Objective:To explore whether the professional commitment of nursing undergraduates was affected and changed during the COVID-19 epidemic.Methods:Three surveys were conducted on all nursing undergraduates in the school of nursing of a comprehensive university at different stages before and during the epidemic. Three surveys all adopted "College Students' Professional Commitment Survey Scale". SPSS 23.0 was used for descriptive statistics and ANOVA analysis.Results:The overall scores of professional commitment in the three surveys were (3.54±0.55), (3.42± 0.57) and (3.57±0.68), all of which were above the average level, with little change. There was no statistically significant difference in the mean scores of professional commitment among the three surveys ( F = 2.803, P = 0.062). In all dimensions, except ideal commitment ( F = 0.966, P = 0.381), affective commitment ( F = 3.502, P = 0.031), normative commitment ( F = 34.791, P < 0.001) and continuance commitment ( F = 7.632, P = 0.001) all had significant statistical significance. Conclusion:The change of professional commitment of nursing undergraduates during the epidemic was not significant, but it was affected positively. During the epidemic, the value of nursing was highlighted and the professional identity of nursing undergraduates was enhanced. We should vigorously carry forward the great anti-epidemic spirit, and make good use of anti-epidemic materials to carry out students' professional ideological education. At the same time, vocational spirit, knowledge of professional prevention and protection and specialized nursing education should be strengthened.

Objective To investigate the clinical efficacy and safety of recombinant human B-type natriuretic peptide(rhBNP)in treatreat of patients with acute myocardial infarction(AMI).Methods 80 patients with AMI were randomly divided into control and treatment group.The two groups were accepted the standard foundation treatment(ABCDE)defined by the WHO and PCI therapy.The treatment group was added the rhBNP on the basis.The rhBNP was uniformly injected by intravenous with 1.5 μg/kg in 90s,and then with 0.0075 μg · kg-1 · min-1 in 48h; To investigate the BNP and myocardiolysis maker(Troponin I,cTnI)levels in blood-serum before and after the treatment;To evaluate left cardiac functions and left ventricular remodeling by left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF);To investigate the major cardiovascular events after treatment within 30 days.Results RhBNP could significantly reduce the concentration of the BNP and cTnI in blood-serum after treating one week(all P ＜ 0.05); It could remarkably deflate LV EDV and LVESV,improve LVEF(allP ＜0.05); It could reduce the incidence of major cardiovascular events(P ＜0.05)within 30 days(P ＜ 0.05).Conclusion The rhBNP could improve left ventricular pressure-phore and volume-phore,improve ventricular remodeling,improve myocardial ischemia and reduce major cardiovascular events within 30 days.It was proved that the rhBNP could improve AMI clinical prognosis.

Objective To study the anatomy of superficial palmar digital veins in fingertip,and explore the clinical application of superficial palmar digital veins as venous drainage in fingertip replantation.Methods One hundred fingers were studied with three methods: microanatomy,sectional anatomy,and X-ray.According to microanatomical observation,thirteen fingers in 10 cases with fingertip amputations and dorsal veins defect were replanted by anastomosis of palmar digital veins to reconstruct the venous drainage of the amputated digits. Results ( 1 ) 1 to 3 tiny superficial palmar digital veins can be found at the level of the onychorrhiza.The average diameters of the superficial palmar digital veins were 0.2-0.5 mm.(2)In clinical practice,13 replanted fingers were survived.After 3-18 months following-up,the appearance and function were satisfactory. Conclusion The distribution of the palmar digital veins was in some pattern.Anastomosis of the superficial palmar digital veins can not only improve the success rate of the fingertip replantation,but also avoid the complications of the other venous drainage methods.

Objective To investigate the epidemiological and clinical features of acute hepatitis E (AHE).Methods All the data of AHE patients from April 2005 to October 2011 were collected and their epidemiological features were retrospectively analyzed.Patients were divided into two groups:patients with single hepatitis E virus (HEV ) infection and patients with HEV/hepatitis B virus (HBV ) coinfection,to compare the biochemical parameters and outcomes and to find out the risk factors for AHE related liver failure.Kruskal-Wallis test,Chi square test,and Logistical regression analysis were used for statistical analysis.Results A total of 621 cases were included in the present study and most patients were elderly male and happened from February to May every year.The incidence of AHE related liver failure and mortality was 18.68% and 1 .93%,respectively.Compared to the single HEV group (n=331 ),the HEV/HBV group (n = 280 )had a longer hospital stay (46 d vs 40 d,Z = - 4.591 ,P < 0.01 ),a significantly lower prothrombin activity (55 .5 % vs 78.7%,Z =-7.998,P <0.01 )and a significantly higher incidence of AHE related liver failure (30.7% vs 9.1 %,χ2 =46.229,P <0.01 ).In single HEV related liver failure group (n=30),the percentages of early-stage,interim-stage and end-stage live failure were 53.33%,23.33% and 23.33%,respectively.While in the HEV/HBV related liver failure group (n=86),the corresponding numbers were 34.88%,31 .40% and 33.72%,respectively.The differences were not statistically significant (χ2 = 3.176,P = 0.204 ).Additionally,the clinical outcome between these two groups was also comparable (83.33% vs 91 .86%,χ2 =0.945 ,P = 0.331 ).The Logistic analysis showed that age over 50 years (OR=2.080,P =0.002)and coinfection with HBV (OR=5 .632, P <0.01)were risk factors for AHE related liver failure.Conclusions AHE is seasonal and mainly occurs in elderly male.Advanced age and HBV coinfection may be risk factors of severe AHE.

Objective To investigate the relationship between HBV mutations in the precore (PC)/core promoter region and the liver histological changes in HBeAg negative CHB patients. Method A total of 71 HBeAg negative CHB patients with liver biopsy from April 2012 to Dec 2013 were enrolled. DNA was extracted from blood serum, then the HBV S gene and PC/core promoter region were amplified by semi-nested PCR and sequenced. The relationship between significant liver histological changes and viral factors were analyzed by Logistic regression analysis. Results The incidence of significant necroinflammation (15.8% vs. 27.3%, χ2 =1.398, P = 0.237) and significant fibrosis (71.1% vs. 84.4%, χ2= 1.926, P = 0.165) were found to be similar between patients infected with HBV genotype B and genotype C . By Logistic regression analysis including risk factors of age, sex, HBV genotype and mutations (T1753V,A1762T/G1764A,A1846T and G1896A), the A1762T/G1764A mutation in HBV associated with significant necroinflammation (OR = 4.296, P = 0.037), while factors of age, sex, genotype and other mutation were not associated with significant liver histological changes. (all P > 0.05). Conclusion Mutation in PC/core promoter region of HBV may act as a marker to evaluate the liver histological changes.

Pulmonary fibrosis is an interstitial lung disease caused by different pathogenic factors. It has the characteristics of high morbidity and poor prognosis, which seriously affects the quality of life of patients. However, its pathogenesis has not yet been fully elucidated. Surfactant protein(SP)-A and SP-D are lipoprotein complexes distributed at the air-liquid interface of alveoli, synthesized and secreted by alveolar type Ⅱ epithelial cells and bronchiolar cells. They are important parts of the innate immune system, which participate in the host defense process through a variety of regulatory methods, and play an important role in regulating cell apoptosis and lung inflammation, promoting the process of epithelial repair and maintaining the stability of alveolar structure. The disorder and mutation of SP-A and SP-D may be the influencing factors of the pathogenesis of pulmonary fibrosis. Serum SP-A and SP-D levels are differentially expressed in patients with pulmonary fibrosis and normal healthy individuals, and are related to the severity of pulmonary fibrosis. They are considered to be a class of biomarkers that sensitively reflect lung epithelial cell damage and can be used in the diagnosis, treatment and prognostic evaluation of pulmonary fibrosis.

Objective To investigate the operation key points, instrument improvement and shortterm effects in total en bloc spondylectomy (TES) via a single posterior approach for thoracic and lumbar tumors. Methods A series of modified instruments have been designed for the TES, including threadwire saw (T-saw) with a diameter of 0.81 mm, director and clamping for the saw, L shape and furcation osteotomes.The corpectomy of original TES which was defined as "one step dissection" from anteriorly to posteriorly, was modified into "two step dissection" which means that corpectomy was performed with saw cutting anteriorposteriorly and the L shape cutting posterior-anteriorly. In the cases with difficulty in pediculotomy using a T-saw, furcation osteotome was used for pediculotomy. Ten patients with thoracic or lumbar tumors were treated with the modified TES. There were 1 case of bone giant cell tumor, 1 case of bone neurilemmoma and 8 cases of metastatic tumors. All patients suffered moderate-severe pain and neurological deficit. Results The average follow-up period was 8.1(3.3-18.1) months. The average operating time was 7.8 h(6.0-10.3 h),and average blood loss was 2100 ml (1200-3500 ml). No disruption of dural mater, the leakage of cerebrospinal fluid, iatrogenic spinal cord injury and major vessel damage occurred. Two patients who underwent pleura disruption happened during the operation were treated with intrathoracic drain remedy. Among 7 cases with thoracic tumors, significant improvement in neurological function were achieved in 5 patients with the improvement of one grade in ASIA classification, while no change was found in 2 cases. In 3 cases with lumbar tumor, lumbar nerve root pain relieved and the muscle strength had recovered to grade 4 at least postoperatively. Conclusion Significant improvement has been achieved in the maneuverability and safety of the modified surgical techniques in TES with a single posterior approach for thoracic and lumbar tumors.

Objective To investigate the diagnosis value of spleen stiffness measurement by transient elastography (FibroScan, FS) for esophageal-gastric varices (EV) in patients with HBV-related liver cirrhosis receiving anti-viral treatment. Method Total of 41 patients from Jan 2014 to Dec 2014 diagnosed with HBV-related liver cirrhosis receiving anti-viral treatment were enrolled. All patients were evaluated for spleen and liver stiffness measurement by FS and checked by gastroscopy for diagnosis of EV. Using gastroscopy as the gold standard, the area under receiver operating characteristic curve (AUROC) were used to evaluate the value of the spleen stiffness and liver stiffness in diagnosis of EV and its degree. Results The spleen and liver FS values in patients were (40.64 ± 25.45) kPa and (20.76 ± 13.21) kPa respectively, and they showed a positive correlation (r = 0.402, P < 0.001). The spleen FS values in patients without EV were significantly lower than those in patients with mild EV and moderate-severe EV (all P < 0.05). Furthermore, they showed significantly lower in patients with mild EV than those in patients with moderate-severe EV too (P < 0.05). The AUROC of spleen FS in patients with EV was 0.863, with sensitivity of 79.4% and specificity of 83.2%. Moreover, the AUROC of spleen FS in patients with moderate-severe EV was 0.924, with sensitivity of 87.9% and specificity of 91.3%. Both of them were much higher than those of liver FS. Conclusion Spleen FS may act as a non-invasive marker to predict EV and its degree in patients with HBV-related liver cirrhosis receiving anti-viral treatment.

ObjectiveTo retrospectively analyze the clinical characteristics and outcomes of endometrial carcinoma patients aged 45 years and younger MethodsFifty-two cases of endometrial carcinoma aged 45 years and younger were treated in Peking Union Medical College Hospital They were further divided into group A (35 years of age and younger) and group B (older than 35 years) Clinical data of these patients were reviewed and the two groups were compared ResultsPatients aged 45 years and younger accounted for 12 7% of all the endometrial carcinoma cases About 50% of the patients were nulliparous, infertile or had irregular menstruation and endometrial hyperplasia, 29% were obese, 23% had polycystic ovaries Eighty-three percent of the patients were stage [ Int ernational Federation of Gynecology and Obstetris (FIGO),1988] Group A had mo re polysystic ovaries and atypical endometrial hyperplasia than group B (53% v s 9%, 59% vs 26% respectively, P

OBJECTIVETo explore the differentially expressed proteins between normal ovaries and ovarian cancer tissues using the protein chips.

METHODSTissues of 11 epithelial ovarian cancer (EOC) and 11 matched normal ovaries were labeled with cy3 and cy5 fluorescent dyes and then were hybridized with 512 monoclonal protein antibody chips. The internally normalized ratio (INR) was calculated according to the intensity of fluorescence of each protein spots. The value of INR > 2.0 or < 0.7 was considered as the cut-value to filtrate the differentially expressed proteins between tissues of EOC and normal ovaries.

RESULTSThirty one differentially expressed proteins were found between tissues of EOC and normal ovaries, in which 17 up-regulated and 14 down-regulated proteins involved in the transcription, proliferation, signal conduction, and apoptosis of cells.

CONCLUSIONAntibody chips can effectively screen the differentially expressed proteins between normal ovaries and ovarian cancer tissues.

Adult ; Aged ; Female ; Humans ; Middle Aged ; Neoplasms, Glandular and Epithelial ; metabolism ; Ovarian Neoplasms ; metabolism ; Ovary ; metabolism ; Protein Array Analysis ; Proteomics