Objective To explore the current situation of nursing students′ self-learning and its influencing factors in the western China.Methods Based on the method of proportion allocation in stratified random sampling,the self-made general questionnaire and Williamson self-directed learning rating scale(translated by Shen Wangqin)were used for questionnaire survey among full-time nursing undergraduates and junior college students in four universities.Results The self-directed learning ability of nursing students was in general at a medium level;and the dimensions with the highest score and the lowest score were interpersonal relationship skills and learning behaviors.The self-directed learning ability of top public university was better than that of basic public universities(P<0.01);and the degree of self-directed learning ability of nursing students who were girls,in senior classes,voluntarily choosing and showing interest in this major was higher than those of other students(P<0.05);the motivation,learning interest,self-directed learning time per week were positive factors,and the learning difficulties acted as a negative impact factor.Conclusion The main factors influencing the self-directed learning ability of nursing students include the grade,gender,the willingness to choose the nursing major,the degree of preference for the nursing major,learning motivation,and learning interest.

Objective To investigate the clinical significance of matrix metalloproteinase-9(MMP-9)in the pathogenesis of Kawasaki disease(KD)and its complications of coronary arterial lesions(CAL).Methods Twenty-three inpatients with KD were admitted in hospital from Jan.2005 to Dec.2006,whose venous blood samples were obtained during the acute and convalescent stage respectively,and CAL was detected with 2-Dechocardiography.Twenty-seven venous blood samples(12 febrile children and 15 normal physical examination children)were collected as healthy controls.Serum levels of MMP-9 were measured by enzyme-linked immunoadsorbent assay(ELISA).According to the results of echocardiography,children were divided into 2 groups:with CAL group(n=13)and without CAL group(n=10).Results During the acute stage,serum MMP-9 levels were significantly higher in KD than those in controls(Pa

Abstract?AlM: To investigate the relationship between carotid artery stenosis and ischemic ocular diseases.?METHODS: The clinical data of 30 cases ( 37 eyes ) of patients with ischemic eye diseases were collected from November 2010 to May 2014, and they were accepted the fundus fluorescein angiography ( FFA ) , transcranial Doppler ( TCD) ultrasonic blood vessels of the eye, neck vascular color Doppler flow imaging ( CDFl) , the neck CT angiography ( CTA ) and carotid artery digital subtraction angiography ( DSA) examination, and then the ischemic eye disease patients with ocular symptoms were analyzed. The peak systolic velocity ( PSV) and resistance index ( Rl) of ophthalmic artery and central retinal artery were compared. Correlation between the internal carotid artery intima- media thickness ( lMT ) and ophthalmic artery, central retinal artery PSV and Rl correlation risk;ipsilateral internal carotid artery plaque and ophthalmic artery PSV and Rl; PSV and Rl associated ipsilateral internal carotid artery plaque and central retinal artery were analyzed.?RESULTS:Eye symptoms:a black dim, reduced vision, the eyes flash, and around the eye pain were 75. 7%, 83. 8%, 51. 4% and 32. 4%;The eye signs:the dilatation of retinal vein, retinal hemorrhage, arterial stenosis and cotton spot and the contralateral side were regarded as main signs. Ophthalmic artery PSV and Rl value of the differences were statistically significant ( P<0. 05 ); The contralateral side of the central retinal artery PSV and Rl value of the differences were statistically significant ( P<0. 05 ); The ipsilateral internal carotid artery lMT and ophthalmic artery, central retinal artery PSV and Rl were not correlated ( P>0. 05 ); The ipsilateral internal carotid artery plaque and ophthalmic artery PSV had no correlation with Rl values (P>0. 05); PSV and Rl and the ipsilateral internal carotid artery plaque and central retinal artery had no correlation (P>0. 05).?CONCLUSlON: The incidence of ischemic eye diseases and internal carotid artery stenosis is associated with very close, the clinical can regard the degree of internal carotid artery stenosis as an important basis for diagnosis and treatment of eye diseases.

Objective To establish a cell level-based negative enrichmen technique to detect circulating tumor cells (CTCs) in the peripheral blood of patients with epithelial ovarian cancer.Methods The colon cancer SKOV-3 cells were mixed with 2 ml whole blood from healthy donors at different ratio.Quantification of CTCs was performed using immunomagnetic bead based negative enrichment combined with immunofluorescence antibody method.The method was evaluated the recovery rate of target cells,Samples of 32 patients with ovarian cancer and 10 controls were assayed for CTCs detection by above method.Results ①The recovery rate was ranging from 64％ ～80％ by spiking varying numbers of SKOV-3 into 2 ml blood samples of healthy volunteers.Regression analysis of number of recovered SKOV-3 cells yielded a regression equation of Y=0.782X-1.408 and a coefficient of determination of R2 =0.998.②Did not detect CK8/18-+ circulating tumor cells in 10 controls,and CK8/18+ circulating tumor cells in 18 cases of 32 Patients with ovarian cancer.The positive rate of CK 8/18 + circulating tumor cells was significantly differences between the two groups (x2 =7.681,P＜0.01).③The presence ofCTCs was significantly correlated with distant metastasis (x2 =5.776,P＜0.05).Conclusion The method of immunomagnetic bead based negative enrichment combined with immunofluorescence antibody technique for CTCs detection in peripheral blood of patients with ovarian cancer has a clinical value of application and extension.

OBJECTIVETo understand the clinical features of gastrointestinal cow's milk allergy in children, and to assess the importance of cow's milk challenge.

METHODAn analysis was performed on the clinical manifestations and the challenge results of 50 children who received cow's milk challenges after admission to the department of gastroenterology, Children' s Hospital of Zhejiang University School of Medicine from January,2009 to December, 2012. The value of immunoglobulin E antibody was also analyzed among the 50 children, 25 cases were male and the other 25 were female. The youngest subject was 1. 6 months old, and the oldest was 20 months, most of the cases were younger than 6 months (36 cases).

RESULT(1) Diarrhea (27 cases, 54%) and hematochezia (25 cases, 50%) were the most common clinical features, vomiting, hematemesis and abdominal distention were rare. (2) Cow's milk challenges failed in 58% of the cases, 90% of whom showed delayed allergy. Diarrhea (19 cases, 73%) was the major later presentation, whereas the immediate hypersensitivity showed angio-edema, gastrointestinal symptom and rash. (3) The neutrophil count ((3.8 ± 2.8) x 10(9)/L vs. (2.5 ± 1.3) x 10(9)/L) was higher after challenge among children who failed the challenge. The change in the count of blood cell, neutrophil and platelet was studied, however, there were no statistical differences between the challenge-failed children and the passed ones. (4) Forty-seven cases had milk specific immunoglobulin E antibody test, and 5 showed positive results, 4 of whom were seen among the challenge-failed children.

CONCLUSIONDiarrhea and hematochezia was the most common clinical manifestation, and cow's milk protein induced proctocolitis was the most common disease in practice. It is important and necessary to perform cow's milk challenge.

Animals ; Female ; Gastrointestinal Diseases ; etiology ; Gastrointestinal Hemorrhage ; etiology ; Hematemesis ; etiology ; Humans ; Hypersensitivity, Immediate ; immunology ; Infant ; Infant, Newborn ; Male ; Milk ; Milk Hypersensitivity ; immunology ; Vomiting ; etiology

Aged ; Bronchogenic Cyst ; complications ; Female ; Humans ; Infection ; complications ; Mediastinal Cyst ; complications

Objective To characterize the alteration in peripheral blood endothelial progenitor cells (EPCs) of patients with systemic lupus erythematosus (SLE).Methods Venous blood samples were obtained from 82 female patients with SLE aged (35 ± 10) years and 50 healthy female controls aged (35 ± 13) years.ACL 9000 automated coagulation analyzer was used to determine the level of Von Willebrand factor antigen (vWF Ag).Flow cytometry was performed to detect peripheral blood EPCs and circulating endothelial cells (CECs).Analysis of variance was performed to assess the differences in these parameters between patients with active and stable SLE and the controls,and Pearson correlation analysis was conducted to evaluate the relationship between these parameters.Results The number of CD34+ cells,CD133+ cells and CD34+CD133+cells per 200 000 peripheral blood mononuclear cells was 35.4 ± 16.7,86.5 ± 32.1 and 361.3 ± 176.4 in patients with active SLE,significantly higher than that in the patients with stable SLE (17.1 ± 10.9,28.7 ± 21.5,107.2 ±44.3,respectively,all P ＜ 0.01)) and the controls (13.8 ± 9.6,11.2 ± 5.5,92.3 ± 50.5,respectively,all P ＜0.01).The patients with active SLE exhibited an elevated level of vWF Ag (438.9％ ± 205.3％ vs.130.2％ ±51.5％,P ＜ 0.01),an increased number of EPCs (361.3 ± 176.4 vs.107.2 ± 44.3,P ＜ 0.01) but a similar number of CECs (127±51 vs.118 ± 39,P ＞ 0.05) per 200 000 peripheral blood mononuclear cells compared with the healthy controls.No significant differences were observed in these parameters between the patients with stable SLE and the controls (all P ＞ 0.05).The number of EPCs was positively correlated with the level of vWF Ag (r =0.67,P ＜ 0.01),but uncorrelated with the number of CECs (P ＞ 0.05) in patients with active SLE.Conclusions The quantity of EPCs in peripheral blood is closely correlated with the level of the vascular injury marker vWF Ag,hinting that the number of EPCs can serve as a useful marker of disease severity.

Objective To investigate the expression and significance of Toll-like receptor 4(TLR4)in the uvea of endotoxin in- duced uveitis.Design Experimental study.Participants 12 Wistar rats were divided into two groups at random,a group(n=6)of endo- toxin induced uveitis(EIU)and a control group(n=6).Methods Cholera vibrio was injected into hind footpad and abdominal cavity in the EIU group.In the control group,cholera vibrio was replaced by PBS.Anterior segment of the rats eyes were observed by slit lamp microscope at 4h,10h,16h,24h after injection.Immunohistochemical staining was performed using polyclonal antibodies to TLR4 on the frozen sections of the eyes and uveal wholemounts at 24 hours after LPS injection.Main Outcome Measures The inflammation of anterior segment and the number of TLR4 positive cells in uveal wholemounts.Results The inflammation began at 4h after LPS injec- tion.Cellulose exudates were observed at 16h after injection.The positive-stained protein located in cellular membrane or cytoplasm. The number of TLR4 positive cells in EIU group is evidently higher than that in the control group.TLR4 positive cells were hardly de- tected in the frozen sections of eyes.Conclusion TLR4 expression increases in the EIU,which suggests that TLR4 probably participates in the formation and development of acute anterior uveitis.(Ophthalmol CHN,2008,17:48-51)

Objective To determine the placental transfer of epidural levobupivacaine for cesarean section. Methods Sixty parturients (ASA ⅠorⅡ) aged 24-35 yr weighing 60-80 kg undergoing elective cesarean section under epidural anesthesia were studied. Epidural anesthesia was performed at L1,2 or L1,3 interspace. The catheter was advanced 3 cm cephalad into the epidural space. A test dose of 0.5% levobupivacaine 5 ml with 1:200 000 epinephrine was injected. If there were no signs of subarachnoid injection in 5 min, 9-12 ml of 0.5% levobupivacaine was administered twice at 5 min interval. Arterial blood samples were taken from the double- clamped umbilical cord segment at delivery for determination of blood pH. Apgar scores at 1 and 5 min after birth were recorded. Blood samples were taken from maternal and umbilical vein for determination of plasma levobupivacaine concentration by high performance liquid chromatography ( HPLC). Results The pH of the umbilical arterial blood was ≥ 7.25. The Apgar scores at 1 and 5 min after birth were ≥ 7.0. The levobupivacaine concentration of maternal and umbilical venous blood was 0.35±0.24 and (0.24 ±0.21) μg/ml respectively at the time of delivery. The ratio of umbilical and maternal venous blood levobupivacaine concentration was 0.7 ± 0.3. Conclusion Epidural levobupivacaine can cross the placenta during cesarean section. The ratio of umbilical and maternal venous blood levobupivacaine concentration is 0.7.

Objective:To investigate the influence of Mannan Peptide combined with 5-Fu on the proliferation and apoptosis of HepG2 cells and to explore the related mechanism.Methods:HepG2 cells were divided into four groups:the control group,5-Fu group,Mannan Peptide group and combination group.Cell proliferation was evaluated by MTT assay.Flow cytometry was used to examine the cell cycle,proliferation index(PI)and apoptosis ratio.The expression of Bcl-2 protein in each group was analyzed by immunocytochemical method.Results:The inhibitive effect of 5-Fu plus Mannan Peptide was significantly stronger than that of Mannan Peptide alone,in a time-and dose-dependent manner. Cells were treated with medicine for 48 hours.Compared with cells in the control group and 5-Fu group,the percentage of cells in G_0/G_1 stage and the apoptosis ratio in the combination group were increased(P<0.01).In immunocytochemical analysis,the combination of Mannan Peptide and 5-Fu could significantly decrease Bcl-2 protein level(P<0.01).Conclusion:The combination of Mannan Peptide and 5-Fu can synergistically suppress the proliferation and induce apoptosis of human hepatoma HepG2 cells.The mechanism might be associated with down-regulation of Bcl-2 protein expression.