Objective To explore the role of mental health between nursing interns' professional commitment and occupational choice self-efficacy.Methods 200 students were surveyed by Career Decisionmaking Self-efficacy Scale,the Symptom Self-rating Scale(SCL-90) and Professional Commitment Scale for Undergraduates.Results Professional commitment showed remarkable positive prediction effect.Mental health exhibits moderating effect on the relationship between professional commitment and occupational choice self-efficacy,the more good mental health level,the bigger the prediction effect of professional commitment on occupational choice self-efficacy.Conclusions Promoting the students' psychological health will improve prediction effect of professional commitment on occupational choice self-efficacy.

Objective To observe the effects of vascular endothelial growth factor(VEGF)from pulmonary stromal cells on differentiation and function of mature dendritic cells (mDC) and the immune tolerance. Methods Co-culture system of murine pulmonary stroma cells (MPSC)/mDC was established as control group,and VEGF-Ab add-on treatment to co-culture cells as experimental group.Cytokines secreted from pulmonary stroma cells were detected by RT-PCR.The expression of cellular phenotype and ability of the mDC-induced T cells reproductive activity were detected by flow cytometry and CCK-8,respectively.Results CD86 expression of VEGF-Ab group was higher than of control group (P ＜ 0.05).There was no difference in the ability of mDC-induced T cells reproductive activity between the two groups(P＞0.05).Conclusions VEGF might be involved in the regulation of immune tolerance by reducing expression of CD86 in dendritic cells.

Objective To identify iron nutritional status in very low birth weight infants (VLBWI) and its influence factors.Methods A total of 115 babies admitted from January to December 2014 were included in the study.Serum ferritin of new born infants was analyzed.The clinical data of gestational age,birth weight,hemoglobin,iatrogenic blood loss,cumulative volume of blood transfusion and pregnancy maternal diseases(diabetes,hypertension and anemia) were analyzed.Results The serum ferritin of 115 VLBWI were 100.8 to 210.3 μg/L,the average were(140.32 ± 13.21) μg/L;the minimum serum ferritin of babies born ＜ 32 weeks gestational age were(124.5 ± 31.3) μg/L.Smaller the VLBWI gestational age,the lower the basic baby serum ferritin(F =14.367,P =0.000).More severe the maternal anemia,the lower the basic baby serum ferritin levels [no anemia:(230.9 ± 68.7) μg/L,mild anemia:(189.5 ± 75.3) μg/L,moderate anemia:(133.5 ± 88.1) μg/L,severe anemia:(122.2 ± 56.8) μg/L;P ＜ 0.05].Lower the level of hemoglobin,the lower the basic level of serum ferritin(P ＜ 0.05).Volume of blood transfusion had a huge impact on the last serum ferritin levels (P ＜ 0.05).Conclusion Improvement of the basic baby serum ferritin level in the early stage is useful to ensure the VLBWI iron reserves.It is necessary to regularly monitor serum ferritin during hospitalization and even after discharge.

Pulmonary hypertension is a group of diseases with high pressure of pulmonary circula-tion,severe cases can lead to increased right ventricular afterload,even right heart failure. Children pulmonary hypertension is difficult to detect in early stage because its nonspecific clinical manifestations. It is a serious complication of many respiratory diseases,it leads to decreased lung function and life quality. Screening early pulmonary hypertension of these children will facilitate it′s diagnosis,treatment and prognosis.

Objective To explore the current situation and influencing factors of moral distress among nurses.Methods 252 clinical registered nurses from 3 Grade-3 Level-A hospitals in Jinan were investigated by the Chinese version of Moral Distress Scale-Revised and Job Diagnostic Survey.Results The mean score of MDF was (1.06±0.46) points and the mean score of MDI was (1.05±0.63) points.The total score of MDS-R was (38.86+26.26) points.Futile care was the main source for the high frequency and high intensity of moral distress among nurses.There were significant differences in the level of moral distress among different groups of age,years of nursing experience,first education degree,professional title,position,department,staffing of government affiliated institutions and income.The result of multiple linear regression analysis showed that age,first education degree,department,professional title,and the importance of assignment,autonomy,collaboration of work were the influencing factors for moral distress of nurses.Contusions It suggested that nurses should strengthen the study of knowledge about ethics to improve their capacity of ethical decision-making,and nurse managers should pay attention to department management,strengthen the medical cooperation,and improve nurses' job autonomy to improve nurses' capacity of coping and decision-making and reduce the level of moral dilemmas.

[Objective]To retrospectively analyze the results of plasma-mediated coblation in treating cervical disc herniation.[Method]From January 2003 to April 2006,127 symptomatic cases(197 disc levels)with cervical contained disc herniation were treated with plasma-mediated coblation technology,including 81 males and 46 females,their average age was 49 years,the treated disc levels were 17 in C3、4,61 in C4、5,90 in C5、6 and 29 in C6、7 ,respectively.All patients were reported to have persistent cervical or unilateral arm pain for a minimum of three months and failed previous conservative treatment.MRI showed herniated cervical disc causing focal compression of the nerve root.An average percentage of symptom relief(VAS score)and subjective satisfaction were administered to measure symptoms at all visits.[Result]In the immediate post-operative period,124 patients reported significant amelioration of symptoms,3 patients complained of arm numbness did not change clinical status,one week after operation,percentage of symptom relief was 64%,perfect rate of subjective satisfaction was 91%.Patients were followed up for average 18 months(range 6～31 months)postoperatively.Percentage of symptom relief was 47%,perfect rate of subjective satisfaction was 62%.In the last follow-up,7 patients were observed a stabilization of clinical status over 2 years and in 15 patients the status was similar to preoperation.The other patients referred some residual symptoms and were still under follow-up.There were no complications observed such as hemorrhages,infections and nerve root injurys due to the procedure.[Conclusion]Our data indicate coblation procedure appearing to be less injury,safety,is a promising treatment option for patients with contained cervical disc herniation who have failed conservative therapies and are not considered candidates for open surgery,also supplementary therapy perioperatively in patients treated with cervical open surgery.

Objective To investigate the correlation between JAK2V617F mutation and clinical characteristics in patients with myeloproliferative neoplasm(MPN) in Xinjiang area.Methods The correlation between JAK2V617F mutation and clinical characteristics about gender,age,nationality,leukocyte counts,platelet counts,hemoglobin and LDH levels,complications of thrombosis,bleeding and vascular disease in 134patients with MPN were analyzed. Results 73.1％ (98/134) JAK2V617F mutation was found in patients (51with PV,66 with ET, 17 with IMF). Compared with negtive mutation, the rata of ≥60 years was significantly higher in positive group [78.6 ％(77/98)vs25.0 ％(9/36)(χ2=32.867,P＜0.001)]. Patients harboring JAK2V617F mutation have higher leukocyte counts[(15.9±8.2)×109/L vs (9.6±5.3)×109 L,t=4.296,P＜0.001],hemoglobin levels [(156.4 ±44.9)g/L vs (133.8 ±44.1)g/L,t=2.590,P =0.011],incidence of thrombosis [73.5 ％(72/98)vs22.2 ％(8/36),χ2=28.740,P＜0.001)] and vascular diseas [81.6 ％(80/98)vs25.0 ％(9/36),χ2=37.859,P＜0.001)]. There was no significant difference in gender, nationality, platelet counts, LDH levels and bleeding complications between JAK2V617F positive and negative patients. Conclusion There is a correlation between JAK2V617F mutation in MPN and age,leukocyte counts,hemoglobin levels,thrombosis and vascular disease complications.

Objective To analyze diagnostic classification and karyotype characteristics of patients with myelodysplastic syndrome(MDS)in Xinjiang Uygur Autonomous Region.Methods 149 patients with MDS were retrospective observed.The features of clinical,laboratory examination,morphologic and cytogenetics were analyzed from patients classified by the 2008 WHO classification.The rates of survival and leukemia conversion in different subgroups,the differences between uygur and han nationalities,and the rates of abnormal karyotypes in different subgroups were compared.Results Among 149 cases,there were 28 cases of RCUD(including 25 RA and 3 RN),8 cases of RARS,32 cases of RCMD,30 cases of RAEB-Ⅰ,44 cases of RAEB-1,5 cases of MDS-U and 2 cases of 5q-.There was no difference between uygur and han nationality of diagnostic classification(x2=3.627,P=0.822).The overall survival time and AML conversion rates were different among subtype groups.Karyotype abnormalities were found in 74 cases(49.7 ％),which showed no difference between uygur and han nationalities.The distribution of karyotype were normal karyotype(72 cases),complex karyotype(34 cases),+8(14 cases),-7(11 cases),+11(7 cases),20q-(5cases),-Y(2 cases),+21(2 cases)and 5q-(2 cases),which were no differences between uygur and ban nationality(X2=10.015,P=0.264).When comparing abnormal karyotype rates in different diagnostic classification subgroups excepting 5q-,RAEB-Ⅰ and RAEB-Ⅱ subtype were higher than that of RCUD subtype(X2=7.034,P=0.008;X2=6.395,P=0.016).Conclusions According to the 2008 WHO classification,the incidence of abnormal karyotype,survival time and AML conversion rates are different among subtype groups.There are no regional and ethnical differences in distribution of diagnostic classification and karyotype in patients with MDS in Xinjiang Uygur Autonomous Region.

ObjectiveTo investigate the effect of expressional chimeric faces on the attentional bias in unilateral spatial neglect (USN) patients.Methods12 USN patients and 30 matched healthy controls (HC) were involved in this study.All of them were performed with happy-neutral and sad-neutral expressional chimeric faces (ECF) and the attentional deviation scores were compared between and within groups.ResultsThere were statistically significant differences of attentional deviation scores ( happy-neutral ECF:t =15.550,P ＜ 0.0l ; sadneutral ECF:t=12.192,P＜0.01 ) between the USN group (happy-neutral ECF:0.78 ±0.22;sad-neutral ECF:0.50 ±0.20) and the HC group (happy-neutral ECF:-0.31 ±0.20;sad-neutral ECF:-0.25 ±0.17),with rightward bias in the USN group and small leftward bias in the HC group.For the USN group,the magnitude of rightward bias in the sad-neutral ECF condition was reduced than in the happy-neutral ECF condition ( t =3.954,P=0.002 ).There were no statistically differences under happy-and sad-neutral ECF conditions within the HC group ( t =- 1.302,P =0.203 ).ConclusionsUSN patients show rightward attentional bias under both happyand sad-neutral ECF conditions.However,the magnitude of rightward bias under the sad-neutral ECF condition are reduced significantly.This might be attributed to the unconscious processing of stimuli in the neglected side and emotion cognition of the brain hemispheres.

Objective To evaluate the clinical application of Hawkeye VG SPECT/CT imaging on diagnosing and locating lower gastrointestinal bleeding using in vivo labeling 99Tcm-RBC.Methods Fiftysix patients (42 males,14 females,age ranging from 10 to 76 years) who had definite lower gastrointestinal bleeding were studied retrospectively.All patients had intravenous injection with 370 MBq 99Tcm-RBC and then underwent planar,SPECT,and CT imaging respectively in the abdomen before exploratory laparotomy.Images from SPECT and CT were fused thereafter to locate the active bleeder,if any.x2 test was performed to show the differences of diagnostic sensitivity and accuracy between planar and SPECT/CT imaging.Results In 56 patients with lower gastrointestinal bleeding,50 patients showed abnormally concentrated radionuclide activity with planar images and 52 patients showed the similar imaging pattern with SPECT/CT.Among these patients,concordant bleeding with operation findings was found in 31 patients with planar images and 48 patients with SPECT/CT images.The sensitivity and accuracy were 89.3％ (50/56) and 73.8％ (31/42) in planar images,and 92.9％ (52/56) and 92.3％ (48/52) in SPECT/CT images (x2 =0.11,P＞0.05 ;x2 =4.63,P＜0.05).Conclusion Hawkeye VG SPECT/CT imaging shows an effective,simple and accurate method and could be used for diagnosing and locating lower gastrointestinal bleeding.