Objective To design standardized cases to evaluate the ability of the assessment among nursing students.Methods A set of standardized cases were designed based on an international standardized nursing language as well as a textbook of health assessment and reference.After validity of the set of standardized cases had been tested by the focus group and expert evaluation,the cases were applied to test the ability of the assessment among a total of 57 nursing students.Data were analyzed statistically.Results The average score of evaluation ability of nursing students was 42.5 (15～57).Nursing students got the highest score in psychosocial dimension,accounting for 50.7％ (13.93/27.5).Among five cases,the most difficult case was case 4,the degree of difficulty was 0.36.Conclusions This set of standardized cases can be used to assess the assessment ability among nursing students,and also can be used to evaluate the effects of training.

Purpose To investigate the activity of language network with brain function connection network analysis method using MRI order statistics correlation coefficient, and to explore the temporal reliability and functional asymmetry, and provide the theoretical foundation for clinical researches of resting-state language network.Materials and Methods Twenty-five healthy volunteers were scanned three times in resting state. All data were processed using 32 bit Matlab 7.11.0 and DPARSF. The two main language functional areas, Broca and Wernicke, were selected as the regions of interest. The functional connectivity of language network was analyzed with order statistics correlation coefficient.Results Based on the functional connectivity diagrams using seed analysis method, the asymmetry index and intra-class correlation were obtained. The functional connectivity of resting-state language network based on order statistics correlation coefficient was similar to that using the traditional correlation coefficient methods. Conclusion The temporal reliability of resting-state language network can provide a reference value for clinical research of language disorders, as well as the clinical diagnosis and treatment of the language disorders or mental diseases caused by abnormal functional asymmetry of language network.

Abstract: Objective　To establish a risk prediction model for nosocomial infection in preterm very low birth weight infants, and conduct internal validation. Methods　A total of 206 cases of very low birth weight premature infants hospitalized in the Department of Neonatology of Union Hospital Affiliated to Tongji Medical College from January 2018 to June 2020 were included in this study, factors that may affect the nosocomial infection of children were collected, and the infants were divided into two groups according to whether there is nosocomial infection. The influencing factors were compared between the two groups, and multivariate Logistic regression analysis was performed after screening variables with LASSO regression. According to the results of multi factor analysis, the nomogram model was constructed and verified internally. Results　A total of 29 of 206 children had nosocomial infection (14.08%), and 33 pathogenic bacteria were detected, including 23 Gram-negative bacteria, 9 Gram-positive bacteria and 1 fungus. The results of multivariate logistic regression analysis based on LASSO regression showed that the risk factors for nosocomial infection of VLBW premature infants were 28-31+6 weeks of gestation, amniotic fluid pollution, mechanical ventilation, indwelling gastric tube, unreasonable use of antibiotics, and hospitalization time ≥ 7 days. The protective factors were Apgar score ≥ 7 points at 1 min and breast feeding accounting for 50% or more (P<0.05). The Area Under Curve (AUC) of ROC curve of nomogram model was 0.946 [95%CI(0.923, 1.000)]. The calibration curve showed that the probability of hospital infection predicted by the model was basically consistent with the actual probability. The decision curve showed that when the probability threshold of nomogram model to predict the risk of nosocomial infection of very low birth weight premature infants was 0-0.85, the net rate of return was greater than 0. Conclusion　Preterm infants with extremely low birth weight are at high risk of nosocomial infection, mainly affected by factors such as gestational weeks, hospitalization time, amniotic fluid pollution, etc. The nomogram model constructed by the above factors has high accuracy and discrimination for predicting nosocomial infection in such children.

ObjectiveTo investigate application value of parametric image processing in contrastenhanced ultrasound imaging in diagnosis of ovarian masses. MethodsFifty cases with ovarian masses underwent routine ultrasound and contrast-enhanced ultrasound imaging using a new dedicated parametric image processing software SonoLiver to analyze patterns of vascular formation and blood stream perfusion in the ovarian mass tissues on a digital video recorder in real time, compare their morphological characteristics of time-intensity curve (TIC) and dynamic vascular patterns (DVP) curve, and analyze quantitatively all indicators generated by SonoLiver.ResultsIn ultrasound imaging of the 50 cases, there were 24 cases (86％) displaying mainly blue lowly-enhanced imaging in those with benign masses and 15 cases (68％)displaying mainly red highly-enhanced imaging in those with malignant masses, with statistical significance (P ＜0. 01 ). There was significantly different characteristics of TIC and DVP between patients with benign and malignant masses. In 23 cases with benign masses, their DVP were significantly higher above the baseline than in those with malignant ones ( P = 0. 000), and in 15 cases with malignant lesions, their DVP were much shorter below the baseline than in those with benign ones, with statistical significance (P ＜0.05). The intensity of contrast medium, the time to reach its peak intensity and average transit time were all significantly higher in those with malignant masses than in those with benign ones (all P ＜ 0. 05 ). But, no statistical difference in the time of initial increasing between the two groups was found (P ＞ 0. 05). ConclusionsThere is significant difference in TIC and DVP of ultrasound imaging between benign and malignant masses, which if combined with contrast enhanced ultrasound parametric image processing can provide a more visualized quantitative information of benign and malignant ovarian masses with SonoLiver software.

Objective To investigate the effect of splenectomy on infarct volume in middle cerebral artery occlusion in focal cerebral ischemia rats and its possible mechanisms.Methods Eighteen male Sprague-Dawley rats were randomly divided into spleneetomy,sham splenectomy,and control groups (n =6 in each group).A model of middle cerebral artery occlusion (MCAO) was induced by the intraluminal suture method 2 weeks after spleneetomy.The rats were decapitated and their brains were removed after 24 hours.The infarct volume was measured with Nissl body staining The number of macrophages in ischemic cortex was detected with immunofluorescence staining Results The infarct volume in the splenectomy group (34.93％ + 3.23％ )was significantly smaller than that in the sham splenectomy group (74.33％ + 2.36％ ; q =39.399,P ＜ 0.001 ) and the control group (77.30％ + 2.62％ ; q =42.369,P ＜ 0.001 ).However,there was no significant difference between the sham splenectomy group and the control group (q =2.970,P =0.082).The number of macrophages of the ischemic cortex in the splenectomy group (3.4 ± 1.07/per high power field) was significantly less than that in the sham splenectomy group (20.7±4.37/per high power field; q =17.300,P＜0.001) and the control group (18.87 ±4.17/per high power field; q =15.467,P ＜0.001).However,there was no significant difference between the sham splenectomy group and the control goup (q =1.833,P =0.384).Conclusions Splenectomy may reduce the infarct volume by reducing the number of macrophages in ischemic corticalregion.

Objective : To investigate the awareness of human papillomavirus ( HPV ) vaccine and willingness to vaccinate daughters among parents of primary and middle school students, so as to provide the reference for the promotion of HPV vaccine in primary and middle school girls. Methods : Using multi-stage stratified cluster sampling method, the parents of girls in in Grade Four to Nine from schools in Gongshu District of Hangzhou, Xiuzhou District of Jiaxing and Wuxing District of Huzhou were selected. A questionnaire survey was conducted to collect demographic information, HPV vaccine related knowledge and willingness to vaccinate daughters with HPV vaccines. The multivariate logistic regression model was used to analyze the influencing factors for the willingness to vaccinate daughters with HPV vaccines among parents. Results : Totally 1 500 questionnaires were sent out, and 1 466 were effectively collected, with an effective rate of 97.73%. There were 313 fathers responded, accounting for 21.35%; and 1 153 mothers responded, accounting for 78.65%. The awareness rate of HPV vaccine was 16.81%. The rate of willing to vaccinate daughters with HPV vaccines was 49.86%. The multivariate logistic regression analysis showed that the patients who ever vaccinated daughters with self-paid vaccines ( OR=1.935, 95%CI: 1.473-2.541 ), knew cervical cancer ( OR=1.424, 95%CI: 1.065-1.904 ), knew HPV vaccine dose ( OR=1.672, 95%CI:1.216-2.301 ), knew the best vaccination period ( OR=1.392, 95%CI: 1.032-1.876 ), knew the need of cervical cancer screening even after vaccination ( OR=1.596, 95%CI:1.227-2.075) were more willing to vaccinate daughters with HPV vaccines, while the parents who thought HPV vaccine expensive ( OR=0.154, 95%CI: 0.099-0.240 ) were less willing to vaccinate daughters with HPV vaccines. Conclusions The rates of HPV vaccine awareness and willingness to vaccinate daughters are 16.81% and 49.86% among parents of primary and middle school students. Their knowledge of HPV vaccine and the price of the vaccine may affect their willingness to vaccinate daughters.

Objective To analyze the clinical characteristic of Chinese autoimmune pancreatitis (AIP) patients.Methods All clinical data of 81 patients with a diagnosis of AIP in Shanghai Changhai Hospital from February 2005 to May 2012 were analyzed.Results The sex ratio was 7.1∶1 and the mean age was (57± 12) years old in 81 patients with AIP.Obstructive jaundice was the initial symptom in 51.9％ (42/81) patients.In patient receiving CT,focal and diffuse type accounted for 45 and 35 patients.respectively,and pseudocyst was the main manifestation in 1 patient,biliary tract was involved in 59(72.8％ ) patients,dilatation of main pancreatic duct was observed in 5 ( 11.1％ ) patients.In patients receiving PET-CT,diffuse increased Flourine-18 FDG uptake by the pancreas was found in 11 patients,focal increased uptake in 2patients,and significant extra-pancreatic uptake was found in 5 patients.The positive rate of serum IgG4,CA19-9,ss DNA,anti-nuclear antibody and ds-DNA antibody was 94.6％ (53/81),54.4％ (37/68),14.3％ (4/28),10.7％ (3/28),7.1％ (2/28),respectively.The pathological findings of H-E staining and IgG4 immunohistochemical analysis in 20 patients were consistent with lymphoplasmacytic sclerosing pancreatitis.Conclusions Type 1 AIP is the main subtype of AIP in China.Combining clinical symptoms,extra-pancreatic manifestations,imaging or nuclear medicine findings,serology,cytology or histology can effectively increase the correct diagnosis rate of AIP.

Objective Analyze current clinical practice guidelines related to pre-anesthesia as-sessment to provide a resource for healthcare providers (or institutions)seeking protocols of their own.Methods National and international guideline databases were searched along with healthcare or-ganizations and associations.Content analysis method was used to analyze clinical practice guidelines searched from internet and obtained in the database search.Results Five clinical practice guidelines were included.A total of 39 items related to pre-anesthesia assessment were identified and when divid-ed into 3 essential areas:1)past history and present medical,2)physical examination,and 3)labora-tory examination.There is no guidance to general anesthesia currently in China.Pre-anesthesia testing in the presence of specific clinical characteristics was recommended.Conclusion We should develop local clinical practice guidelines of preanesthesia assessment with consideration of the actual medical situations in China.

OBJECTIVE:To optimize extraction technology of protein from Cryptotympana pustulata and investigate its in vitro antioxidant activity,so as to provide reference for further research of protein from C. pustulata. METHODS:Using extraction amount of protein as response value,based on single factor test,Box-Behnken response surface methodology was used to optimize the ratio of liquid to material,ultraonic time and extraction times.Validation test was conducted. Using Vitamin C(VC)as positive control, in vitro antioxidant activity of protein from C. pustulata was evaluated by using scavenging rate of 1, 1-diphenyl-2-picrylhydrazyl(DPPH)and 2,2′-azino-bis(3-ethyl benzothiazoline-6-sulfonic acid)(ABTS)free radical as index. RESULTS:The optimal extraction condition of protein from C.pustulata was as follows as the ratio of liquid to material 28:1(mL/g), ultrasonic time of 65 min,extracting for twice. In validation test,average extraction amount of protein from C. pustulata was 65.45 mg/g(RSD=1.68%,n=3),relative error of which to predicted value was 5.48%. The protein from C. pustulata showed strong scavenging effect on ABTS and DPPH free radicals. When the concentration of protein from C. slough was 0.2 mg/mL,and the scavenging rate of it to ABTS free radicals was 97%,the effect of which was similar to VC.The protein from C. pustulata showed weak scavenging ability to DPPH free radical,IC50was 0.96 mg/mL,the effect of which was not as good as VC. CONCLUSIONS:The extraction technology of protein from C. pustulata optimized by Box-Behnken response surface methodology shows high accuracy and good reliability.The protein from C.pustulata shows certain antioxidant activity in vitro.

OBJECTIVE：To study the difference of dissolution performance of chemical component and anticonvulsant effect of Bombyx mori decoction and powder taken with water，and to provide reference for the selection of application forms of B. mori. METHODS：The yield of dry extract was determined for decoction and powder biomimetic gastric juice of B. mori. HPLC method was used to detect the content of ammonium oxalate in decoction and powder biomimetic gastric juice of B. mori. The content of protein in decoction and powder biomimetic gastric juice of B. mori was determined with bicinchoninic acid（BCA）method. Mice was divided into normal group（1％Sodium carboxymethylcellulose solution），model group（1％Sodium carboxymethylcellulose solution），positive group （phenytoin，2 mg/kg） and B. mori decoction and powder suspensions high-dose，medium-dose and low-dose groups（0.75，1.5，3 g/kg by crude drug）according to random number table，with 20 mice in each group. After 60 min of intragastric administration，electric stimulation was conducted，and the rate of convulsion in mice was recorded. RESULTS：The yields of dry extract were 22.08％ and 26.40％ in decoction and powder gastric juice of B. mori （P＜0.05）；the contents of ammonium oxalate were 11.22％ and 16.83％ （P＜0.05），and the contents of protein was 3.39％ and 4.92％ （P＜0.01）. Compared with normal group，convulsion rate of mice was increased significantly in model group （P＜0.01）；compared with model group，convulsion rates of mice were decreased significantly in administration groups （P＜0.05 or P＜0.01），and the convulsion rate of mice in B. mori powder suspensions group was lower than decoction group. CONCLUSIONS：The dissolution performance of the chemical component from gastric juice of B. mori powder is better than that of decoction， and the anticonvulsant effect of B. mori powder is better than decoction.