Objective To investigate the level and characteristics of working satisfaction of nurses, explore the role of top-up continuing education in clinical nursing work,and provide effective basis for the reasonable nursing post arrangement for nursing administrators. Methods Using cluster sampling method, the general information and the self-designed working satisfaction of clinical nurses questionnaire survey for 926 nurses from 22 three level of first-class hospitals of Guangxi Zhuang Autonomous Region. Results The total score of working satisfaction of the upgraded nurses was higher than that of the junior college nurses. The scores comparison of 6 dimensions which were nursing working identity, the work to be recognized, job autonomy, interpersonal relationship, scientific research and teaching opportunities, personal professional development were (29.25±6.27) points vs. (21.39±5.72) points, (21.96±4.73) points vs. (18.22±3.79) points, (16.67±5.21) points vs. (13.16±4.28) points, (17.83±3.56) points vs. (13.37±4.21) points, (21.32±4.63) points vs. (15.73±5.16) points, (20.51±3.52) points vs. (15.17±4.22) points, the difference was statistically significant (t=3.936, 2.762, 2.936, 3.323, 7.616, 6.215, P<0.05). There was no statistical difference between them in 2 dimensions which were scheduling situation, welfare treatment (P>0.05). Conclusions After upgraded continuing education, the comprehensive quality of nurses has been improved,and the working satisfaction has been improved significantly.

Objective To investigate the expressions of regulatory T cell (Treg) and interleukin-35 (IL-35) in patients with cholangiocarcinoma and to explore their clinical significance.Methods Flow-cytometry,PCR,Enzyme-linked immunosorbent assay (Elisa) and immunohistochemistry were used to detect the levels of Treg and IL-35 in peripheral blood and cholangiocarcinoma tissues in 42 patients with cholangiocarcinoma.Healthy volunteers were used as a control group.Result The percentage of Treg cells to CD4 + T cells in patients with cholangiocarcinoma was (5.6 ± 1.7) ％,while that in the normal control group was (2.9 ± 0.8) ％.There was a significant difference between the two groups (P ＜ 0.05).The plasma levels of IL-35 in patients with cholangiocarcinoma was (198.4 ± 81.4) pg/ml,while that in the normal control group was (33.7 ± 18.0) pg/ml.Again,a significant difference was observed between the two groups (P ＜ 0.05).In peripheral blood mononuclear cell,the IL-35 mRNA level was positively correlated with the plasma IL-35 level (p35,R =0.795,P ＜0.05;EBI3,R =0.812,P ＜ 0.05).Immunohistochemical studies showed that FOXP3 + tumor cells and Treg cells increased significantly in tumor tissues.Conclusion Overexpressions of Treg and IL-35 in peripheral blood and tumor tissues of patients with cholangiocarcinoma suggested that they may play important roles in the development of cholangiocarcinoma.

Objective To investigate the use of laryngeal mask airway (LMA) ProSeal for airway management during open heart surgery performed under CPB in children. Methods Seventy-six ASA Ⅱ and NYHA class Ⅰ or Ⅱ patients aged 3 months-8 yr, weighing 3.3-34.5 kg undergoing open heart surgery under CPB were randomly divided into 2 groups ( n = 38 each): tracheal intubation group (group T) and ProSeal LMA group (group P1). Tracheal tube and LMA were inserted after induction of anesthesia with 8% sevoflurane. The rate of successfultracheal intubation and LMA placement, placement time, peak airway pressure and side effects during and after surgery including hypoxemia, tachycardia, bradycardia, hypotension and hypertension, laryngesl edema, dysphagia, bucking, dyspnea and hoarseness were recorded. Results There were no significant differences in the rate of successftl tracheal intubation and LMA placement, peak airway pressure, bucking, dyspnea and hoarse voice between the two groups (P＞ 0.05). The LMA placement time was significantly shorter than tracheal intubation time and the incidence of laryngeal edema and dysphagia lower in group P than in group T ( P ＜ 0.05). Conclusion The LMA ProSeal can provide adequate ventilation during operation with less complications and can be used effectively for cardiac surgery performed under CPB in children.

Clinical research design is the beginning and the cornerstone for clinical research,and it functions as the preliminary step of translational research.In order to improve clinical research ability,foster quality research talents team,and to promote the development of translational research,Peking Union Medical College Hospital (PUMCH) started to provide the online course Designing Clinical Research (DCR),which has greatly contributed to enhancing clinical research capacity.The management of DCR online course serves as a great exploration on training junior medical professionals and international research collaboration.This study aims at sharing the management experiences of clinical research design and junior talents training.

Objective To provide effective reference for quality analysis of the chemical composition and extraction of astragalus separation process by comparing the extract of astragalus and it’s IR spectra. Methods The saponins and flavonoids in astragalus were firstly extracted by the method of circumfluence with ethanol as solvent and the residue of ethanol-extraction was then used to extract polysaccharides by distilled water. Fourier transform infrared spectroscopy (IR) combined with second derivative infrared spectroscopy was applied to quickly identify astragalus herbs powder, water extraction of astragalus, astragalus alcohol extraction and water extraction of the residue of ethanol-extraction. Results The powder and 70% ethanol extract, 80% ethanol extract were around at 1 735 cm-1 (carbonyl stretching vibration absorption peak) has a weak, broad absorption, while the absorption peak was less obvious in boiling water extraction. So the maln components of astragalus water extraction are polysaccharides and also contaln a small amount of water-insoluble flavonoids. Alcohol extraction malnly contalns saponins and flavonoids, and flavonoid extract volume increases with increasing alcohol concentration in a certaln range.Conclusion This method can be a quick and easy identification for astragalus and it’s extraction for its chemical composition class, and provide the basis for further research quality.

Objective To analyze the clinical characteristics and risk factors for post-traumatic seizures (PTS) in children,so as to provide a theoretical evidence for clinicians to prevent PTS.Methods From January 2010 to November 2016,the clinical data and auxiliary examination of 388 post-traumatic patients hospitalized at the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.According to the presence of epileptic seizure,these patients were divided into PTS group and non post-traumatic seizures (nPTS)group.The risk factors associated PTS were investigated by univariate analysis.Results Among the 388 post-traumatic children,72 cases had seizures,which occurred almost predominantly less than 1 year.Fifty-six point nine percent (41/72 cases) were immediately PTS,and 31.9％ (23/72 cases) were early PTS,and 11.1％ (8/72 cases) were late PTS.Among the seizures types,generalized seizures accounted for 51.4％ (37/72 cases),and tonic-clonic seizures were in common;focal seizures accounted for 36.1％ (26/72 cases);focal combined generalized seizures accounted for 2.8％ (2/72 cases),and the remaining 9.7％ (7/72 cases) were ominous.Electroencephalogram showed the slow wave and spike wave most common.There were significant differences in factors statistically,included age,Glasgow Coma Scale (GCS) score,the severity of traumatic brain injury,cerebral contusion,subdural hematoma,therapy method between the patients with seizures group and the patients without seizures group (Z =4.717,x2 =13.079,17.852,5.664,17.457,5.496,all P ＜ 0.05).In single factor analysis and multi-factor regression analysis,age,GCS score,the severity of traumatic brain injury,subdural hematoma,therapy method were associated with the incidence of PTS (all P ＜ 0.05).Conclusions PTS is a severe complication of brain trauma in children.Small age,GCS ≤8 scores,severe brain injury,subdural hematoma,surgery are the risk factors of PTS.

Objective The study reviewed the exchanges and the outcome of the research cooperation of the platform of the Beijing International Cooperation Base for Science and Technology (ICBST),to explore a combined mode of internationalized research management of "base","talents" and "projects".Methods To analyze the outcomes of talents programs,international research cooperation projects and publications with the support of the Beijing ICBST.Results The establishment of BICBST has nurtured research talents to develop international vision,facilitated project-oriented international research cooperation,and encouraged high level research publication and grants.Conclusions ICBST is of great significance for the implementation of international research cooperation,which brought in more resources,cultivated a group of creative research talents,and broadened the channels for international collaborations and achieved capacity and influence of international competitiveness.

Objective To understand and analyze the effect and impact on Hospital-level Young Scholar Scientific Research Program in personal training and project promoting.Methods To review and analyze the archived documents and data materials of total 402 Young Scholar Scientific Research Program involving 339 young fellows from 2003 to 2013,compared the research input and output with general hospital level,including getting new fund,publications,Awards and patent.Results Output on researchers with Young Scholar Scientific Research Program is much higher than the general hospital level,but showing unbalanced distribution in medical disciplines.Conclusions To establishment of Young Scholar Scientific Research Program has achieved very good effect in promoting research in tertiary public hospital as well as has empowered the young fellows for conducting scientific research independently.It is proposed to go on strength the scientific management and optimize the system construction of research input,further establishing academic communication platform for young fellows.

Chondroitin sulfate (CS) is a sulfurated glycosaminoglycan, a major component of the extracellular matrix, widely distributed in skin, cartilage and vascular tissue. CS plays an important role in the physiological state regulation of articular cartilage, which affects tensile strength and elasticity of tissues by influencing aggrecan. Previous studies have shown that CS sulfate modification may be related to the growth and development disorders of cartilage tissue and the occurrence of osteoarticular diseases. At the same time, CS is also a common joint supplement, often used in the treatment of osteoarthritis and Kashin-Beck disease. In this paper, the research progress of CS sulfate modification characteristics in Kashin-Beck disease and osteoarthritis and the application of the preparation in the treatment of Kashin-Beck disease and osteoarthritis are reviewed, aiming to provide help for the investigation of the etiology of Kashin-Beck disease and the treatment of osteoarthritis and Kashin-Beck disease.

The competency-based medical education has formed a global trend, and puts forward a greater challenge for educational design of resident training. The traditional curriculum cannot meet the goal of competency-based education as the curriculum design is lack of theoretical support. Curriculum design is the core of training content, and serves as a significant contributing factor of training outcome. Based on the six-step approach curriculum design, the theory and practice are integrated to form a curriculum design based on theoretical guidance. Through feedback evaluation, the current curriculum design is continuously improved in order to achieve a higher competency-based training quality. With the 5-year experiences and practice, preliminary reform demonstrates effectiveness. The current study hopes to share the teaching reform experiences of residency training base and provide references for colleagues of medical education.