Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Humans ; Purpura, Thrombotic Thrombocytopenic ; therapy ; Rituximab

Objective To investigate the evaluation of the employing hospital about nursing undergraduate students,to understand the actual working capacity of graduates and explore the quality requirement and individual needs of nuring undergraduates according to the findings,to improve the quality of nursing undergraduates and personnel training specifications.Methods The self-evaluation questionnaires on nursing undergraduates was used to investigate eight hospitals which accepted three or more graduates of our college by letter investigation.Results The employing hospital had the highest satisfaction degree on the moral character and working attitude,respectively 98.1%and 96.2%;the satisfaction degree of management and research capability was the lowest,respectively 81.0%and 80.0%. Conclusions Overall assessment of the quality of graduates is better,the graduates' clinical competence,interpersonal relations and psychological quality is satisfactory,nursing skills and adaptability should be improved;foreign language,scientific research,administration and management capacity is rehtively weak.In the future,the college should adapt to the reeds of employers in the teaching process,strengthening the training of practical ability and adaptability,using appropriate methods to enhance research and foreign language skills,appropriately adjust training goal of undergraduates.

[Objective] To retrospectively study and discuss the indications,surgical techniques and effect of treating hallux valgus with modified Austin operation-Chevron-Gerbert osteotomy or Chevron-Youngswick osteotomy.[Method]From October 1998 to April 2006,34 patients(62 feet)with hallux valgus were treated with modified Austin operation.The X-ray films of all patients were collected preoperatively,two weeks postoperatively and during the follow-up.The hallux valgus angle(HVA),intermetataral angle(IMA),proximal articular set angle(PASA)and distal articular set angle(DASA)were measured and analyzed on radiogram.[Result]All patients were followed up for 1-8 years(mean 3.6 years).HVA before and after surgery was 33.50??1.02?and 13.6??0.826 respectively.IMA was 16.0??0.837?before and 8.6??1.078 after surgery.AOFAS score was 44.8?5.7 before,and 87.6 4.2 after surgery.Significant difference was found between the results.According to AOFAS rating system,46 feets had a excellent result and 10 feet had a good result and the other 5 feet had a fair result.The rate of excellent or good results was 90.3%.[Conclusion]The modified Austin operation is a good,simple and reliable operation means for treatment of hallux valgus,which especially applies to severe hallux valgus with big PASA.The adductor hallucis or the sesamoid is not necessarily interfered in patients with slight or moderate hallux valgus.

Objective: To prepare the conjugate of supcrantigen (SAg) staphylococcal enterotoxin A (SEA) and monoclonal antibody (McAb) against human hepatocellular carcinoma HAbl8 F(ab' )_(2) fragment and to investigate the anti-human hepatoma effect of peripheral blood mononuclear cells (PBMC) targeted by HAbl8 F(ab' )i-SEA. Methods: McAb HAbl8 was extracted and its F(ab' )_(2) fragment was prepared with papain; the conjugate HAblS F(ab' )_(2)-SEA was prepared with N-succinimidyl-3-(2-pyridyldithio) propionate (SPDP); eveny collected peak after purification was identified with gel chromatography; the activity of antibody in the conjugate was identified with immunohistocheinical ABC method; the anti-hepatoma effect of PBMC targeted by HAbl8 F(ab' )_(2)-SEA was observed with MTT method. Results: The conjugate HAbl8 F(ab' )_(2)-SEA was prepared successfully and it had obvious effect of targeting PBMC to kill hepatoma cells, and this effect is correlated positively with the dose of HAbl8 F(ab')_(2)-SEA. Control groups had no such effect. Conclusion: Targeting therapy of hepatoma with McAb-SAg conjugate might be a kind of hopeful model of hepatoma im-munotherapy.

Objectives To help nursing students to adapt to the environment of the job interviews by simulation interview, train the students'psychological quality and the adaptability, give the necessary guidance for seeking job after graduation. Method Five interview groups were composed by 15 nurse executives and interpersonal communication teachers from 4 hospitals, after the simulation interview, the students were surveyed using the self-desigued questionnaire. Results There are 10 items having the most significant influence, 10 items having more obvious influence the last 7items.Conclusion It can improve all aspects'ability of the students effectively through carrying out the simulation interview pertinence, and can help the students find job successfully.

The incidence of toileting problems is associated with the level of intellectual disability,and more common among the children with severe intellectual disability.This paper would review the classification,prevalence,consequences,origins of toileting problems,and also include the descriptions,assessment and practical considerations of behavioral interventions.

Objective To evaluate the optimal surgical approach for huge liver neopiasms in the caudate lobe.Methods Thirty-three patients with huge liver neplasms（≥10cm) underwent caudate lobectomy at a single tertiary referral center between January 2001 and June 2007.The surgical out-comes of pateints who underwent isolated caudate lobectomy or caudate lobectomy combined with partial hepatectomy were compared.Result Fifteen（45.5％）of 33 patients underwent isolated total or partial caudate lobectomy（group A）,whereas 18（54.5％) had total or partial caudate lobectomy cellular carcinoma (HCC) (51.5％),followed by hemangioma(21.2％),intrahepatic cholangiocarcinoma(9.1％),angiomyolipoma(6.1％),hepatic adenoma (3％),focal nodular hyperplasia(3％),colorectal liver metastases(3％)and sarcoma(3％).The median diameter of the tumour was 12.3 (range,10.2-21)cm.Patients in group A had significantly longer operative time (280 minutes vs.170 minutes),longer length of hospital stay (17 days vs.12 days)and more blood loss(1250 ml vs.670 ml) than patients in group B.There was no perioperative death in the 2 groups of pateints.Complication rates in group A and group B were 26.7％ and 16.7％ respectively.There was no disease-related death in patients with benign lesions.The1-,3- and 5-year disease-free survivals of patients with malignant lesions in group A and group B were 25.9％,0％,0％and 74.3％,46.7％,31.2％,respectively.The 1-,3- and 5-year overrall survivals were 68.6％,19.7％,0％ and 100％,66.5％,41.8％,respecively.Conclusion The approach to caudate lobectomy depends on the size and location of the lesion and the liver functional reserve.For patients with sufficient liver functional reserve,caudate lobectomy combined with partial hepatectomy is preferred because it is technically less demanding.For patienls with marginal liver functional reserve,isolated caudate lobectomy is the only viable surgical option.

Objective To explore the effects of a microbubble agent (SonoVue) on radiofrequency ablation(RFA).Methods Twenty rabbits underwent RFA with or without SonoVue on two areas per rabbit liver.SonoVue were injected in bolus intravenously in 0.1 ml/kg.The morphology of hyperechogenic area were observed by conventional ultrasonography.The size of RFA lesions and ablation time were measured.The correlation was analyzed between hyperechogenic area and ablation size.Results Microbubbles didn't change the size of RFA lesions.However,with the addition of SonoVue to ablation,the morphology of hyperechogenic area was showed more regular and stable,and hyperechogenic area and ablation size were well correlated (r =0.849,P =0.000).Besides,the ablation time was much shorter (P ＜ 0.05).Conclusions The addition of SonoVue to ablation improve the prediction of ablated areas and reduce the ablation time,therefore it might be useful to prevent the unfavorable ablation of adjacent organs and vessels.

Objective To investigate the effects of paired associative stimulation (PAS) on the recovery of upper limb motor function in stroke patients,and to analyze the relationship between the change of motor cortex excitability in the contralesional hemisphere and the recovery of motor function in the affected upper limb.Methods Thirty hemiplegic stroke patients were divided randomly into a treatment group and a control group.Both groups were given routine rehabilitation therapy,but the treatment group also received PAS consisting of transcranial magnetic stimulation (TMS) of the intact motor cortex and electrical stimulation (ES) of the median nerve at the wrist of the intact arm with an interval of 10 ms between the TMS and ES (PAS10).The PAS10 was delivered at a frequency of 0.05 Hz and an intensity of 120％ the resting motor threshold (RMT),once daily for 30 minutes,five times a week for 4 weeks.Corticospinal excitability was measured using motor evoked potentials (MEP) and the RMT.The FuglMeyer upper limb assessment (FMA),Brunnstrom staging and the modified Barthel index (MBI) were also applied before and at the end of the 4 weeks of treatment.Correlation was sought between any changes in MEP amplitude,the RMT of the contralesional hemisphere and changes in the FMA results.Results Before the intervention there were no significant differences between the two groups in terms of any of the assessments.After 4 weeks of treatment,all the assessments had changed significantly compared to those before the treatment,but there were still no significant differences between the two groups in terms of any the assessments.After 4 weeks of treatment,the differences in MEP amplitude from the contra-lesional hemisphere and the differences in FMA scores were positively and significantly correlated with a correlation coefficient of r =0.431.The lesioned hemisphere was also positively correlated with the differences in FMA scores with a significant correlation coefficient of r =0.608.Conclusion PAS10 can facilitate the recovery of upper limb motor function.The change in motor cortex excitability of the contra-lesional hemisphere significantly correlates with functional recovery in the upper limb.

Objective To explore the effect of acupoint injection of bone marrow mesenchymal stem cells (BMSCs)on hemodynamics of rat model with acute myocardial infarction(AMI). Methods Sixty Sprague-Dawley (SD)rats were randomly divided into sham group,model group,myocardium injection BMSCs group and acupoint injection BMSCs group(each n=15). The left anterior descending coronary artery(LAD)was ligated to establish a rat model of AMI. After the rat model was successfully established for 72 hours,0.2 ml BMSCs(1×1010/L)were transplanted by a micro-quantity syringe at 6 points in equal amount in the LAD blood-supply area and its periphery in the myocardial injection group,while in the acupoint injection group,0.3 ml BMSCs(1×1010/L)was transplanted at each of the following acupoints:Xinshu,Zhiyang and Tanzhong. Four weeks after AMI,polyethylene tubing was inserted into the right carotid artery to measure the hemodynamics,at the same time animals were sacrificed,and the heart was take out to calculate the heart mass index(HMI)and left ventricular mass index(LVMI). Results One, 3,5 and 4 rats were respectively dead in the sham group,model group,myocardium injection group,and acupoint injection group during the experimental period. Compared with the sham group,the left ventricular systolic pressure (LVSP,mm Hg,1 mm Hg=0.133 kPa),the maximum rate of increase of left ventricular pressure(+dp/dt max, mm Hg/s), the maximum rate of decrease of left ventricular pressure(-dp/dt max,mm Hg/s), the maximum logarithmic change rate of left ventricular pressure〔(dp/dt)?P-1max,s-1〕,HMI(mg/g),LVMI were significantly decreased,and left ventricular end-diastolic pressure(LVEDP,mm Hg),heart rate(HR,bpm)were obviously increased in model group(all P<0.05). Compared with the model group,the LVSP,+dp/dt max,-dp/dt max, (dp/dt)?P-1max, HMI,LVMI were significantly increased in myocardial injection group and acupoint injection group〔LVSP:130.38±14.96,124.36±14.36 vs. 114.36±12.71,+dp/dt max:4707.52±394.36,4597.14±411.05 vs. 3791.43±327.29,-dp/dt max:4075.11±317.89,3938.05±373.76 vs. 3116.32±275.04,(dp/dt)?P-1max:215.26±21.29,197.39±18.96 vs. 155.93±25.14〕,and the LVEDP and HR were significantly decreased(LVEDP:5.15±2.39,5.64±1.96 vs. 10.58±2.49,HR:400.50±42.58,395.55±44.62 vs. 414.51±35.75,all P<0.05). There were no significant differences in above indexes between myocardium injection group and acupoint injection group. Conclusion Acupoint injection of BMSCs can improve the heart function of rat model with AMI.