Objective To investigate the professional attitudes and occupational values of undergraduate students and to compare the differences between the first-year and fourth-year students? Method A scale concerning the professional attitude and a questionnaire concerning the occupational values were used to investigate the occpational values in 196 first-year and fourth year college nursing students? Results The professional attitude score of the first-year students was(6?7±1?3),which was significantly higher than that of the fourth students(5?3±1?1,P = 0?027)? The occupational value on the hygiene factor of the first-year students was significantly higher than that of the fourth-year students(P < 0?001)? The occupational value of reputation and social status,development between the students of the two grades achieved no significant difference? Conclusions The professional attitude and occupational value of students from different grades are different? The professional attitude and occupational value of the senior students tend to be rational?

Objective To review the experiences of 31 cases of totally thoracoscopic cardiac surgery of cardiopulmonary bypass in children with congenital heart disease.Methods Thirty one children with congenital heart disease received totally thoracoscopic cardiac surgery procedures during the period from October 2012 to May 2016.The ages of these children were ranged from 2 years and 7 months old to 6 years old with average value (4.6 ± 1.4)years old.The body weights were ranged from 12 ～ 24 kg with average value (17 ± 3.5) kg.Among 31 children,there were 12 cases of atrial septal defect,and 19 cases of ventricular septal defect.Through three-hole shape incision at the right chest wall,each hole was 1.5 to 2.0 cm long,and operation field were revealed totally by thoracoscope.Cardiopulmonary bypass was built through femoral arteriovenous intubation.Results Thirty one children were all cured.None of them suffered severe complications such as renal failure,respiratory failure,low cardiac output syndrome,atrioventricular block,and residual shunt.Duration of cardiopulmonary bypass was 62 ～ 185 (126.4 ± 45.2) min,and duration of myocardial ischemia was 18 ～ 118 (53.4 ± 31.2)min.Duration of Postoperative mechanical ventilation was 2 ～ 7 (5.3 ±-1.5) h.Duration of intensive care unit (ICU) stay was 15 ～ 21 (19 ± 1.3) h.Drainage volume of 24 hours after operation was 0～ 130(57 ± 36.2)ml.Volume of red blood cell transfusion was 0 ～ 2 (1.2 ± 0.8) U.Postoperative hospital stay was 4 ～ 7 (6.2 ± 1.2) d.Conclusions For children with congenital heart disease as simple atrial septal defect or ventricular septal defect,thoracoscopic surgical repair can be achieved the same therapeutic results as traditional median sternotomy surgery while having advantages such as smaller incision,less bleeding and none sternal maluniorts.

Purpose It is still undetermined about the application of regular ultrasound (US) combined with ultrasonic elastography (UE) in diagnosing superficial lymph nodes disease.Therefore our aim is to evaluate the value of US combined with UE in diagnosing superficial lymph nodes disease.Materials and Methods The ultrasonography and pathological data of 214 patients (with 266 superficial lymph nodes) were analyzed retrospectively.The US and UE data were compared with the pathologic results.Results The elastic classification of reactive hyperplastic and lymphomatous lymph nodes were no greater than grade 3,respectively;that of malignant metastatic lymph nodes was greater than grade 4.The accuracy of UE or US+UE was higher in diagnosing reactive hyperplastic lymph nodes and metastatic lymph nodes' nature compared with US (P＜0.05).The sensitivity and accuracy of US+UE in diagnosing malignant superficial lymph nodes were higher than those of US (90.13％ vs.72.37％;86.09％ vs.68.05％,P＜0.05).Compared with UE alone,those of US+UE were also higher (90.13％ vs.77.63％;86.09％ vs.72.56％,P＜0.05).Conclusion The accuracy of differential diagnosis of benign or malignant superficial lymph nodes can be improved by US+UE method.

Objective To search one ultrasonic method which could evaluate gastric emptying function accurately.Methods The gastric emptying time of 74 normal volunteers were measured by radioisotope scanning and different ultrasonic methods which including gastric antrum area,gastric antrum volume and whole gastric cylinder method.Results The gastric emptying time measured by whole gastric cylinder method related best with those measured by radioisotope scanning (r =0.79).The gastric emptying time was no significant difference between the cylinder method and radionuclide scanning (P ＞0.05).Compared with radionuclide scanning,those measured by gastric antrum area and gastric antrum volume had significant differences.Conclusions The whole gastric cylinder method can accurately reflect the gastric emptying function.

Objective Shkbp is also called Shkbp1,can competitively inhibit binding CIN85 and c-Cbl,thereby blocking the epidermal growth factor receptor (EGFR) endocytosis and degradation,to play a role in tumor promotion.This study aims to explore the changes in blood cell classification and T cell subsets in blood,bone marrow,and spleen in Shkbp1-deletion (Shkbp-1-/-) mice.Methods Shkbp-1-/-transgenic mice were identified by PCR genotyping.Blood cell classification was performed using an automatic classification system.Flow cytometry was used to detect the T lymphocyte subsets in the blood,bone marrow,and spleen of Shkbp-1-/-and control mice.Results Routine blood examination showed that neutrophils and eosinophils tended to increase and showing significant differences,and there was no significant difference in lymphocytes.The flow cytometry results showed that there was a decrease of CD4+CD8+ double positive cells and increase of bone marrow CD3+ and CD4+ cells in the control group.However,there was a decreasing trend of CD3+,CD4+,CD8+,and CD4+CD8+ cells in the spleen tissues.Conclusions Shkbp1 is involved in the maturation and differentiation of blood cells,and affects the number of immune cells.This study lays a foundation for the study of how Shkbp1 is involved in the differentiation of blood cells.

Objective To explore the etiologies of fever of unknown origin(FUO)and methods for confirming di-agnosis in patients at a hospital,and provide reference for clinical diagnosis and treatment of FUO.Methods Pa-tients with FUO admitted to a hospital between January 2008 and July 2014 were performed clinical diagnosis with methods of serology,bacteriology,molecular biology,bone marrow aspiration,tissue biopsy,and diagnostic thera-py,the etiologies and final diagnosis of 224 patients were analyzed retrospectively.Results Of 224 FUO cases,189 (84.38%)eventually got confirmed diagnosis,35 (15.62%)were not confirmed.The percentage of infectious dis-eases,connective tissue diseases,malignant tumor,and other diseases were 50.45%,18.75%,9.82%,and 5.36%respectively.Among infectious diseases,the major pathogens were bacteria,followed by virus.The major connec-tive tissue diseases were systemic lupus erythematosus and polyarteritis nodosa;the main malignant tumor was he-matological tumor,lymphoma was the main form.Among 189 patients with confirmed diagnosis,30.16% and 24.34% were performed pathogenic and pathologic detection respectively,and 20.11% were performed the other (compre-hensive)methods.Conclusion Infectious diseases,connective tissue diseases,and tumor are major etiologies of FUO.

Objective To explore the effect of inhaled iloprost (Ventavis) for patients with congenital heart disease associated with pulmonary hypertension.Methods Twenty-two patients with congenital heart disease associated with pulmonary hypertension were selected to inhale Ventsvis by atomizer before surgery ,the required dosage is 25-30ng/(kg.min),aerosolization of iloprest was inhaled by PARI Junior BOY N after diluted with 2ml physiological saline at 3-hour intervals .The change of hemodynamic effects was measured by Doppler ultrasonography after 60min,120min,and 180min.Results The left and fight vemfieular cardiac output at 60min,120min and 180rain after therapy were markedly higher than that before inhaled iloprost ,respirator therapy time was shorter in patients inhaled iloprost.Conclusion inhaled iloprost can increase cardiac output and improve patients cardiac function.Thus,the therapy with inhaled iloprost is effective and feasible.

Objective To investigate the status of nursing professional values and its influencing factors to make contribution for nursing managers to improve nursing professional values.Methods 280 registered nurses selected by convenient sampling method were investigated by demographic questionnaires and the Revised Nursing Professional Values Scale (NPVS-R).Results The score of nursing professional value was (100.70 ± 6.36) points,the highest scoring dimension wasprofessional characteristic ,followed by trust, behavioristand providing care.The scores of protecting patients privacy,being trusted by patients,constantly improving professional ability,etc.were higher.The scores of involving in research,peer review and public decision,etc.were lower.Medical department,profession and interest,job satisfaction were the influencing factors,F values were 2.575,3.750 and 2.909.Conclusions The nursing professional value was higher than middle level and unbalanced development.Nursing managers should take individualized approach to improve nursing professional values based on the characteristics of departments and lower score parts.

Objective: To explore the relationship between platelet counts at admission and in-hospital mortality in patients with type A acute aortic dissection (AAD). Methods: We investigated 183 consecutive patients with CT conifrmed diagnosis of type A AAD treated in our hospital from 2012-02 to 2013-05. There were 126 (68.9%) male and the patients were divided into 3 sets of groups.①In-hospital surviving group,n=157 and In-hospital death group,n=26.②According to platelet counts, the patients were divided into 5 groups: Q1 group, platelet counts ≤ 119×109/L,n=36, Q2 group, platelet (120-149) ×109/L,n=37, Q3 group, platelet (150-173)×109/L, n=36, Q4 group, platelet (174-228)×109/L,n=37, Q5 group, platelet >228×109/L,n=37.③At admission, platelet ≤ 119×109/L,n=36 and platelet >119×109/L,n=147. In addition, the patients were further divided into another 4 groups based on operative condition: platelet ≤ 119×109/L with operation,n=18, without operation,n=18; platelet > 119×109/L with operation,n=96, without operation,n=51. The basic information at admission including platelet counts, WBC and D-dimer were studied in all groups, the primary endpoint was in-hospital mortality. Results: The overall in-hospital mortality was 14.3%. Compared with In-hospital surviving group, the In-hospital mortality group had decreased platelet counts, lower blood pressure and higher level of D-dimer. The mortality in Q1 group (38.9%) was higher than those in Q2, Q3, Q4 and Q5 groups (10.8%, 11.1%, 8.1% and 2.7%), allP<0.001. The risk of death in Q5 group was higher than Q1 group (HR=11.2, 95% CI 2.13-123.3,P=0.007). With adjusted age, gender and other relevant factors, when platelet counts ≤ 119×109/L, the risk of in-hospital mortality with Cox multivariate model I analysis was (HR3.90, 95% CI 1.67-9.09,P=0.002), with Cox model II was (HR=2.67, 95% CI 1.15 -6.19,P=0.023). Conclusion: AAD patients with admission platelet counts ≤ 119×109/L had the high risk of in-hospital death, even with operation, lower platelet counts was still related to in-hospital death.

Objective To investigate the influence of iodixanol-320 and iopromide-370 on the heart rate of patients in coronary dual-source CT angiography (CTA).Methods The data of 389 patients underwent coronary CTA examinations were retrospectively collected and received contrast media (CM) with either iodixanol-320 (group A) or iopromide-370 (group B), randomly.The heart rate before CM injection (predose HR), during injection (postdose HR) were both recorded.As for the preclinical protocol, patients with heart rate less than 75 beats per minute were pretreated with nitrates (n=278),0.25 mg.Mean heart rate changes from pre to postdose HR were assessed.Results The patients whose mean heart rate changes from pre to postdose were larger than 10 beats per minute was 8(4.4%) for group A and 10(4.8%) for group B.No statistically differences were observed between them(P>0.05).With only intravenous injections of two contrast agents, the patients' heart rates decreased in both groups (4.2 vs 2.7 beats per minute,P>0.05), while the effect could be reduced by nitrates.Conclusion There is no difference in the heart rate between the 2 agents after intravenous injection of either iodixanol-320 or iopromide-370 in coronary CTA with approximately 4% patients whose mean heart rate changes from preto postdose were larger than 10 beats per minute in each group.