Objective To explore the self perceived burden and its related factors in patients with chronic heart failure,and provide evidence for clinical nursing intervention.Method Using activity of daily living scale,general self-efficacy and selfperception burden interview scale to investigate the 298 cases of patients with chronic heart failure from our hospital.Results The self-perceived burden score was (24.84±6.74),and it was at the mild to moderate level,there were 77.52％ patients with mild to severe self-feeling burden.The self-efficacy score was (23.71 ±6.66),below the national norm (P＜0.01).The self-perceived burden was negatively correlated with self-efficacy (r=-0.365,P＜0.001).Factors including ages,gender,primary caregivers and self-efficacy were related with self-perceived burden in patients with chronic heart failure (all P＜0.05).Conclusions The self-perceived burden score of CHF patient is mild to moderate level,where age,gender,primary caregiver and self-efficiency are factors.Clinical staff should develop targeted interventions to reduce the burden on the level of self-feelings such patients,improving the quality of life of patients.

Ductular reaction (DR) is a phenomenon that refers to impaired hepatocellular proliferation and activated hepatic stem cells at times of demand such as hepatic regeneration.The components of ductular reactions are thought to be derived from activated hepatic progenitor cells,intermediate hepatobiliary cells,and reactive ductular cells.DRs are thought to play two roles in hepatocarcinogenesis:their hepatic progenitor cells may undergo malignant transformation and migration,and they may contribute to the development of the tumor's microenvironment.Exploring DR phenotype,cellular diversity,and relationship to hepatocarcinogenesis will further enhance our understanding of the pathogenesis of human hepatocellular carcinoma with an ultimate goal of developing new therapies.

Objective To understand the etiology and clinical manifestation of malignant atrophic papulosis,to report the psychological care of one case with malignant atrophic papules,and patients to maintain a good psychological state.Methods Nursing measures such as strengthening skin care,reducing discomfort,avoiding aggravating the injury; attention to abdominal signs,detection of changes in disease condition,prevention of intestinal perforation,related medication education to increase medication compliance were given to this patients.Results The abdominal pain disappeared,lower limb muscle force recovered,and the patient was discharged after the disease condition was steady.Conclusions To patients with malignant atrophic papulosis,early detection and early treatment should be given to them.

Objective To explore the effects of human menopausal gonadotropopin(HMG) supplementation on the outcome of women underwent in vitro fertilization-embryo transfer(IVF-ET) .Methods The data of 406 IVF-ET cycles in Reproductive Medi-cine Center of the 105th Hospital of PLA were analyzed retrospectively .All cases underwent long down regulation protocol with gonadotropin releasing hormone agonist(GnRH-a) in the mid-luteal phase and controlled ovarian stimulation(COS) was carried out with follicle stimulation hormone(r-FSH) on the days 3 -5 of the menstrual cycle .Then 75 -150 U HMG was administrated in group A(257 cycles) when a dominant follicle reached a diameter of 14 mm ,while the remaining cases(149 cycles) underwent HCG still with r-FSH were served as group B .Based on the LH levels on the day of HMG administration ,the cases in group A were sub-divided into :group A1(99 cycles) ,LH<1 U/L ;group A2(96 cycles) ,1 U/L≤LH≤2 U/L ,and group A3(62 cycles) ,LH>2 U/L .Clinical outcomes of all groups were analyzed and compared .Results The durations and doses of gonadotropin(Gn) ,the rates of fertilization and pregnancy were higher and the abortion rate was lower in group A than that in group B (P<0 .05) .There were no significant difference in serum LH concentrations on the days of HMG and HCG administration ,oocytes retrieved ,the rates of cleavage and embryo implantation between group A and group B(P>0 .05) .There was significant difference in serum LH levels on the day of HMG supplementation among group A1 ,A2 and A3(P<0 .05) and the doses of HMG supplemented reduced gradually from group A1 to group A3(P<0 .05) .The duration of Gn was significantly lower and the fertilization rate was significantly higher in group A3 compared with group A1 and A2(P<0 .05) .The pregnancy rate in group A2 and A3 was higher than that in group A1 ,which showed significant difference between group A2 and A1(P<0 .05) .Meanwhile ,there were no significant difference in doses of r-FSH ,serum LH concentrations on the day of HCG administration ,oocytes retrieved ,the rates of cleavage ,implantation and abortion among the three groups(P>0 .05) .Conclusion HMG supplementation in the middle and late follicle phases in stand-ard long down-regulation protocol during IVF could obtain higher pregnancy rate and lower abortion rate ,especially when their ser-um LH level was between 1 U/L and 2 U/L without obvious increase of LH .

Objective To investigate the scale and educational-level composition of nursing education in Guangdong Province,identify the issues in the development process,and provide suggestions accordingly.Methods Data on the scale and education level of nursing education were obtained from the Ministry of Education of China.Results Scale of nursing education at three levels for entering nursing (secondary diploma,advanced diploma,and baccalaureate degree) expanded rapidly during 2006～2010 in Guangdong,with 25.6 thousand recruitments totally in 2010,which as 2.05 times as in 2006.The portion of students recruited in secondary diploma programs had increased gradually,resulted in 83.53％ in 2010 (9.41％ for recruitments in advanced diploma programs and 7.06％ for baccalaureate degree programs).179 and 16 students were recruited in master's and doctoral programs in Guangdong,respectively,during 2006～ 2010.Conclusions The current scale and composition of nursing education in Guangdong should be improved according to the dynamic supply-need relationship of nursing workforce.Initial nursing education should be upgraded by increasing the recruitments of advanced diploma and baccalaureate programs and decreasing the recruitments of secondary diploma programs,expand graduate education,and ensure the quality of education.

Objective To investigate the correlation between prostacyclin synthase (prostaglandin I2 synthase, PGIS) gene rs5602 single nucleotide polymorphism and ischemia stroke in Chinese Han population. Methods The patients with ischemia stroke and healthy controls in Chinese Han population were enroled. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) was used to detect the rs5602 polymorphism. Results A total of 297 patients with ischemic stroke (male 177 and female 120) and 291 healthy controls (male 165, female 126) over the same period were enroled. The frequencies of TT genotype (31. 1% vs. 43. 6% ; χ2 = 5. 773, P = 0. 016) and T alele (56. 8% vs. 65. 8% ; χ2 = 5. 793, P = 0. 016) in the male patients with ischemic stroke were significantly lower than those in the male healthy controls. Multivariate logistic regression analysis showed that the rs5602 TT genotype was a protective factor for ischemic stroke in male (odds ratio 0. 260, 95% confidence interval 0. 118-0. 570; P = 0. 001). Conclusions PGIS gene rs5602 polymorphism is associated with ischemic stroke in male in Chinese Han population.

Objective To discuss the MSCT performances of appendix mucinous cystadenoma in order to improve the preoperative diagnosis.Methods MSCT plain and enhanced findings of mucinous appendix mucinous cystadenoma proved by pathology in 6 pa-tients were analyzed retrospectively.Results CT showed cystic dilatation of the appendix in 2 patients with heterogeneous density, and cystic mass in the right iliac fossa in 4.As for the cystic wall,uniform thin wall was seen in 4,curvilinear mural calcification in 3 and septation in 2.Dynamic enhanced CT showed the ring mural enhancement in 4.In addition,the blurred surrounding fatty tis-sues were seen in 2.Conclusion MSCT findings of mucinous appendiceal cystadenoma appeared as cystic dilatation or cystic mass in the right iliac fossa,curvilinear mural calcification and enhanced wall.

BACKGROUND:Systemic lupus erythematosus (SLE) is classified into four types, and the major treatment is to tonify kidney and nourishyin, clear blood stasis and toxin by the traditional Chinese medicine (TCM). Even though, there are stil many patients with poor efficacy. Mesenchymal stem cels have the capacity of multiple differentiation, hematopoietic support and immune regulation, thus having been used for the treatment of refractory, recurrent SLE and achieving good effects. OBJECTIVE:To investigate the therapeutic effect of umbilical cord-derived mesenchymal stem cel transplantation on SLE patients with different patterns of syndromes. METHODS: Twenty-one SLE patients were clustered to four syndrome types of TCM, including heat-toxin,yin deficiency of liver and kidney,yang deficiency of spleen and kidney, andqi stagnation and blood stasis. The changes in clinical and laboratory indicators were analyzed statisticaly before and after cel transplantation. RESULTS AND CONCLUSION:The level of 24-hour proteinuria and SLE disease activity index scores in SLE patients were significantly decreased at 1, 3, 6 months after cel transplantation (P < 0.01). Umbilical cord-derived mesenchymal stem cel transplantation could significantly reduce the 24-hour proteinuria in SLE patients withyin deficiency of liver and kidney at 1, 3 and 6 months (P < 0.01), while slightly reduce the 24-hour proteinuria in SLE patients with heat-toxin andqi stagnation and blood stasis at 1, 3 months (P < 0.05) as wel as in SLE patients withyang deficiency of spleen and kidney at 1 month (P < 0.05). Additionaly, umbilical cord-derived mesenchymal stem cel transplantation could increase the serum albumin levels in al the SLE patients (P < 0.01), although the changes in patients with heat-toxin were moderate (P < 0.05). Al the SLE patients of four types had an increasing trend of their platelet counting after cel transplantation, but there was no statistical difference before and after cel transplantation. Taken together, umbilical cord-derived mesenchymal stem cel transplantation is effective for treatment of SLE, but has different therapeutic efficacy on SLE patients with different syndrome types of TCM.

Objective To investigate the relationship between Epstein-Barr virus (EBV) DNA and EBV serology markers and evaluate the clinical application values in different diseases.Methods Plasma samples from 397 diagnosed EBV infection-associated patients and 120 health donors from May 2014 to November 2015 in Wuhan Tongji Hospital were collected.Real-time fluorescent quantitative PCR was performed to detect the levels of EBV-DNA in peripheral blood mononuclear cell and plasma.ELISA was used to detect VCA IgA,VCA IgM,VCA IgG,EA(D) IgG and EBNA IgG antibodies in plasma.The positive rate of EBV-DNA and EBV antibodies were counted in each group according to the detection threshold.Kappa statistic and Spearman sank correlation test were used to analysis the correlation and uniformity between EBV-DNA and EBV serology indicators.Results The positive rate of VCA IgG in patient and health control was 94.2% (374/397) and 93.3% (112/120) respectively (χ2=0.125,P=0.67);The positive rate of EBNA IgG in patient and health control was 95.4% (379/397) and 95.0% (114/120) respectively (χ2=0.045,P=0.807);but the positive rate of VCA IgM was 5.5% (22/397) and 0% (0/120) respectively (χ2=6.9,P<0.01);The positive rate of VCA IgA was 43.3% (172/397) and 9.2% (10/120) respectively (χ2=49.5,P<0.01);The positive rate of EA(D) IgG was 42.0% (167/397) and 7.5% (9/120) respectively (χ2=49,P<0.01).The positive rate of EBV-DNA was 65.5% (260/397) and 16.7% (20/120) respectively (χ2=88.5,P<0.01);The positive rate of EBV-DNA in plasma was 45.8% (182/397) and 5.0% (6/120) respectively (χ2=66.4,P<0.01).Furthermore,the uniformity and Spearman correlation analysis showed that there was no significant correlation between EBV-DNA and EBV serology indicators.The correlation analysis between PBMC EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.073,0.147,0.073,respectively;the correlation analysis between plasma EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.144,0.369,0.288,respectively.Thus,the patients were divided into different groups according to the discharge diagnosis,it was observed that the positive rates of EBV-DNA is more than 90% in extra-nodal NK/T cells lymphoma,EBV-associated hemophagocytic lymphoid tissue hyperplasia,chronic active EBV infection and infectious mononucleosis.In nasopharyngeal carcinoma patients,the positive rate of EBV antibodies (VCA IgA and EA(D) IgG) were higher than the detection of EBV-DNA.Conclusions There was no significant correlation between EBV-DNA and EBV serology markers for the same sample.The clinical application values of EBV DNA and EBV serology markers were not identical in nasopharyngeal carcinoma,extra-nodal NK/T cells lymphoma,infectious mononucleosis and EBV-associated hemophagocytic lymphoid tissue hyperplasia.

Objective To study CT value of diagnosis and identified diagnosis in osteolytic metastases of the vertebral column through describing their CT manifestation.Methods In 46 patients, 72 vertebrae osteolytic metastases were analyzed and compared with X-ray findings of 28 cases.Results In 72 vertebrae osteolytic metastases, there were destruction of 74 corpus vertebrae in 45 patients, of pediculus arcus vertebraes in 22 cases, of processus transverses in 15 cases, of processus spinosus in 11 cases and lamina vertebrae in 11 cases. Micrometastases were concentrated in corpus vertebrae(45/49). CT found the rate of bone-destruction, affection of vertebrae canal and soft tissue around vertebrae were 100%, 67.8% and 71.4%, but the corresponding rates were only 53.6%, 14.3% and 32.1% by X-ray. Conclusion Vertebral column metastases destructed corpus vertebrae at first, vertebral metastases are the origin or base of destruction of the pediculus arcus vertebrae, lamina vertebrae, processus transverses and processus spinous. CT scanning is more sensitive in finding and evaluating the lesions than X-ray plain film.