Objective To explore the correlation between the levels of nitrite/nitrate(NO2/NO3) in exhaled breath condensate (EBC) and pulmonary infection in mechanically ventilated patients.Methods The clinical data from ventilated patients in critical care units of Peking University People' s Hospital from November 2006 to August 2007 were collected and analyzed.The patients' clinical pulmonary index score (CPIS) were calculated.EBC of those patients were collected via endotracheal tube or tracheostomy cannula, and the concentrations of NO2/NO3 were assayed.The level of NO2/NO3 in different CPIS patients in 24 hours' ventilation,weaning proportion in 3 days and mortality in different NO2/NO3 level patients were compared.The correlation of the CPIS and level of NO2/NO3 were explored between survival and non-survival patients.Results A total of 76 patients were enroled.The NO2/NO3 levels in patients of CPIS≤3 ,CPIS 3-6 and CPIS >6 in 24 hours of ventilation were (23.31±5.79), (28.72±9.10) and (35.42±12.10) μmoL/L respectively, with significantly differences between each other (P < 0.01).The lower the patients' concentration of NO2/NO3 was, the earlier the weaning and the lower the mortality were.The NO2/NO3 levels on 4th and 7th day were detected in 24 survival patients and 23 non-survival patients.The difference of NO2/ NO3 levels between the survival patients and non-survival patients became significant on 7th day [(29.32±9.52) μmol/L vs.(37.22±12.03) μmol/L, P < 0.01].Linear correlation analysis showed that the NO2/ NO3 level was positively correlated with CPIS (r = 0.76, P < 0.01).Condusions The NO2/NO3 level of EBC in ventilated patients is positively correlated to the severity of pulmonary infection, thus may be used as a new predictor for weaning and prognosis.

Objective To observe the effect of intravitreal triamcinolone acetonide injection on choroidal neovascularization in brown Norway rats. Methods Thirty-six healthy brown Norway rats were divided randomly into control group (n=18) and experimental group (n=18), while one eye was chosen randomly as experimental eye. The choroidal neovascularization model was establishied, while 8μl triamcin-olone acetonide was injected in vitreous body immediately after photocoagulation in the experimental group, and the same volume isotonic balanced salt solution was injected in the control group. The eyes of six rats were enucleated for histological slices in the second, forth, and sixth week, respectively. The expression of nuclear factor-kappa B was detected with immunohistochemical method, and the max area of choroidal neovascularization was also measured. Results The area of choroidal neovascularization was smaller, and the expression of nucle-ar factor-kappa B was lower in the experimental group than in the control group (t>7.450, P<0.001). Conclusion Triamcinolone acetonide could effectively inhibit the development of choroidal neovascularization, and decrease the expression of nuclear factor-kappa B in brown Norway rats.

Objective To analyze the correlation of discomfort experience and factual recollection (FR) in patients of intensive care unit (ICU). Methods Fifty-five ICU patients and 63 ward patients par-ticipated in the study. Standardized questionnaires were used to evaluate all patients" FR and the results underwent analysis. Results The prevalence of recollection of any type of discomfort in the ICU patients was 64%. The presence of an endotracheal tube, pain and hallucinations were identified as sources of dis-comfort.The median score for FR in the ICU patients was 7.25. The median score for FR in the ward pa-tients was 13.50. The difference between them was highly significant (t =3.34, P < 0.01 ). Logistic analysis revealed that discomfort, especially discomfort caused by the presence of an endotracheal tube, pain and hallucinations, was positively related to FR, 0R95%CI (1.2～2.1), P < 0.01. Conclusions The presence of an endotracheal tube, pain and hallucinations were most frequently reported as sources of discomfort in ICU patients and their memory was often impaired. FR and recollection of discomfort appear to be related significantly in ICU patients.

Executive function is an important advanced cognitive process, and it is the function that integrates different cognitive processes to achieve one's aim. Updating is an important component of executive function. According to the classifications of Miyake & Colletee on executive function, two study paradigms on memory updating are discussed: n-back paradigm & running memory paradigm. A new study method called latent variable analysis and new studies of cognitive neuroscience on memory updating are introduced. Issues on ethics and morality in research on cognitive experiment of psychology are briefly demonstrated to explore appropriate direction for research of executive function in future.

Background Extracellular matrix (ECM) has various kinds of types and important biological function.The important role of ECM during choroidal neovascularization (CNV) arouse attention.Intercellular adhesion molecule-1 (ICAM-1), which is one of ECMs, involves in the formation of blood vessels, but the relationship between CNV and ICAM-1 is still unknown.Objective This study was to observe the dynamic expression of ICAM-1 in krypton laser-induced CNV and explore the effect of ICAM-1 on CNV.Methods Forty-eight healthy male clean BN rats were randomly divided into post-photocoagulation 1-week group,2-week group,3-week group,4-week group, 5-week group, 6-week group, 7-week group and 8-week group.Laser-induced CNV models were monocularly established and the fellow eyes served as the normal controls.Fundus fluorescein angiography (FFA) was carried out to quantitate the leakage degree (absorbency).The eyeballs were enucleated on various time points,and CNV areas were assessed by hematoxylin and eosin staining;immunohistochemistry and in situ hybridization assay were employed, respectively, for the detection of relative expression levels of ICAM-1 protein and mRNA (absorbency).The use and care of the animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Committee.Results After laser photocoagulation,the retinal inner and outer nuclear layers were ruptured and invaginated.Disruption of Bruch membrane and macrophages migrating to the photocoagulation zone were seen under the optical microscope.The proliferation of fibroblasts and vascular endothelial cells was exhibited.ICAM-1 protein was mainly expressed in vascular endothelial cells,retinal pigment epithelium (RPE) cells and macrophages,and ICAM-1 mRNA was mainly expressed in the outer nuclear layer.Statistically significant differences were found in the fluorescence leakage degree, the relative expression levels of ICAM-1 protein and mRNA as well as CNV areas among the groups (F=178.839, 739.077,2 463.508,194.434, all at P＜0.05).The gradually enlarged CNV area, increased fluorescence leakage, up-regulation of ICAM-1 protein and mRNA expressions were matched with the extension of time after photocoagulation and peaked in the post-photocoagulation 8-week group.Conclusions The expressions of ICAM-1 protein and mRNA up-regulate upon the increase of CNV area and fluorescein leakage, suggesting that ICAM-1 might play an important role in CNV development.

With the globalization of higher education,the scale of foreign medical students in China has been increasing year by year.Clinical external teaching is an important connection between medical theoretical study and clinical practice.Digestive diseases are complicated and may need endoscopic therapy.Therefore,the external education for foreign students in gastroenterology has its distinctive characteristics.In recent years,in training foreign students,the gastroenterology department of our hospital has effectively improved the teaching effect by carrying out the teaching of endoscopy,establishing one plus one peer teaching,using multimedia assisted teaching of audio-visual materials,and paying more attention to improving the training teachers' English.

Objective To study the effect of SMART principle on the management of nursing research in hospitals. Methods The SMART principle was used in the management of nursing research,including the development,specification and verification of research goals as well as supervision of the process.The number of nurses having published research papers and the number of published papers were calculated during November 2008 to November 2011. Result The number of published papers went down but the number of scientific research papers went up in the year of 2003.Conclusion The SMART principle is effective for promoting the quality of nursing research.

Objective To investigate the prevalence of congenital digestive tract malformation in Foshan city ,and to investi‐gate the influential factors on congenital digestive tract malformation .Methods A total of 17 hospitals in Foshan city were moni‐tored from 2011 to 2014 ,the data of digestive tract malformation defects of neonates were analyzed .Results A total of 308 530 newborn infants were monitored ,among them ,189 cases were diagnosed with digestive tract malformation ,the incidence rate was 0 .61‰ .The high risk factors for digestive tract malformation were as follows :infant‐mother aged or more than 30 years old ,smok‐ing or passive smoking ,adverse pregnancy history of infant‐mother ,male gender of neonate and infant born at full term . Conclusion The age of infant‐mother ,smoking or passive smoking ,adverse pregnancy history of infant‐mother ,gender of neonate and gestational age could influence the incidence of gastrointestinal malformations .

Objective To investigate the changes and clinical significance of serum prealbumin (PAB) and bilirubin in patients with coronary heart disease (CHD). Methods The levels of serum PAB and bilirubin were measured respectively in 234 patients with CHD (CHD group) and 77 patients with paroxysmal supraventricular tachycardia (PSVT, control group), and the former group was divided into stable angina pectoris (SAP) group with 80 patients,unstable angina pectoris (UAP) group with 84 patients and acute myocardial infarction (AMI) group with 70 patients,according to the chnical manifestation. Results The levels of total bilirubin (TBIL),direct bilirubin (DBIL) and indirect bilirubin (IBIL) in CHD group [ (11.8 ± 6.1 ), (4.8 ± 1.0) and (7.7 ± 2.7) μ mol/L] were significantly lower than those in control group [(14.6 ±5.6), (6.2 ±1.3) and (9.5 ±6.1)μmol/L] (P ＜0.05). The levels of TBIL, DBIL and IBIL decreased gradually from SAP group, UAP group to AMI group, but there was no significant difference among three groups (P ＞ 0.05 ). The levels of serum PAB in CHD group were also significantly lower than those in control group [(205.55 ±5.68) mg/L vs.(229.78 ± 9.62) mg/L] (P ＜ 0.05),and decreased gradually from SAP group,UAP group to AMI group [(215.73 ± 7.98), (214.12 ± 3.79) and (195.75 ± 7.07) mg/L],but there was no significant difference among three groups (P ＞ 0.05 ). Conclusion The levels of serum PAB and bilirubin are related to the severity of CHD, and can be used as important biochemical indicators in monitoring the attack and severity in patients with CHD.