Objective To investigate medical and nursing interns' differences and similarities of role expectation on clinical nurses,and provide the basis for further carrying out physician-nurse cooperative education.Methods Using self-designed questionnaires of role expectation on clinical nurses to investigate medical and nursing interns of two degrees in Zhengzhou University who already had full ten months' internship,among them,154 medical students,145 nursing students.Results Medical and nursing students' differences were mainly on “physician-nurse collaboration and communication.Nursing students were more active than medical students.Both medical and nursing students had the lowest scores in item 15 (reverse entry)“The nurses just need to perform doctors' orders,without providing comments or suggestions”.Conclusions Colleges and clinical teachers should encourage nursing students to learn more medical knowledge,strengthen their clinical practice capacity,improve their professional competence and professionalism,thereby enhancing the status of nursing and nurses.Launching physician-nurse collaboration education in nursing and medical students,and help medical and nursing students realize nurses' different roles,improve the trust between doctors and nurses,promote the development of physician-nurse relationship.

Objective To investigate the syndromes, syndrome elements and target sites of diabetic cerebral infarction. Method Firstly, literatures were searched from January 2003 to October 2013 in China Academic Journals Database (CNKI) retrieval system, then a database of 22 eligible articles was established. Syndromes of diabetic cerebral infarction were extracted from the database, then syndromes, syndrome elements and target sites were analyzed. Results Totally 2550 cases of diabetic cerebral infarction were concerned with 15 syndromes, including 659 cases of stagnation of phlegm and blood (25.84%), 445 cases of stagnation of phlegm-heat (17.45%), 366 cases of wind-phlegm syndrome (14.35%) and 341 cases of qi deficiency and blood stasis (13.37%). There were 10 syndrome elements in the 2550 cases, of which 1588 cases with phlegm (62.27%), 1026 cases with blood stasis (40.24%), 649 cases with qi deficiency (25.45%) and 539 cases with yin deficiency (21.14%). And seven target sites were encompassed, the highlights of which included 2502 cases of liver (98.12%), 2194 cases of spleen (86.04%), 2096 cases of kidney (82.20%) and 1026 cases of brain (40.24%). Conclusion The important syndrome elements of diabetic cerebral infarction were phlegm, blood stasis, qi deficiency and yin deficiency. The four major syndromes comprising stagnation of phlegm and blood, stagnation of phlegm-heat, wind-phlegm syndrome and qi deficiency and blood stasis were concluded, mainly affected the liver, spleen, kidney and brain. And there were two fundamental pathogenesis in diabetic cerebral infarction:qi and yin deficiency, phlegm and blood stasis.

Objective To study the effect of thyroid-stimulating hormone (TSH) on human vascular endothelial cells and smooth muscle cells and to explore the roles of TSH in the development of atherosclerosis.Methods Human vascular endothelial cells and smooth muscle cells were cultured in vitro.MTT method was used to assay the effect of TSH on cell viability.Real-time PCR was used to determine the levels of endothelial nitric oxide synthase (eNOS),prostacyclin(PGI2),endothelin-1 (ET-1),plasminagen activator inhibitor(PAI-1) (mRNA) in endothelial cells and the phenotype transition of smooth muscle cells.The effect of TSH to the cycle of smooth muscle cells was detected by using flow cytometry.Immunocytochemistry and Western blot were used to investigate the expression of the cell cyclin A,D1,and the expression of endothelial cell associated factors eNOS and ET-1.Results Compared with the control group,eNOS and PGI2 mRNA levels decreased while ET-1 and PAI-1 mRNA levels increased when different concentrations of TSH were applied to endothelial cells(P＜0.05).The level of eNOS protein was decreased gradually while the level of ET-1 protein was gradually increased(P＜0.05).Different concentrations of TSH applied to smooth muscle cells could promote the transition of cell cycle phase G2 to phase M and increase the expression of cell cyclin A and D1.Conclusion TSH may damage the function of vascular endothelial cells and promote the proliferation of smooth muscle cells.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) stimulating on cholesterol influx in human renal proximal tubular epithelial cells (HK-2) and the relation to low-density lipoprotein receptor (LDLr) pathway.Methods HK-2 cells were cultured and divided into the control group (incubated with serum-free medium) and Ang Ⅱ group (treated by 10-7 mol/L of Ang Ⅱ for 24 hours).The effects of Ang Ⅱ on lipid accumulation were examined by Oil red O staining and a quantitative assay of intracellular cholesterol.The expression of LDLr,sterol regulatory elementbinding protein (SREBP) cleavage activating protein (SCAP) and SREBP-2 mRNA and protein were examined by real-time PCR and Western blotting.The cotranslocation of SCAP-SREBP-2 from endoplasmic retieulum to Golgi in HK-2 cells was examined by immunofluorescent staining under confocal microscopy.Results Ang Ⅱ treatment increased intracellular lipid accumulation in HK-2 cells,which was associated with increased mRNA and protein expression of LDLr,SCAP,and SREBP-2 in HK-2 cells induced by Ang Ⅱ.Furthermore,results from confocal microscopy observation demonstrated that Ang Ⅱ increased the translocation of SCAP/SREBP-2 complex from endoplasmic reticulum to Golgi,thereby up-regulating LDLr gene transcription.Conclusion Ang Ⅱ disrupts LDLr feed-back regulation to increase cholesterol uptake and induce intracellular lipid accumulation.

Objective The objective of the present study was to evaluate the early auditory development in hearing impaired infants by LittlEARS? auditory questionnaire .Methods A total of 162 hearing impaired infants participated in the study .LEAQ consists of 35 items ,which were further divided into receptive auditory behavior , semantic auditory behavior ,and productive auditory behavior .The assessment was performed before hearing aid fit‐ting ,3 ,6 and 12 months after hearing aid fitting ,respectively .Results LEAQ scores improved dramatically in the first 12 months after hearing aid fitting ,total LEAQ scores prior to hearing aid fitting ,3 ,6 and 12 months after hearing aid fitting were 10 .47 ,17 .73 ,20 .64 and 26 .47 ,respectively .The receptive auditory behavior performance improved significantly after 3 months of hearing aid use .The duration of hearing aid use for dramatic improvement of semantic auditory behaviors ,and productive auditory behavior was 6 and 12 months ,respectively .The age of hearing aid fitting ,living environments ,degrees of parent education and degrees of hearing loss influenced LEAQscores significantly .Conclusion Hearing impaired infants exhibited significant auditory improvement in the first 12 months after hearing aids fitting .Early hearing aid fitting ,high level of parent education and well living environ‐ments promote preverbal auditory development .LEAQ is an effective tool for clinical auditory assessment and moni‐toring in infants and little toddlers .

· AIM: To summarize the clinical features of Chinese primary congenital glaucoma and to investigate the discrepancies of the clinical features between the Chinese and Indian patients.congenital glaucoma patients were reviewed. The clinical features were summarized as several quantifiable clinical parameters and the severity of the disease was evaluated. Both the quantified clinical features and severity were statistically compared with those of the Indian patients, which were cited from the previous published articles.included in the study. In Chinese patients, sex ratio (male to female )was about 2:1, family history was presented in 3 patients (7.5%) and consanguinity was found in one patient (2.5%). The main symptoms and signs observed in Chinese patients spanned a wide spectrum of manifestations. The most frequent signs noted on the initial examination were enlarged eyeball (42.5%) and decreased visual acuity (35.0%). Compared with Indian patients, Chinese patients had a later onset, a delayed diagnosis, more severe corneal changes and more severe optic nerve damages (P＜0.01). The combined tabeculectomy and trabeculotomy operation was preferred by both Chinese and Indian doctors whereas a higher proportion of Indian patients received the combined operation (P＜0.01). The proportions of the severity grade were different between Chinese and Indian patients. Most Chinese patients were in the severe grade while most Indian patients were in the very severe grade (P＜0.01).patients were sporadic and non-consanguineous.Compared with Indian patients, Chinese patients had a relative later onset, a delayed diagnosis and treatment.More attempts are needed in Chinese PCG prevention and treatment.

Objective To investigate the expression of HSPB1 in pancreatic cancer and its relationship with clinicopathological characterization.Methods Pathological specimens from 47 cases of pancreatic cancers,13 cases of para-cancerous normal pancreatic tissues and 3 cases of chronic pancreatitis tissues were selected,and tissue microarray construction instrument was used to prepare tissue microarray,then the expression of HSPB1 was determined by immunohistochemistry SP method.The scores of the proportion of positive cells and staining intensity were multiplied to make the judgment.Results The expression of HSPB1 in malignant,para-cancerous and chronic pancreatitis tissues was 80.9％ (38/47),12.5％ (2/16),respectively; and the difference between the two groups was statistically significant (X2 =24.058,P =0.000).The expression of HSPB1 in pancreatic cancer tissue was not significantly related to sex,age,location,differentiation degree and nerve infiltration of tumor ( P ＞ 0.05 ).Conclusions The expression of HSPB1 is related to development and progression of pancreatic cancer,and may be an early molecular event.

Objective To study the differentially expressed microRNA (miRNA) between pancreatic ductal adenocarcinoma (PDAC) and para-cancerous tissues,and determine related target genes.Methods Nine fresh PDAC tumor tissues and 3 adjacent normal pancreatic tissues were collected,then Agilent miRNAmicroarray with 713 miRNA loci was used to identify the differentially expressed miRNA.Real-time PCR method was applied to verify the up-regulated miRNA.TargetScan 5.1 and miRandaV5 software were used to analyze the related target genes.Results miRNA microarray identified 11 PDAC related miRNAs,among them,the expressions of miR-194*,miR-192*,miR-602,miR-194 were up-regulated,while the expressions of miR-139-3p,miR-513a-5p,miR-630,miR-30c-1 *,miR-887,miR-508-5p,miR-516a-5p were down-regulated.The expressions of miR-192,miR-194 and their homolog were verified in 31 PDAC tumor tissues.After software analysis,it was found that target genes of miR-192 were ZEB2,CXCL-2,EEF1A1,ERCC3,and target genes of miR-192 * were DCC,SMAD4,FAS,and target genes of miR-194 included DACHI,IGSF11,PTPN2,RBBP4,while target genes of miR-194 * included CD40LG,CIDEB,FHL1.Conclusions Eleven differentially expressed miRNAs are present in PDC,and they may be involved in the occurrence and development of PDC.

Objective:To understand the characteristics and practice of standardized training for resident in psychiatric department,providing a reference for other hospitals in the similar situation.Methods:Using qualitative method,in-depth interview and focus group interview were carried out with clinical teaching and teaching management experts of a tertiary hospital,to understand the characteristics,practice,and deficiencies of resident doctors standardized training for psychiatrists.Results:Focusing on clinical operation,psychotherapy,and communication capability were the major characteristics of resident doctors' standardized training for psychiatrists in this hospital.Though this hospital did positive trials on guarantee system improvement,outpatient and inpatient training combination,and training content expansion,it was not perfect enough in united training and training pattern.Conclusions:The psychiatry resident's standardized training for psychiatrists should establish complete standards of performance for united training,strengthen training mechanism and training mode,and make full use of modem distance education resources to further improve quality of the psychiatric residency training.

Objective To investigate the effect of alprostadil combined with Salvia miltiorrhiza in treatment of hyperlipidemic acute pancreatitis.Methods Patients with high cholesterol of hyperlipidemic acute pancreatitis were randomly divided into control group and treatment group,32 cases in each group.The control group were treated with conventional therapy combined with alprostadil 10μg intravenous injection,the treatment group was given Salvia miltiorrhiza injection 20mL vein infusion on the basis of the control group.The abdominal pain relief time,APACHE -II,C reactive protein levels,prognosis,hospitalization time and cost were compared between the two groups.Results The abdominal pain relief time,APACHE -II score,C reactive protein level in the treatment group were (5.31 ± 1.09)d,(2.34 ±1.18),(48.41 ±22.64)mg/L,which were better than those in the control group (8.16 ±1.39)d, (4,47 ±1.68)and (65.34 ±18.02)mg/L,the differences were statistically significant (t =9.08,0.14,5.84,-0.49,3.31,all P <0.05).There was no difference in mortality between the two groups (P >0.05).The operation rate of control group was 31.25% (10 /32),which was significantly higher than that of the treatment group [6.25%(2 /10)],the total hospitalization time,total cost of the treatment group were (14.50 ±1.55 )d and (4.97 ± 1.00)ten thousand yuan,which were significantly lower than those of the control group (16.78 ±1.83)d and (5.72 ± 1.71)ten thousand yuan,the differences were statistically significant (χ2 =6.65,t =1.00,t =5.39,all P <0.05). Conclusion Alprostadil combined with Salvia miltiorrhiza injection in the treatment of hyperlipidemia hyperlipidemia acute pancreatitis is safe,has good treatment effect,and can shorten the course of disease,reduce patients'hospitaliza-tion time and cost,and effectively improve the cure rate.