Objective To investigate the cognition level of nurse students on the influencing factors of nursing safety.Methods Totals of 371 nurse students prior to entering the bunch from three hospitals were involved in this study and relevant data were investigated with "The Questionnaire of Influencing Factors on Nursing Safety".Results The average scores of influencing factors ( list from highest to lowest priority) of four dimensions were that,"quality and expertise of nurse personnel" ( 4.584 ± 0.557 ),"administration of organization" (4.464 ±0.634),"work environment of nurse personnel" (4.319 ±0.693 ),"environment of clinic" (4.383 ± 0.685 ).The term score of "basic knowledge theory and operation skills" in the dimension of "quality and expertise of nurse personnel" "was highest ( 4.80 ± 0.443 ),and the" Drug put and marking" score in the dimension of "work environment of nurse personnel"was highest (4.61 ± 0.561 ),the term score of "medical equipment and ward products performance" (4.46 ± 0.64) was highest in the dimension of "environment of clinic",and "all kinds of rescue accident emergency plan" score (4.70 ±0.540) was highest in administration of organization dimension.Conclusions Nurse students can realize the importance of influencing factors of nursing safety. Strengthen consciousness of nursing students on nursing safety and regulations is important for cultivating nursing students' comprehensive quality and the capacity to prevent security risks and avoid the occurrence of mistakes and accidents in internship hospitals.

Objective To understand the influencing factors of self-management behavior for type 2 diabetes mellitus patients and thus to provide a good reference for further interventions.Methods Qualitative method was used in the study.Thirteen type 2 diabetes mellitus were interviewed by semi-structure interviews.The data was analyzed with phenomenological procedure.Results The influencing factors of self-management behavior were as follows:individual' s cognition,self-care ability,experience of disease hazards,attitude to disease,sense of responsibility and social support.Conclusions To further improve patients' self-management behaviors,we should help patients acquire disease-related knowledge and skills and take an active coping style.In addition,strengthened responsibility,good social support and disease hazards experience are all conducive to improving patients' self-management behaviors.

Objective To investigate the level and influencing factors of nurses' occupational stress,so as to provide reference for the prevention and control of occupational stress.Methods Totally 300 nurses from several hospitals in Shijiazhuang were selected by convenience sampling and investigated with Occupational Stress Inventory-Revised Edition (OSI-R) from June to August 2012.Results Three hundred questionnaires were sent out and 286 were responsive,with the rate of 95.3％.The scores of nurse occupation mission were (152.36 ± 32.64),individual strain response were (100.75 ± 24.61),individual coping resources were (116.67 ± 22.94),which was significantly higher than the Chinese norm (t =2.02,2.32,2.58,respectively;P＜0.01).Nervous reaction was positively correlated with occupational task (r=0.381,P ＜ 0.01),and negatively correlated with coping resources (r =-0.336,P ＜ 0.01).Influencing factors of the stress included unsuitable tasks,task conflicts,responsibility,working environment,self-care and social support.Conclusions Nurses suffer from high level of occupational stress,therefore,managers should create favorable working conditions to reduce influencing factors and nurses should improve self-care to alleviate occupational stress.

OBJECTIVETo investigate the effect of nano-hydroxyapatite/collagen (nHA/collagen) composite as a graft extender and enhancer when combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) on lumbar intertransverse fusion in rabbits.

METHODSSixty-four adult female New Zealand white rabbits, aged 1 year and weighing 3.5-4.5 kg, underwent similar posterolateral intertransverse process arthrodesis and were randomly divided into 4 groups based on different grafts: autogenous cancellous bone alone (ACB group), nHA/collagen alone (HAC group), half autogenous cancellous bone and half nHA/collagen (ACB+HAC group) and nHA/collagen combined with rhBMP-2 (HAC+BMP group). The fusion masses were analyzed by manual palpation, radiography, biomechanical testing and histological examination.

RESULTSFusion was observed in 4 cases in the 6th week and in 5 cases in the 10th week after surgery in ACB group. No case showed fusion in HAC group. In ACB+HAC group, there was fusion in 3 cases in the 6th week and in 4 cases in the 10th week after surgery. In HAC+BMP group, fusion in 1 case was found in the 4th week, in 5 cases in the 6th week and in 6 cases in the 10th week after surgery. It suggested that ACB, ACB+HAC and HAC+BMP groups showed similar fusion ratio and mechanical strength in the 6th and 10th week after surgery. According to the microstructure analysis of the samples, nHA/collagen had no negative effect when implanted together with ilium autograft. In HAC+BMP group, new bone-like tissue was observed in the 2nd week postoperatively, and nearly all of the implanted composites were replaced by mature bone matrix and new bones in 10th week postoperatively.

CONCLUSIONSThe nHA/collagen, especially combined with rhBMP-2, is a promising bone substitute, for it has quick biodegradation, fine bone-bending ability, and high osteoconductivity on posterolateral spinal fusion in rabbits.

Analysis of Variance ; Animals ; Biomechanical Phenomena ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; pharmacology ; Disease Models, Animal ; Durapatite ; pharmacology ; Female ; Lumbar Vertebrae ; drug effects ; surgery ; Osseointegration ; drug effects ; Probability ; Rabbits ; Sensitivity and Specificity ; Spinal Fusion ; methods ; Tensile Strength ; Transforming Growth Factor beta

Antibody-drug conjugates (ADCs) are one of the most important classes of anticancer therapeutics. Human epidermal growth factor receptor-2 (HER2), which is highly expressed in many types of aggressive cancers including breast and ovarian cancer, has been approved as an ideal target for ADCs. Lidamycin (LDM), developed by Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences, is an enediyne-containing antibiotic with potent anti-tumor activity. LDM is a promising payload for ADCs. In the present research, using a special site-directed conjugating technology, we made a novel ADC (607-LDM) with a drug-to-antibody ratio (DAR) of 2 and composed of the anti-HER2 antibody 607 and LDM. The new ADC exhibited potent antitumor activity against human ovarian cancer SKOV3 and breast cancer BT-474 cells. It also induced apoptosis and G2/M arrest. In nude mice with SKOV3 xenografts and a tumor volume of 150-200 mm³, a single intravenous injection 607-LDM at 1 mg·kg^-1 induced tumor growth inhibition of 72.4%, which was significant compared to either LDM (50.6%) or antibody (30.2%) treatment alone, or both in combination (50.1%, P < 0.05). All animal experiments were performed in accord with National Regulations and approved by the Animal Experiments Ethical Committee of College of Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences. The novel ADC designed in this study, 607-LDM, is a promising candidate for the treatment of HER2-positive cancers.

Objectives: To investigate the clinical value of adjuvant chemotherapy(ACT) in patients with intrahepatic cholangiocarcinoma(ICC) who underwent radical resection and to explore the optimal population that can benefit from ACT. Methods: A retrospective cohort study method was adopted. The clinical and pathological data of 685 patients with ICC who underwent curative intent resection in 10 Chinese hepatobiliary surgery centers from January 2010 to December 2018 were collected;There were 355 males and 330 females. The age(M(IQR)) was 58(14) years (range: 22 to 83 years). Propensity score matching(PSM) was applied to balance the differences between the adjuvant and non-adjuvant chemotherapy groups. Log-rank test was used to compare the prognosis of the two groups of patients. A Bayesian network recurrence-free survival(RFS) prediction model was constructed using the median RFS time (14 months) as the target variable, and the importance of the relevant prognostic factors was ranked according to the multistate Birnbaum importance calculation. A survival prognostic prediction table was established to analyze the population benefiting from adjuvant chemotherapy. Results: Among 685 patients,214 received ACT and 471 did not receive ACT. A total of 124 pairs of patients were included after PSM, and patients in the ACT group had better overall survival (OS) and RFS than those in the non-ACT group(OS: 32.2 months vs. 18.0 months,P=0.003;RFS:18.0 months vs. 10.0 months,P=0.001). The area under the curve of the Bayesian network RFS prediction model was 0.7124. The results of the prognostic factors in order of importance were microvascular invasion (0.158 2),perineural invasion (0.158 2),N stage (0.155 8),T stage (0.120 9), hepatic envelope invasion (0.090 3),adjuvant chemotherapy (0.072 1), tumor location (0.057 5), age (0.042 3), pathological differentiation (0.034 0), sex (0.029 3), alpha-fetoprotein (0.028 9) and preoperative jaundice (0.008 5). A survival prediction table based on the variables with importance greater than 0.1 (microvascular invasion,perineural invasion,N stage,T staging) and ACT showed that all patients benefited from ACT (increase in the probability of RFS≥14 months from 2.21% to 7.68%), with a more significant increase in the probability of RFS≥14 months after ACT in early-stage patients. Conclusion: ACT after radical resection in patients with ICC significantly prolongs the OS and RFS of patients, and the benefit of ACT is greater in early patients.
Bayes Theorem ; Bile Duct Neoplasms/surgery* ; Bile Ducts, Intrahepatic/pathology* ; Chemotherapy, Adjuvant ; Cholangiocarcinoma/surgery* ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies

OBJECTIVE: To observe the clinical effect of high suspension and low incision (HSLI) surgery on mixed haemorrhoids, compared with Milligan-Morgan haemorrhoidectomy. METHODS: A multi-centre, randomized, single-blind, non-inferiority clinical trial was performed. Participants with mixed haemorrhoids from Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing Rectum Hospital, Air Force Medical Center of People's Liberation Army of China, and Puyang Hospital of Traditional Chinese Medicine were enrolled from September 2016 to March 2018. By using a blocked randomization scheme, participants were assigned to two groups. The experimental group was treated with HSLI, while the control group was treated with Milligan-Morgan haemorrhoidectomy. The primary outcome was the clinical effect evaluated at 12 weeks after operation. The secondary outcomes included the number of haemorrhoids treated during the operation, pain scores, use of analgesics, postoperative oedema, wound healing, incidence of anal stenosis, anorectal manometry after operation, as well as surgical duration, length of stay and total hospitalization expenses. A safety evaluation was also conducted. RESULTS: In total, 246 eligible participants were enrolled, with 123 cases in each group. There was no significant difference in the clinical effect between the two groups (100.00% vs. 99.19%, P>0.05). Compared with the control group, the number of external haemorrhoids treated during the operation and the pain scores after operation were significantly reduced in the experimental group (P<0.05 or P<0.01); the patient number with wound healing at 2 weeks after operation and the functional length of anal canal at 12 weeks after operation were significantly increased in the experimental group (P<0.05). There was no significant difference in the incidence of anal stenosis, the numbers of patients using analgesics and patients with postoperative oedema between the two groups after operation (P>0.05). The surgical duration and length of stay in the experimental group were significantly longer than those in the control group, and the total hospitalization expense was significantly higher than that in the control group (all P<0.05). No adverse events were reported in either group during the whole trial or follow-up period. CONCLUSION HSLI had the advantages of preserving the skin of anal canal completely, alleviating postsurgical pain and promoting rapid recovery after operation. (Registration No. ChiCTR1900022883).