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.

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 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.

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 investigate the ability of repairing bone defect with the combination of recombinant human insulin-like growth factor-1(rhIGF-1),coralline hydrolyapatite(CHA) and autogeneous red bone marrow(ARBM) by way of imaginology.[Method]Bilateral middle radius periosteum-bone defects (11mm in length) were created in 54 Chinese rabbits,and were ramdonly devided into 6 groups(each group containning 18 radial defects of one forearm): group A, defects transplanted with rhIGF-1/CHA/ARBM,group B,with CHA/ARBM,group C,with rhIGF-1/CHA,group D,with CHA,group E,with autograft,group F,no implant.At 2,4,8,and 12 weeks postoperation,the repair effects of defects were evaluated by observation of gross appearance,roengenodiagnosis and radionuclide bone image assay.[Result]In group A,radiological and bone density image analysis showed that the defects were bridged well at 12 weeks postoperatively and was significantly superior to those of any other groups(P0.05).[Conclusion]The recombinant compound rhIGF-1/CHA/ARBM,which possesses the potential ability of osteogenesis,osteocondution and osteoinduction for bone defect repairing,can enhance bone healing and serve as a new type of bone substitute.

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.