ObjectiveTo explore the nursing students'puzzles about career planning,and provide a basis for the training.MethodsA qualitative research was conducted on 14 university nursing interns by in-depth interview and observing.The whole interview was noted.The data was analyzed according to Colaizzi's phenomenological procedure.ResultsThe experience could be classified into four aspects,including hazy understanding of career planning,lack of understanding of themselves,limited ca reer identity and lack of social cognition.ConclusionNursing educators should enhance the training against the nursing students'puzzles and make sure they can make a good career planning.

Livin is the inhibitor of apoptosis proteins (IAPs), a new member, in most malignant tissues of high expression, and its main function is to inhibit cell apoptosis. Apoptosis and tumor cells is closely related to the occurrence and development, more on which the survival of tumor angiogenesis. Vascular endothelial growth factor (VEGF) is one of the strongest of vascular growth factor, and almost all human tumors and tumor cell lines have over-expression of it. Livin and VEGF protein expression in tumor was summarized.

Objective To research the risk factors of new-onset atrial fibrillation (AF) during hospitalization in patients with acute myocardial infarction.Methods Five hundred and one patients first diagnosed with acute ST-segment elevation myocardial infarction who accepted primary coronary intervention from January 2012 to May 2014 in the Second Hospital of Tianjin Medical University were selected.These patients were divided into non-AF group and new-onset AF group depending on whether happened new-onset AF during hospitalization.Data of the patients in acute myocardial infarction complicated with new-onset atrial fibrillation were collected.Univariate and multivariate logistic regression analysis were used to determine the predictors of new-onset AF.Results AF occurred in 49 cases of the 501 (9.8％) patients diagnosed as acute myocardial infarction.Logistic regression analysis showed that admission heart rate(OR =1.019,95％CI:1.004-1.034,P =0.012),left atrial diameter (OR =1.086,95％ CI:1.021-1.156,P =0.009),previous stroke (OR =2.060,95％ CI:1.029-4.123,P =0.041) were independent risk factors for new-onset AF in acute myocardial infarction.Use of β-blockers before coronary intervention treatment can reduce the risk of new-onset atrial fibrillation(OR=0.222,95％CI:0.064-0.768,P=0.017).Conclusion Admission heart rate and left atrial diameter are independent predictors of new-onset atrial fibrillation,and β-blockers in early stage can effectively reduce the incidence of atrial fibrillation.

Objective:To investigate the sleep quality of the people aged over 18-years-old in Hebei province and the impact of relative factors on it.Methods:Sum total of 20 716 random samples at ages over 18 were selected among the general population.The tools were Pittsburgh Sleep Quality Index(PSQI),Simplified Coping style Questionnaire(SCSQ).Results:The total prevalence of low sleep quality was 11.6 %(2411/20716).Female had higher standardized prevalence rate than male(6.8% vs.4.8%).Logistic analysis showed that risk factors to low sleep quality were ages over 70-years-old,remarriage,divorce,bereft,negative coping style(OR=1.776,1.515,2.046,1.254,1.097).On the other hand,factors to good sleep were the Han nationality,male,farmer,the family average annual income ranged 5001-10000 RMB,10001-20000 RMB,20001-40000 RMB,positive coping style(OR=0.839,0.703,0.732,0.750,0.660,0.573,0.936).Conclusion:Low sleep quality had high prevalence in Hebei.It should be recognized by medical workers.

Purpose:To study the relationship between expression of TGF-?_(1) and invasion and metastasis of bladder cancer.Methods:ELISA was used to examine TGF-?_(1) in serum of patients with bladder cancer.Results:Compared to the control group,TGF-?_(1) level in patients serum was higher(P

ObjectiveTo study the mechanism of infection-related reactive thrombocytosis.MethodsSeventy-five infectious disease patients were selected including 42 cases with acute infections phase thrombocytosis (acute infectious phase thrombocytosis group),18 cases with acute infectious phase normal platelet count (acute infectious phase normal platelet count group),15 cases with recovered phase (infectious recovered phase group) and 16 cases with healthy controls(control group).The serum thrombopoietin (TPO),intefleukin-6 (IL-6),white blood cell,platelet was determined and compared among 4 groups.Results The serum TPO in acute infectious phase thrombocytosis group [( 159.1 ± 65.9) ng/L]was higher than that in acute infectious phase normal platelet count group,infectious recovered phase group,and control group [(43.5 ± 14.4),(40.3 ± 15.2),(41.8 ± 18.9) ng/L](P＜ 0.05).There was no significant difference in the serum IL-6 between acute infectious phase thrombocytosis group [(542.7 ± 247.0) ng/L]and acute infectious phase normal platelet count group [(598.5 ± 250.4) ng/L] (P ＞ 0.05 ),but which was higher than that in infectious recovered phase group [(43.5 ± 20.7 ) ng/L] and control group [( 38.3 ± 17.6 )ng/L] respectively (P ＜ 0.05 ).The serum IL-6,TPO was positively correlated with platelet,white blood cell.The serum TPO was positively correlated with IL-6.ConclusionElevated TPO leads to the thrombocytosis,which is the possible mechanism of infection-related reactive thrombocytosis.

Job satisfaction of contract nurses has been an important subject on modern hospital HR management. It has been the base of hospital service and its sustainable development and turned to be the main part to facilitate the patients' satisfaction and loyalty. Therefore, it is imperative to improve the satisfaction of contract nurses. Based on Herzberg's Double-factor Theory, this essay analyzed the key elements that affect contract nurses' job satisfaction. Moreover, it also studied two main strategies for the improvement of contract nurses' satisfaction. The first is the theory of exerting the factor of health care, which helps divert contract nurses from dissatisfaction to satisfaction without any incompatibility. The second is to enhance the effect of motive factor, diverting contract nurses from satisfaction absence to highly rated satisfaction.

Objective To investigate the predictive value of CHADS2 and CHA2DS2-VASc score in left atrial (LA) or left atrial appendage (LAA) thrombus in patients with non-valvular atrial fibrillation (AF). Methods A total of 164 consecu?tive non-valvular AF patients confirmed by transesophageal echocardiography (TEE) were included in this study, and were divided into two groups, LA/LAA thrombus group and non LA/LAA thrombus group. The previous history was recorded in two groups of patients. Their CHADS2 and CHA2DS2-VASC scores were calculated based on the general data of two groups. The laboratory examinations and TEE indexes were compared between two gropes. Results Of all patients, the rate of LA/LAA thrombus was 19.5%. The CHADS2 and CHA2DS2-VASC scores were significantly higher in LA/LAA thrombus group than those of non LA/LAA thrombus group (2.1±1.3 vs 1.0±0.9, 3.4±1.8 vs 1.9±1.4,P<0.01). There were 13(11.9%) and 5 (8.8%) patients showed LA/LAA thrombus under low-moderate risk in the two score systems, respectively. Multivariate logis?tic regression analysis showed that CHADS2 score≥2 points(OR=3.735, 95%CI:1.508-9.251, P=0.004) and CHA2DS2-VASc score ≥2 points (OR=5.104, 95%CI:1.586-16.425, P=0.006) were independent risk factors of LA/LAA thrombus. ROC curve showed that AUC of CHADS2 and CHA2DS2-VASc scores to predict LA/LAA thrombus were 0.731 (95%CI:0.630-0.832, P<0.001) and 0.742 (95%CI:0.640-0.843, P<0.001), respectively. Conclusion CHADS2 and CHA2DS2-VASC score ≥2 points are independent risk factors of LA/LAA thrombus in patients with non-valvular atrial fibrillation. The pre?dictive values of both score systems are moderate. There are also LA/LAA thrombus in low-moderate risk patients when us?ing the two score systems, and with the increased risk stratification, the rate of LA/LAA thrombus is increased.

Objective To observe any change in the active volume of the hand motor cortex during rehabilitation therapy after acute cerebral infarction and analyze the mechanisms involved in motor function rehabilitation.Metbods Of 16 patients with acute brain infarction,8 were administered routine intemal medicine treatment only,while and the other 8 received rehabilitation therapy in addition.Before treatment and after 14 days,the patients were assessed with functional magnetic resonance imaging(fMRI)and the Fugl-Meyer assessment of motor function (FMA).The active volume of the motor cortex was compared between the two groups of patients.Ten healthy volunteers were examined with fMRI to confirm the location and the volume ofthe active area when performing the sanle exercises.Results After treatment,all the 16 patients showed increased motor cortex active volume,and their FMA scores also increased.Those receiving rehabilitation therapy improved tO a significantly greater extent than those treated with internal medicine treatment alone.Conclusion Rehabilitation of patients with acute infarction Can activate a greater volume of the motor cortex and promote functional recovery.

Objective To report a case of primary breast T-cell lymphoblastic lymphoma/leukemia (T-LBL/ALL) and study its clinico-pathological features and treatment,to improve the recognition of T-LBL/ ALL.Methods A case of primary breast T-LBL/ALL was reported and reviewed the literatures.Results The female patient was 17 years old,was diagnosed as primary breast T-LBL/ALL who presented with multiple bilateral breast masses and left axillary lymph node enlargement for two months.The patient was treated with modified BFM-90 and achieved complete remission.The patient was in complete remission 12 months after diagnosis at present and till in follow-up.Conclusion Primary breast T-LBL/ALL is very rare and highly aggressive with bad prognosis.T-cell lymphoblastic leukemia chemotherapy regimens is often effective.