Objective To explore the influence of self-handicapping and learning motivation on career adaptability in nursing undergraduates. Methods In March 2017, we selected a total of 220 nursing undergraduates in first to third grade from School of Nursing, China Medical University by cluster sampling. The investigation was carried out with the Self-handicapping Scale, Learning Motivation Scale and College Students' Career Adaptability Questionnaire. Results The mean score of Learning Motivation Scale, Self-handicapping Scale and College Students' Career Adaptability Questionnaire of nursing undergraduates was (83.88±10.36), (43.68±9.50), (3.59±0.53) respectively. Among nursing undergraduates, the career adaptability was negatively correlated with the self-handicapping (P< 0.05) and was positively correlated with the learning motivation (P<0.01). Multiple linear regression showed that the learning motivation and the self-handicapping were the influencing factors of career adaptability of nursing undergraduates (P< 0.05). Conclusions The self-handicapping and learning motivation of nursing undergraduates have influence on career adaptability. The career adaptability could be improved by reducing the self-handicapping of nursing undergraduates and promoting their learning motivation.

Objective To explore the influence of self-acceptance and academic achievement on career adaptability, and the mediating effect of academic achievement between self-acceptance and career adaptability among nursing undergraduates. Methods In September 2017, we selected 281 nursing undergraduates from Grade 1 to 3 of School of Nursing at China Medical University as subjects by convenience sampling. All of the patients were investigated with the College Students' Career Adaptability Questionnaire (CSCAQ), Unconditional Self-acceptance Questionnaire (USAQ) and Academic Achievement Scale. Results The average score of CSCAQ, USAQ and academic achievement scale of nursing undergraduates were (3.70±0.39), (3.64±0.51) and (3.51±0.46) respectively. Nursing undergraduates' career adaptability had positive correlations with self-acceptance and academic achievement (r=0.395, 0.382; P＜ 0.05). Three-step mediating regression analysis showed academic achievement played a partial mediating effect in the influence of self-acceptance on career adaptability with a significant mediating effect (P＜0.01). The mediating effect accounted for 27.94% of the total effect. Conclusions Nursing undergraduates' academic achievement has effects on their career adaptability. Their self-acceptance not only has effects on career adaptability directly, but also has effects on career adaptability by the mediating effect of academic achievement indirectly.

Objective:To report our experience of treating open comminuted limb fractures caused by gunshots using the Masquelet technique.Methods:Between January 2016 and July 2018, 3 patients were admitted to Institute of Orthopedics, 920 Hospital of Joint Logistic Service of People's Liberation Army for open comminuted limb fractures caused by gunshots.They were all male, aged from 18 to 41 years (average, 30.7 years).Their fractures were complicated with perforating wounds and belonged to Gustilo type ⅢB for open fractures.The bone defects were 5 to 9 cm in length (average, 6.7 cm), located at the proximal femur in 2 cases and at the upper middle humerus in one.They were treated by standard Masquelet technique at 2 stages.The postoperative functions of the hip, knee and shoulder were evaluated according to the Harris hip score, Lowa knee score and Constant-Murley shoulder function score.Results:The 3 patients obtained an average follow-up of 17.3 months.The bone defects were all repaired in the 3 patients without any signs of infection.The 2 patients with femoral defects were rated as both excellent by the Harris hip score, as excellent in one and as good in the other by the Lowa knee score; the patient with humeral defects was rated as excellent by the Constant-Murley shoulder function score.Conclusion:Masquelet technique is a desirable treat-ment of segmental long bone defects caused by gunshots.