Objective To analyze the status of family hardiness and its influencing factors in children with refractory nephrotic syndrome (RNS).Methods A cross-sectional study was carried out in the family members of 120 children patients with RNS admitted to our hospital from January 2013 to February 2016.The general information questionnaire,family hardiness scale (FHI),general self-efficacy scale (GSES),self-rating anxiety scale (SAS),self-rating depression scale (SDS) and simplified coping style questionnaire (SCSQ) were used for investigation and evaluation.The status of family hardiness of children patients with RNS was summarized and its influencing factors were analyzed.Results (1)Among the scores of family hardiness in patients of children with RNS,the score of responsibility dimension was the highest,followed by the score of control dimension.The self-efficacy scores of the family members were in the middle level,the scores of anxiety and depression were in mild level,and the score of positive coping was relatively higher.(2)The univariate analysis showed that the treatment time,education level of family members,place of residence,family per capita monthly income and medical payment method were the related factors influencing the family hardiness score (P<0.05);the Pearson correlation analysis showed that self-efficacy score and positive coping score were positively correlated with the family hardiness score (r=0.425,P=0.011;r=0.536,P=0.002),while the anxiety and depression scores were negatively correlated with the family hardiness score (r=-0.581,P=0.001;r=-0.671,P=0.000).The multivariate regression analysis showed that the family per capita monthly income,self-efficacy score,anxiety score,depression score and positive coping were the independent factors influencing the family hardiness.Conclusion The family hardiness of patients of children with RNS is in the middle and upper level.The family income,self-efficacy of family members,positive coping style,anxiety and depression emotions are related factors influencing family hardiness.

Objective:To observe the localization of chicken infectious anemia virus VP3 gene in normal cells and breast cancer cells in different times and its apoptosis-inducing effect.Methods: The fundamental cloning method,inserting the VP3 gene of chicken anemia virus into the eukaryotic expression vector pEGFP-C1 was used.Then,the positive recombinant containing VP3 gene pEGFP-C1-VP3 was transfected into human breast cancer cell line MCF-7 and mouse fibroblasts L929 by FuGENE(R)6 transfection reagent in vitro respectively.After 24 hours,48 hours and 72 hours,fluorescence microscope was used to observe the distribution of VP3 in cells and the rate of apoptosis was studied on the treated MCF-7 cells by FCM(Flow Cytometry).Results: The recombinant plasmid pEGFP-C1-VP3 could be localized in the nuclei of breast cancer cells,which showed the typical nuclear changes in different stages of apoptosis.In L929 cells,pEGFP-C1-VP3 underwent a process of migration from the nucleus to the cytoplasm,which didn′t induce apoptosis of L929 cells.Conclusion: VP3 located in the nucleus of MCF-7 breast cancer cells,which can led to cancer cell death by inducing apoptosis,and the apoptosis rate was higher than the control group with time dependence.VP3 located in the cytoplasm of normal cells,and didn′t induce apoptosis.

Objective To observe the effect of topical application with warm and wet carthamus tinctorius alcohol and anisodaminum on phlebitis caused by mannitol injection. Methods 100 patients with fractured bones suffered from phlebitis caused by mannitol injection were randomized into the observation group and the control group with 50 cases in each group. The observation group adopted topical application with warm and wet carthamus tinctorius alcohol and anisodaminum while the control received external application of 50% magnesium sulfate. The dosage was 3 hours per time,2 times a day, one time in the morning and afternoon respectively. The treatment continued till the phlebitis disappeared and the effect at the 24th,48th and 72th post treatment was compared between the two groups. Results The effect at the above mentioned time points in the obsevation group was superior to that of the control group(P＜0.05).Conclusion Topical application with warm and wet carthamus tinctorius alcohol and anisodaminum on phlebitis caused by mannitol injection proved to be safe and had no adverse effect.

A CdTe/ZnSe quantum-dot submicrobead ( QBs ) , which exhibited fluorescence intensity approximately 2800-fold stronger than that of single quantum dots, was conjugated with the anti-histidine rich protein( HRP )-Ⅱ mAbs using N-( 3-( Dimethylamino ) propyl )-N'-ethylcarbodiimide hydrochloride ( EDC ) method as fluorescence probe. The goat anti-HRP-Ⅱ polyclonal antibodies and donkey anti-mouse polyclonal antibodies were sprayed onto the nitrocellulose membrane as test line and control line, respectively. The resultant fluorescence probes were introduced to the immunochromatographic strip for the quantitative determination of Plasmodium falciparum. For determination of Plasmodium falciparum in serum, the QBs based immunochromatographic strips exhibited a good dynamic linear range from 5 . 8 Parasite/μL to 8010 Parasite/μL with a limit of detection of 5. 8 Parasite/μL. The detection time of the proposed QBs based immunochromatographic strips for each sample was only 15 min. Moreover, the recovery rates of the intra-and inter-assay ranged from 93. 0% to 111. 9%, and 98. 3% to 115. 1% respectively, while the relative standard deviations ( RSDs) of intra-and inter-assay were below 5%.

Objective To understand the effect of teacher training to provide reference for teachers' teaching methods in the standardization of clinical resident training.Method The teachers carried out five days of teacher training.Teacher training adopted the method of theory teaching and group discussion.The main content of the training had a "daily rounds with teaching","the proper use of ORIME evaluation","feedback of sandwich type","a minute tutor teaching method","SOAP method to report cases".Before the training,100 residents were randomly selected to evaluate the teaching in teaching teachers through self-designed questionnaire.After the training,the questionnaire survey was conducted among 100 residents again.All data were statistically analyzed by SPSS 22.0.The measurement data were represented by (mean or + standard deviation),and the date were compared by t test.Results Residents believed that after the teacher training,teachers' teaching level improved (P＜0.05).The three aspects of "general and phased learning goals","training students' clinical thinking ability through questions","requiring students to report cases and give guidance and feedback" were the most obvious.The pre training score was (3.28 ± 0.92) (3.31 ± 1.12) (3.55 ± 0.85),and the corresponding score was after training (3.98 ±0.85) (4.19 ± 0.85) (4.11 ± 0.74).Conclusion From the comparison of the survey results before and after the residents,the teachers' teaching modes,skills and methods have been improved after receiving teachers' training.

ObjectiveTo investigate the effects of Ningxin Shugan decoction combined with an antagonist fixation regimen on in vitro fertilization and embryo transfer （IVF-ET） outcomes and serum kisspeptin expression in infertility patients with polycystic ovary syndrome. MethodsA total of 96 infertile patients with polycystic ovary syndrome treated in Yancheng No.1 People's Hospital and Yancheng Affiliated Hospital of Nanjing University of Chinese Medicine were enrolled in this study and randomized into control and observation groups （n=48）. The control group was treated with an antagonist fixation regimen， and the observation group was treated with Ningxin Shugan decoction on the basis of the treatment in the control group. The clinical efficacy was compared between the two groups. The total score and single scores of TCM symptoms， ovulation promotion status， and serum levels of reproductive hormones， miR-335-5p， miR-141-3p， and kisspeptin were determined before and after treatment. The IVF-ET outcome indicators and treatment safety were evaluated. Pearson test was conducted to analyze the correlations of serum levels of follicle-stimulating hormone （FSH）， kisspeptin， miR-335-5p， and miR-141-3p with IVF-ET outcomes. ResultsThe total response rate in the observation group was 90.91%， which was higher than that （70.45%） in the control group （P<0.05）. The total score and single scores of TCM symptoms and the testosterone， luteinizing hormone （LH）， and LH/FSH levels declined after treatment （P<0.05）， and they were lower in the observation group than in the control group （P<0.05）. After treatment， the serum levels of FSH， kisspeptin， miR-335-5p， and miR-141-3p rose in both groups， being higher in the observation group than in the control group （P<0.05）. The observation group showed higher ovulation number， number of MⅡ oocytes， embryo implantation rate， clinical pregnancy rate， and live birth rate than the control group （P<0.05， P<0.01）. Serum levels of FSH， kisspeptin， miR-335-5p， and miR-141-3p were positively correlated with embryo implantation rate， clinical pregnancy rate， and live birth rate （P<0.01）. ConclusionNingxin Shugan decoction combined with the antagonist fixation regimen can improve the IVF-ET outcome， promote the serum kisspeptin expression， and increase the ovulation rate and pregnancy rate in infertility patients with polycystic ovary syndrome.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.