Objective To explore the status quo of clinical nursing students' caring ability and clinical learning environment,and analyze the correlation between them.Methods 112 clinical nursing students in a grade three and first-class hospital in Hefei were investigated by using the caring ability inventory and nursing clinical learning environment scale.Results The mean score of nursing students on caring ability inventory was (203.12±12.14) points,and the scores of knowing,courage and patience were (78.26±8.27) points,(66.41±5.68) points and (58.45±4.30) points.The total score of clinical learning environment was (146.79±11.76) points,and the scores of six dimensions were task location (25.52±4.77) points,work atmosphere and team culture (25.33±5.21) points,student participation (24.96±4.14) points,interpersonal relation (24.54±5.20) points,innovation (23.59±3.54) points and individuation (22.87±3.26) points.By Pearson correlation analysis,the coefficient of correlation was 0.509 between caring ability and clinical learning environment of nursing students in clinical practice.Conclusions Most nursing students are moderately satisfied with clinical learning environment while their caring ability remains to be improved.There is positive correlation between the caring ability and clinical learning environment of nursing students.Therefore,nursing managers should take corresponding measures to create favorable clinical learning environment,so as to promote the caring ability of nursing students.

Currently, malignant tumors are a major public health problem and pose a serious threat to human health. Because of the diversity and complexity and the high mortality rates, they have been a popular but complicated research topic for several years. Heterogeneity is one of the main characteristics of malignant tumors, and thus, this characteristic may affect many other aspects, such as tumorigenesis, development, metastasis, and therapeutic effects. With the completion of the Human Genome Project and the continuous advancement in sequencing technology, single-cell sequencing technology has been applied in many medical research fields; in particular, it is useful for analyzing tumor cell subpopulations, cell heterogeneity, tumor occurrence, evolution, and drug resistance. Therefore, this technology has provided us with a new tool for clinical diagnosis and treatment of malignant tumors and for estimating the prognosis at an early stage. In this article, we aimed to review the advances in single-cell sequencing technology and its application in malignant tumor research.

Clinical internship is a key step for training qualified clinician. This article narrates the measures that the hospital have taken to improve administration of clinical internship and teaching quality on the aspect of clinical intern training, examination and quality control.

Objective To discuss the value of emergency bedside ultrasound in diagnose of blunt abdominal injury. Methods Portable ultrasound was used in 184 patients with blunt abdominal trauma in emergency department. The abnormal changes of the sound and image of the abdomen were observed,paying equal attention to free intraperitoneal fluid and gas. Results The emergency bedside ultrasound identified 169 (91.8%) patients with blunt abdominal injury, of whom 149 patients (95.5%) with single-organ injury and 20 patients (71.4%) with multi-organ injury. There were 21 patients missed diagnosis and three misdiagnosed, with rate of missed diagnosis and misdiagnosis of 13%. Surgical treatment was performed in 119 patients and conservative treatment in 65, which were proved by CT/MRI examination or clinic conservative treatment. Conclusion Emergency bedside ultrasound can provide fast and credible diagnostic information for blunt abdominal trauma, with high diagnosis accordance rate.

This study was aimed to reveal the relationship of bronchioloalveolar carcinoma (BAC) syndromes and metastasis, in order to provide new scientific basis for syndrome differentiation, treatment and prognostic assessment, which proved the scientificity and feasibility of internal and external inspection. A total of 60 BAC cases were divid-ed into two groups according to the syndrome of deficiency and excess. Another 30 cases of benign pulmonary nod-ules were simultaneous collected in the physical examination as control group. The quality of life (FACT-L) was scored one day before operation for patients in each group. The thoracoscopic technique was used in the biopsy of targeted tissues, in order to reveal indicators related with metastasis. The results showed that the comparison of FACT-L score of patients from two syndromes of BAC and that of the control group indicated that the score of physi-ological state, social/family condition, emotional condition, functional situation, additional situation and total score of the previous one were obviously higher than the latter one (P < 0.01). And the score of patients in the deficiency syndrome group was higher than that of the excess group with statistical significance (P< 0.01). The comparison be-tween the tumor tissues of patients from two syndromes of BAC and the benign pulmonary nodules showed that the VEGF, MMP-2, MMP-9 of the previous one were higher than the latter one (P< 0.01). The comparison between two syndromes showed that all indexes of the deficiency syndrome were higher than the excess syndrome (P < 0.01). It was concluded that syndromes of BAC was related with metastasis.

Objective To evaluate the reliability and validity of the short form of the Chinese Childbirth Self-Efficacy Inventory (CBSEI-C32) in Haikou,analyze the influencing factors of pregnant women's self-efficacy.Methods The CBSEI-C32 was used to investigate the self-efficacy of the 138 pregnant women in Haikou.Cronbach's α coefficients and confirmatory factor analysis were used to evaluate the reliability and validity of the questionnaire,the influencing factors were analyzed by the univariate analysis and multiple regression analysis.Results The Cronbach's α coefficients for the scale and subscales were 0.973 and between 0.971 and 0.976 respectively;and the cumulative variance was 82.60％,which indicated the scale's reliability and validity was good.The pregnant women's self-efficacy score was (189.64±36.54) points,The times of childbirth,family function and the main coping methods were the influence factor.Conclusions CBSEI-C32 was suit to measure the confidence of natural childbirth in Haikou pregnant women,and their self-efficacy level was general,diversity nursing intervention had to apply for improve pregnant women's self-efficacy.

Objective To explore the treatment opportunity of mechanical ventilation for acute severe organophosphorus pesticide poisoning patients with respiratory failure.Methods According to the different indications of mechanical ventilation,115 acute severe organophosphorus pesticide poisoning patients with respiratory failure were divided into the observation group A (40 cases),the observation group B(38 cases)and the control group(37 cases).The cure rate,aspiration pneumonia incidence,duration of mechanical ventilation,length of hospital stay of the three groups were analyzed.Results The cure rate of the observation group A(97.5％) was significantly higher than that of the control group(83.4％)and the observation group B (92.1％) (P ＜ 0.05 or P ＜ 0.01) ;The aspiration pneumonia of the observation group(2 cases) was significantly less than that of the control group(8 cases)(P ＜ 0.05) ;The hospitalization time [(4.46 ± 0.51) d,(7.11 ± 0.83) d] and the duration of mechanical ventilation [(55.40 ± 5.24)h,(79.47 ± 2.44) h] of the observation group A and the observation group B were significantly shorter than those of the control group [(10.40 ± 1.12) d,(100.30 ± 2.15) h] (all P ＜ 0.01) ; The hospitalization time and the duration of mechanical ventilation of the observation group A [(4.46 ± 0.51) d,(55.40 ± 5.24) h] were significantly shorter than those of the observation group B [(7.11 ± 0.83)d,(79.47 ± 2.44)h] (all P ＜ 0.01).Conclusion Respiratory rate ≥30 times/min and ＜ 34 times/min or ≤ 10 times/min,or spontaneous breathing weakened,and blood gas analysis prompted hypoxemia(60 mm Hg ＜ PaO2 ≤ 70 mm Hg)is best opportunity of mechanical ventilation for acute severe organophosphorus pesticide poisoning patients with respiratory failure.

Objective To investigate the effect of sodium demethylcantharidate injection on adherence,invasion and metastasis and to investigate the related mechanism in human hepatocarcinoma cell line HepG2.Methods Adherence ability,migration and invasion of HepG2 cells inhibited by sodium demethylcantharidate injection were assessed by MTT and Transwell techniques.Expression levels of MMP-9 protein in HepG2 cells were determined by immunohistochemistry.Results The number of adhesion,migration and invasion of HepG2 cells were significantly lower in sodium demethylcantharidate injection group than those in the control group (P ＜ 0.05).HepG2 cells co-incubated with sodium demethylcantharidate injection in the concentration of 0.25 μg/ml for 30,60,90 and 120 min showed higher cell adhesion than the control group.The adhesion inhibition ratios were 48.11％,33.81％,28.97 ％ and 16.83 ％,respectively.The migration and invasion inhibition rates were 64.19 ％ and 58.19 ％.With concentration of sodium demethylcantharidate injection to increasing,expression levels of MMP-9 protein in HepG2 cells more and more lower than control group.Conclusion The adherence,migration and invasion abilities of HepG2 cells are markedly inhibited by sodium demethylcantharidate injection,the mechanisms is possible related to the expression levels of MMP-9 protein.

Objective To evaluate the value of hyperbaric oxygen treatment on patients with traumatic brain injury and to explore the possibility of C-reactive protein(CRP) as a index for estimating the effect of hyperbaric oxygen treatment on patients with traumatic brain injury.Methods 70 patients with traumatic brain injury were divided into two groups by randomization:hyperbaric oxygen treatment group(group A) and control group(group B).The recovery of patients was evaluated with Glasgow Coma Scale(GCS),while the content of serum CRP in 70 patients was measured before and after a course of treatment.Results ⑴After a course of treatment,GCS of group A was (11 9?1 7) scores,while GCS of group B was(10 7?2 0) scores,there was significantly difference between two groups(P

Objective To establish the determination method of Tubeimoside Ⅰ in Jiazhongxiao preparation and serum of rat. Methods RP-HPLC/UV method was used as follows:Diamonsil C18 column (250 mm?4.6 mm, 5 ?m) and Easyguard column, methanol-water (65∶35) as mobile phase with flow rate of 1.0 mL/min, UV detection at 214 nm. Results The mean recovery rates of Tubeimoside Ⅰ in preparation and serum of rat were (103.49?3.49)% and (104.70?4.69)% respectively. The linearity of Tubeimoside Ⅰ was shown in the range of 1.18～88.5 ?g/mL. Tubeimoside Ⅰ in preparation and serum of rat were 995.3 ?g/g and 3.19 ?g/mL. Conclusion The method was simple, reliable and rapid. It’s quite suitable to be used in the analysis of Tubeimoside Ⅰ in Jiazhongxiao preparation and serum of rat.