Objective To assess the reliability and validity of the Chinese version of Conditions of Learning Effectiveness Questionnaire (CLEQ). Methods To translate and revise the Chinese version of CLEQ. A total of 176 baccalaureate nursing students were surveyed by the Chinese version of CLEQ and the results about the reliability and validity of the Chinese version of CLEQ were assessed. Results Cronbach's α of the total Chinese version of CLEQ was 0.956. Cronbach's α of four subscales were all over 0.70. The internal consistency was good. The reliability of Split half was 0.926 and retest reliability was 0.869. CVI of the four subscales were 0.91～1.00. The average CVI of the scale was 0.94. There were significant relationships among subscales. The correlation coefficient was 0.691～0.829. Four common factors were found through factor analysis, which explained the percent of 61.63% rotation sums of squared loadings. Conclusions The reliability and validity of the Chinese version of CLEQ were good, so it could be used to evaluate the level of clinical learning environment among nursing students.

Objective To analyze the risk factors and prognosis of Clostridium difficile infection (CDI) among hospitalized patients with inflammatory bowel disease (IBD).Methods From March 2014 to February 2015,216 first-time hospitalized patients with IBD were enrolled.Once hospitalized,stool samples were obtained for Clostridium difficile culture immediately,and at the same time toxins of Clostridium difficile (tcd) A and tcdB were detected by polymerase chain reaction(PCR).The incidence and risk factors of CDI in enrolled patients were analyzed.Chi square test and nonparametric test were performed for statistical analysis.Results Among the 216 IBD patients,there were 73 patients with ulcerative colitis(UC) and 143 patients with Crohn's disease(CD).The positive rate of CDI was 13.9 ％ (30/216) in IBD patients.The positive rate of CDI was 24.7 ％ (18/73) in UC patients,which was higher than that of CD patients (8.4％,12/143),and the difference was statistically significant (x2 =10.690,P＜0.01).As the severity of the disease increased,the rate of CDI positive patients in UC patients increased.Among three patients at remission period,17 patients at mild active stage,23 patients at moderate active stage and 30 patients at severe active stage,the CDI positive patients were zero,two,five,11,respectively,and the difference was statistically significant (x2 =4.820,P=0.028).In UC patients,the incidences of patients with hospitalization history in other hospitals within three months before admission in CDI positive group and negative group were 6/18 and 7.3％ (4/55),respectively,and the difference was statistically significant (x2 =5.740,P=0.020).In 30 days before admission,the rates of patients with proton pump inhibitor (PPI) taking history of two groups were 7/18 and 7.3％ (4/55),and the difference was statistically significant (x2=8.270,P=0.004).The length of hospital stay in CDI negative UC patients was 7.0 d (5.0 d,12.0 d),which was shorter than that of CDI positive patients (10.5 d (8.8 d,18.2 d)),and the difference was statistically significant (U=277.000,P=0.005).The rate of patients underwent intestinal operation in CDI negative CD patients within three months after CDI examination was 10.7 ％ (14/131),which was significantly lower than that of CDI positive patients (5/12) (x2 =4.520,P=0.010).Conclusions The incidence of CDI in hospitalized IBD patients was high,especially in UC patients;the risk factors included disease severity,prior hospitalization history within three months before admission and PPI taking history within 30 days before admission.CDI was correlated with poor prognosis.

Objective To study the characteristics of the working memory in patients with Chinese aphasia in different ways of tasks and test materials .Methods Fifteen aphasia patients (aphasia group ,54~70 years old) and fifteen matched normal cases (control group) were requested to finish auditory retelling and auditory recognition tests of numerical materials ,content and function words .The maximum length of the string correctly completed was referred to as the working memory span .The working memory span was compared between the two groups .Results The working memory span of the aphasia group was significantly smaller than that of in the normal group (P<0 .01) .The working memory span of in patients with the aphasia group in the positive sequence retelling tasks were significantly greater than in reverse retelling ,positive recognition and reverse recognition (P<0 .01) .Reverse retell-ing was significantly greater than reverse recognition (P<0 .01) .The positive recognition was significantly greater than the reverse recognition(P<0 .01) .In retelling tasks ,the order of the working memory span was numbers , function words ,content words from high to low in the aphasia group ,but there was no significant difference be-tween them .In the positive recognition tasks ,the average working memory span for the numerical material was sig-nificantly greater than the content words(P< 0 .01) and the function words(P< 0 .01) .The content words were greater than the function words(P<0 .01) .In the reverse recognition tasks ,average working memory span for the numerical material was significantly greater than the function words (P<0 .01) .Conclusion The working memoryspan of in patients with aphasics significantly lags behind the normal people .Numbers are the easiest for aphasics . In different task modes ,the difficulties from high to low are as follow :positive retelling ,reverse retelling ,positive recognition and reverse recognition .

Objective To study the inhibitory effect of panax notoginseng saponins (PNS) on 3-nitrotyrosine (3-NT) formation in brain induced by heme/NO2 -/H2O2 or ONOO - pathways in vitro. Methods According to the two major pathways of 3-NT formation in vivo, the models of protein nitration induced by heme/NaNO2/H2O2 or ONOO-system were established, respectively, in vitro. Bovine serum albumin (BSA)/rat plasma protein or rat brain homogenate protein were utilized as reactive substrates in both systems. Samples were divided into blank-control group, 3-NT group and PNS group (including low-, medium-and high-concentration subgroups). In 3-NT group, samples were exposed to heme/NaNO2/H2O2 or ONOO-system, respectively, at 37℃for 30 min, whereas in PNS group, samples were pre-incubated with PNS (at final concentrations of 50 mg/L, 100 mg/L, and 200 mg/L) at 37℃for 5 min before the nitrating system exposure. The 3-NT level in each group was detected by Western blot assy. Results Compared with the blank-control group, both heme/NaNO2/H2O2 and ONOO-system can induce significant 3-NT generation in BSA/rat plasma protein or rat brain homogenate protein (P<0.05). Compared with model group, PNS pre-treatment markedly inhibited 3-NT expression in BSA/rat plasma protein in a dose-dependent manner (P<0.05), the inhibitory effect of low intervention on the level of 3-NT in rat brain homogenate protein was not significant (P>0.05). Medium- and high-concentrations of PNS pre-treatment markedly inhibited 3-NT accumulation, with maximum effect at the concentration of 200 mg/L (P<0.05). Conclusion Medium- and high-concentrations of PNS can inhibit 3-NT formation in brain tissue mediated by either heme/NO2-/H2O2 or ONOO-pathways, implying that potential neuroprotective action against 3-NT involves pathological conditions, like trauma, stroke, and neurodegenerative diseases.

Objective To investigate the expression and purification I278T-mutant human cystathionineβsynthase(CBS) in E . coli .Methods Site-directed mutagenesis by overlap extension using the polymerase chain reaction (PCR) was employed to construct mutant plasmids pGEX4T-1-CBS(I278T) ,which was induced and expressed in a medium containing 3% ethanol ,purified by affinity chromatography to obtain mutated CBS (I278T) protein .The activity ,UV-visible absorption spectroscopy ,protein particle size and Zeta potential of the purified protein were measured .Results Plasmid pGEX4T-1-CBS(I278T) was successfully constructed .The yield ,the specific activity and activity recovery of purified mutant CBS (I278T ) protein were 2 .3 mg/L ,21 .4 U/mg and 22 .6% .S-adenosylmethionine(AdoMet) with final concentration of 1 mmol/L showed no activation toward mutant CBS (I278T) protein .Ac-cording to UV-visible absorption spectroscopy analysis ,purified mutant CBS(I278T) had characteristic absorption peaks at 429 nm and 550 nm for heme-binding proteins .Protein average particle size was 7 .5 -10 .1 nm ,mainly in the form of tetramers ,and Zeta potential was - 16 .3 mV .Conclusion The methods of expression ,purification and identification of I278T-mutant human cystathionineβsynthase in E .coli were successfully established .

Objective To establish a method for the determination of berberine hydrochloride and phellodendrine in Lishukang Capsules by HPLC. Methods Waters Symmetry C18 column (4.6 mm× 250 mm, 5μm) was used, the mobile phase was acetonitrile-0.1%phosphoric acid (0.1 g sodidum dodecyl sulfonate in 100 mL water), with the flow rate of 1 mL/min by gradient elution. The detection wavelength was set at 284 nm. Results Berberine hydrochloride showed good linear relationship (r 2=0.999 1) in the range of 403.4-10 084.7 μg, the average recovery rate was 99.8%(RSD=1.7%). Phellodendrine showed good linear relationship (r 2=0.999 2) in the range of 169.137 6-4228.44 μg, the average recovery rate was 95.5%(RSD=3.2%). Conclusion The method is specific, accurate and convenient to be used for the quality control of Lishukang Capsules.

Objective To evaluate the prognostic value of three different staging system based on positive lymph nodes,lymph node ratio and log odds of positive lymph nodes in breast carcinoma.Methods In 472 breast carcinoma patients,survival analysis was performed with Kaplan-Merier and COX regression model,the hazard ratio (HR) of the three staging system were compared.Results When more than 10 lymph nodes were dissected in the operation,there was statistical differences in survival among the staging systems based on lymph node ratio and log odds of positive lymph nodes (P ＜ 0.05),while the prognosis was highly homologous between the staging systems based on positive lymph nodes in stage N0 and N1.Univariate analysis showed age,tumor size,Her2 status,estrogen receptor status and the total lymph nodes dissected were related to overall survival (all P ＜ 0.05).COX multivariate analysis showed that the staging system based on lymph node ratio (5.495) and log odds of positive lymph nodes (4.662) had the higher HR than the N staging system (2.722).Conclusions Compared with the number of involved lymph nodes,the staging system based on lymph node ratio and log odds of positive lymph nodes were superior to the staging system based on positive lymph nodes for prognostic assessment of breast carcinoma.

Objective Temporal lobe epilepsy (TLE),frequently accompanied by working memory dysfunction,is an important form of adult epilepsy syndrome.Study on neural mechanisms of TLE with working memory dysfunction has important scientific value and clinical significance.Theta oscillations are synchronous activity of the brain in the 4-8 Hz frequency range.It is well recognized that there is a close relationship between the theta oscillations and working memory behavior.TLE patients with working memory dysfunction were taken as the research subjects,and the theta oscillations absence in TLE with working memory behavioral disorder was carried out,which provide the reference for further research into the neural mechanisms of TLE with working memory dysfunction.Methods The 34-channel electroencephalographs (EEGs) were recorded from TLE group (18 TLE patients) and control groups (18 healthy subjects) while subjects were performing visual working memory (delayed matching-tosample) tasks.The EEGs during the 3 s delay period was analyzed as experimental data.Fourier transform was used to assess the EEGs spectrum.The channel with the strongest spectrum was selected as the feature channel.Short-time Fourier transform algosiths was employed to calculate the time-frequency representation of the feature channel for the TLE and control groups.Frequency band with the strongest spectrum was selected for control group as the feature frequency band in working memory.Then,the topographical maps of the feature frequency band spectrum were calculated for the TLE and control groups.Results Compared with the control group,the working memnory behavioral performance of the TLE group was lower:accuracy of the TLE group was significantly lower than that of the control group (P＜0.05),and reaction time of the TLE group was significantly longer than that of the control group (P＜0.001).The feature channel in working memnory was frontal midline (Fz) and the feature frequency band was theta band.The Fz spectrum of the feature frequency for TLE was lower than that for control (P＜0.05).The frontal spectrum (seven channels) of the feature frequency for TLE was lower than that of control (P＜0.01).Conclusions Theta oscillations for TLE with working memory behavioral disorder is absent,which maybe one of the possible neural mechanism of TLE with working memory dysfunction.

Objective To make a systematic review of pressure ulcers risk factors in critically ill patients. Methods We systematically reviewed all articles related to the pressure ulcers risk factors in critically ill patients. The Cochrane Library, PubMed, EMBASE, Web of Science Core Collection, CNKI, WANFANG and SinoMed were searched to August 2016. Results In total, 13 eligible articles were included. These studies included 18, 184 critically ill patients, six studies were classified as high quality, and seven were classified as moderate quality. Risk factors for the development of pressure ulcers include age, ICU stay, diabetes, mean arterial pressure<60-70 mmHg (1 mmHg=0.133 kPa), mechanical ventilation and mechanical ventilation, drugs, sedation and postural changes. Conclusions There is no single factor that can explain the occurrence of pressure ulcers. So it is in a variety of factors interaction, the occurrence of a significant increase in risk.

Objective To establish an HPLC method for determining the content of swertiamarin in Gantaishu capsules. Methods Using a Waters Symmetry C18 column (4.6 mm×250 mm, 5μm), the mobile phase was acetonitrile-0.02%phosphoric acid, with flow rate of 1.0 mL/min. The detection wavelength was at 250 nm, the column temperature was room temperature. Results The content of swertiamarin showed a good linear relationship in the range of 0.373 556-2.988 448 μg, r 2=1.000 0. The average recovery was 106.81%, and RSD was 3.7%. Conclusion This method is fast, accurate and simple with good reproducibility, which can be applied to the quality control of Gantaishu capsules.