Objective In order to understand the students' experience and satisfaction in community nursing practice and the factors that influence them,to provide a basis for improving the quality of teaching in community practice.Methods The students were invited to compete the questionnaire that consisted of preceptors,the length of clinical practice time in hospital,practice items and satisfaction,opinions and harvest to community practice after completing 3-week practice in a designated community placement.Results 327 nursing undergraduates participated in the survey,and the average practice items were (9.7±2.0).The satisfaction of students was (3.89±0.58) points.There were significant differences of practice items and the scores among different preceptors,duration of students practice in hospital ahead,and the length of community conducting the practice teaching.There was a positive correlation between practice items and the satisfaction of students.Conclusions It is time to improve the quality of preceptors,strengthening the practice management in late stage,and promote students self-improvement.

Objective To study the mechanism of Ulinastat’s enhancement for antibiotics’curative effects in sepsis Children caused by bacteria. Methods Children with sepsis caused by bacteria were treated with Ulinastat combined with antibiotics (UTI group) and antibiotics only (CON group), The curative effects, GSC scores and APACHEⅡscores in two groups were observed and compared, pre-and post-therapy serum procalcitonin and inlfammatory factors were detected and compared. Results The efifciency rate and GSC score in UTI group were signiifcantly higher than in CON group (P<0.05), but lower in mortality and APACHEⅡscore (P<0.05). hs-CRP, TNF-α, IL-6 and IL-8 of UTI group in one week, two weeks and three weeks post-therapy were signiifcantly lower than in CON group (P<0.05), while IL-10 was higher(P<0.05). Conclusion The Ulinastat can signiifcantly increases antibiotics’curative effects for sepsis Children caused by bacteria though lowering down serum PCT, hs-CRP, TNF-α, IL-6 and IL-8 and increasing IL-10.

Objective To investigate the effect of Xuesetong Dripping Pills combined with alprostadil intervention on serum brain natriuretic peptide in elderly patients with chronic congestive heart failure.Methods In 74 patients with chronic congestive heart failure, were randomly divided into observation group and control group, 37 cases in each group.Control group received conventional method.The observation group received Xuesetong Dripping Pills combined with alprostadil on the basis of conventional therapy.Compared the efficacy, the heart function level, walking test and level of serum brain natriuretic peptide between two groups after 15 days’ treatment.Results The total efficiency of observation group was 94.59%, which was higher than 75.68% in the control group, the difference was statistically significant(P<0.05).After treatment, the heart function level improvement in the observation group was better than the control group, the difference was statistically significant(P<0.05).After treatment, 6 min walking test in the observation group(316.4 ±20.7) m, was better than the control group(303.5 ±28.1) m, the difference was statistically significant(P<0.05).The level of serum brain natriuretic peptide in the observation group(608.9 ±158.1)ng/L, was lower than that of the control group(792.7 ±179.4) ng/L, the difference was statistically significant ( P <0.05 ) .Conclusion Xuesetong Dripping Pills combined with alprostadil has good curative effect in the treatment of chronic congestive heart failure,can relieve the abnormal increase of serum brain natriuretic peptide, improve blood circulation and heart function.

Objective To investigate the distribution characteristics and clinical features of familial aggregation hemangioma to improve the level of the diagnosis and treatment.Methods Total 1202 cases of vascular disease were treated in this department from June 2006 to June 2011.The clinical data and family distribution characteristics in 36 cases of familial aggregation hemangioma were analyzed and their effects of laser treatment were evaluated.Results 36 cases were familial aggregation hemangioma,whose incidence was 2.99 ％ in 1202 cases of vascular disease cutis; and the ratio of male to female was 1 ∶ 1.There were 9 cases of parents suffering from hemangioma.But the incidenceof the next generation suffering from vascular disease was 28.5 ％.Among these 36 cases of familial aggregation hemangioma,33 cases underwent the long pulse 1064 nm Nd ∶ YAG laser and optimized pulse light combination therapy.The effective rate was 100 ％.Conclusions There may be a genetic predisposition in hemangioma.The application of long pulse 1064 nm Nd ∶ YAG laser and optimized pulsed light treatment to hemangioma cutis can obtain satisfactory results.The intervention should be taken in early stage.

Objective To investigate the effect of STAT3 knockdown on the sensitivity of breast cancer cells with drug-resistant to adriamycin (MCF-7/ADR). Methods Levels of STAT3 and p-STAT3 in MCF-7/ADR and MCF-7 cells were detected by Western Blot. The MCF-7/ADR cells were infected with lentivirus expressing STAT3-shRNA and the negative control vectors in the STAT3-RNAi group and NC group, respectively, wihle the cells in the blank group received no treatment. The transfection efficiency was observed with fluorescence microscope, the mRNA level of STAT3, protein levels of STAT3 and p-STAT3 were detected by qRT-PCR and Western Blot, respectively. MCF-7/ADR cells were treated with different concentrations of adriamycin for 48 hours, cell proliferation was detected by MTT assay and cell apoptosis was detected by flow cytometry. Results Levels of STAT3 and p-STAT3 in MCF-7/ADR cells were significantly higher than those in the MCF-7 cells (P < 0.05). The levels of STAT3 mRNA, STAT3 and p-STAT3 in the STAT3-RNAi group were significantly lower than those in the Con group and the NC group (P<0.05, respectively). The Adriamycin IC50 in the Con group, NC group and STAT3-RNAi group was (56.1 ± 3.00)ug/mL,(54.9 ± 11.9)ug/mL and (7.6 ± 0.2)ug/mL, respectively. The flow cytometry results showed that the cell apoptosis in the Con group, the NC group and the STAT3-RNAi group was (10.5+0.7)%, (11.7+0.7)%and (34+3.1)%, respectively. Conclusion LV-shRNA-STAT3 can significantly inhibit STAT3 expression and enhance the sensitivity of breast cancer cells to adriamycin, and the underlying mechanism may be related to cell apoptosis.

Objective To compare the characteristics of lymph nodes on 18F-FDG imaging in patients with NHL and widespread lymph node metastases carcinoma (WLNMC) for helping the differential diagnosis.Methods A total of 40 NHL patients(22 males,18 females,average age 51 years) and 42 WLNMC patients (19 males,23 females,average age 61 years) confirmed by histopathology from November 2010 to May 2015 were included in this retrospective study.The regions and the metabolism features of the lesions on PET/CT images were observed and recorded with routine visual method.Two-sample t test and x2 test were used for statistical analysis.Results Lymph nodes of NHL were kidney-shaped (47.2％,142/301),which was significantly different from that of WLNMC with circular form (47.6％,140/294;x2 =36.261,P＜0.05).Lymph nodes of NHL mostly showed homogeneous density with no necrosis (51.8％,156/301);however,that of WLNMC showed uneven density (20.4％,60/294) or with necrosis (32.3％,95/294;x2 =26.266,P＜0.05).Both of the two kinds of lymph nodes showed the characteristic of fusion (30.6％ (92/301) vs 36.1％ (106/294);x2 =2.019,P＞0.05).The ratios of lymph nodes with clear boundary in NHL and WLNMC were significantly different:28.2％(85/301) vs 19.4％(57/294);x2 =6.413,P＜0.05.Lymph nodes with symmetric distribution were more in NHL patients (52.5％,158/301)than that in WLNMC patients (42.2％,124/294;X2=6.347,P＜0.05).Sizes of lymph nodes in NHL patients and WLNMC patients were not significantly different:(2.08±0.65) cm vs (1.97±0.81) cm;t=0.316,P＞0.05.SUVmax of lymph nodes in NHL patients (9.02±3.97) was much higher than that in WLNMC patients (6.92± 1.34;t=0.370,P＜0.05).Conclusions Some characteristics of lymph nodes on 18F-FDG PET/CT imaging,such as the distribution,morphology,density and glucose metabolism features,are different in patients with NHL and WLNMC.Those differences may be helpful for the differential diagnosis.

Objective To determine the value of spectral karyotyping(SKY)in identification of the marker chromosome.Methods Selected six cases that could not be identified in clinic were studied,using samples of peripheral blood from four cases,and samples of amonic fluid and fetal cord blood for prenatal diagnosis in two cases were investigated.All cases were analyzed with the routine SKY method.and the results with the SKY View software.The SKY results were identified by using fluorescence in situ hybridization(FISH).And C-banding technique was used to help diagnose the heterochromatin.Results SKY wag successfully performed on all of 6 cases.The origin of all marker chromosomes was identified by SKY.Except case No.4,the others were confirmed by FISH.It helped determine the pregnancy outcome in two cases of prenatal diagnosis:one case of genetic marker chromosome continued the pregnancy,and another case of de novo marker chromosome was terminated of the pregnancy.Conclusion SKY may be a vahable tool to diagnose the marker chromosome with rapidness,direct-viewing and sensitiveness.It can be used to assess the prognosis and the pregnancy outcome.

Objective:To investigate the differential diagnosis of MRI between male malignant and benign breast lesions.Methods:Totally 34 patients with male breast lesions who underwent breast MRI examination from January 2011 to March 2019 were collected from Shanghai Cancer Center.All images were evaluated by two radiologists who were blinded to pathological results. When there was a disagreement, another independent senior radiologist assessed the imaging features. The imaging features including lesion location, T 1WI signal, T 2WI signal, lesion type and accompanying signs were evaluated. All lesions were confirmed by biopsy or surgical pathology. Twelve patients were in benign group, 22 patients in malignant group. The imaging findings of MRI were recorded and statistically analyzed by univariate analysis (continuous variables were tested by Mann-Whitney U test and categorical variables were tested by Fisher′s exact test). Results:Among the 34 patients, 31 cases clinically touched the mass and 3 cases showed simple nipple bleeding. In MRI signs, breast cancer showed mass-like enhancement (22/22), benign lesions showed non-mass enhancement (7/12), the difference was statistically significant ( P<0.05). And ipsilateral axillary enlarged lymph nodes only appeared in breast cancer, which was significantly different from that in benign lesions ( P<0.05). There was no significant difference in age, lesion location, T 1WI signal, T 2WI signal, skin thickening and nipple invagination between benign and malignant lesions. There was no significant difference in the size, shape and edge of the mass between benign and malignant lesions on MRI ( P>0.05). Conclusions:MRI can distinguish male malignant and benign breast lesions. Most of non-mass enhancement are benign lesion and enlarged lymph nodes are helpful to detect breast cancer, nipple retraction and skin thickening in the diagnosis of male breast cancer are limited.

Objective To investigate the relationship between spontaneous miscarriage and embryonic chromosome abnormalities,and to evaluate the clinical application of karyotype analysis by chorionic villus cell culture. Methods The chorionic villus karyotype of 1983 cases of miscarriage from January 2010 to July 2016 in Guangzhou Women and Children′ s Mecical Center were analyzed retrospectively. The miscarried chorionic villi were obtained by curettage under sterilized condition. The chromosome specimens were prepared after chorionic villus cell culture. Karyotype analysis was performed by G-banding technique. Results In the 1983 samples, successful karyotype analysis was performed in 1770 cases, with the successful rate of 89.98%. Chromosomal abnormalities were found in 1038 cases (58.64%,1038/1770). Chromosomal structural abnormalities were found in 37 cases. The numeral abnormalities were more common than structural abnormalities, and most of the numeral abnormalities were aneupoidies. In turn, they were trisomy 16, 45,X, trisomy 22, trisomy 2, trisomy 21, trisomy 15. The most common structural abnormality was balanced translocation, including Robersonian translocation. Female embryoes accounted for 61.02%(1080/1770) miscarriages and for 57.4%(596/1770) of chromosomal abnormalities, while male embroyes acoounted for 61.02%(1080/1770),57.4%(596/1770)respectively. The proportion of female embryoes was higher than male embryoes. The median age of the patients was 30 years old(16-46 years old). As the maternal age increased, the proportion chromosomal abnormalities increased. The incidence of chromosomal abnormalities in the advanced age group (≥35 years) was 68.38%(240/351), which was significantly higher than that in the younger group (56.24% ,798/1419; χ2=17.10, P<0.01). Conclusions Embryonic chromosomal abnormalities are the most common cause of early spontaneous miscarriage. The abnormalities centralize in some karyotypes. There is certain relationship between maternal age and the incidence of miscarriage, as well as the embryonic gender. Chorionic villus cell culture and karyotype analysis are helpful in finding the cause of miscarriage and counsel the patients.

Objective To compare the 18F-FDG PET metabolic characteristics and VHRCT morphological characteristics between invasive and non-invasive adenocarcinoma presenting as pure ground-glass nodules(pGGN).Methods Fifty-one patients with pGGN from October 2010 to June 2016 were retrospectively enrolled in this study.There were totally 52 lesions with sizes of no more than 30 mm and were grouped depending on pathological and follow-up diagnosis (31 lesions in the invasive adenocarcinoma group and 21 lesions in the non-invasive group).Clinical and imaging features were analyzed including age,gender,lesion location,size,density,SUVmax T/N,spiculation,lobulation,pleural indentation,vascular connection signs,vacuole sign and the air bronchogram.T test or x2-test was used in the comparison of different manifestations between the two groups.Logistic regression analysis on clinical parameters was applied.The ROC curve was used to find the cutoff of T/N.Results In the invasive adenocarcinoma group,T/N,SUV density and size were 1.97±0.71,1.16±0.54,-(431±104)HU,(18.48±5.65)mm,respectively.In the non-invasive group,T/N,SUVmax density,size were 1.20±0.28,0.64±0.20,-(533± 109)HU,(12.05±5.04)mm,respectively.The differences of T/N,SUVmax density and size had statistical significance between the two groups (t=-5.40,-4.87,-3.39,-4.21,P＜0.05).Lobulation and vascular connection signs in the invasive adenocarcinoma group were found in 21 and 13 cases respectively,while in the non-invasive group,they were present in 2 and 1 case,respectively,which showed significant differences between the two groups(x2=17.85,7.01,P＜0.05).T/N,lobulation,and vascular connection signs were the independent factors for the differentiation of benign and malignant lesions.The ORs were 52.547,8.375,72.206,respectively.When T/N=l.62,the area under the ROC curve was 0.885.The sensitivity,specificity and accuracy were 77.42％,90.48％,82.69％,respectively.Conclusions Pulmonary pGGNwith T/N no less than 1.62,lobulation and vascular connection sign indicates an invasive adenocarcinoma.