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 investigate the effect of therapeutic dual-plasmid HBV DNA vaccine on specific humoral and cellular immunity in cancrivorous monkey (Macaca fascicularis). Methods The eukaryotic expression plasmids encoding human IL-2 and IFN-? fusion protein (pFP) were constructed to enhance the cellular immunity of therapeutic HBV DNA vaccine (pS2.S) encoding HBV envelope middle protein in the form of dual-plasmid (pS2.S+pFP). Thirty cancrivorous monkeys were randomly divided into 5 groups (6 each) with sex rotio of 1∶1, namely the dual-plasmid DNA vaccine group in high dosage (2000?g/kg), medium dosage (660?g/kg), low dosage (200?g/kg), and EP-mediated pFP (330?g/kg) or PBS administration groups as the controls. The monkeys were vaccinated repeatedly with the dual-plasmid HBV DNA vaccine, and then the immune responses including level of serum anti-HBs and number of IFN-? secreting T-cells induced by HBsAg were examined by means of enzyme-linked immunosobent assay (ELISA) and enzyme-linked immunosobent spot assay (ELISPOT) respectively. Results Ten weeks after immunization of HBV DNA vaccine, various levels of serum anti-HBs was detected in all the monkeys of three different dose groups. Sixteen weeks after administration of EP-mediated HBV DNA vaccine, the positive HBsAg-specific INF-? T cell responses was found in 3, 2 and 3 out of 3 monkeys, respectively in the high, medium and low losage groups, and HBsAg-specific INF-? T cell responses were positive in all the animals with the respective cell count of 30.0?13.5 SFCs/3?105 PBMCs, 30.7?26.3 SFCs/3?105 PBMCs and 17.7?6.4 SFCs/3?105 PBMCs in each corresponding group at the 29th week. However, HBsAg-specific INF-? T cell responses were negative in the pFP and PBS group at the same time. Conclusion Electroporation-mediated vaccination of the HBV DNA vaccine can effectively induce both humoral and cellular HBsAg-specific immune responses in cancrivorous monkeys.

Objective To investigate the therapeutic effectiveness of video-assisted thoracoscopic surgery(VATS)and thoracotomy for spontaneous pneumothorax in high altitude.Methods 256 concecutive patients diagnosed as having spontaneous pneumothorax in high altitude between July 1997 and August 2007 were analyzed retrospectively.VATS was performed in 158 cases and thoracotomy was performed in 98 cases.The operating time,blood loss during operation,chest drainage time,postoperative hospital stay,the costs of operation,the total costs of hospital stay and postoperative complication were compared between the two groups.Results The operating time in VATS group and thoracotomy group was(55.6?5.8)min and(66.3?5.1)min respectively(t=11.678,P=0.000),the blood loss during operation(40.6?5.8)ml and(120.3?6.5)ml respectively(t=11.678,P=0.000),the chest drainage time(2.6?0.7)d and(3.2?0.8)d,respectively(t =3.024,P=0.000),the postoperative hospital stay(4.8?0.9)d and(5.2?0.6)d respectively(t =4.168,P=0.000),the the costs of operation(9876?687)Renminbi Yuan and(4948?562)Renminbi Yuan respectively(t =44.532,P=0.000),the the total costs of hospital stay(17 028?956)Renminbi Yuan and(13 892?835)Renminbi Yuan respectively(t=21.743,P=0.000),the postoperative complication 12 cases and 38 cases respectively(?2 =21.351,P=0.000).The number of recurrence after operation was not statistical significant difference(?2=0.734,P=0.512).Conclusion VATS is accepted easily by patients and the total curative effect is dominant comparing to standard thoracotomy.The VATS method is the first selection for spontaneous pneumothorax in high altitude.But the defect of VATS is higher in the costs of operation and hospital stay.Decreasing applying the consumptive material of one time can reduce the costs.

Objective To study the cellular immune response to a large-dose of HBsAg vaccine in transgenic (Tg) mice. Method After the Tg mice was immunized with HBsAg vaccine, the number of dentritic cells (DC), the level of proliferation of T-lymphocytes, and the production of IL-2 and IFN-?were determined. Results The percentage of cells positive for common stimulating factors CD80, CD86, and I-E k were significantly higher than that of the control group (P

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 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 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.

Objective To investigate the feasibility of video-assisted thoracoscopic surgery (VATS) for treating spontaneous chylothorax. Methods Four patients with spontaneous chylothorax were treated by VATS from April 2000 to October 2003. Results Operations were successfully completed in all the 4 patients. The operative time was 40, 52, 55, and 95 min, respectively (mean, 60.5 min). The postoperative chest drainage time was 3~8 d (mean, 5.2 d). The postoperative hospital stay was 8~13 d (mean, 10.5 d). No severe complications or operative mortality were seen. Conclusions Treatment of spontaneous chylothorax by VATS gives advantages of less invasion and quick recovery.