Objective:To understand the attitudes of medical students to public elective courses of humanistic quality and the existing problems. Method:Questionnaires were used in 1 ~5 grade students in randomly selected five medical colleges in Guizhou. Results:Total 1000 questionnaires were sent out, 957 were received, the recovery rate was 95. 7%;817 valid questionnaires, the effective rate was 81. 7%. 75. 56% of the students supported for medical colleges and uni-versities setting up humanistic quality public elective courses, but 24. 44% had negative attitude. Conclusions:It's nec-essary to make efforts to improve the mind medical student's humanistic quality. From the perspective of serving students, school should improve medical college students' humanistic quality from various aspects.

OBJECTIVE To evaluate the antibiotic susceptibility on coagulase negative staphylococci(CNS) in Xiangya Hospital and to investigate the role of slime in the resistance mechanism of biofilms.METHODS To isolate and identify CNS from clinical(specimens).The susceptibility of 15 antibiotics was tested by the disc diffusion method.The quantity of slime(produced) by CNS was measured by the colorimetric method.Slime was isolated from selected strains of CNS and analyzed by SDS-PAGE.The MICs to vancomycin,gentamicin and rifampin were determined with and(without) the addition of extracted slime by a standard microtiter method.RESULTS Of all these 15 antibiotics,the highest resistance to CNS was penicillin,followed by erythromycin and trimethoprim-sulfamethoxazole.CNS was more susceptible to ampicillin/sulbactam and rifampin.None was resistant to vancomycin.All of 158 CNS,except one strain,could produce slime.There was a statistical difference between the quantities of slime produced by CNS that produced high and low quantity slime.However,there was a non-statistical difference of resistance to these 15 antibiotics of above CNS. There was an increase in the MICs to vancomycin and gentamicin,but no in the MIC to rifampin,in the absence of 20mg/ml extracted slime.The extracted slime seemed to be similar to the glycosaminoglycans(GAG);it had mobility similar to that of chondroitin sulfate.CONCLUSIONS CNS can(produce slime) on some condition,universally,then to form biofilms.However,in vitro susceptibility testing(employed) cannot really reflect the susceptibility of bacteria in biofilms in vivo.Slime can increase the MICs to vancomycin and gentamicin because of interference with either the antimicrobial action of these drugs or the(perfusion) of these drugs through the medium to increase the resistance of biofilms.It does not affect the MIC to rifampin.

AIM: To construct HBx eukaryotic expression vector pEYFP-C1-X and eukaryotic expression vector pGL3-P4 driven by P4 promoter of human IGF-II gene and to investigate the effect of HBx on the transcription activity of IGF-II gene P4 promoter. METHODS: HBx gene and P4 promoters were cloned into pEYFP-C1 and pGL3-basic vectors respectively by gene recombination techniques to construct recombinant plasmids pEYFP-C1-X and pGL3-P4. HepG2 cells were transfected with pEYFP-C1-X and the resistant cell clones were selected by G418. Then methylated pGL3-P4 was transiently transfected into the above cell clones, and the transcription activity of P4 promoter was determined by dual-luciferase reporter assay system. RESULTS: (1) Aim fragments HBx gene and P4 promoter that were cloned were 465 bp and 1 246 bp, respectively and the DNA sequences were accordant with GenBank data confirmed by restricted enzyme digestion and sequencing. (2) HepG2-EYFP-X cells that expressed HBx protein were obtained. (3) Luciferase activity of methylated P4 promoter in the HepG2-EYFP-X was more than that of control cell HepG2-EYFP (P<0.01). CONCLUSION: HBx may enhance the transcription activity of the P4 promoter.

Objective:To evaluate the effectiveness and safety of anticoagulant therapy with rivaroxaban in atrial fibrillation( AF) pa-tients after radiofrequency catheter ablation( RFCA) . Methods:A retrospective analysis was performed in the study. Totally 141 AF pa-tients with RFCA in our hospital were enrolled from January 2014 to October 2015. The patients were divided into rivaroxaban group(70 patients)and warfarin group (71 patients). In rivaroxaban group,rivaroxaban(10 mg, po,qd)was given for at least 3 months after RFCA. In warfarin group,low molecular heparin (100 IU·kg-1,ih) was given before RFCA, and standard dose of warfarin (3-5 mg,po,qd) was given for at least 3 months by adjusting the INR within the range of 2. 0-3. 0 after RFCA as bridging therapy. The death rate, throm-boem bolism events and bleeding events between the groups were evaluated and companed groups. Results: There were no significant differences in baseline characteristics between the groups except the diastolic pressure. There were no significant differences in the death and thromboembolism events(transient cerebral ischemia , ischemic encephalopathy, 2/70 vs 4/71,P>0. 05)between the groups. There were no TIMI major bleeding events in both groups. There were no significant differences in minor bleeding events between the groups (3/70 vs 4/71,P>0. 05). Conclusion: Compared with those of warfarin,the effectiveness and safety of rivaroxaban show the similar effect in AF patients after RFCA. Rivaroxaban can be safely and effectively used in AF patients with low or middle risk of thromboembo-lism after RFCA.

BACKGROUND:The morphological structure of nanofiber scaffold which fabricated by electrospinning technique is similar to the natural extracelular matrix, which provides a good microenvironment for cel growth and proliferation, and can also enhance cel adhesion, migration, proliferation and differentiation. OBJECTIVE: To observe the biocompatibility of double-layer poly(L-lactic acid) electrospun nanofiber scaffold and human periodontal ligament cels. METHODS: Electrospinning technique was used to prepare double layers poly(L-lactic acid) electrospun nanofiber scaffold. The toxicity of different concentrations of (100%, 75%, 50%, 25%) double-layer poly(L-lactic acid) electrospun nanofiber scaffold extracts to human periodontal ligament cels was evaluated by MTT assay. The double-layer poly(L-lactic acid) electrospun nanofiber scaffold was co-cultured with human periodontal ligament cels. The cel adhesive capacity in early stage was determined by MTT assay. The growth of cels on the scaffold was observed by scanning electron microscopy. RESULTS AND CONCLUSION: Different concentrations of double-layer poly(L-lactic acid) electrospun nanofiber scaffold extracts did not create any toxicity to human periodontal ligament cels. After co-culture for 2, 6, 24 hours, human periodontal ligament cels were poorly adherent onto the double-layer poly(L-lactic acid) electrospun nanofiber scaffold. After 7 days of co-culture, human periodontal ligament cels adhered wel on the loose surface of scaffold, maintained the original shape, stretched wel, and interconnected processes were observed; on the dense surface of the scaffold, multi-layer cels were observed. The cels showed fusiform or polygonal appearance and were connected together. These results demonstrate that the double-layer poly(L-lactic acid) electrospun nanofiber scaffold has good biocompatibility with human periodontal ligament cels.

Objective To investigate the effect of electro-acupuncture at Guanyuanshu, Xinshu, Neiguan points on cardiac function after acute myocardial ischemia in rabbits. Methods A total of 36 rabbits were randomly divided into a control group, a model group and a treatment group. Acute myocardial ischemia was induced with Jugular vein injection of pituitrin. At 10 min before modeling, 1 hour and 1 week after modeling, the levels of malondialdehyde (MDA) and creatine kinase(CK) were determined respectively, the cardiac function was assessed as the maximum rate of left ventricular pressure rise(dp/dtmax)and the peak left ventricular pressure (LVSP). Results After 1 week of treatment, the serum levels of CK and MDA in the treatment group reduced significantly(120.21±10.67 U/L, 21.35±2.04 mmol/L], compared to the model group (162.37±13.21 U/L, 30.13±2.75 mmol/L) (all P<0.05);the dp/dtmax and LVSP decreased percentage in the treatment group (20%±2.43%, 7.22%±0.97%) decrease significantly compared to the model group (31.5%± 4.14%, 12.19%±2.21%) (all P<0.05). Conclusion Electro-acupuncture of Guanyuanshu, Xinshu, Neiguan acupoints can significantly improve cardiac function after acute myocardial ischemia and protect against acute myocardial ischemia in rabbits.

Objective To develop a curriculum of a training course for oncology nurses in regard to patient education in sexuality for breast cancer patients. Methods Delphi Method was used in the study. Two rounds of questionnaire investigation were conducted among 21 specialists in breast nursing care, sexology, and psychology. The curriculum was developed after revised based on the comments and suggestions brought up in the experts. Results The training curriculum in sexual health of the breast cancer patients for oncology nurse consisted of 5 sections, professional education, sexology, medicine, psychology and practice, which were divided into 45 teaching topics included in 13 courses. The comments of the specialists on the training curriculum were consistent. The coefficients of variation ranged from 0.07 to 0.20. The coordination coefficient was 0.344. Conclusions The current study developed an integral curriculum for oncology nurses in regard to patient education in sexuality for breast cancer patients, which will benefit oncology nurses for their nursing practice.

Objective To investigate the efficacy and safety of secondary anti-fungal prophylaxis (SAP) in haematopoietic stem cell recipients who had a history of antecedent invasive fungal infection(IFI). Methods The patients with hematological diseases,who were scheduled to undergo haernatopoietic stem cell transplantation (HSCT) in our unit from April 2005 to July 2008, received our routine conditioning regimen. Patients,who had a history of antecedent IFI,were given SAP from the start of conditioning chemotherapy until the end of the at-risk period. We chose the effective antifungal drug that was used for antecedent IFI as the secondary prophylaxis drug. Results There were 26 patients at entry. Six patients had probably adverse events (AEs) related to the secondary prophylaxis drug during the prophylactic process and the secondary prophylaxis terminated in two patients because of AEs. The remaining patients received SAP for a medium of 75 days (range 10-212 days). Relapsing IFI occurred in four patients during SAP and in one after SAP. The rate of reLapsing IFI was 19. 2% (5/26). The median time of re]apsing IFI was day 42(range,1-146). The mortality rate among relapsed patients was 60. 0% (3/5). No risk factors that might be associated with IFI was identified by logistic regression model. Conclusion Prior IFI is not an absolute contraindication for HSCT. Secondary antifungal prophylaxis can reduce the risk of recurrent infection in patients with prior IFI, but its schedule and time of therapy need further study.

Objective To investigate the nutritional risk,malnutrition rate,and nutritional support in elderly inpafients with hepatobiliary diseases.Methods Totally 156 eldedy inpatients(≥65 years)with hepatobiliary diseases were consecutively enrolled.Nutritional Risk Screening 2002(NRS 2002)was applied to screen nutritional risks on the next morning after admission and two weeks after admission or on the discharge day.Results Of 156 enrolled patients,151 patients(96.8%)completed the NRS 2002 screening.The nutrition risk and malnutrition rate were 36.9%(57/156)and 26.2%(41/156),respectively.The nutrition risk and malnutrition rate were significantly higher in patients with a hospital stay longer than 2 weeks than those with a hospital stay less than 2 weeks(49.6%and 36.7% vs.37.3%and 21.4%,respectively)(both P<0.05).In addition,100 patients(64.1%)with nutrition risk received nutrition support and 27 patients(17.3%)without nutrition risk received nutrition support.Among patients who had undergone major abdominal surgeries,137 patients(87.9%)with nutrition risk received nutrition support while 57 patients(36.8%)without nutrition risk received nutrition support.Conclusions NRS 2002 is a feasible nutritional risk screening tool for elderly inpatients with hepatobiliary diseases.A hospital stay more than 2 weeks the morbidity of the nutritional risk and malnutrition rate increased.Seems the value of nutritional support has not been well recognized in the department of hepatobiliary surgery,inappropriate application of nutritional support still exists.

Objective To investigate the clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis and grading of acute rejection of the transplanted pancreas after simultaneous pancreas-kidney transplantation.Methods Seventy cases pancreas grafts underwent gray scale ultrasound,color Doppler flow imaging(CDFI) and CEUS examination,the contrast agent perfusion processes were observed,and the parameters of time intensity curves(time-intensity curve,TIC) were calculated.The CEUS results were compared with the pathological findings.Results Twenty-one cases were acute rejection in 70 cases,of which 10 cases were mild,8 cases were moderate and 3 cases were severe;and 49 cases were non-rejection.①Gray scale and CDFI ultrasound:The pancreatic grafts of acute rejection were edema and enlarged,the parenchyma echo were decreased.The artery resistance index(RI) were significant different between acute rejection group and non-rejection group (0.77 ± 0.05 vs 0.74 ± 0.10,P ＜0.05),but there were no significant differences between mild,moderate and severe group (P ＞0.05).②CEUS:TIC curves showed a significantly longer time to reach peak [TTP,(21.7 ± 4.3)s vs (13.0 ± 2.9) s,P ＜0.01] and significantly reduced peakintensity(PI,18.8 ± 7.9 vs 29.6 ± 2.4,P ＜0.05).There was no significant difference between the mild and moderate groups (P ＞0.05) but statistically difference was found when the severe group compared with the other two groups (P ＜0.05).Conclusions CEUS can be used to observe the perfusion of the vascular and parenchyma of the pancreas,the results also can be quantitative analyzed.It is an effective method for the diagnosis of pancreas acute rejection of simultaneous pancreas-kidney transplantation.