Objective To analyze the current status and influencing factors of job competence of clinical nursing teachers. Methods A total of 673 clinical nursing teachers from 35 second-level and above hospitals in Anhui Province were selected as research subjects using convenient sampling method. Their job competence was evaluated using the Clinical Nursing Teacher Post Competency Evaluation Scale. Results The score of job competence of clinical nursing teachers was 87.1±9.7. The results of multiple linear regression analysis showed that with the increase of service length and clinical teaching years，the job competence score of clinical nursing teachers increased（all P<0.05）. For those who thought the higher the satisfaction with the teaching atmosphere of the hospital，the hospital teaching training can meet their requirements and the higher the willingness to accept the teaching training，the higher their job competence score（all P<0.05）. Conclusion There is still much room for improvement in job competence of clinical nursing teachers in Anhui Province. The length of service，clinical teaching years， hospital teaching atmosphere，teaching training meeting demand，and willingness to accept clinical teaching training are the influencing factors of job competence of clinical nursing teachers.

BACKGROUND: There are different methods to isolate and culture human nucleus pulposus cells, and the differences in digestive enzymes components and digestion time quite are significant. So how to rapidly and efficiently harvest human nucleus pulposus cells has become a research hotspot. OBJECTIVE: To optimize the digestive enzymes components and digestion methods for the preparation of human nucleus pulposus cells. METHODS: Nucleus pulposus tissue specimens were selected from three adult discs in the Department of Orthopedics, China-Japan Union Hospital of Jilin University. The acute traumatic disc tissues that outstanding to the spinal canal were taken under aseptic conditions, and then the peripheral white annulus and jel y-like nucleus pulposus in the center could be seen. According to different mixed enzyme concentration ratio, the samples were divided into two groups. The enzyme Ⅰ group was treated with 0.2% Ⅱ col agenase; and the mixed enzymeⅡ group was digested with 0.25% trypsin for 30 minutes, and then treated with 0.2% Ⅱ col agenase. According to digestion time, each group was divided into three subgroups: 2 hours group, 4 hours group, and overnight group. Final y, suspended cel volume was decided as 2 mL to count cells. Dulbecco’s modified Eagle’s medium containing fetal bovine serum was used for cel culture in vitro. Trypan blue staining was performed to count total cel number and ratio of living cells. Methylthiazolyldiphenyl-tetrazolium bromide assay was used to detect the growth curve of nucleus pulposus cells. RESULTS AND CONCLUSION: Based on the two digestion enzyme concentration, the number of digested cells in the enzyme Ⅰ group was larger than that in the enzyme Ⅱ group after digested for 2 and 4 hours, but the difference was not significant (P > 0.05). Overnight, cellsurvival rate was decreased in the enzyme Ⅰ group after digested for 2 and 4 hours when compared with the enzyme Ⅱ group, and the difference was significant (P < 0.05). After digested for 4 hours, tissue blocks disappeared, and the number of cells reached maximum. The results indicate that enzyme Ⅰgroup composite with Ⅱ col agenase is benefit for the separation of nucleus pulposus cells, and the digestion time is appropriate to 4 hours. This condition has the advantages of simple operation, high efficiency and low cost, and it considered that digestion of nucleus pulposus tissues with 0.2% Ⅱ col agenase for 4 hours is the best condition to obtain nucleus pulposus cells.

Background:Colorectal polyps are common gastrointestinal diseases,which are closely related to the development of colorectal cancer. Aims:To investigate the clinical features of high-risk people with intestinal polyps in colorectal cancer screening. Methods:People in Hongkou District,Shanghai,who were positive in fecal occult blood test or of the high risk category in colorectal cancer questionnaire from April 2013 to December 2014 were enrolled,and colonoscopy was performed at Branch of Shanghai First People’s Hospital. The overall detection rate,gender,age,location of lesion, morphology,and pathology were analyzed. Results:A total of 985 patients with colorectal polyps were recruited in this study. The overall detection rate of polyps was 48. 7% . The prevalence of colorectal polyps was significantly higher in males than in females(58. 7% vs. 38. 9% ;χ2 = 79. 788,P < 0. 01). The detection rates of colorectal polyps in different age groups were statistically significant(χ2 = 23. 820,P < 0. 01). Detection rate of polyps was significantly higher in left colon than in right colon(62. 4% vs. 37. 6% ;χ2 =190. 643,P <0. 01). The overall detection rate of protruding lesion 0-Ⅰwas 94. 5% ,and slightly elevated lesion 0-Ⅱa was 48. 3% . Detection rate of adenomatous pylops was significantly higher than non-adenomatous pylops(59. 3% vs. 47. 1% ;χ2 = 27. 326,P < 0. 01). The histological results were differed between two examination in 119 patients. Only 17. 8% of the patients operated were followed up by colonoscopy,and polyps recurred in 62. 3% of them. Conclusions:A higher incidence of colorectal polyps is found in people with high risk of colorectal cancer screening. High quality colonoscopy examination and effective operation in time can reduce the incidence of colorectal cancer.

Objective To investigate the prevalence of colorectal cancer in community people in Shanghai,and clarify the necessity of colorectal cancer screening in community residents.Methods From April 2013 to September 2014,colonoscopy examination was carried out in people who participated in colorectal cancer screening in Shanghai with positive result of fecal occult blood test or with high-risk in colorectal cancer evaluated with the risk factors questionnaire.A total of 1 990 individuals were recruited.The colonoscopic results of them were retrospectively analyzed.Chi-square test was performed for statistical analysis.Results The 1 990 individuals received colonoscopy examination aged from 50 to 92.Among the 1 990 individuals with colonoscopy examination,colorectal polyps,colorectal cancer and carcinoid were found in 1 027 cases,and the total detection rate was 51.6％.The detection rate of colorectal polyps was 48.7％ (969/1 990),and the maximum diameter of polyps was 3.5 cm.The detection rate of colorectal polyps of the male was 59.3％ (532/897),which was higher than that of the female (40.0％,437/1 093),and the difference was statistically significant (x2 =73.7,P＜0.01).The detection rate of colorectal polyps in group 50 to 60 (not include 60) years old,60 to 70 (not include 70) years old,70 to 80 (not include 80) years old and ≥80 years old was 37.5％ (139/371),48.7％ (524/1 075),55.9％ (248/444) and 58.0％ (58/100),respectively.The difference was statistically significant (x2 =31.3,P＜0.01).The detection rate of colorectal cancer was 2.7 ％ (54/1 990).The detection rate of male rectal cancer was 3.8％ (34/897),which was significantly higher than that of female (1.8％,20/1 093),and the difference was statistically significant (x2 =7.2,P＜0.05).The detection rate of colorectal cancer in group 50 to 60 (not include 60) years old,60 to 70 (not include 70) years old,70 to 80 (not include 80) years old and ≥80 years old was 1.6％ (6/371),1.9％ (20/1 075),4.3％ (19/444) and 9.0％ (9/100),respectively.The difference was statistically significant (x2 =23.7,P＜0.01).The detection rate of rectal carcinoid was 0.2 ％ (4/1 990).Conclusions The prevalence of colorectal polyps and cancer is high in screening community people with high-risk of colorectal cancer.Colorectal cancer screening in community people ≥ 50 years old with sequential screening method is important.

Objective To investigate the roles of P53/P21 during neuronal differentiation with a differentiated model of PC12 cells. Methods A new cell line PC12(P53/m175) was created by stable transfection of a retrovirus plasmid pBabe-P53/m175, which contains a dominant-negative P53 gene mutant. After NGF treatment, observing with phase-contrast microscopy, flow cytometric analysis and western blotting of P53 and P21 were performed. Results Expression of P53 and P21 was obviously increased in NGF-induced PC12 cells. The appearance of cell cycle G1 phase arrest paralleled the increased expressions of P53 and P21. The level of P21 protein did not change after treatment with NGF in PC12(P53/m175) cells and the extent of G1 phase arrest markedly decreased. However, we did find the normal neurite outgrowth in NGF-treated PC12(P53/m175) cells. Conclusion NGF-induced an increased protein levels of P53 and its transcriptional element, P21 is essential for cell cycle G1 phase arrest, but does not necessarily correlate with the neurite outgrowth of PC12 cells.

OBJECTIVE: To investigate the location, staging, clinical symptoms, imaging features, and surgical treatment of the congenital cholesteatoma of middle ear (CCME). METHOD: This was a retrospective review of 20 CCME cases. RESULT: Of 20 cases with CCME, 2 cases were classified as Postic stage I, 0 as stage II, 13 as stage III, 5 as stage IV. Conductive hearing loss was the most common clinical symptom. The mean preoperative PTA was 54.1 dB, and the mean ABG was 41.7 dB. One case underwent a modified mastoidectomy and a second-stage ossicular reconstruction; 2 cases experienced a radical mastoidectomy without ossicular reconsturction for extensive cholesteatoma; 5 cases underwent modified mastoidectomy and a one-stage tympanoplasty, with one case diagnosed as congenital malformation of ossicular chain (stapes hypoplasia); other 12 cases underwent a one-stage tympanoplasty. The cholesteatoma localized to the posterior-epitympanum or mesotympanum in all patients, mainly located in the incudostapedial joint. The mean postoperative PTA from 16 cases was 35.3 dB, and A-B gap was 20.2 dB. All patients were followed-up for at least 1 year after operation and recurrence was found in 2 cases. Three cases were accompanied with congenital malformation of ossicular chain. CONCLUSION CCME is a rare entity and diagnosis is usually delayed in clinical practice due to the silent nature of disease in its early stage. The prognosis of CCME mainly depended on the stage of the lesions.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; classification ; congenital ; pathology ; surgery ; Cholesteatoma, Middle Ear ; classification ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Young Adult

ObjectiveTo explore the prevalence and influencing factors of restless legs syndrome (RLS) in elderly maintenance hemodialysis (MHD) patients, to analyze the relationship between RLS and sleep quality, and to observe the efficacy and safety of hemoperfusion in improving RLS and sleep quality in elderly MHD patients with RLS. MethodsA total of 118 cases with maintenance bemodialysis were involved in this study. The RLS was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group (IRLSSG). The subjects' quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The elderly MHD patients with RLS received hemoperfusion once a week for 3 months. The clinical and biochemical indexes were collected including age, gender, duration of hemodialysis, pre-dialysis blood concentrations of creatinine, hemoglobin, parathyroid hormone, β2-microglobulin, etc. T test, X2 test and binary logistic regression analysis were performed. ResultsRLS prevalence was found in 26.27% (11 men, 20 women, the ratio was 0. 55 : 1) of 118 elderly MHD patients. The duration of hemodialysis,sex ratio (female/male), the level of serum phosphorus, β2-microglobulin and parathyroid hormone in elderly MHD patients with RLS were significantly higher than those in elderly MHD patients withoutRLS (t=2. 332,X2=15. 343,t=4. 784,13. 124,10. 900;all P<0. 05). And there were no significant differences in age, dry weight, material of dialyzer membrane, and levels of serum creatinine, urea nitrogen, hemoglobin, hematocrit, calcium, ferritin and transferrin saturation between patients with RLS and without RLS(t=0. 341,0. 008, 1. 055,0. 051,0. 899,0. 912,0. 601,0. 192,0. 200,1. 094;all P>0.05). Logistic regression analysis revealed that serum parathyroid hormone and β2-microglobulinwere the important risk factors for RLS in elderly MHD patients. PSQI was higher in RLS group than in non-RLS group[(10. 7±2.7) vs. (4.9±2.5), t=10. 948,P=0. 000] . The manifestations of poor sleep were poor indexes of subjective sleep quality, sleep duration, habitual sleep efficiency and daytime dysfunction in MHD patients with RLS. And the RLS severity was correlated with PSQI (r=0. 839,P<0. 05). After the treatment with hemoperfusion, the level of serum phosphorus, serum parathyroid hormone, serum β2-microglobulin, RLS severity score and PSQI were significantly decreased in RLS patients compared with pre-hemoperfusion. The vital sign of RLS patients were stable during hemoperfusion, and there were no adverse events after the treatment with hemoperfusion. ConclusionsThe prevalence of RLS is high, and poor sleep quality is found in elderly MHD patients with RLS. Serum parathyroid hormone and β2-microglobulin are the important risk factors for RLS in elderly MHD patients. Hemoperfusion can effectively improve the RLS and sleep quality and is well tolerated.

Objective To analyze the epidemiology and clinical characteristics of acquired immunodeficiency syndrome (AIDS) and pulmonary tuberculosis (TB) co-infection.Methods A retrospective study was conducted with the clinical data of patients diagnosed with AIDS and TB in Shanghai Public Health Clinical Center during the period from 2011 to 2015.The outcome of the patients were evaluated by outpatient and telephone follow-up.The data were analyzed by descriptive analysis using SPSS 22.0 software package.Results A total of 359 patients with AIDS/TB co-infection were included in this analysis,including 325 males and 34 females,the highest proportion in 30-44 age group.The diagnosis was delayed in about 42.6％ of the patients.The clinical symptoms were mainly fever,cough and weight loss,but hemoptysis uncommon.Both lungs were affected in most cases,with lesions in at least 3 lung fields,but rare pulmonary cavity.T-SPOT.TB test showed lower positive rate.CD4+T lymphocyte count was 50 cells/μL or less in 50.7％ of the patients at their first test.About 43.5％ of the 69 patients with antimicrobial susceptibility data showed resistance to therapy.Majority (93.2％) of the patients with known viral status received antiretroviral treatment.Extra-pulmonary tuberculosis was identified in 282 cases.The complication and opportunistic infection included central nervous system infection,syphilis,hepatitis B virus infection,hepatitis C virus infection,pulmonary infection,and drug-induced liver injury.Of the 333 patients with known outcome,53 died,most (79.2％,42/53) within 6 months.Conclusions The patients with AIDS/TB co-infection showed higher proportion of young people.The CT finding was atypical.The patients showed lower positive rate for T-SPOT TB test and lower CD4+T lymphocyte count at their first test.Most patients had extra-pulmonary tuberculosis and other complications or opportunistic infections.

Objective To analyze the susceptibilities of Escherichia coli isolates collected from blood and the prevalence of ESBLs encoding genes.Methods A total of 121 Escherichia coli isolates collected from blood during 2012 were analyzed for antimicrobial susceptibilities by software of WHONET 5.6,the production of ESBLs was confirmed by confirmatory pheno-typic testing,PCR and DNA sequence were further implemented to analyze the ESBLs-encoding genes.Results 121 E.coli isolates displayed high resistance towards broad spectrum penicillin and 2nd or 3rd generation cephalosporins,levofloxacin and cotrimoxazole,with the resistance rates being more than 40%,susceptibilities to imipenem,piperacillin/tazobactam,ami-kacin were observed,with the resistance rates to be less than 12%,86(88.7%)out of 121 isolates were found to produce ESBLs.Among them,59.5% (72),38.8% (47)and 4.1% (5)were confirmed to carry blaCTX-M,blaTEM and blaSHV genes.Additionally,2(1.7%)isolates carried all the genes detected,30(24.8%)isolates carried both of blaCTX and bla-TEM,1(0.8%)isolate carried both of blaSHV andblaTEM.Conclusion Most of the E.coli isolates from the blood culture in Nanjing Gulou Hospital produce ESBLs,and displayed resistance towards most of the penicillins,cephalosporins and sin-gle amide antimicrobial agents should be chosen according to susceptibility results.

Objective To discuss the clinical manifestations,imaging features and prognosis of children with mild encephalitis/encephalopathy with a reversible splenial lesion(MERS).Methods Twenty-five patients with MERS admitted to Beijing Children′s Hospital,Capital Medical University,between November 2013 and March 2016 were enrolled and their clinical and imaging data were retrospectively analyzed.Ages of onset of these 25 cases were from 6 months to 13 years old.Because of different clinical manifestations in different onset ages,these 25 cases were divided into 2 groups:≤6 years old group (20 cases),with the onset age of 6 months to 3 years and 9 months old(average 2 years and 2 months);>6 years old group(5 cases),with the onset age of 9 years 3 months to 13 years old (average 10 years and 10 months).Results Nineteen cases among the 25 patients had infection history before onset,including 10 cases of digestive tract infection(all were ≤6 years old children),9 cases of respiratory tract infection(6 children ≤6 years old and 3 children >6 years old).The main clinical manifestations included convulsion (18/25 cases,72.0%),fever (17/25 cases,68.0%),vomiting (11/25 cases,44.0%),and disturbance of consciousness (11/25 cases,44.0%).The main clinical manifestation of ≤6 years old group was convulsion (18/20 cases,90.0%),while the main clinical manifestations of the>6 years old group were fever(3/5 cases,60.0%),headache and dizziness(2/5 cases,40.0%),and none of the patients in >6 years old group had convulsion.Eight cases had liver function injury,myocardial enzymes increased in 10 cases,and hyponatremia occurred in 9 cases.Magnetic resonance imaging (MRI) showed 21 cases were type Ⅰ MERS(only involving corpus callosum),and 4 cases of type Ⅱ MERS which involved corpus callosum as well as deep brain white matter,subcortical white matter (centrum semiovale).MRI lesions disappeared after 8-56 days (average 16.5 days) of anti-infection and reducing intracranial pressure treatment.Conclusion MERS is more common in ≤6 years old children,and digestive tract infection is common in ≤6 years old children,while respiratory tract infection is common in >6 years old children.The symptoms in children are mainly manifested as fever,convulsion,vomiting,conscious disturbance,and so on.Infection and hyponatremia are the main causes of MERS in children.MRI is the first choice of imaging examination methods.