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.

Anemia, Pernicious ; complications ; surgery ; Biopsy ; Endoscopy ; methods ; Humans ; Male ; Middle Aged ; Stomach Neoplasms ; complications ; surgery ; Tomography, X-Ray Computed ; methods ; Treatment Outcome ; Ultrasonography ; methods

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.

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 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 analyze the correlation of preoperative serum vascular endothelial growth factor(VEGF)level with serum CA125 level in patients with epithelial ovarian cancer(EOC),and to evaluate the prognostic value of preoperative serum VEGF in these patients.Methods Forty-one patients with EOC were included as study group,while 20 healthy women were selected as control group.Enzymelinked immunosorbent assay(ELISA)and chemiluminescence assay were used to measure serum VEGF and CA125 level respectively.The correlations of serum VEGF with CA125 level,postoperative recurrence rate and survival time were analyzed retrospectively.Resuits Serum VEGF levels in patients with EOC were higher than those in healthy women,with the median of 415 and 165 ng/L,range 110-2120 and 100-735 ng/L respectively(P＜0.01).No correlation was found between preoperative serum VEGF and CA125 level (Spearman test,P=0.989).High preoperative serum VEGF was positively correlated with postoperative recurrence.Serum VEGF level in patients with postoperative recurrence was higher than that in patients without recurrence,with the median of 490 and 315 ng/L respectively(P=0.035).Univariate analysis showed that higher serum level was reversely correlated with shorter survival.Median overall survival time in patients with higher serum VEGF level and lower serum VEGF level was 18 months and＞35 months respectively(P=0.010).Multivariate Cox model analysis showed that high VEGF level was an independentfactor for the prognosis of EOC(P=0.042).Conclusion Preoperative serum VEGF level is not correlated with CA125 concentration in patients with EOC,and it is an independent risk factor for prognosis.

Purpose: The study aimed to investigate the utility of ultrasonographic (US) findings in predicting the subsequent radiographic parameters of developmental dysplasia of the hips. Methods: In this 12-year retrospective cohort study, all new-born infants with a positive clinical examination or risk factors were included. They were scheduled for hip ultrasonography in the first 3 months, and subsequent radiographs at 1 year of life. The US images were evaluated using the Graf classification, Harcke’s dynamic screening method, and Terjesen’s femoral head coverage method. The radiographic images were evaluated using the acetabular index and femoral head position. The overall US or radiographic findings were considered abnormal if they were classified as abnormal for any of their respective parameters. The overall US and radiographic parameters were correlated. Results: A total of 160 patients were included. The overall US and radiographic parameters showed no statistically significant difference (P=0.050). The sensitivity, specificity, and accuracy of the overall US parameters were 57.1%, 84.9%, and 81.3%, respectively. All three individual US parameters showed no statistically significant differences, with the overall radiographic findings and acetabular index (P>0.05). However, they showed a statistically significant difference, with the position of the femoral head (P<0.001), with the US parameters having an excellent negative predictive value of 100% for identifying an abnormal femoral head position. Conclusion The current study suggests that US findings evaluated in the first 3 months of life showed no statistically significant difference with radiographic findings evaluated at 1 year of life. The US parameters showed an excellent negative predictive value for abnormal femoral head position on radiographs.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; instrumentation ; methods ; Diskectomy ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Prospective Studies ; Spinal Fusion ; instrumentation ; methods