Objective To investigate the employment pressure among graduates from nursing school,and explore influencing factors,in order to make suggestions on education management,career guidance and psychological intervention.Methods Students graduated from Nanyang Medical College in 2012 who majored in nursing and nursing graduates from Nanyang Institute of Technology were surveyed with medical students employment pressure questionnaire designed by DU Tian-jiao from China Medical University.SPSS13.0 was used to establish database and analyze data.Results The total employment pressure of all students was M=3.2.Seven stressors scores from high to level were:post requirements,social environment,family support,personal qualities,the school effect,professional requirements,and career guidance.Multiple regression analysis showed that whether or not the student leaders,different sources and the education background were the influencing factors of employment pressure.Conclusions This research suggests that different psychological intervention should be given to students majored in different specialty and sources in order to release employment pressure and anxiety.

Extracellular vesicles (EVs) are vesicles like body of phospholipid bilayer membrane, which are able to mediate the transfer of genetic material. There are receptors, proteins and nucleic acids in the body, with carrying tumor genetic material, regulating tumor microenvironment, promoting tumor angiogenesis and mediating tumor cell metastasis. At present, it is found that there is a close re-lationship between the secretion and the metastasis of lung cancer. The main aspects of the brain metastasis of the lung cancer medi-ated by the exocrine body include the regulation of the microenvironment of the brain, the destruction of the blood-brain barrier, and the regulation of tumor cell pathology. The study on the relationship between the tumor and the metastasis of lung cancer may pro-vide more molecular targets for the development, diagnosis and treatment of lung cancer.

Objective:To analyze the morphological characteristics of maxillary first molars,mesiobuccal roots and the incidence of second mesiobuccal(MB2)roots in Uyghur adults.Methods:1 00 Uyghur adults with full dentition were included.The morphology of maxillary first molars and root canals were examined by cone beam computerized tomography(CBCT).The prevalence of MB2 and the difference between sexes were analysed.Results:Among 200 maxillary first molars,1 54(77%)teeth were with 3 roots and 3 ca-nals,42(21 %)with 3 roots and 4 canals,2(1 %)with 3 roots and 5 canals,1 (0.5%)was with 4 roots and 6 canal,1 (0.05%) with 4 roots and 7 canal.The percentage of type Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ mesiobuccal roots was 77.0,1 3.5,9.0,0 and 0.5 respec-tively.The prevalence of MB2 was 22.32% in male and 21 .2% in female(P =0.901 ).Conclusion:The prevalence of MB2 in Uy-ghur adults is about 22% and the predominant morphology of maxillary first molarsmesiobuccal roots was type I.

Objective To synthetize a novel MR molecular imaging probe named USPIO?PEG?tLyP?1,and to evaluate its value in detecting U87 cells by MR imaging. Methods USPIO?PEG?tLyP?1 was synthetized by conjugating USPIO?PEG with tLyP?1. Neuropilin?1 expression levels of glioma cell lines were detected by Western blot. The cytotoxicity of USPIO?PEG and USPIO?PEG?tLyP?1 were assessed by MTT colorimetric assay. The uptake efficiency of USPIO?PEG?tLyP?1 was measured by Prussian blue staining, transmission electron microscope and MR imaging in vitro. Results The novel MR molecular imaging probe was synthetized with an average diameter of 43.84 nm. U87 glioma cell line was screened as test subject for the highly expression of NRP?1(P<0.05). USPIO?PEG?tLyP?1 group showed much more intracellular blue particles than USPIO?PEG group after Prussian blue staining. After incubation,USPIO?PEG?tLyP?1 mainly existed in lysosme,endoplasmic reticulum and mitochondria. In vitro MRI showed that USPIO?PEG?tLyP?1 significantly enhanced the negative contrast effect compared with USPIO?PEG(P<0.01). Conclusion The decoration of tLyP?1 enhanced targeting ability of USPIO?PEG to glioma cells and MR molecular imaging can be a promising method for early diagnosis of gliomas.

Adult ; Diagnosis, Differential ; Endometriosis ; pathology ; surgery ; Female ; Humans ; Laminectomy ; Spinal Canal ; pathology ; surgery ; Spinal Diseases ; pathology ; surgery ; Spinal Neoplasms ; pathology ; surgery

Objective To compare the egicacy and security of intracoronary administration of tirofiban combined high-dose adenosine during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (STEMI).Methods Eighty-eight cases with STEMI were randomly divided into observation group(44 cases) who were accepted 2 times intracoronary adenosine(2 mg,10 ml 0.9％ NaCl),and control group(44 cases) who were afforded only 10 ml 0.9％ NaCl by prospective,double-blind,and random study.The two groups were received10 g/kg tirofiban after aspiration catheter in the culprit lesion distal bolus injection of 3 rain,at the same time,continuous infusion of 0.15 g/(kg · min) for 24 h.The postoperative coronary arteriography and electrocardiogram were evaluated.Meanwhile,the postoperative myocardial blush grade(MBG),thrombolysis in myocardial infarction (TIMI),corrected TIMI frame counts (CTFC),ST-segment elevation resolution (STR) major adverse cardiac events (MACE),and adverse reactions of adenosine were recorded.Results There was no significant difference in terms of postoperative TIMI and STR between two groups (P ＞ 0.05).The CTFC of observation group was (24.4 ± 4.9) frames,significant better than that of control group((21.9 ±3.7) frames;t =2.701,P ＜0.01).The ratio of MBG in observation group was 24/44,higher than that of control group(14/44 ; x2 =4.632,P ＜ 0.05).There were no significant difference regarding of the ratio of death,MACE,target vessel revascularization,grade of NYHA between observation and control group at followed up for 1 and 12 month (P ＞ 0.05).The ratio of patients with blood pressure decrease ≥ 10 mm Hg,new second degree atrioventricular block in observation group were 15.9％ and 20.5％,higher than that in control group (2.3％ and 15.9％ ; x2 =4.950,7.221 ; P =0.026,0.007).The adverse reaction was transient.Conclusion The intracoronary administration of tirofiban combined high-dose adenosine during PCI in patients with STEMI plays an effective role on improvement of myocardial perfusion.

Objective :To study influence of valsartan combined hydrochlorothiazide on 24h diastolic blood pressure (DBP) ,24h systolic blood pressure (SBP) and blood pressure variability (BPV) in patients with hypertension .Meth—ods : A total of 94 hypertensive patients treated in our hospital were randomly and equally divided into valsartan group and combined treatment group (received valsartan combined hydrochlorothiazide ) ,both groups were treated for one month .The 24hDBP ,24hSBP ,BPV ,levels of nitric oxide (NO ) and endothelin (ET ) before and after treatment and incidence of adverse reactions were compared between two groups .Results : Compared with valsartan group after treatment ,there were significant reductions in 24hSBP [ (130. 64 ± 10.01) mmHg vs .(121.53 ± 9.35) mmHg] ,24h DBP variability (24hDBPV) [ (12.47 ± 3.32)% vs.(10.82 ± 2.71)%] ,24hSBPV [ (10. 42 ± 2. 00)%vs.(8.51 ± 1. 64)%] and daytime SBPV [ (10.87 ± 2. 05)% vs.(8. 66 ± 1.65)%] , P＜0. 05 or ＜0.01 ;significant rise in NO level [ (42.92 ± 6.84) μmol／L vs.(53.43 ± 7. 16) μmol／L] and significant reduction in ET level [ (38. 62 ± 5.52) ng／L vs .(31. 01 ± 5. 01) ng／L] in combined treatment group , P＝0.001 both .There were no significant difference in incidence of adverse reactions between two groups , P＞ 0.05 all.Conclusion : Valsartan combined hydrochlorothiazide can effectively improve levels of 24hDBP ,24hSBP and blood pressure variability ,and contrib— ute to regulating NO and ET levels in patients with hypertension .

Objective: To analyze molecular feature of rabies virus (RABV) epidemic strains in Sichuan province during 2011 to 2017, and explore differences at nucleotide, amino acid and protein modification between these street strains and vaccine strains. Methods: Nucleoprotein(N) and glycoprotein(G) genes were amplified by RT-PCR using specific primers for 23 antigen-positive canine brain specimens collected from 2011 to 2017. The evolutionary relationship and immune antigenicity of N and G genes was analyzed. Bioinformatics software was used to analyze and organize data. Results: We obtained the N and G genes sequences of 23 RABV strains by sequencing. Genetic evolution relationship analysis showed that all the 23 RABV strains belonged to rabies virus species and could be divided into three branches, which had apparent geographically specific characteristics but some Sichuan strains co-circulated with the epidemic strains in the eastern and northern regions of China.The N genes of Sichuan strains had nucleotide and amino acid homology of 97.4% to 100% and 99.6%-100%. The nucleotide and amino acid homology between Sichuan strains and reference strains were 72.1%-99.8% and 81.6%-100%, respectively. There were some differences in antigenic sites, cell epitopes and signal peptide sequences between vaccine strain and Sichuan strains but no significant change was found in antigenicity, organizational preference and virulence. Conclusions The 23 strains of RABV of Sichuan belonged to rabies virus species and had no obvious differences. There were few differences between Sichuan strain and vaccine strain in amino acid sequences of G, but the virulence did not change.

Objective To investigate the clinical and pathologic characteristics of rectal gastrointestinal stromal tumor (GIST),and to evaluate the management of rectal GIST. Methods The clinical and pathological data of 19 cases of rectal GIST in recent 19 years were studied retrospectively. Results The diagnosis of 19 cases of rectal GIST were identified by surgery and pathology. Most rectal GISTs were spindle cell type. Immunohistochemical analysis displayed positive reactivity for CD117(100%) and CD34(73. 7% ). Graded by aggressive behavior there were 4 cases of high risk, 3 cases of intermediate risk, 5 cases of low risk and 7 cases of very low risk. Conclusions Rectal GISTs have a low prevalence and have no specific symptom in the early stage. Most tumors are low risk in aggressive behavior. It is difficult to get an accurate pathological diagnosis before operation and difficult to decide whether a sphincter preserving procedure is justified however trans-anal local resection is the therapy of choice for low risk submucosal rectal GIST(

Objective To evaluate the outcomes and prognostic factors of image-guided 125I seed implantation for locally recurrent soft tissue sarcoma(RSTS).Methods A total of 60 patients with RSTS who received image-guided 125I seed implantation in Peking University Third Hospital,from September 2002 to December 2015,were retrospectively analyzed.The enrollment criteria: KPS ＞60 points,refused or could not tolerate surgery or radiotherapy,the expecting survival time ＞3 months,relapsed after multiple treatment of soft tissue sarcoma,and underwent CT or ultrasound guided 125 I seed implantation treatment.In all,the median activity of seeds was 25.9×106Bq(range,11.1×106-29.6×106Bq),median number of implanted seeds was 58(range,3-133),and the median D90was 120 Gy(range,36.50-460.97 Gy).The local progression-free survival(LPFS)and overall survival(OS)were calculated using the Kaplan-Meier method.The log-rank test and Cox regression model were used for the univariate and multivariate analyses.Results The median follow-up was 18.75 months(range,1-146).The median OS was 18.5 months(95％CI 13.1-23.9).The 1-,3-and 5-year OS rate were 63.3％,33.0％and 29.5％,respectively.The 1-,3-and 5-year LPFS rate were 72.5％,63.7％and 59.7％,respectively.The general rate of pain relieving was 100％(6/6).8.3％(5/60)presented grade Ⅳskin toxicity.No fatal complications ocurred.The univariate analysis suggested that tumor size,tumor volume,KPS score,D90were prognostic factors of OS and LPFS.The multivariate analysis demonstrated that previous chemotherapy history and distant metastases were independent prognostic factors of survival.Conclusions Image-guided 125I seed implantation for recurrent soft tissue sarcoma is a safe treatment option with high efficacy and low morbidity.Tumor size and D90were the prognostic factors of OS and LPFS.