Objective To describe classroom teaching quality and to develop strategy for improving teaching quality of undergraduate pediatric nursing.Methods A total of forty-six junior students drawn from a nursing college were selected as subjects for cross-sectional study.The Teacher's Lecture Practice Evaluation Form developed by Sichuan University was used to measure teaching quality.A semi-structural interview was applied to obtain information from ten nursing students.Results The overall assessment of nursing teacher's classroom lecture was (89.60±5.63) points.Items of enrichment of contents,emphasized points,proficient in contents,explanation of terms and application of professional English got high score,items of heuristic question,lecture appeal,enlighten students obtained low scores.The interview results identified problems in teaching content,teaching method,and teaching behavior.Students provided suggestions for classroom teaching.Conclusions The classroom lecture performance of pediatric nursing is satisfactory,but teaching content,teaching method,and effective teaching behavior need to be upgraded.

Objective To explore core competency of nursing students during internship in western China,and to provide reference for the nursing education.Methods 380 nursing students during internship were investigated with Competency Inventory for Registered Nurse (CIRN).Results The total score of core competency of nursing students was (136.40±31.99) points,weighted mean scores of eight dimensions was (2.36±0.51)points;the highest mean score was the dimension of legal and ethical practice (2.88±0.57)points,and the lowest mean score was the dimension of critical thinking (1.91±0.52)points.There was significant difference of core competency in students with different education background and with varied firstchoice profession.Conclusions The core competence of nursing students during internship remains at lower middle level.The nursing educators should shift their concept of nursing education to the new mode of professional competence orientation.

Objective To investigate risk factors for feeding intolerance of preterm infants under the reactive scope model guidance, and provided empirical evidence for effective prevention and treatment of feeding intolerance in preterm infants. Methods Checked the cases of 242 preterm infants been treated in the neonatal department from August 2014 to January 2015 according to the order of admission. Through literature reviewing and expert consultation, the clinical observation table was designed based on the reactive scope model, and risk factors for feeding intolerance of preterm infants were investigated by single factor analysis and logistic regression analysis from the feeding intolerance (FI) group and non-FI group. Results The incidence of feeding intolerance in preterm infants was 33.8%(70/207), feeding intolerance in preterm infants often occurred during the period of being fed within 72 hours, and the clinical manifestations were gastric retention, abdominal distension and emesis. Single factor analysis showed that gestational age, birth weight, fetal distress, aminophylline application, intrauterine infection, breast milk feeding and twice stool interval were the related factors to the feeding intolerance. Logistic regression analysis showed that gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval >3 d were the risk factors of FI. Conclusions Gestational age and birth weight were the protective factors of FI. Fetal distress, aminophylline application, twice stool interval>3 d were the risk factors of FI.

Objective To investigate the seasonal variability of the onset of acute deep vein thrombosis(DVT).Methods The clinical manifestations in 774 DVT patients during January 2008 to December 2012 were collected and circular distribution statistics was used to identify seasonal variability.Results The total sample had the significant seasonal variability (P ＜ 0.01):DVT was most frequent in winter while less frequent in summer and the peak day was January 1.Female subgroup has significant seasonal variability (P ＜0.01):on peak in winter and at trough in summer while male subgroup has no significant seasonal variability (P ＜ 0.01).Different age subgroups (＜ 40 years,40-69 years,＜70 years)have significant seasonal variability(P ＜ 0.05,P ＜ 0.01,P ＜ 0.01).DVT was most common in December and less frequent in August.Left lower limb subgroup and both lower limb subgroup has significant seasonal variability (P ＜ 0.01,P ＜ 0.01),on peak in December-January.Immobilization subgroup also has significant seasonal variability (P ＜ 0.001):frequent in winter,January 1 is on the peak.Conclusions DVT has significant seasonal variability in onset:it is most frequently seen in winter while less frequent in summer.Some subgroups (female,＜70 years and immobilization) have the most significant seasonal variability in onset.

Varicose vein of lower extremity and varicocele show tortuosity,dilatation in different parts of venous.They are linked in venous anatomy structure.Their pathogenesis are not clear,but have certain similarity in venous wall structures,venous pressure,venous valvular incompetence,venous insufficiency,level of serum sex homone and apoptosis.We review the related literature to investigate the correlation between pathogenesis of them,in order to provide reference for the etiology,diagnosis and treatment.

Objective To analyze the imaging manifestations of primary non-Hodgkin lymphoma of skeletal muscle and improve the recognition of this rare disease.Methods Five cases of primary non-Hodgkin lymphoma of skeletal muscle proved pathologically underwent imaging exam,including MRI and CT in 3 cases,only MRI in 1 case,only CT in 1 case,X-ray in 2 cases and bone scintigraphy in 2 cases.Results Diffuse enlargements of involved muscle with presentation of overall configuration were observed in all five cases.All 4 cases manifested as homogeneous soft masses,which is isoattenuating to normal muscle on unenhanced CT images.After intravenous injection of contrast media,the masses enhanced homogeneously and slightly(2 cases)or moderately(1 case)on CT images.The lesions were homogenous and had isointense or slightly low signal intensity compared with that of uninvolved muscle on T1-weighted images and high signal intensity on T2-weighted images.After intravenous injection of contrast media,all 2 cases enhanced homogeneously and moderately with the enhanced signal intensity of involved muscle greatly higher than that of uninvolved muscle on MR images.Two cases of X-ray plain showed no destruction of bone and 2 cases of bone scintigraphy exams showed increased radiotracer uptake of involved muscle with no infiltration of bone marrow.Conclusion There are several characteristics on the imaging of primary non-Hodgkin lymphoma of skeletal muscle.MRI is the optimal imaging method for the diagnosis of this disease.

Objective To investigate the effect of one-stage total hip arthroplasty (THA) for advanced active tuberculosis of the hip.Methods Data of 19 patients who had received one-stage THA for advanced active tuberculosis of the hip in our hospital from September 1998 to October 2010 were retrospectively analyzed.There were 14 males (15 hips) and 5 females (5 hips),aged from 21 to 74 years (average,44.1 years).According to the clinicoradiologic classification of tuberculosis of the hip introduced by Babhulkar and Pande,there were 3 cases of grade Ⅲ and 16 cases of grade Ⅳ.The average time interval from onset of symptoms to THA was 15.1 weeks (range,5-26 weeks).Chest radiographs showed old pulmonary tuberculosis in 3 patients.One patient had a sinus tract in hip skin.The diagnosis was confirmed by histopathology in all patients.The antituberculous medication was applied for at least 2 weeks preoperatively and 9 to 12 months postoperatively.Results All patients were followed up for 12 to 142 months (average,57 months).Dislocation of the hip occurred in 1 patient 6 days after operation,which was cured by manual reduction.Tuberculosis recurrence occurred in 1 patient 5 months after operation,which was cured after debridement without removing component and antituberculous medication for 1 year.Cup loosening was found in 1 patient 9 years after operation.No reactivation of infection or implant loosening was found in other patients.The average Harris score improved from preoperative 35 (range,27-46) to 90 (range,65-96) at final follow-up.Conclusion One-stage THA can be safely performed in advanced active tuberculosis of the hip,which can relief symptoms and improve hip function.

Objective To investigate the feasibility and clinical effect of one-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis.Methods From January 2003 to December 2010,11 patients with old femoral condyle fracture combined with knee osteoarthritis,including 4males and 7 females,aged from 38 to 77 years (average,58.3 years),underwent one-stage total knee arthroplasty.There were 8 cases of supracondylar fracture,and 3 cases of intercondylar fracture.Moreover,there were 2 cases of knee fibrous ankylosis with mild amyotrophy,3 cases of collateral ligaments injury of the knee,2 cases of fibrous union,and 2 cases of infective nonunion.Results All patients were followed up for 6 to 72 months (average,41.3 months).The HSS score improved from preoperative 6.65±7.01 (range,0-13)to 88.5±6.18 (range,81-95) at final follow-up.The range of motion of the knee improved from preoperative 32.7°±17.6° (range,0°-50°) to 101.3°±9.8° (range,85°- 115°) at final follow-up.One case underwent knee disarticulation 6 years after operation owing to infection.For other patients,there were no complications such as infection,deep vein thrombosis,knee instability,component loosening and inequality of lower limb.Conclusion One-stage total knee arthroplasty is a technically difficult but effective method for patients with old femoral condyle fracture and knee osteoarthritis.

Objective To determine the methylation status and expression of Ras association domain family 1A (RASSF1A), and the possible effect between promoter aberrant methylation and pathogenesis of pancreatic cancer. Methods The methylation status of RASSF1A promoter CpG island (CGI) pancreatic cancer cell line BxPC3 was detected in 5 cases of normal pancreatic tissue and 13 pairs of pancreatic cancer tissues (tumor and peri-tumor) by using COBRA (combined bisulfite restriction analysis) and the methylation rate was calculated. The RASSF1A mRNA expression of BxPC3 was compared between pre- and post-treatment of the inhibitor of DNA methyltransferase (5-Aza-2-deoxycitydine, 5-Aza-dC). Results The average methylation rate of RASSF1A promoter CGI was 62.90% in BXPC3, 9.14% in normal pancreas, 53.79% in peri-tumors (TP), and 55.82% in tumors. The methylation rates in port-tumors and tumors were significantly increased when compared with that of normal pancreas (P < 0.01), while there was no significant difference between in peri-tumors and tumors (P > 0.05). After 5-Aza-dC treatting BxPC3 cells, the methylation rates decreased to 42.5% (P < 0. 05) and RASSF1A mRNA expression was enhanced. Conclusions Aberrant hypermethylation of RASSF1A promoter CGI could be considered as an early event in the process of pancreatic cancer and participates in the pathogenesis of pancreatic cancer.

llary-like mural nodules of PTC showed less enhancement on post-contrast CT and cervical lymph node metastases were more frequently seen in PTC.