Objective To examine the relationships between critical thinking competence and clinical communi-cation competence in higher vocational nursing students.Methods The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV)and the clinical communication competence scale of nursing students were adopted to investigate 1135 higher vocational nursing students from grade 2009 to 2011 in Zhangzhou Health Vocational College.Results The total score of critical thinking disposition was (278.54±25.98) points,the total score of the clinical communication competence disposition was(86.07±10.06)points in higher vocational nursing students.Correlation analysis showed that the higher vocational nursing students'critical thinking competence had significant positive relationship with the clinical communication competence.Conclusions The critical thinking competence affects the clinical communication competence of higher vocational nursing students,the result suggests that we can set about to build the positive critical thinking competence of higher vocational nursing students for their good clinical communication competence.

Objective: To observe the effects of reliving cancerous pain with mitomycin C(MMC). Method:Sixteen patients with terminal cancerous pain received epidural, sacral or neuroplexus administration of MMC 4-8mg (concentration:1-2mg/ml) once a day or every other day, lasting 3-4times and degree of pain relief was evaluated. In different concentration solutions of MMC and normal saline, the pathologic changes of separated nerve of live body in sharp dissection, immersed for 1-24hours (37℃), was observed under microscope. Result: All patients got a good pain relief for 2-6 weeks, nine of them did not required any narcotic analgesic, the other cases needed analgesics, but the dosage required was reduced by 1/2-1/3 and adverse effects did not occur. Pathologic results showed that nerve fiber atrophy appeared with range disturbance, neurilemma changes were dominated by fatty degeneration. Conclusion: MMC can relive cancerous pain,through producing fatty degeneration of neurilemma to reduce excitatory transmission and alleviating nervous constriction of tumor.

Objective To study the changes of biological characteristics of CD34~+/CD133~+/VEGFR-3~+ lymphatic endothelial progenitor cells(EPCs) isolated from umbilical cord blood after induction with VEGF-C and investigate the mechanisms of EPCs differentiation toward lymphatic endothelial cells. Methods Mononuclear cells were isolated from umbilical cord blood using density centrifugation with Percoll solution.CD34~+/CD133~+/VEGFR-3~+ cells were sorted with FACS.Differentiation of the cells was induced with VEGF-C.The ultrastructural changes of the cells were viewed under scanning and transmission electron microscopes.Changes in expression of markers of the cells were viewed under confocal laser scanning microscope. Results Lymphatic EPCs isolated from umbilical cord blood expressed CD34,CD133 and VEGFR-3.At 7 day after induction with VEGF-C,CD34~+/CD133~+/VEGFR-3~+ cells were shuttle-like,there were a lamellipodium,numerous filopodia and many short microvilli.Caveolae were observed.Mitochondrion and rough endoplasmic reticulum were rich in cytoplasm.At 14 day after induction,the cells demonstrated appearance of the endothelial cell and expressed lymphatic endothelial specific makers LYVE-1 and 5'-nucleotidase,the expression of CD133 disappeared.Weibel-Palade body was observed in the cytoplasm of the cell.Conclusion There are CD34~+/CD133~+/VEGFR-3~+ lymphatic EPCs in human umbilical cord blood.The cells may differentiate into lymphatic endothelial cells through VEGF-C/VEGFR-3 signaling pathway after induction with VEGF-C.

Objective To investigate plasma homocystein (Hcy) level in cardiac transplant patients.Methods Fourteen cases of heart transplant patients were recruited in this study. Plasma Hcy levels were measured by using high-performance liquid chromatography with fluorescence detection and flow-mediated dilatation in brachial arteries detected with high-resolution ultrasound in all patients, while coronary artery angiography were performed in 7 patients.Results In 2 cases of heart transplant who had single coronary artery stenosis, the plasma Hcy levels were above 12 ?mol/L. The average plasma Hcy levels in heart transplant patients were higher than in health volunteers [( 13.47? 2.78) ?mol/L vs (9.26? 3.57) ?mol/L], and flow-mediated dilatation in brachial arteries of heart transplant patients was lower than that of health volunteers [( 8.2? 3.7) % vs ( 12.5? 1.6) %]. There was a linear correlation between levels of plasma Hcy and flow-mediated dilatation (r= -0.804). Conclusion Endothelial dysfunction in the heart transplant patents might be contributed to hyperhomocysteinemia which may be potential cause of transplant coronary artery disease.

Objective To explore the clinical significance of experimental index in incomplete Kawasaki disease (iKD).Methods Eighty-eight cases of KD were reviewed,including iKD 36 cases (iKD group),complete KD(cKD) 52 cases (cKD group).The 88 cases were divided into traditional criterion group (43 cases) and supplement criterion group (45 cases).The experimental indexes of supplement criterion were compared between iKD group and cKD group.Results The rate of coronary artery lesion (CAL) in iKD group was significantly higher than that in cKD group [50.00％(18/36) vs.26.92％(14/52),P ＜ 0.05].Plasma NT-proBNP and cardiac troponin Ⅰ (cTnI) in CAL children (32 cases) in early were significantly higher than those in non CAL children (56 cases) [(468 ± 141) ng/L vs.(379 ± 120) ng/L and (0.95 ±0.22) μg/L vs.(0.49 ±0.15) μg/L,P ＜0.01].The diagnosis rates of KD in the 5th,7th,9th day in supplement criterion group were significantly higher than those in traditional criterion group [64.44％(29/45)vs.25.58％(11/43),84.44％ (38/45) vs.46.51％ (20/43),93.33％(42/45) vs.58.14％ (25/43),P ＜ 0.01].There was no statistical significance between iKD group and cKD group in C reactive protein,erythrocyte sedimentation rate,albumin,alanine aminotransferase,platelet,white blood cell,NT-proBNP and cTnI etc (P ＞ 0.05).There was no statistical significance between iKD group and cKD group in the positive rate of each experimental index (P ＞ 0.05).Conclusions There are some changes of supplement experimental index in acute phase of KD,but there is no statistical significance between iKD and cKD.Plasma NT-proBNP and cTnI are significantly higher in early KD.

A suitable ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) method was developed for the determination of 11 mycotoxins with isotope internal standard in malt. The mycotoxins in malt were extracted and purified by one-step ultrasonic extraction procedure using acetonitrile/water/acetic acid (80 : 19 : 1), and then detected and confirmed by UPLC-MS/MS, and quantified by isotope labeled AFB1 ([13C17]-AFB1) and ZEN ([13C18]-ZEN) internal standards. Rapid separation of the 11 mycotoxins was successfully achieved on a Phenomenex Kinetex C18 column (100 mm x 2.1 mm, 2.6 μm) with gradient elution using the mobile phase of methanol containing 0.1% formic acid and 2 mmol x L(-1) ammonium acetate in water. Simultaneous acquisition was performed in multiple reaction monitoring (MRM) mode with electrospray ionization (ESI) source operated in both positive and negative ionization modes. The established method provided a good linearity for the 11 mycotoxins within their respective linear ranges with correlation coefficients all higher than 0.999 1. The average recoveries ranged from 75.0% to 117.0% with relative standard deviations (RSDs) below 5.1%. The limits of detection (LODs) and quantitation (LOQs) ranged from 0.05 to 30 μg x kg(-1) and 0.15 to 87.5 μg x kg(-1), respectively, which were below the maximum residue levels (MRLs) set by the European Union. Twenty malt samples were analyzed and nine samples were detected with mycotoxins, which were confirmed according to the same fragment ions found in positive samples and the standards at the same retention time. This study has demonstrated that the one-step extraction procedure of mycotoxins from complex matrices coupled to UPLC-MS/MS method is simple, quick, accurate and sensitive for quantitative and qualitative analysis of multiple mycotoxins in malt.

BACKGROUND:Bone marrow mesenchymal stem cells (BMSCs) of mice are different from human and rats.The difficulties of culture,sustaining impermanency activity of BMSCs after passage and short-term effect of stem cells tracking limited the study of mice.OBJECTIVE:To obverse modified isolated culture method of BMSCs of mice and the feasibility of long-term fluorescent labeling stem cells.DESIGN,TIME AND SETTING:The experiments were conducted at the Affiliated Hospital of Academy of Military Medicine Science from June to December in 2008.MATERIALS:C57BL/6 mice,males and females,4-6 weeks of age,mean weighing 20 g,were used.METHODS:Stem cell culture fluid serum and liquid change manner were optimized using adherent screening and Percoll separation method.Rat BMSCs were incubated.In accordance with previous experiences of MSCs between human and macaque,Hyclonehigh-grade fetal bovine serum was selected for mouse MSC incubation.Serum was 10% of the medium.Bone marrow cells were washed out using LG-DMEM to filter bone dregs and small muscle blocks.Subsequently,samples were added on the Percoll separating medium at relative density of 1.082,and then incubated in 75 cm~2 culture flask at the concentration of 1.5×10~6/cm~2.BMSCs at the second passage were labeled with CM-Dil.MAIN OUTCOME MEASURES:Morphological changes in primary cultured and subcultured mouse BMSCs were measured.BMSC surface antigen of the second passage of mice (CD105,CD44,CD25,CD34) were determined using flow cytometry.The modified method was assessed to harvest the purity of stem cells.Activity of mouse BMSCs was identified using adipogenic and osteoplastic differentiation.The strength of fluorescent cells following multiple passage was observed.RESULTS:①The attached cells were observed 48 hours after primary cells culture and changed shuttles,triangles and flats at 7 days after culture.The figure become bunches and radial pattam at 3 passages.②MSCs highly expressed CD105,CD44 phenotypes and seldom expressed CD34 and CD45.③Spindle shape of cells gradually disappeared,with increased cell body.Some cells grew in cluster.MSCs changed figures to multilayer knots 10 days after inducing osteoplastic differentiation.MSCs became roundness and appeared fat drops in cells 9 days after inducing adipogenic differentiation.Red fat particles were shown following oil O staining.④The labeling cells gave out oranges light,and marked rates were over 80% in MSCs under the fluorescent microscope.The labeling cells were over 47% in 4 passages MSCs using flow cytometry.CONCLUSION:The modified method gained high-dosage cells in shorten culture time at passage 2 and made CM-Dil long lime labeling cells,which made more convenient for MSCs experiment on mice and stem cells tracer experiment in vivo.

Objective To study the effect of anti anxiety treatment in residual dizziness after successful canalith repositioning procedure in benign paroxysmal positional vertigo.Methods 68 cases of benign paroxysmal position vertigo patients with residual dizziness after successful canalith repositioning procedure were collected,who visit department of Neurology..They were randomly assigned to anti anxiety group and the control group according to randomized controlled method.Deanxit (0.5mg/10mg,1times/day)combined with betahistine mesilate tablets (6mg, 3 times/day)were taken by patients in the anti anxiety group;take betahistine mesilate tablets (6mg,3 times/day) were taken in the control group.Follow up 3 months,the duration of residual dizziness and the changes of symptoms between the two groups were compared.The symptoms of all patients were evaluated before and after treatment by dizziness handicap inventory.Results The duration of residual dizziness in the control group was (16.38 ±8.83)days, and that in the anti anxiety group was (10.13 ±5.10)days.The duration of residual dizziness in the anti anxiety group was significantly shorter than that in the control group (t =3.440,P <0.05).In the control group,the scores of first week,s econd week and third week were (26.60 ±13.54)points,(20.80 ±10.97)points and (6.27 ±5.88)points.In the anti anxiety group,the scores of first week,second week and third week were (23.10 ±11.02)points,(13.33 ± 5.83)points and (0.67 ±2.50)points.There was not significant difference between the two groups (t =1.122,P >0.05)in the treatment of first week.In second week and third week,the scores of the anti anxiety group were lower than those of the control group,the differences were statistically significant (t =3.378,4.935,all P <0.05).After 3 weeks of treatment,the scores of the anti anxiety group were significantly decreased in the functional,emotional and physical scores (t =5.297,4.537,4.451,all P <0.01 ).Conclusion Deanxit can shorten residual dizziness duration of benign paroxysmal position vertigo patients after successful canalith repositioning procedure,and can reduce the degree of residual dizziness.

Objective:To explore the feasibility and application effect of Mini-CEX in pediatric clinical practice.Methods:Residents who received standardized residency training in pediatrics department of Peking University Third Hospital from March 2016 to September 2017 were selected as research objects. The clinical ability of the residents were evaluated by application of the Mini-CEX structured form. Its effectiveness as a training guide and assessment method was also evaluated. SPSS 25.0 was used for t test. Results:The Mini-CEX scale was refined according to the characteristics of pediatrics. In this study, a total of 36 residents participated in the evaluation and 110 cases were completed by introducing Mini-CEX structured form in 7 examinations. Compared with 2016, the Mini-CEX scores of the residents in the 2017 showed different degrees of improvement in information gathering [(7.4±0.9) vs. (7.7±0.7)], clinical examination [(7.5±1.1) vs. (7.6±0.9)], clinical judgment [(7.5±0.9) vs. (7.6±0.9)], organizational effectiveness [(7.4±0.9) vs. (7.7±0.9)], and overall clinical competency [(7.5±0.9) vs. (7.7±0.9)], without significant differences ( P > 0.05). A total of 17 residents completed the assessments more than or equal to 3 times. Compared with 2016, the mean scores of the 17 individuals' Mini-CEX scales in 2017 were significantly improved in terms of information gathering, organizational effectiveness, and overall clinical competency. Conclusion:The results have shown that the Mini-CEX scale is simple and easy to operate, it maybe helpful to improve the clinical ability of pediatric residents, and it can be used as a method to evaluate the clinical ability of pediatric residents.

Objective:To search for carrier of short active peptide with binding to human CD59 of the surface of HeLa cell.Methods:Ph. D. 12 display peptide library was biopanning with HeLa cell high-expressing CD59. After competitive test, positive phage clones were identified by sandwich ELISA and sequenced.Results:10 phage clones were identified to have higher combination with CD59.Conclusion:The sequence of peptide with binding to CD59 has been obtained.That might lay a basis for design of short peptide of CD59 on tumor sneaking through.