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.

Peroxisome proliferators-activated receptor γ (PPARγ) belongs to a nuclear receptor superfamily. Many studies have shown that PPARγ can help to improve the outcome of cerebrovascular disease. PPARγ can reduce inflammatory response, oxidative stress as wel as enhance the hematoma removal abilities of microglia and macrophages, and it plays an important protective role in intracerebral hemorrhage.

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 validate the accuracy of the colorectal cancer model of the Association of Coloproctology of Great Britain and Ireland(ACPGBI-CCM),and to find out the relationship between clinical risk factors and the predictive value produced by ACPGBI-CCM.Methods The patients diagnosed definitely as colorectal cancer in the department of anal-colorectal surgery,West China hospital from April 2007 to July 2007 were analyzed retrospectively.And the predictive value of mortality for each patient was calculated by ACPGBI-CCM,then the difference of risk factors was compared by classifying the patients into lower risk group and higher risk group by making the median predictive mortality as a cut point.Results From April 2007 to July 2007,a total of 99 patients diagnosed definitely as colorectal cancer accepted treatment,and among which 67 patients included in this study were admitted whose average age was 60.09 years.And there were 34 male and 33 female patients;15 right hemicolon cancer,9 left hemicolon cancer,43 rectal cancer;Dukes staging:A 0 case,B 37 cases,C 24 cases,D 6 cases.The observed mortality 30 days after operation was 0,whereas the predictive mortality was 0.77%-25.75% with a median value of 3.36%.Then the patients whose predictive mortality were ≤3.36% were grouped as lower risk group(34 cases),the others higher risk group(33 cases),and there was strikingly different predictive mortality between two groups 〔(8.86?4.51)% vs(1.76?0.68)%,P0.05).Furthermore,stratification analysis was made for risk factors,and it came out that there were great differences of predictive mortality for different age groups and ASA grading,having internal medicine complications or not,having chemotherapy or not,and for cancer resected or not,and the differences were statistically significant(P0.05).Conclusion The clinical applicability of the ACPGBI-CCM is ascertained in such a large volume single medical centre,but the ACPGBI-CCM overpredicts the mortality in this study which may be attributed to the different areas,nations,or the different cultures.The complications and the neo-adjuvant or adjuvant therapy are further found out that they may be independent predictive factors of survival,and more research will be needed to prove this.

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 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.