Analysising of the students' role will contribute to improve the quality of clinical teaching.The core of the students' role is “student”,they are the principal part of the learning activities.At the same time,students have on the shoulders the practice role of clinical nurse.The remarkable thing is that the students have kinds of needs of different levels,they should be regarded as the holistic person who have the individual otherness and commonness and the inimitable value.The characteristic of students can influence their behaviors in clinical activities.

Objective To evaluate the diagnostic value of per perineal high -frequency ultrasound and/or per rectal endoscopic ultrasound in anorectal diseases. Methods 54 patients suffered from anorectul diseases, including 22 patients with anal fistula, 14 patients with perianal abscess, 12 patients with rectal cancer, and 6 patients with perianorectal inflammation, were performed with per perineal high-frequency ultrasound and/or per rectal endoscopic ultrasound examination. The diagnostic results were confirmed by clinical diagnosis, including operative and pathological detection. Results Except for the misdiagnosis of 4 cases of orifice location and 1 case of rectal cancer, all the other cases were correctly diagnosed. Conclusion Combined application of per perineal high-frequency ultrasound and per rectal endoscopic ultrasound examination has great practical value for ascertaining the trend and internal orifice location of anal fistula, location of perianul abscess, the infiltration depth of rectal cancer, and lymph node metastases.

Objective To explore the role of serum levels of Klotho protein and fibroblast growth factor(FGF)-23 in patients with chronic kidney disease(CKD).Methods A total of 160 patients with CKD were recruited into CKD group in this study,160 healthy controls were selected in the control group from March 2014 to March 2016.Basic clinical data,blood biochemical index,serum level of Klotho protein and FGF-23 were analyzed and compared between the two groups.Results The hemoglobin,serum albumin,blood calcium,glomerular filtration rate,Klotho protein levels in the CKD group were lower than those in the control group,and the serum creatinine,blood urea,blood serum phosphorus and FGF-23 were higher than those in the control group(P<0.05).With the progress of CKD stages,hemoglobin,glomerular filtration rate,Klotho protein levels gradually decreased,serum creatinine,blood urea,blood serum phosphorus,FGF-23 level increased(P<0.05).The levels of FGF-23 were negatively related to hemoglobin,glomerular filtration rate,Klotho(r=-0.584,0.692,-0.724)and were positively correlated to serum creatinine,blood urea,blood serum phosphorus(r=0.814,0.703,0.527).The levels of Klotho protein were positively related to hemoglobin,glomerular filtration rate(r=0.612,0.685),and were negatively correlated to serum creatinine,blood serum phosphorus,blood urea,FGF-23(r=-0.720,-0.690,-0.519,0.724).Conclusion High concentrations of FGF-23 and Klotho protein with low concentration were not only related to calcium phosphate metabolic disorders of patients with CKD,and were also associated with the prognosis of patients with CKD,which might be early biomarkers and predictor in patients with CKD.

Objective To investigate the immunologic etiology of pregnancy induced hypertention (PIH)by studying the changes of T H1 and T H2 cell ratio in the peripheral blood from patients with severe PIH. Methods We examined the cell percentage of T H1 cell(secreting cytokine IFN ?) and T H2 cell(secreting cytokine IL 4),which were from CD4 positive, by flow cytometry tri stained with PerCP CD4,FITC IFN ? and PE IL 4 monoclonal antibody. The blood samples were from severe PIH patients and normal third trimester patients. Results The percentage of T H1 cell 38.01?9 04% from the peripheral blood of severe PIH partuients was significantly higher than that of the normal partuients of the third trimester 30.26?8.65%, while the percentage of T H2 cell 2.25? 0.61% was much lower P

Objective To determine the bacterial composition and antibacterial resistance in female urinary tract infections (UTI) in China. Methods The disc diffusion test, minimum inhibition concentration (MIC), test or E-test was used to detect the antimicrobial susceptibility in 86 tertiary hospitals in China from June 1, 2006 to May 31, 2007. WHONET 5.4 was applied for data analysis. Results A total of 6071 pathogenic germs were collected from urine cultures of UTI female patients in the surveillance period, which included 5958 bacterial isolates. Escheriehia coll 3529 strains (59. 23% ), Enterococcus spp 938 strains (15.74%) and Klebsiella pneumoniae 394 strains (6.61%) were the most common pathogens. Escherichia coli and Klabsiella pneumoniae had 35.7% and 34. 0% extended spectrum beta-lactamases (ESBL) positive rates, and their resistant rates to quinolones were about 70% and 40%, respectively. Enterococcus faecium was much more resistant to almost all the antibiotics than Enterococcus faecabs. 0. 9% Escherichia faecalis and 3.8% Escheriehia faecium were resistant to vancomycin, whereas 2.7% and 4. 8% were resistant to teieoplanin. Staphylococcus epdermidis was more common in UT1 than Staphylococcus aureus, 79. 1% and 75.0% of the isolates being methiciUin-ressitant Staphylococcus epdermidis(MRSE) or methicillin-ressitant Staphylococcus aureus (MRSA), respectively. No vancomycin intermediate or resistant staphylococcus was detected, but 4. 9% teicoplanin intermediate rate was found in Staphylococcus epdermidis. The resistant rates to quinolones increased with the patient age. Condnsions Bacterial resistance in UTI in Chinese females is a severe problem, which could be resulted from antimierobial irrational use. In the selection of antimicrobial agents in the treatment of UTI, doctors should refer to the results of bacterial resistant surveillance.

Objective To investigate the effects of different volumes of ropivacaine with the same solubility in supraclavicular brachial plexus block(SCBPB) under ultrasound guidance on ipsilateral diaphragmaticparalysis.Methods Seventy two patients (32 males,40 females, aged 18-65 years, of ASA Ⅰ or Ⅱ, scheduled for the right upper limb fracture internal fixation removal were randomized into group A (0.375% ropivacaine 20 ml) and group B (0.375% ropivacaine 30 ml), 36 cases in each group.The onset and duration of sensory and motor block were observed as well as complication.Diaphragmatic excursion were evaluated by M type ultrasound before and 30 min after drug injection under eupnea and forced respiration through observing diaphragmatic excursion to study diaphragmatic paralysis.Results The onset time of sensory block and maintaining time of sensory block or motor block had no significant difference between the two groups.Compared with group A,the onset time of motor block in group B was significantly shorter (P<0.05).Twelve cases (33.3%) in group A and 22 cases (61.1%) in group B respectively showed complete or partial hemidiaphragmatic paralysis 30 min after drug injection.Compared with group A, the rate of diaphragmatic paralysis in group B was significantly higher (P<0.05).Conclusion Supraclavicular brachial plexus block under ultrasound guidance with 0.375% ropivacaine 20 ml or 30 ml both can provide excellent anesthetic effect.0.375% ropivacaine 20 ml is less likely to lead to diaphragmatic paralysis.

Objective To investigate the correlation between umbilical cord blood tire mass measles antibody and maternal measles antibody degrees,in order to evaluate the crowd measles antibody level and provide scientific basis for lasting elimination of measles.Methods Collected 40 cases of healthy maternal venous blood and their paired cord blood,enzyme-linked immunosorbent assay (ELISA) was used for the detection of measles antibody.Results In the 1:200 level,mother blood and umbilical cord blood of measles antibody level were 11.29 ±4.81 and 12.76 ± 5.32,in the 1:800 level were 6.89 ±4.11 and 8.28 ± 4.91,both had correlation (r =0.575,0.618,P ＜0.05).Conclusions Measles antibody titers of maternal venous blood and paired cord blood are highly correlated.The results show that maternal measles antibodies could pass through the placenta to the daughter,and measles antibody titers detected in umbilical cord blood can be used not only to assess the maternal measles antibodies level,but also can be used as a predictor of measles antibody levels for newborns and young children.

Objective To investigate the pregnancy outcomes of in vitro fertilization (IVF) and embryo transfer (ET) in infertile women with polycystic ovarian syndrome (PCOS).Methods From August 2005 to June 2011,200 IVF-ET cycles performed in women with polycystic ovarian syndrome in Shengjing Hospital and Shenyang 204 Hospital were enrolled in this retrospective study,matched with 400 IVF-ET cycles in infertile women with fallopian tube factors as control group.The incidence of abortion,gestational diabetes mellitus (GDM),hypertensive disorders in pregnancy,preterm birth,small for gestational age infant(SGA),large for gestational age infant (LGA),neonatal asphyxia,neonatal death and deformity was compared between two groups.Results The incidence of spontaneous abortion was 26.0％ (52/200) in PCOS group,which was significantly higher than 10.2％ (41/400) in control group (P ＜ 0.05).The incidence of GDM,hypertensive disorders in pregnancy,preterm birth,cesarean section in PCOS group was 23.6％ (35/148),16.2％ (24/148),17.6％ (26/148),83.1％ (123/148),which were significantly higher than 4.2％ (15/359),6.1％ (22/359),7.8％ (28/359),73.8％ (265/359) in control group (P ＜0.05).The incidence of SGA,LGA,neonatal asphyxia,neonatal death and deformity did not show remarkable difference between two groups,which were 2.7％ (4/148),4.7％ (7/148),5.4％ (8/148),0 in PCOS group and 1.4％ (5/359),2.2％ (8/359),2.8％ (10/359),0 in control group (P ＞0.05).Conclusion IVF-ET is an effective treatment for infertile women with PCOS,however,the incidence of spontaneous aborcion,GDM,hypertensive disorders in pregnancy,preterm birth,cesarean section in PCOS patients was increased.

Objective To summarize the clinical manifestations,pathological character,diagnosis and treatment of aggressive angiomyxoma (AAM).Methods A computer-based online search of PubMed database and CHKD database was undertaken for literature about AAM published from all the relevant documents with the key words of aggressive angiomyxon.According to the condition 210 articles were analyzed.All the articles were analyzed about natural history,clinical manifestation,diagnosis,pathological character,treatment and prognosis of AAM.Results A total of 282 cases in well-documented articles had been reported,among which 64 were male and 218 were female,with male to female ratio of 1:3.4.The age of the patients from 1 to 83 years(mean 40.38 years).The most common sites were the perineum,genital tract and soft tissue in pelvic cavity in females and the scrotum,spermatic cord and groin in males.None of the cases could be accurately diagnosed as AAM preoperatively.The minimum diameter of the tumors was 1 cm,and the maximum was 60 cm.All the specimens showed typical pathological features of AAM as reported previously.Immunohistochemistry indicated that AAM tended to be strongly positive for vimentin,CD34,Desmin,estrogen receptor,progesterone receptor but mostly negative for S-100 and Ki-67 and Actin.The medical history was from 1 month to 20 years.The recurrence of the postoperative follow-up was 2 months to 20 years.The diagnosis depended on pathological examination.Conclusions AAM is a sort of unusual soft connective tissue tumor.It is a kind of unknown cause,slow progression,locally invasive,easy to recur after tumor resection.Long-term follow-up is quite necessary because of the high rate of local recurrence.

OBJECTIVE: To explore the expression of interleukin-25 (IL-25) in chronic rhinosinusitis with nasal polyps (CRSwNP) and its potential significance in pathogenesis. METHOD: IL-25 expression in blood was detected by enzyme-linked immunosorbent assay (ELISA). IL-25 expression in tissue was detected by immunohistochemistry (LSAB method) from polyps (68 CRSwNP patients) and 55 inferior turbinate mucosa from patients with deviation of nasal septum served as control. Complete blood count and HE staining of blood and tissue eosinophil infiltration degree. RESULT: IL-25 expression in CRSwNP group were significantly higher than the control group, the difference was statistically significant (P < 0.01). IL-25 expression in local organizations was positively correlated with the number of eosinophil infiltration in CRSwNP group (r = 0.679, P < 0.01). CONCLUSION The expression of IL-25 in CRSwNP patients mutually reinforcing and might increase eosinophil infiltration and play an important role in the development of CRSwNP.
Chronic Disease ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-17 ; blood ; Nasal Polyps ; blood ; Nasal Septum ; Rhinitis ; blood ; Sinusitis ; blood ; Turbinates