Objective To explore the current situation of nursing students′ self-learning and its influencing factors in the western China.Methods Based on the method of proportion allocation in stratified random sampling,the self-made general questionnaire and Williamson self-directed learning rating scale(translated by Shen Wangqin)were used for questionnaire survey among full-time nursing undergraduates and junior college students in four universities.Results The self-directed learning ability of nursing students was in general at a medium level;and the dimensions with the highest score and the lowest score were interpersonal relationship skills and learning behaviors.The self-directed learning ability of top public university was better than that of basic public universities(P<0.01);and the degree of self-directed learning ability of nursing students who were girls,in senior classes,voluntarily choosing and showing interest in this major was higher than those of other students(P<0.05);the motivation,learning interest,self-directed learning time per week were positive factors,and the learning difficulties acted as a negative impact factor.Conclusion The main factors influencing the self-directed learning ability of nursing students include the grade,gender,the willingness to choose the nursing major,the degree of preference for the nursing major,learning motivation,and learning interest.

Abstract?AlM: To investigate the relationship between carotid artery stenosis and ischemic ocular diseases.?METHODS: The clinical data of 30 cases ( 37 eyes ) of patients with ischemic eye diseases were collected from November 2010 to May 2014, and they were accepted the fundus fluorescein angiography ( FFA ) , transcranial Doppler ( TCD) ultrasonic blood vessels of the eye, neck vascular color Doppler flow imaging ( CDFl) , the neck CT angiography ( CTA ) and carotid artery digital subtraction angiography ( DSA) examination, and then the ischemic eye disease patients with ocular symptoms were analyzed. The peak systolic velocity ( PSV) and resistance index ( Rl) of ophthalmic artery and central retinal artery were compared. Correlation between the internal carotid artery intima- media thickness ( lMT ) and ophthalmic artery, central retinal artery PSV and Rl correlation risk;ipsilateral internal carotid artery plaque and ophthalmic artery PSV and Rl; PSV and Rl associated ipsilateral internal carotid artery plaque and central retinal artery were analyzed.?RESULTS:Eye symptoms:a black dim, reduced vision, the eyes flash, and around the eye pain were 75. 7%, 83. 8%, 51. 4% and 32. 4%;The eye signs:the dilatation of retinal vein, retinal hemorrhage, arterial stenosis and cotton spot and the contralateral side were regarded as main signs. Ophthalmic artery PSV and Rl value of the differences were statistically significant ( P<0. 05 ); The contralateral side of the central retinal artery PSV and Rl value of the differences were statistically significant ( P<0. 05 ); The ipsilateral internal carotid artery lMT and ophthalmic artery, central retinal artery PSV and Rl were not correlated ( P>0. 05 ); The ipsilateral internal carotid artery plaque and ophthalmic artery PSV had no correlation with Rl values (P>0. 05); PSV and Rl and the ipsilateral internal carotid artery plaque and central retinal artery had no correlation (P>0. 05).?CONCLUSlON: The incidence of ischemic eye diseases and internal carotid artery stenosis is associated with very close, the clinical can regard the degree of internal carotid artery stenosis as an important basis for diagnosis and treatment of eye diseases.

Objective To investigate the clinical significance of matrix metalloproteinase-9(MMP-9)in the pathogenesis of Kawasaki disease(KD)and its complications of coronary arterial lesions(CAL).Methods Twenty-three inpatients with KD were admitted in hospital from Jan.2005 to Dec.2006,whose venous blood samples were obtained during the acute and convalescent stage respectively,and CAL was detected with 2-Dechocardiography.Twenty-seven venous blood samples(12 febrile children and 15 normal physical examination children)were collected as healthy controls.Serum levels of MMP-9 were measured by enzyme-linked immunoadsorbent assay(ELISA).According to the results of echocardiography,children were divided into 2 groups:with CAL group(n=13)and without CAL group(n=10).Results During the acute stage,serum MMP-9 levels were significantly higher in KD than those in controls(Pa

Objective To establish a cell level-based negative enrichmen technique to detect circulating tumor cells (CTCs) in the peripheral blood of patients with epithelial ovarian cancer.Methods The colon cancer SKOV-3 cells were mixed with 2 ml whole blood from healthy donors at different ratio.Quantification of CTCs was performed using immunomagnetic bead based negative enrichment combined with immunofluorescence antibody method.The method was evaluated the recovery rate of target cells,Samples of 32 patients with ovarian cancer and 10 controls were assayed for CTCs detection by above method.Results ①The recovery rate was ranging from 64％ ～80％ by spiking varying numbers of SKOV-3 into 2 ml blood samples of healthy volunteers.Regression analysis of number of recovered SKOV-3 cells yielded a regression equation of Y=0.782X-1.408 and a coefficient of determination of R2 =0.998.②Did not detect CK8/18-+ circulating tumor cells in 10 controls,and CK8/18+ circulating tumor cells in 18 cases of 32 Patients with ovarian cancer.The positive rate of CK 8/18 + circulating tumor cells was significantly differences between the two groups (x2 =7.681,P＜0.01).③The presence ofCTCs was significantly correlated with distant metastasis (x2 =5.776,P＜0.05).Conclusion The method of immunomagnetic bead based negative enrichment combined with immunofluorescence antibody technique for CTCs detection in peripheral blood of patients with ovarian cancer has a clinical value of application and extension.

OBJECTIVETo understand the clinical features of gastrointestinal cow's milk allergy in children, and to assess the importance of cow's milk challenge.

METHODAn analysis was performed on the clinical manifestations and the challenge results of 50 children who received cow's milk challenges after admission to the department of gastroenterology, Children' s Hospital of Zhejiang University School of Medicine from January,2009 to December, 2012. The value of immunoglobulin E antibody was also analyzed among the 50 children, 25 cases were male and the other 25 were female. The youngest subject was 1. 6 months old, and the oldest was 20 months, most of the cases were younger than 6 months (36 cases).

RESULT(1) Diarrhea (27 cases, 54%) and hematochezia (25 cases, 50%) were the most common clinical features, vomiting, hematemesis and abdominal distention were rare. (2) Cow's milk challenges failed in 58% of the cases, 90% of whom showed delayed allergy. Diarrhea (19 cases, 73%) was the major later presentation, whereas the immediate hypersensitivity showed angio-edema, gastrointestinal symptom and rash. (3) The neutrophil count ((3.8 ± 2.8) x 10(9)/L vs. (2.5 ± 1.3) x 10(9)/L) was higher after challenge among children who failed the challenge. The change in the count of blood cell, neutrophil and platelet was studied, however, there were no statistical differences between the challenge-failed children and the passed ones. (4) Forty-seven cases had milk specific immunoglobulin E antibody test, and 5 showed positive results, 4 of whom were seen among the challenge-failed children.

CONCLUSIONDiarrhea and hematochezia was the most common clinical manifestation, and cow's milk protein induced proctocolitis was the most common disease in practice. It is important and necessary to perform cow's milk challenge.

Animals ; Female ; Gastrointestinal Diseases ; etiology ; Gastrointestinal Hemorrhage ; etiology ; Hematemesis ; etiology ; Humans ; Hypersensitivity, Immediate ; immunology ; Infant ; Infant, Newborn ; Male ; Milk ; Milk Hypersensitivity ; immunology ; Vomiting ; etiology

Objective To determine the expression of inducible nitric oxide synthase (iNOS) in brain after cerebral hypoxia / reoxygenation and the effects of preoxygenation with different concentrations of oxygen in rats.Methods Seventy-two male Wistar rats weighing 250-300 g were randomly divided into 4 groups : group Ⅰ, Ⅱ ,Ⅲ ,and Ⅳ . Each group was further divided into 3 subgroups : a, b, c. Group Ⅰ a, Ⅱ a, Ⅲ a and Ⅳa were preoxygenated with 21 % O2 (Ⅰa), 50 % O2 (Ⅱ a) , 75 % O2 (Ⅲa) and 95 % O2 (Ⅳ a) for 30 min. GroupⅠ b-Ⅳb were subjected to hypoxia (5 % O2 ) for 20 min after preoxygenation. Group Ⅰc-Ⅳc were reoxygenation (98 % O2) for 20 min after preoxygenation and hypoxia. The animals were sacrificed 48 h after the experiment. Brains were immediately removed for microscopic examination and determination of iNOS expression in brain using immuno-histochemistry technique. Results The number of iNOS positive cells was significantly greater in hypoxia groups than that in preoxygenation groups ( P

Objective To investigate the changes of T cells and disease development in the mice with Smad3 deficiency in the bone marrow cells.Methods Bone marrow cells obtained from Smad3 null(Smad3~(-/-))mice and wild type(Smad3~(+/+))mice were injected to Co~(60)-irradiated GFP mice,respectively.The general states of the bone marrow recipients were observed.The mice were sacrificed at the sixth week and the histopathological changes in the intestines were examined.The changes of T cells from lymph nodes were detected by flow cytometry.Results Smad3~(-/-) bone marrow recipient mice appeared a wasting syndrome and intestinal inflammation.The amount of CD4~+ CD62L~(lo) T cells in lymph nodes was significantly increased.Conclusion These results indicate that the mice with Smad3 deficiency in the bone marrow cells present an inflammatory disorder and their T cells are activated.

Objective To investigate the effect of immunosuppressive drugs on the activity of pancreatic islet cells, and to explore their role in islet allotransplantation. Method Human pancreatic islet cells were isolated and purified in vitro, and their activity was determined by MTT assay after incubation with immunosuppressive drugs in different concentrations. Results The activity of the islet cells was not reduced after exposure to rapamycin at lower concentrations, although exposure to rapamycin at higher concentrations (≥1ng/ml) was associated with a significant inhibition of activity. No reduction of islet cell activity was observed after exposure to daclizumab and FTY720, at either lower or higher concentrations. Conclusion Rapamycin acts to damage islet cells directly, and the degree of the damage was concentration-dependent. No obvious toxicity to the islet cells was observed after exposure to daclizumab and FTY720.

0 05) One patient of group A had in stent thrombosis after procedure Fifty one patients of group A and 41 of group B were followed up (from 1 to 39 months) after procedure, and 48 of group A and 37 of group B without cardiac events, such as death, AMI 3 patients of group A and 4 of group B were repeated coronary angiography because of chest pain There were 1 patient with restenosis and 2 with severe stenosis in non infarct related artery in group A, and 1 with restenosis and 3 with severe stenosis in non infarcted related artery in group B Conclusion Compared with short stenting in short lesions, long coronary stenting in long or diffuse infarct related artery disease after AMI is the same as a high procedure success rate, low complication and good clinical outcomes

Objective The purpose of this study was to determine the feasibility and efficiency of direct stent implantation with intravascular ultrasound (IVUS) guidance Methods 12 native vessel target lesions in 12 patients were studied by coronary angiography and direct stent implantation Ultrasound imagines obtained at the treatment site before and after stenting were analyzed quantitatively for in lesion vessel wall diameter, in lesion minimal lumen diameter and in lesion vessel length Direct stent deployment was performed with IVUS guidance The ends of follow up were acute or subacute thrombosis and major cardiac events (MCE: cardiogenic death, angina pectoris, myocardial infarction and revascularization correspondence with target vessel) Results Direct stenting was successfully performed in 12 patients with IVUS guidance Coronary angiography showed that there was no residual stenosis and TIMI 3 flow was obtained in all patients Further balloon dilation of the stent was performed by observation of the IVUS imagines in two patients The final IVUS imagines showed that ratio of minimal lumen diameter/maximum lumen diameter ≥0 7 and in lesion minimal lumen diameter increased from 1 2?0 87 mm to 3 4?2 8 mm No thrombosis and MCE were found in all patients in 1 4 months follow up Conclusion Direct stenting with IVUS guidance in selected patients had higher success rates, less complications and better clinical results