Objective:To learn about the current medical security level of hospitalization expenses for rural children in Xiantao City, Hubei Province through the analysis of the inpatient service demand and the actual medical insurance compensation level. Methods:Access to hospitalization information for children through institutional survey;Focus group interview;Using Excel 2010 and SPSS19. 0 software to analyze data. Results:The hospitalization rate for children aged 0~4 reaches 25. 5%. Their actual inpatient reimbursement rate, which is only 44. 7%, is lower than the total population. The proportion of the expenditures out of the reimbursement directory is almost equal between the children and total population. Conclusion:This paper suggests to reduce the deductibles and increase the reimbursement rate of children's medical securi-ty, improve the settlement on ecdemic medical care, and increase the investment of pediatric medical resources.

BACKGROUND:It is a key to choose an appropriate method to trans-differentiated bone marrow mesenchymal stem cells (BMSCs)into neuron-like cells for clinical therapy of neural system injury.OBJECTIVE:To observe the feasibility of the differentiation of rat BMSCs supplemented with rat dentate gyrus extract(DGE)into neuron-like cells.METHODS:DGE was applied to induce rat BMSC trans-differentiation,using 20,40,60,80 mg/L protein concentration.Neuron differentiation was measured using Western blot to screen an optimal dosage.After trans-differentiation,different concentration treated cells were collected.Morphology change was observed following differentiation under an inverted microscope.Neuron specific enolase(NSE)and NeuN expression was determined using Western blot.NeuN expression in cells was detected using immunofluorescence technique.RESULTS AND CONCLUSION:After 7 days,60 mg/L DGE was the optimal induction dose detected by Western blot.With increased concentration,NSE and NeuN expression was increased.At 80 mg/L mass concentration,NSE and NeuN expression was reduced.At 60 mg/L DGE,BMSCs following induction became long,with synapses,Immunofluorescence NeuN staining found that neuron-like cells were positive for NeuN following induction.Results indicated that DGE is an effective biological inductor that can induce BMSC differentiation.

Objective To explore the influence of uncertainty in illness in compliance of respiratory function exer-cise and rehabilitation after surgery in patients with coronary artery bypass graft (CABG) surgery. Methods Mishel uncer-tainty in illness scale and compliance of respiratory function exercise scale were used to collect data in 108 patients with CABG. The correlation of the uncertainty in illness and compliance of respiratory function exercise was analyzed. Patients were divided into three groups (high score, medium score and low score groups) according to the detection of uncertainty in illness. Values of compliance of respiratory function exercise, postoperative care time, postoperative ventilation time, postop-erative hospital stay duration, 6-min walking test (6MWD) and left ventricular ejection fraction (LVEF) were compared be-tween three groups. Results The uncertainty in illness was in medium level (95.51±9.48) in patients with CABG surgery, which was negatively correlated with compliance of respiratory function exercise (r=-0.926, P<0.01). The postoperative venti-lation time and postoperative care time were less in low score group than those of medium score group and high score group. The compliance of respiratory function exercise, 6-min walking test and postoperative LVEF were better in low score group than those of medium score group and high score group. Conclusion Medical personnel should take targeted interventions to reduce the uncertainty in illness in patients, enhance the compliance of respiratory function exercise, reduce the postopera-tive complications and promote early recovery of patients.

Objective To explore the effect of unsupported arm exercise (UAE) on dyspnea, exercise endurance of upper limbs and qual-ity of life in patients with chronic obstructive pulmonary disease (COPD). Methods From May to October, 2014, totally 70 patients with COPD were recruited and were randomly assigned to control group and intervention group. Both groups received routine care, and the inter-vention group performed UAE for six weeks additionally. The COPD Assessment Test (CAT), baseline dyspnoea index (BDI) and six-min-ute Pegbord and Ring Test (6PBRT) were recorded. Results The scores of CAT and BDI, and the number of turns in six minutes were better in the intervention group than in the control group (P<0.05). Conclusion UAE can increase the exercise endurance of upper limbs, relieve the dyspnea, and improve the quality of life in patients with COPD.

Breast cancer is the most common cancer among females. During the time of treatment and rehabilitation, the patients and their relatives need to help them to prevent, control or relieve all sorts of complications and adverse events that beyond their medical, surgi-cal or radiation interventions, called Supportive Care Need. There are many tools to evaluate these needs, such as Supportive Care Need Sur-vey, Cancer Patients Needs Questionnaire, etc., and mainly involved the needs of health system, information, patient support, psychology, physical and daily living, and sexuality, varied with the factors of social demography, disease and treatment, and psychology;and the inter-ventions contain cognitive behavior and psychology.

Objective To investigate the correlation between professional commitment and academic self-efficiency of nursing undergraduates.Method A total of 258 students were investigated by nursing professional commitment questionnaire and academic self-efficiency scale.Results The score of professional commitment was (89.05±14.92) and the academic self-efficiency was scored (73.78±10.38).The professional commitment was positively correlated with academic self-efficiency (P＜0.01).Conclusions There are close relationships between professional commitment and academic self-efficiency for nursing undergraduates.The nursing educator should take effective measures to improve nursing students' professional commitment and academic self-efficiency.

OBJECTIVE:To determine the rheological properties of xanthan gum and to investigate its suspending effect.METHODS:Under different conditions such as light,refrigeration and additives,the NDJ-1 rotative viscometry was used to measure the change of viscosity by various rates of shearing.We used sucralfate as model drug,xanthan gum as suspension agent,and prepared 100g.L-1 of sucralfate suspesion.RESULTS:Plastic construction and thixotropy appeared in the solutions.Its optimum concentration for suspension was 3g.L-1 and this suspension appeared significant thixotropy.CONCLUSION:Some factors such as light,refrigeration and additives have no effects on thixotropy.The solution of xanthan gum can be applied as suspension agent.

Objective To do a longitudinal study of nursing undergraduates′ humanistic care ability in different period of clinical practice, and analyze its trend, aiming to provide reference about how to intervene to enhance the nursing undergraduates' humanistic care ability. Methods A total of 67 nursing undergraduates were investigated about their humanistic care ability with the Care Ability Inventory (Caring Ability Inventory, CAI) at the beginning, middle and end of the internship. Results The scores of seniors′ humanistic care ability at the beginning, middle and end of the internship were 194.97±22.93, 192.18±26.87, 187.24±22.15, and there was a statistically significant difference among the three time points (F=3.234, P<0.05), there was significant difference of the dimension of courage in different periods (F=7.511, P<0.01). Conclusions There is a downtrend of nursing undergraduates′humanistic care ability in different stages of clinical practice, and we suggest that nursing educators and administrators should consider the characteristics of different periods in the clinical practice, and then do a targeted training to foster nursing students′humanistic care ability.

P2Y12 receptor antagonists and morphine are often recommended in patients with acute myocardial infarction.P2Y12 receptor antagonists can rapidly and potently reduce the platelet activity and prevent future thrombotic events.Meanwhile,combined morphine is used to relieve symptoms of angina.A number of studies have confirmed that morphine can decrease plasma concentrations of clopidogrel and impair its anti-platelet activity,which may lead to poor response in clopidogrel-treated patients with acute coronary syndrome.The randomized trials in healthy volunteers and patients with acute myocardial infarction also confirmed the similar drug-drug interaction between morphine and ticagrelor or prasugrel.Although the P2Y12 receptor antagonists combined with morphine are still used for myocardial infarction patients,there are few report on the objective evaluation of this drug interaction.This review,based on the findings of experimental as well as observational and randomized clinical studies,summarizes completely the drug interactions between oral P2Y12 receptor antagonists and morphine.

Objective To discuss the expression and mutation of β-catenin gene in breast carcinoma.Methods 119 breast carcinomas, 72 adenosis of breast tissues and 40 normal breast tissues were studied.Using immunohistochemistry studies to detect the expressions of β-catenin, then analyzing their relationship with the clinicopathological features of breast carcinomas. Gene mutation of β-catenin (exon 3) in 44 cases of breast carcinoma were analyzed by polymerase chain reaction (PCR) and then by direct sequencing.ResultsIn 40 cases of normal breast tissues, epithelial cells showed equally strong membranous of β-catenin protein at the cell-cell boundaries. The abnormal rate of β-catenin in breast carcinomas (78.15 %) was much higher than that of adenosis of breast tissues (44.44 %), the significant correlation was found (P＜0.01). The abnormal expression of β-catenin was associated with lymph node metastasis (P=0.031). Mutation of β-catenin gene was not detected in 44 cases of breast carcinoma, while the abnormal rate of β-catenin in 44 cases of breast carcinoma was 77.30 %. Conclusionβ-catenin abnormal expression could be considered as an useful marker for determining metastasis and prognosis of human breast carcinoma and for guiding treatment. β-catenin abnormal expression is not caused by β-catenin gene mutation, maybe by other mechanisms. It needs further study.