aerosol particle size was 1.1 μm,and the geometric standard deviation was 1.8. The results met the technical requirements of Organization for Economic Cooperation and Development regarding acute inhalation exposure. Under these equipment conditions,the LCt50 of CPF acute inhalation of SD male rats was 1654.2 mg · m-3 · h,suggesting that plasma ChE inhibitory rate was higher with the increase in the exposing dose,and that there was a significant difference as compared with the controls(P<0.05). CONCLU?SION The model for whole-body dynamic-inhalation exposure of CPF is applicable to rats,which can serve as an experimental platform and technical support to inhalation vulnerability and the research on prevention and cure of organophosphate industrial products and nerve agents.

Objective Methicillin-resistant Staphylococcus aureus (MRSA) is a growing public health concern that has been associated with pediatric fatalities. This study investigated the genotypes of staphylococcal cassette chromosomal mec (SCCmec) and Panton-Valentine Leukocidin (PVL) in MRSA strains isolated from Shanghai Children's Hospital by PCR. Methods A total of 30 strains of MRSA were isolated from various clinical specimens from October 2005 to June 2006. The antimicrobial susceptibility was measured by agar diffusion method. SCCmec typing was conducted using a novel multiplex PCR assay allowing for concomitant detection of methicillin resistance (mecA gene) to facilitate detection and classification of all currently described SCCmec typesⅠ, Ⅱ, Ⅲ, Ⅳa, b, c, d andⅤ. PVL gene was also determined by PCR. Results mecA gene was positive in all the strains. SCCmecⅡ was identified in 6(20.0%) isolates, SCCmecⅢ in 15(50.0%) isolates, SCCmecⅤ in 2 and SCCmecⅣa in 1 isolate. Six MRSA strains were non-typeable. The isolates with SCCmecⅡ or SCCmecⅢ were resistant to multiple antibiotics. The strains harboring SCCmecⅣa or SCCmecⅤwere susceptible to all antibiotics except β-lactams. Eleven (36.7%) isolates were PVL positive. The genotypes and subgenotypes of staphylococcal chromosomal cassette mec of eleven PVL-positive MRSA were SCCmecⅡ(1 isolates), SCCmecⅢ (5 isolates), SCCmecⅣa (1 isolate), SCCmecⅤ (2 iso-Lates) non-typeable (2 isolates). Conclusions SCCmecⅡ and SCCmecⅢ are the major genotypes of MRSA in our hospital. These isolates are multi-resistant to antibiotics. The prevalence of PVL gene is higher in SCCmecⅡ- or SCCmeⅢ-positive MRSA. The isolates with SCCmecⅡ or SCCmecⅢ were resistant to multiple antibiotics.

Objective To investigate the efficacy of sequential add-on of pegylated interferon α-2a (PEGIFN-α-2a) for 48 weeks in chronic hepatitis B (CHB) patients with low serum hepatitis B e antigen (HBeAg) titer after long term adefovir dipivoxil (ADV) monotherapy.Methods This was a randomized,open and prospective clinical trial.Patients who had been treated with ADV for 72 to 144 weeks,with undetectable serum hepatitis B virus (HBV) DNA level,low HBeAg titer (5 S/CO＜ HBeAg＜50 S/CO) and serum hepatitis B surface antigen (HBsAg) ＜5000 IU/mL were included.The patients were categorized into ADV monotherapy group and ADV plus PEGIFN-a-2a combination therapy group by random number table.Patients in ADV group continued ADV monotherapy and patients in combination therapy group added PEGIFN-α-2a to ADV for 48 weeks.After the treatment,efficacy of the two therapies were assessed by comparing the reduction of serum HBeAg reduction,HBeAg loss rate,HBeAg seroconversion rate,and reduction of intrahepatic HBV DNA and HBV covalently closed circular DNA (cccDNA).Pre-and post-treatment results were compared by paired samples t test.Comparison between groups was performed using indepedent samples t test.Comparison of rates between groups was performed using x2 test.Results The trial enrolled 55 CHB patients,and there were 27 patients in ADV monotherapy group,28 patients in combination therapy group.Baseline characteristics including age distribution,sex ratio,alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBil),serum HBeAg and HBsAg,hepatic HBV DNA and HBV cccDNA were all comparable (all P＞0.05).Twenty-five patients in ADV monotherapy group and 26 patients in combination therapy group completed 48 weeks treatment.HBeAg loss rates and seroconversion rates of combination therapy group were higher than those of ADV monotherapy group (x2 =5.38 and 4.69,respectively,both P＜0.05).HBeAg titers of both groups were significantly lower than those of baseline (t=8.43 and 8.50,respectively,both P＜0.05).The HBeAg titer of combination therapy group was lower than that of monotherapy group (t=5.60,P＜ 0.01).HBV DNA and HBV cccDNA in liver tissue of combination therapy group was (6.934±0.52) lg IU/mg and (5.63±0.54) lg IU/mg post-treatment,respectively,which were both lower than baseline (t＝7.12.6.67,respectively,both P＜0.01).HBV DNA in liver tissue of monotherapy group was (7.09＝0.43) lg IU/mg post-treatment,which was lower than baseline (t=2.67,P=0.02).After treatment,HBV cccDNA in liver tissue of combination therapy group was lower than that of monotherapy group (t =2.87,P=0.00).Conclusions Compared with ADV monotherapy,sequential add-on of PEGIFN-a-2a in combination with ADV can achieve higher serum HBeAg loss rate and seroconversion rate and facilitate the clearance of hepatic HBV DNA and HBV cccDNA in CHB patients with low HBeAg titer after long-term ADV monotherapy.

Objective To evaluate 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama.Methods The 3D CT features on MIP,VR images were analyzed retrospectively in 589 pediatric cases.The normal anatomy,anatomic variations and fractures of occipital squama were observed respectively,and the differential diagnostic features including the individual location,appearance and extension were analyzed.Results Four hundred and thirty-three patients (75.2％) showed normal anatomy,including 154 patients with adult occipital anatomical features,279 patients with posterior intraoccipital synchondrosis,and 37 patients with Kerckring-supraoccipital synchondrosis.When cases with recent trauma history were excluded,113 patients (19.1％) showed anatomic variants,including unpenetrating sutures and penetrating sutures.The former could be subdivided to Mendosal sutures in 23 cases,superior median fissures in 19 cases,and midline supraoccipital fissures in 4 cases,while the latter could be subdivided to the interparietal bone variations in 54 cases,wormian bones in 23 cases,and accessory bones in 7 cases.Two or more variations coexisted in 33 cases.The occipital squama fractures were shown in 34 cases (5.6％),including linear fractures in 27 cases,comminuted fractures in 3 cases,with depression fracture in one case,separation of cranial sutures in 3 cases,and other fractures associated with variants in 3 cases.The fractures were sharp,or jagged,without limitation of the occification.Conclusion There are different 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama in children,which are important for making the accurate diagnosis.