Objective To investigate and analyze the characteristics and stratified influencing factors of self-directed learning of nursing college students.Methods In November 2016,a total of 304 students from three nursing colleges in Sichuan province were investigated with self-rating scale of self-directedness learning (SRSSDL).304 copies of the questionnaires were issued and recovered.Using SPSS 13.0,the independent sample t test and variance analysis were used to compare the differences between groups.Pearson correlation test and multiple linear regression were used to analyze the influencing factors.Results The average SRSSDL score of key undergraduate students of nursing college was (220.27 ± 30.16),the score of general undergraduate students was (212.37 ± 25.01),the score of Junior college students was (205.26 ± 29.84),The score difference has statistical significance (F=6.191,P=0.002).Students from key undergraduate had the highest self-directed learning ability,and students from general undergraduate and Junior college had the medium self-directed learning ability.The factors such as different levels,whether the one-child,self-study time every day,team learning experience affect students' self-directed learning ability.Conclusions We should create conditions for students to study independently,cultivate professional identity and independent spirit under the premise of clear educational objectives to improve their SDL ability.

Objective To determine sonographic features and outcome of fetal lung abnormal lesions. Methods Blood supply of the lesion, fetus hydrops and other extra-lung anomalies should be evaluated by color Doppler flow image(CDFI) when abnormal lesion was detected in fetus lung during routine scanning. The fetus with lung abnormal lesion without hydrops at the first time scanning should be monitored by ultrasound in every four to six weeks. Results Forty cases fetus presented lung abnormal lesions, which included 21 cases with hyperechogenic solid masses,15 cases with cystic-solid mixture masses,4 cases with cystic masses. Lesions of 8 cases were demonstrated systemic arterial blood supply arising from the aorta on CDFI and the diagnosis of pulmonary sequestration (PS) were suggested. Seventeen cases lesion that had small size or decreased or disappeared or remained stable in size with gestational age developing had normal neonate. Conclusions CDFI is very useful in detecting abnormal lesion of the fetal lung and differentiating pathology and evaluating the prognosis. The outcome of isolated lung lesion without hydrops and mediastinal shift that decreased or disappeared or remained stable in size had a good prognosis.

Objective To investigate the differences between indocyanine green (ICG) fluorescence imaging plus methylene blue and plus Carbon Nanoparticles Suspension Injection for sentinel lymph node biopsy (SLNB)in breast cancer patients. Methods A total of 134 cases of early breast cancer patients performed SLNB from November 2013 to November 2016 were involved,of which 48 cases were performed with ICG fluorescence imaging plus methylene blue,and another 86 cases plus Carbon Nanoparticles Suspension Injection. Results There was no significant difference between ICG plus Methylene Blue group and ICG plus nano carbon group in terms of detection rate(P>0.05),detected numbers(P>0.05),sensitivity(P>0.05),accuracy(P>0.05)and false negative rate(P > 0.05). Age,and body mass index(BMI)exerted no influence on the detection rate and accuracy of SLNB in two groups(P>0.05). Conclusion ICG Fluorescence Imaging plus Methylene Blue showed similar detection rate , detected numbers , sensitivity , accuracy and false negative rate as it plus Carbon Nanoparticles Suspension Injection for SLNB in breast cancer patients ,and both of them can be performed easily and conveniently.

Objective To analyze the laboratory diagnosis results and epidemiological characteristics of imported malaria cases in Chongqing Municipality in 2015. Methods According to the Standard Operating Procedures of Malaria Diagnosis Ref-erence Laboratory Manual,all the blood samples collected from the imported malaria patients were detected by microscopy, RDT and nest PCR. Meanwhile,the epidemiological data of the malaria cases were collected from the Parasitic Diseases Informa-tion Management System and analyzed. Results Totally 31 cases of imported malaria were reported in Chonqing Municipality in 2015,among which,there were 2 vivax malaria cases(6.45%),23 falciparum malaria cases(74.19%),5 ovale malaria cas-es(16.13%),1 malariae malaria case(3.22%). For the 5 ovale cases,three of them were confirmed as Plasmodium ovale wal-likeri infection. Among all the cases,30 cases(96.77%)were from African countries,1(3.33%)was from Southeast Asia. Thir-ty patients were male,and 1 was female. All the patients were aged from 23-61 years. There was no obvious seasonality in the case distribution. Both the medians of duration from malaria attack to first visiting a doctor and from first visiting a doctor to diag-nosis were 2 days. The medical care units that the patients first visited were mainly county-level units,while those that made the diagnosis were mainly provincial level institutes. Conclusions All the malaria cases in Chongqing in 2015 are imported,no lo-cal cases have been found,which suggests that this municipality still maintain the malaria elimination state. However,the moni-toring and management of imported malaria cases as well as the training on malaria control for related medical staff still need to be strengthened.

This study was aimed to observe the clinical efficacy of Highly Active Antiretroviral Therapy (HAART) combined withPing-Ai(PA) Mixture in the treatment of Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) patients with non-infectious skin lesions, in order to study the advantages of integrative medicine in AIDS prevention and treatment. A total of 9 cases, who met the inclusion criteria of AIDS-associated non-infectious skin lesion with the pattern ofqi-yin deficiency and internal obstruction of phlegm-stasis, were selected. The combination of HAART and number 1 and 4 prescription of PA Mixture were used in the treatment for 3 months. The observations were made on changes of clinical symptoms, body signs, Karovsky integral and CD4+ T cells of patients before and after treatment. Stata 12.0 was used in the statistical analysis. The results showed that after integrative therapy, the single integral of clinical symptoms and body signs, such as skin spot papula, subcutaneous nodules, skin itching, fatigue was obviously reduced compared to that of the pretreatment. The total score decreased than that of the pretreatment. The patients’ quality of life (QOL) significantly increased. The Karovsky integral increased compared with that of pretreatment. The CD4+ T cells values were higher than that of the pretreatment. It was concluded that the integrative therapy had a certain effect in the treatment of AIDS-associated non-infectious skin lesions, which can improve the clinical symptoms, body signs, obviously increase the patients’ QOL and immune function.

Objective To analyze the composing principles of Astragali Radix in Drug Standard of Ministry of Public Health of the People’s Republic of China-TCM Prescription Preparation;To provide references for clinical application and research and development of new medicine. Methods Traditional Chinese Medicine Inheritance Support System (V2.0) was used to establish database. Data mining methods, such as association rules, improved mutual information method, were used to analyze the diseases, syndrome rules, and common composing combinations of prescriptions containing Astragali Radix. Results Through analysis on the 446 cases of prescriptions containing Astragali Radix, 16 core medicine combinations and 18 diseases were discovered. Then, based on the 18 diseases, insomnia, consumptive disease and vertigo were chosen to make comparative analysis, the medicine using regularity and compatibility features of Astragali Radix in different diseases were disclosed. Conclusion Herbal medicines used frequently in prescriptions containing Astragali Radix could tonify qi and nourish blood. The medicine using is relatively concentrated, and the composition is clear. The composing principles reflect the compatibility features of Astragali Radix in treating different diseases, which are in accordance with the clinical application of multiple-efficacy Chinese medicine.

Objective To evaluate the clinical significance of bone marrow minimal residual disease (MRD) monitoring by multi-parameter flow cytometry (FCM) regularly after the first complete remission (CR1) in patients with acute myeloid leukemia (AML).Methods A total of 63 paitents with AML who had got CR1 after chemotherapy were regularly monitored for MRD in bone marrow by FCM,and MRD ≥ 10-4 was positive.According to the latest standards of National Comprehensive Cancer Network (NCCN) for disease risks,they were categorized into three groups:better risk group (20 cases),intermediate risk group (27 cases) and poor risk group (16 cases).The probability of continuous complete remission (CCR) was calculated by KaplanMeier formula,and the statistical difference between MRD positivc and MRD negative CCR probabilities was evaluated by log-rank test.Results The positive rates of MRD were 20％(4/20),30％(8/27) and 10/16 in better risk group,intermediate risk group and poor risk group respectively.The difference between better risk group and intermediate risk group had no statistical significance (P=0.454),and the difference between poor risk group and intermediate risk group had statistical significance (P =0.035).Twenty-two cases showed positive MRD,and 41 cases showed negative MRD.The probability of CCR at 24 and 36 months in MRD positive patients were 18％ (4/22),18％ (4/22),in MRD negative patients were 83％ (34/41),80％ (33/41),and there were significant differences (P ＜ 0.01).Conclusions The dynamic detection of MRD by FCM can be used to evaluate the therapeutic effect and prognosis of AML.MRD monitoring has important clinical significance and can help to adjust the intensity of chemotherapy,carry out individualized treatment,predict prognosis,and choose appropriate therapy.

BACKGROUND:Primary culture in vitro of neurons plays an important role in the development, regeneration, signal transduction mechanisms, neuropharmacology and gene expressions of the nervous system.
OBJECTIVE:To establish a simple method for primary culture of high-purity cortical neurons in neonatal Sprague-Dawley rats.
METHODS:Cortical tissues were acquired from neonatal Sprague-Dawley rats born 1 day. In traditional experimental group, the whole cortex was removed;in improved experimental group, the cortical tissues, 2-3 mm thick on the brain surface were removed. Single cel suspensions were prepared after papain digestion and centrifugation and were then seeded onto 24-wel culture plates containing neuron solutions for primary culture (1×105 per wel ). Cel s were identified by neuronal specific markers MAP-2 and Tuj1 after 3-day culture. The number of neurons and neurite length were observed under inverted phase contrast microscope and recorded at 6, 24, 48 and 72 hours, 5 and 7 days of culture, resprctively.
RESULTS AND CONCLUSION:The cultured cel s expressing MAP-2 and Tuj1 were neurons that could be used in the fol owing experiments. The purity of neurons in the improved experimental group was 92%at 3 days, while only 51%in the traditional experimental group. Cel s in both two groups had attached to the wal presenting with smal processes at 6 hours, and a simple neural network formed at the 3rd day until dense neural networks could be found at the 5th day. To conclude, our culture method herein is simple and convenient, and can be used to produce neurons with high purity, which wil be helpful for the experimental studies on cortical neurons from Sprague-Dawley rats.

Objective To investigate the therapeutic effect,safety and its prognostic factors of capecitabine as maintenance treatment agent for prolonging the PFS of patients with recurrent and metastatic breast cancer after they received combination chemotherapy.Methods From January 2011 to June 2013,38 cases with recurrent and metastatic breast cancer were collected in the department of medical oncology of the First Hospital of Lanzhou University.All the 38 patients received NX scheme (vinorelbine combined capecitabine chemotherapy),and some patients among of them had stabile disease after chemotherapy and were administered X scheme (capecitabine,twice a day,2 000 mg/m2 daily,withdrawal for 7 days after a consecutive intake of 14 days,21 days as a cycle,at least 2 cycles) until disease progressed or toxicity could not be tolerated.Adverse reactions and PFS were observed and recorded.Single factor chi square test and multivariate COX proportion hazard model were used to evaluate the relationships between clinic features and RR,PFS.Results The overall response rate (CR + PR) was 55.26％ (21/38),clinical benefit patients rate (CR + PR + SD) was 84.2％ (32/38),with 4 patients of CR (4/32),17 patients of PR,11 patients of SD,6 patients of PD.Thirty-two no progressived patients were administered capecitabine until PD.The median PFS was 10.0 months.Stratification analysis showed that patients whose Karnofsky (KPS) ≥80 had an average PFS of 14.1 months,while an average PFS of 6.8 months for patients whose KPS ＜ 80,with a statistical significance (x2 =6.251,P =0.000).Cox proportion hazard model also showed that age (RR =3.561,95％ CI:1.372-5.216,.x2 =4.025,P =0.031),menopausal status (RR =1.895,95 ％ CI:1.124-4.452,x2 =5.725,P =0.048),KPS score (RR =4.553,95％ CI:1.131-7.703,x2 =11.205,P =0.005),the number of metastasis (RR =5.781,95％ CI:2.321 ～11.243,x2 =3.925,P =0.011) were important prognostic factors for the patients with breast cancer.Major treatment-related adverse reaction was grade Ⅰ-Ⅱ hand-foot syndrome.One patient discontinued treatment because of grade Ⅲ hand-foot syndrome.Conclusion Capecitabine as maintenance treatment can significantly prolong the PFS of patients with recurrent and metastatic breast cancers at remission or stable stage after combination chemotherapy with a better tolerance.Age of patients,menopausal status,KPS score,the number of metastasis are the prognostic factors for the efficacy of NX-X regimen.

Objective To investigate the mechanisms modulating the functions of dendritic cells (DCs) and suppressing the activation and proliferation of T cells by transforming growth factor-β (TGF-β).Methods Mouse splenic DCs were purified with CD11c+ immunomagnetic beads and the purity of isolated DCs were detected by flow cytometry.Gene chip was used to detect gene expression in DCs after stimulation with TGF-β, and then real-time PCR was performed to analyze the differentially expressed genes in microarray at mRNA level.The activation and proliferation of CD4+ T cells which were co-cultured with DCs after stimulation with TGF-β were detected by flow cytometry.Results The purity of DCs reached over 95% after isolation.TGF-β down-regulated the expression of cell surface markers CD53, CD69, CD33, CD74 and CD93 on DCs;decreased the expression of chemokines Ccl3, Ccl5, Ccl9, Ccl6, Ccl17, Cxcl10, Ccl22, Ccl4, Ccr7, Ccl2, Cxcl9 and Ccl7;inhibited the expression of inflammatory cytokines IL-2ra, IL-12rb2, IL-15ra, IL-1b and IL-15.Moreover, the DCs-mediated activation and proliferation of CD4+ T cells were suppressed by TGF-β.Conclusion TGF-β inhibits the DCs-mediated activation and proliferation of CD4+ T cells by suppressing the expression of surface markers on DCs and down-regulating the expression of chemokines and inflammatory cytokines.