Objective To explore the effect of fetal thymus transplantation on enhancing the immunity of patients with late-stage malignant tumors. Methods The whole thymus of 24～32 weeks fetus was transplanted into the forearm of the patients with late-stage milignant tumors by microvascular surgery. The levels of serum IgA,IgG and IgM were measured before and at the third, 6th and 12th months after operation. No immunosuppressive regimen was performed in all the patients after operation. The follow-up period was 1 to 2 years. Results The clinical symptoms of all the patients improved after treatment, and no rejection reaction occurred. The levels of serum IgA,IgG and IgM significantly increased 3,6 and 12 months after treatment(t≥4.23,P

Objective To understand the career needs of the first session specialist nurses of intensive care unit (ICU) in Jiangxi province and to provide reference for their career management.Methods A qualitative research based on phenomenology was adopted.The first session specialist nurses of ICU in Jiangxi province were enrolled and received in-depth interviews.Results Three themes were found,including career identity needs,career development needs and career management needs.Conclusions Nursing managers should understand the ICU specialist nurses' real feelings and developing career management strategies.

Objective To investigate and analyze the nursing assistance requirements and the influencing factors of county hospital of Nanchang city.Methods A total of 327 nurses in 6 country-level hospital of Nanchang city were surveyed by the self-made questionnaire.Results The total demand score of county hospital was (4.29±0.47) scores,which was in a high level.The helping content demand was the highest,the form of assistance needs was the lowest.From the specific items of view,prevention of incision infection,nursing training,critically ill patients with bedsore nursing were higher in the content of assistance.Send a nurse to support education,nursing training,hospital experts on-site guidance were higher in the form of assistance.Long term assistance for 1 years,short-term assistance for 4-6 months were the highest in demand of helping times.The main factors of influencing county hospital nursing assistance were work area,department,degree,title etc.The work area was the important influencing factor of nursing assistance of county hospital.Conclusion The relevant departments are recommended to develop personalized assistance scheme according to the recipient hospital needs.

Objective To establish the questionnaire of nursing assistant requirements of county hospital, test and analyze its reliability and validity. Methods According to the nursing assistant requirements framework had been constructed, document literature and interview to develop a questionnaire item pool, then established the prequestionnaire after research group discussion and expert evaluation. 250 clinical nurses were selected for investigation. Then item analysis,factor analysis, correlation analysis and reliability analysis were applied to test the scale′s validity and reliability. Results The effective questionnaire was 224 copies. Questionnaire of nursing assistant requirements was consisted of 44 items, the factor analysis of the questionnaire identified six principal factors and explained for 53.225% total variances. Correlation coefficient between each dimension and the total scale was 0.532-0.794, the Cronbach α coefficient of each dimension was 0.789-0.910,the Cronbach α of whole scale and split- half coefficient were 0.923 and 0.868. Conclusions The questionnaire of nursing assistant requirements of county hospital has high reliability and validity.It can provide a scientific basis for county hospital to carry out nursing assistance.

Objective To investigate the level and influencing factors of PICC catheter patients' willingness to participate in patient safety. Methods A total of 198 PICC catheter patients were sampled from the targeted hospital by convenience sampling,and investigated by the Patient Participate Patient Safety Willingness and Behavior Scale ( PSWBS). Results The PSWBS score of PICC catheter patients was 3.73 ± 0.52 , including initiative willingness 4.13 ± 0.54, initiative tendency 3.82 ± 0.49, attention for technique level 3.70 ± 0.50, attention for environmental safety 3.27 ± 0.48. Among these factors, age(F=14.75, P<0.01), education degree(F=9.588, P<0.01), occupation(25.070, P<0.01), residence(t=8.570, P<0.01)and complications(t=8.880, P<0.01)were the influencing facts with statistical difference (P<0.05) . Conclusions Most of the patients have a high willingness to participate in patient safety , the distribution of impact factors have certain characteristics. Clinical nurses should take targeted nursing measures according to these different characteristics.

Objective To prepare PTD4-Cu,Zn-SOD fusion protein.Methods The recombinant plasmid of pET 1 6b-Cu,Zn-SOD and pET16b-PTD4-Cu,Zn-SOD was transformed into Escherichia coli BL21 (DE3).Isopropyl β-D-1-thiogalactopyranoside was then added at a final concentration of 0.84 mmol/L,and the cells were incubated for 4 h to induce the expression of Cu,Zn-SOD and PTD4-Cu,Zn-SOD fusion protein.Lysozyme and ultrasound were used to lyse the bacteria,the supernatant was collected for 15％ SDS-PAGE to analyze the expression of the target protein.Ni-NTA His bind resin was used to purify Cu,Zn-SOD protein and PTD4-Cu,Zn-SOD fusion protein under natural conditions.Western blot was used to identify the target protein.Results The results of Western blot showed that the purity of the target protein was about 90％,and the Cu,Zn-SOD protein with a molecular weight about 19 kDa and the PTD4-Cu,Zn-SOD fusion protein with a molecular weight about 20 kDa were found.Conclusion PTD4-Cu,Zn-SOD fusion protein is prepared successfully.

Background: Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. Methods: Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P<0.001). Most of the guidelines advocated systolic BP targets <130 mm Hg (12 guidelines, 60%) and diastolic BP targets <80 mm Hg (14 guidelines, 70%) in DM patients. Approximately half of the guidelines supported systolic BP thresholds >140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. Conclusion The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.

Background: Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. Methods: Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P<0.001). Most of the guidelines advocated systolic BP targets <130 mm Hg (12 guidelines, 60%) and diastolic BP targets <80 mm Hg (14 guidelines, 70%) in DM patients. Approximately half of the guidelines supported systolic BP thresholds >140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. Conclusion The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9％ and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .