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.

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.

[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.

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 compare the effects of paired associative stimulation (PAS) and repetitive transcranial magnetic stimulation (rTMS) on motor cortex excitability.Methods The baseline corticospinal excitability of the left hemispheres of 10 healthy subjects was measured in terms of resting motor threshold (RMT) and other indicators of motor evoked potentials (MEP).On the following day they received PAS composed of trascranial magnetic stimulation (TMS) to the motor cortex of the left hemisphere and electric stimulation (ES) of the median nerve contralateral to the motor cortex,with an interval of 10ms between the TMS and ES (termed PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ of the RMT,for a total of 90 pulses.The MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.After the PAS intervention,an interval of one week was allowed to eliminate any effect of PAS on motor cortex excitability.Then rTMS was delivered to the subjects' left motor cortex at the same time of day at a frequency of 1 Hz and an intensity of 120％ of the RMT,for a total of 1000 pulses.MEP amplitude,MEP latency and RMT were evaluated one minute after the stimulation.The two interventions were compared in terms of MEP amplitude,MEP latency and RMT.Results The average MEP amplitude,MEP latency and RMT at baseline were (2.93 ± 0.99) mV,(20.97 ± 1.67) ms,and (46.06 ±5.32) ％,respectively.One minute after PAS10,the MEP amplitude,MEP latency and RMT were (1.14 ± 0.76) mV,(21.87 ± 1.09) ms and (52.06 ±4.20) ％,respectively.One minute after rTMS,the MEP amplitude and latency and the RMT were (2.24 ± 0.79) mV,(20.88 ± 1.94) ms,and (49.00 ± 4.54) ％,respectively.The differences in MEP amplitude,MEP latency and RMT pre-and post-intervention were (0.69 ± 0.10) mV,(0.09 ±0.05) ms and (3.94 ± 0.93) ％,respectively for rTMS.For PAS10 they were (1.83 ± 0.14) mV,(0.90 ± 0.26)ms and (6.00 ± 1.13)％,respectively.The differences in MEP amplitude decrease and MEP latency lengthening between the two stimulation protocols were significant,but the difference in RMT elevation was not.Conclusion Both PAS10 and low frequency rTMS suppressed motor cortex excitability,but the suppressive effect of PAS10 is more significant.

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 investigate the effects of paired associative stimulation (PAS) on the recovery of upper limb motor function in stroke patients,and to analyze the relationship between the change of motor cortex excitability in the contralesional hemisphere and the recovery of motor function in the affected upper limb.Methods Thirty hemiplegic stroke patients were divided randomly into a treatment group and a control group.Both groups were given routine rehabilitation therapy,but the treatment group also received PAS consisting of transcranial magnetic stimulation (TMS) of the intact motor cortex and electrical stimulation (ES) of the median nerve at the wrist of the intact arm with an interval of 10 ms between the TMS and ES (PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ the resting motor threshold (RMT),once daily for 30 minutes,five times a week for 4 weeks.Corticospinal excitability was measured using motor evoked potentials (MEP) and the RMT.The FuglMeyer upper limb assessment (FMA),Brunnstrom staging and the modified Barthel index (MBI) were also applied before and at the end of the 4 weeks of treatment.Correlation was sought between any changes in MEP amplitude,the RMT of the contralesional hemisphere and changes in the FMA results.Results Before the intervention there were no significant differences between the two groups in terms of any of the assessments.After 4 weeks of treatment,all the assessments had changed significantly compared to those before the treatment,but there were still no significant differences between the two groups in terms of any the assessments.After 4 weeks of treatment,the differences in MEP amplitude from the contra-lesional hemisphere and the differences in FMA scores were positively and significantly correlated with a correlation coefficient of r =0.431.The lesioned hemisphere was also positively correlated with the differences in FMA scores with a significant correlation coefficient of r =0.608.Conclusion PAS10 can facilitate the recovery of upper limb motor function.The change in motor cortex excitability of the contra-lesional hemisphere significantly correlates with functional recovery in the upper limb.

Objective To evaluate efficacy in detecting lung nodules at low-dose CT(LDCT) by nodule enhanced viewing(NEV).Methods One hundred and twenty seven patients who were referred to undergo low-dose CT (LDCT) for the evaluation of pulmonary metastasis or screening lung cancer were selected randomly.Two radiologists with at least 10 years experience read the images with normal clinical reading speed to find actionable nodules ≤ 2.0 cm in maximum diameter,and their consensus result was referred as Standard.NEV was adopted to detect the pulmonary nodules.Two residents with experience of less than three years read first detected suspicious nodules and recorded reading time,first consensus and mean time were recorded.Then,they made second decisions on the images with the help of NEV and the results and the reading time were recorded and analyzed by using wilcoxon test.The sensitivity and accuracy of NEV,residents and residents with NEV were analyzed.Results Standard,resident,NEV and resident with NEV detected 570,404,768 and 593 lung nodules ≤2.0 cm in maximum diameter,respectively.More than 60％ nodules were less than 0.5 cm in maximum diameter.The performance of NEV in detecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of the resident(Z =-6.887,P ＜0.01 and Z =-7.235,P ＜0.01),and the performance of resident with NEV indetecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of resident without NEV (Z =-6.606,P ＜ 0.01 and Z =-6.657,P ＜ 0.01).The resident,NEV and the resident with NEV detected nodules ＜ 20 mm in maximum diameter with sensitivities of 61.4％,86.3％ and 95.3％,and with accuracy of 56.1％,58.1％ and 87.6％,respectively.The resident achieved sensitivities of 51.4％,88.1％ and 94.8％,and accuracy of 47.0％,56.9％ and 87.5％ for nodules ＜5 mm in maximum diameter,respectively.The resident,NEV and resident with NEV spent 120-444 s,85-262 s and 131-1512 s per case to read the CT scans,respectively.The reading time of resident with NEV in was significantly higher than that of resident without NEV(Z =-9.781,P ＜ 0.01).The resident spent 23 s per NEV mark.Conclusion NEV considerable improves the resident's performance in lung nodule detection,especially in maximum diameter ＜ 0.5 cm nodule detection.