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.

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.

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.

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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 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 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.

Background Glaucoma is characterized by loss of retinal ganglion cells (RGCs) followed by visual field defects.Spectral domain OCT(SD-OCT) enabled more precise and quantitative assessments of macular ganglion cell complex (GCC) thickness.Objective This study was to evaluate the diagnostic ability of GCC thickness in identifying primary open angle glaucoma (POAG).Methods A prospective study was performed.Seventy POAG patients and 30 healthy volunteers were enrolled in Beijing Tongren Hospital from November 2015 to April 2016.Macular GCC thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were measured with RTVue SD-OCT,and Humphrey perimetry was performed on the eyes.The patients were assigned to the early stage POAG group,advanced POAG group and later stage POAG group based on the mean defect (MD) of visual field.The average,superior,inferior GCC and RNFL,focal loss volume (FLV),and global loss volume (GLV) were measured and compared among the groups.The correlations between GCC thickness or RNFL thickness with MD were evaluated in the POAG eyes.The discrimination capabilities of GCC thickness or RNFL thickness were assessed and compared by using areas under the receiver operating characteristic (ROC) curves (AUC).Results Compared with the normal control group,the average,superior,inferior GCC thickness and RNFL values were evidently reduced,the FLV and GLV were significantly increased in the early stage POAG group,advanced POAG group and later stage POAG group (all at P＜0.001).Compared with the early stage POAG group,the average GCC and RNFL thickness values were significantly reduced,and GLV was increased in the advanced POAG group and later stage POAG group (all at P＜0.05).In the later stage POAG group,superior RNFL was thinner than that in the early stage POAG group (P =0.003).The superior GCC value were lower in the later stage POAG group than that in the early stage POAG group and advanced POAG group (all at P＜0.001).Compared with the early stage POAG group,the inferior GCC and RNFL thicknesses were decreased and the FLV was increased in the advanced POAG group and the later stage POAG group (all at P≤0.01).Linear positive correlations were found between average GCC,superior GCC,inferior GCC,average RNFL,superior RNFL or inferior RNFL and MD (r =0.624,0.583,0.601,0.571,0.447,0.537,all at P＜0.001),and the positive correlations were also seen between average GCC and average RNFL,between superior GCC and superior RNFL or between inferior GCC and inferior RNFL (r =0.648,0.630,0.602,all at P＜0.001).The AUCs were 0.965,0.979,0.924,0.985,0.980,0.990,0.979 and 0.992 in the average GCC,superior GCC,inferior GCC,FLV,GLV,average RNFL,superior RNFL and inferior RNFL,with the largest AUCs in the FLV and inferior RNFL thickness.No significant difference was found in the AUC between FLV and inferior RNFL thickness (P＞0.05).Conclusions Inferior GCC is more susceptible to glaucomatous damage.FLV and GLV from GCC pattern parameters are sensitive indicators for diagnosis of POAG.GCC thickness could be a valid structural parameter for detecting glaucoma and can be used as a marker in glaucoma assessment.

Objective To explore the effect of comprehensive intervention on anxiety in patients of acute myocardial infarction (AMI) undergoing intra-aortic balloon pump (IABP). Methods 50 patients with AMI undergoing IABP with the score of Hamilton Anxiety Rating Scale (HAMA) more than 14 points, were divided into conventional intervention group (n=25) and comprehensive intervention group (n=25). The conventional intervention group received all the conventional nursing measures including cognitive behavioral intervention, and the comprehensive intervention group received propofol intravenous pumping in addition with Ramsay sedation at II-III level. The vital signs, HAMA scores, major cardiovascular events, and vascular complications were recorded before and the 1st-5th days after intervention. Results The HAMA scores, systolic blood pressure, diastolic blood pressure and mean pressure decreased in most of the time points after intervention in the comprehensive intervention group (P<0.05). And there was no complication such as low blood pressure, respiratory depression. The incidence rates of cardiac arrhythmias, puncture hematoma/bleeding and catheter displacement were lower in the comprehensive intervention group than in the conventional intervention group (P<0.05). Conclusion Comprehensive intervention can improve the symptoms of anxiety in the patients with AMI undergoing IABP, and reduce the incidence of arrhythmia, vascular complications and catheter displacement.