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2020 Vol. 50, No. 11 Published: 2020-11-25   861 Development and identification of polyclonal antibody against Toxoplasma gondii chaperonin 60(TgCpn60) CAO Jiaxin, CHENG Linyan, LIU Shuxian, TAN Feng DOI: 10.3969/j.issn.2095-9400.2020.11.001 Objective: To develop and identify the specific polyclonal antibody against Toxoplasma gondii chaperonin 60 (TgCpn60). Methods: A 507 bp sequence fragment encoding the C-terminal 168 amino acids of TgCpn60 (TgCpn60C168AA) was amplified by PCR from T. gondii cDNA and then was cloned into prokaryotic expression vector pGEX-4T-1. The constructed plasmid pGEX-4T-1-TgCpn60C168AA was transformed into E.coli BL21 cells and induced by isopropyl-β-D-thinoglucoside (IPTG) for expression of the fusion protein tagging GST at its N-terminus, GST-TgCpn60C168AA. Recombinant fusion proteins were purified by Glutathione-SepharoseTM4B affinity chromatography. A polyclonal anti-serum was generated by immunizing BALB/c mice with purified GST-TgCpn60C168AA and was detected using Western blot assay. Furthermore, pFNR-RFP plasmid was transiently transfected into T. gondii RH strain, followed by IFA to detect the co-localization between TgCpn60 and T. gondii ferredoxin-NADP+ reductase (TgFNR), a marker protein for apicoplast lumen.Results: Successful construction of pGEX-4T-1-TgCpn60C168AA plasmid was confirmed by PCR amplification and sequencing. SDS-PAGE analysis showed that the recombinant GST-TgCpn60C168AA protein was expressed highly by IPTG induction. Western blot showed that both the recombinant GST-TgCpn60C168AA and native TgCpn60 from total parasite proteins could be recognized by the specific mouse anti-TgCpn60 polyclonal antibody. Moreover, the colocalization of TgCpn60 with the apicoplast marker FNR was demonstrated by IFA with the specific mouse polyclonal antibody. Conclusion: The obtained polyclonal antibody against the recombinant GST-TgCpn60C168AA can specifically react with the endogenous TgCpn60, which provides a favorable tool for further study into the function of TgCpn60. 2020 Vol. 50 (11): 861-866 [Abstract] ( 820 ) HTML (1 KB)  PDF (2344 KB)  ( 993 ) 867 Proteomic analysis by a comparison in protein difference between porcine and human decellularized nerve matrices using JIANG Yongsheng, ZHANG Mengpei, HAN Chunchan, HUANG Lijiang DOI: 10.3969/j.issn.2095-9400.2020.11.002 Objective: To analyze the proteomic differences between porcine and human peripheral nerves after acellularization, which will provide the porcine decellularized material as a promising platformfor repairing peripheral nerve injury (PNI). Methods: All proteins in the porcine decellularized nerve matrix (pDNM) and human decellularized nerve matrix (hDNM) were extracted by grinding and enzymolysis. Then, the differentially expressed proteins (DEPs) were done with GO and KEGG pathway analysis using TMT labeled nano-HPLC-MS/MS technology. Results: A total of 1 448 corresponding proteins were identified, of which 456 and 170 proteins in pDNM manifested respective upregulation and downregulation, when compared with hDNM. Moreover,pDNM also contained more extracellular matrix (ECM) related proteins. GO functional annotation results suggested that the upregulated expressing proteins involved GO terms for cellular component were commonly enrichedin growth cone, axon and neuronal cell body; involved GO terms for biological process were generally associated with cell migration, cytoskeleton organization and axon development; andinvolved GO terms for molecular function were mainly related with molecular function regulator, structural constituent of cytoskeleton and motor activity. KEGG analysis also revealed that most of these DEPs participated in the regulation of actin cytoskeleton, axon guidance and ECM-receptor interaction. Conclusion: pDNM, thanks to its abundant structural and functional proteins, is a potential optional substitute for repairing PNI. 2020 Vol. 50 (11): 867-872 [Abstract] ( 646 ) HTML (1 KB)  PDF (1825 KB)  ( 890 ) 873 An analysis of the correlation between different audiological phenotypes and common genes causing deafness in non-syndromic deafness ZHANG Chuqin, CHEN Bobei, YI Song, LIU Xuejun, XIANG Haijie DOI: 10.3969/j.issn.2095-9400.2020.11.003 Objective: To investigate the correlation between GJB2, GJB6 gene and mitochondrial DNA A1555G, C1494T mutation and clinical audiology and age of onset in non-syndromic deafness. Methods: GJB2,GJB6 and mitochondrial DNA A1555G, C1494T mutations were tested in 269 patients with non-syndrome deafness and the results analyzed. Results: The study showed that 16.73% and 0.37% of all patients were found to have GJB2 and GJB6 mutations, while 23.79% and 0.37% were found to have mtDNA A1555G and C1494T mutations. The rates of hearing loss in patients with a mild, moderate, severe to profound were 9.67%, 27.88%,23.42% and 39.03% respectively. The mutation rates of GJB2 and GJB6 among each group were 7.69%, 8.00%,25.40% and 20.95% respectively, while the mutation frequencies of mtDNA A1555G, C1494T among each group were 38.46%, 34.67%%, 30.16% and 9.52% respectively. Among pre-lingual group (0-3 years old), preschool group (3-6 years old); School age group (6-18 years old) and the adult group, the rates of GJB6 and GJB2 gene mutations were 26.57%, 13.51%, 5.56%, 1.89%, respectively; the rates of mtDNA A1555G and C1494T mutations were 14.69%, 24.32%, 41.67%, 37.74%, respectively. There was significant difference among groups with different degrees of hearing loss (χ2=21.199, 18.357, P<0.001). Conclusion: The pathogenic mutations of GJB2 and GJB6 were detected mainly in severe and extremely severe deafness, while the mtDNA gene mutations were detected in all levels of deafness, and the more serious the hearing loss, the lower the detection rate. GJB2 and GJB6 mutations tend to cause pre-lingual onset deafness, while mtDNA A1555G and C1494T mutations seem to affect patients of old age. 2020 Vol. 50 (11): 873-877 [Abstract] ( 735 ) HTML (1 KB)  PDF (1440 KB)  ( 764 ) 878 Analysis of chest CT findings in patients with novel coronavirus pneumonia complicated by cardiovascular disease JIN Qike, DONG Jianghu, LI Lei1, XU Mei, ZENG Jingjing, RUAN Yongxue, REN Fangfang, XIE Zuoyi, WU Lianpin DOI: 10.3969/j.issn.2095-9400.2020.11.004 Objective: To analyze the chest CT features of patients with novel coronavirus pneumonia (COVID-19) complicated by cardiovascular disease (CVD) including hypertension and cardiogenic diseases and evaluate its role in clinical diagnosis and treatment. Methods: A retrospective analysis of 65 COVID-19 patients diagnosed in the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University during January 20 to February 8, 2020. They were divided into CVD group and non-CVD group and their basic information, clinical symptoms, blood routine and chest CT signs were collected. The characteristics of chest CT manifestations were evaluated and analyzed. Results: In all 65 patients with COVID-19, the main clinical manifestations were fever and cough, accounting for 80.0% and 53.8 respectively. The increase of C-reactive protein in blood routine indicators accounted for 52.3%, leukopenia accounted for 18.5% and lymphopenia accounted for 26.2%. CT showed that 84.6% of the lesions were bilaterally distributed, and 95.4% with flaky ground glass shadows, which may be accompanied by consolidation, and a grid-like texture was visible in the inner lungs. The lesions were distributed along the bronchi and pleura, and the degree of lung involvement was related to the patient’s history of exposure and cardiovascular disease. The duration of symptoms and the percentage of lung involvement in the CVD group were greater than those in the non-CVD group, with statistical difference(P<0.05). As time progressed, the percentage of lung involvement in the CVD group and the non-CVD group was statistically different, respectively (P=0.046) and (P=0.026). Re-examination of pulmonary fibrosis was statistically different (P=0.047). Conclusion: Chest CT can clearly show the imaging changes during the course of COVID-19 disease. The chest CT of patients with cardiovascular disease is more serious and the recovery is slower. Imaging diagnosis combined with clinical features is helpful for better treatment. 2020 Vol. 50 (11): 878-883 [Abstract] ( 673 ) HTML (1 KB)  PDF (3110 KB)  ( 654 ) 884 Protective effect of agaricus blazei polysaccharide on LPS-induced injury of human umbilical vein endothelial cells and its mechanism CHEN Qin, CHEN Lili, ZHOU Aiming, HUANG Xucai, PAN Jingye DOI: 10.3969/j.issn.2095-9400.2020.11.005 Objective: To investigate the protective effect of Agaricus blazei Murrill polysaccharide (ABP) on the injury of human umbilical vein endothelial cells (HUVECs) induced by lipopolysaccharide (LPS) and its possible mechanism. Methods: The cell damage model was constructed with LPS at a final concentration of 1 μg/mL and divided into control group, LPS group, and ABP intervention group (10, 20, 50 μg/mL). CCK-8 method was used to detect the effects of ABP on HUVECs. Cytotoxicity, ELISA, Western blot and RT-PCR were used to detect the expression of inflammatory factors and cell adhesion molecules in each group. Western blot and immunofluorescence were used to detect the expression of proteins related to the NF-κB signaling pathway and nuclear translocation in each group. Results: The relative expressions of TNF-α, IL-6, COX-2, iNOS, ICAM-1, VCAM-1, p-p65/p65, p-IκB/IκB protein in LPS group were significantly higher than those in control group (P<0.01). With the increase of drug concentration, the expression of above proteins in ABP group were significantly lower than that in LPS group (P<0.05). RT-PCR detection showed that TNF-α, IL-6, COX-2, iNOS, ICAM-1 and VCAM-1 mRNA expressions in LPS group were significantly higher than those in control group (P<0.01). With the increase of drug concentration, the expression of above-mentioned mRNA expressions in ABP group were significantly lower than that in LPS group (P<0.05). Conclusion: ABP can inhibit the expression of inflammatory factors and cell adhesion molecules induced by LPS to reduce the damage of HUVECs. The mechanism may be related to the inhibition of the activation of NF-κB signaling pathway in cells. 2020 Vol. 50 (11): 884-889,895 [Abstract] ( 662 ) HTML (1 KB)  PDF (2191 KB)  ( 726 ) 890 The expression of long non-coding RNA Linc00658 in colorectal cancer and its relationship with cetuximab resistance ZHANG Zhiyong, QIU Feng DOI: 10.3969/j.issn.2095-9400.2020.11.006 Objective: To investigate the expression of long non-coding RNA (lncRNA) Linc00658 in colorectal cancer (CRC) and its relationship with cetuximab resistance. Methods: Bioinformatics was used to predict the lncRNA which are closely related to the expression of miR-19a-3p and PTEN. CaCo2 cells were treated with cetuximab and DMSO as the resistance group and the control group, and overexpressing Linc00658 was used as the overexpression group in resistance group. miR-19a-3p mimic and NC transfected into CaCo2 cells were respectively as mimic group and NC group. The expression levels of Linc00658, miR-19a-3p and PTEN mRNA were detected by real-time fluorescent quantitative PCR (qRT-PCR) in the control, resistance, overexpression group. The expression of PTEN and its downstream genes phosphorylated Akt (p-Akt) and phosphorylated mTOR (p-mTOR) were detected by Western blot. The 50% inhibitory concentration (IC50) of cetuximab was detected by CCK-8 assay, and the binding of Linc00658 and miR-19a-3p and its effect on the binding of miR-19a-3p and PTEN were verified by dual luciferase reporter gene. Results: Compared with the control group, the expression of Linc00658, PTEN mRNA and protein decreased significantly in the resistant group, the expression of miR-19a-3p, p-Akt and p-mTOR increased significantly, and the IC50 of cetuximab enhanced significantly(P<0.01). Compared with the resistant group, the expression of Linc00658, PTEN increased significantly in the overexpression group, and the expression of miR-19a-3p, p-Akt, p-mTOR and cetuximab IC50 decrease dsignificantly(P<0.05). Compared with NC group, IC50 of cetuximab in mimic group was significantly higher(P<0.01). miR-19a-3p mimic could significantly inhibit luciferase activity of pGL3-basic-Linc00658, suggesting that miR-19a-3p and linc00658 had binding effect. Overexpression of Linc00658 could restore the fluorescence inhibition mediated by miR-19a-3p mimic on pGL3-basic-PTEN. Conclusion: Linc00658 could promote PTEN re-expression and sensitivity to cetuximab of CRC cells by sorption of miR-19a-3p. 2020 Vol. 50 (11): 890-895 [Abstract] ( 590 ) HTML (1 KB)  PDF (1749 KB)  ( 624 ) 896 Feasibility study of preoperative precise graded prediction model for renal clear cell carcinoma based on quantitative imaging biomarkers SHU Enfen, KONG Chunli, XIA Haihong, GAO Yang, WU Xulu, XIE Liangjun, ZHAO Xuemiao, JIANG Chunyan, CHEN Chunmiao, ZHOU Yongjin, JI Jiansong DOI: 10.3969/j.issn.2095-9400.2020.11.007 Objective: To explore the feasibility of constructing accurate prediction model of WHO/ISUP classification for clear cell renal cell carcinoma (ccRCC) by screened quantitative imaging biomarkers via CT imaging based radiomics. Methods: Retrospective collection of 72 patients with ccRCC who were confirmed by surgery and pathology in Lishui Central Hospital from January 2009 to October 2018. All patients were underwent abdominal CT scanning and enhanced three-phase scanning before surgery, who were divided as highdifferentiation group (I+II grade, 52 cases) and low-differentiation group (III+IV grade, 20 cases).Preoperative arterial CT images of the enrolled patients were collected for screening imaging biomarkers by radiomics analysis and then trained predictive models.Firstly, the ITK-SNAP software was used to manually delineate the target lesion (maximum lesion) edge into the whole lesion three-dimensional region of interest (VOI); secondly, the texture parameters were extracted as imaging biomarkers by A.K software, and the characteristic texture parameters are screened based on R language. The Rad-score of each patient was calculated based on the above texture parameters, and the accurate hierarchical prediction model of renal clear cell carcinoma was finally constructed. Results: A total of 396 texture features were extracted from this study, and five characteristic texture parameters of the CT image of the arterial phase were screened by Lasso reduction dimension combined with10-fold cross-validation method as the predictive biomarkers, which were root mean square (RMS), kurtosis, correlation, entropy, inertia, and calculated the corresponding Rad-score for each patient. The preoperative grading prediction model of renal clear cell carcinoma was constructed based on rad-score, and it was found that the area under the curve (ROC) was 0.891 (95%CI=0.797-0.952), and the sensitivity and specificity were high up to 84.6% and 85.3%, respectively. Conclusion: The preoperative precise grading prediction model constructed by angiography based on arterial CT images has high accuracy, specificity and sensitivity, which is feasible for grading prediction of renal clear cell carcinoma 2020 Vol. 50 (11): 896-900 [Abstract] ( 746 ) HTML (1 KB)  PDF (1945 KB)  ( 732 ) 901 Application of low iodine concentration contrast agent combined with Z-dom and iDose4 technology in carotid CT angiography GE Huaizhi, WU Aiqin, CHEN Jiuzun, XU Lei, YAN Zhihan DOI: 10.3969/j.issn.2095-9400.2020.11.008 Objective: To explore the value of low iodine contrast agent combined with Z-dom and iDose4 in carotid CT angiography (CTA) to reduce contrast agent and ionizing radiation damage.Methods: A total of 100 patients with CTA examination from the Second Affiliated Hospital of Wenzhou Medical University between January 2018 and September 2019 were randomly divided as the routine group (n=50), with routine scanning, 120 kV, 250 mAs, iohexol (350 mgI/mL) and filtered back projection (FBP) reconstruction, and the low-dose group (n=50), with 120 kV, Z-dom automatic tube current, iodixanol (270 mgI/mL) and iDose4 reconstruction.The iodine injection amount and radiation dose were compared between the two groups. Objective evaluation was performed on the upper edge of the aortic arch and the bifurcation of the carotid artery, followed by subjective evaluation of the images. Results: The amount of iodine injection in the low-dose group was (16.61±2.87)g,lower than that in the routine group (22.82±3.81)g (P<0.001). The tube current in the low-dose group was(149.22±70.49)mAs, lower than that in the routine group (250 mAs) (P<0.001). The CT dose index volume(CTDIvol), dose length product (DLP), and effective dose (ED) of the low-dose group were lower than those of routine group (P<0.001). Objective evaluation of two groups of images showed the CT value of blood vessels and background noise of the two levels in the low-dose group lower than the routine group, and the SNR and CNR of the initial level of the common carotid artery were higher than the routine group (P<0.001).The subjective evaluation showed no significant difference (t=-1.676, P=0.097) in the scores of the routine group (3.44±0.48)and the low-dose group (3.60±0.47), both images could meet the diagnostic needs. Conclusion: Low-iodine contrast agent combined with Z-dom and iDose4 technology can reduce the amount of iodine injection and ionizing radiation dose in carotid CT angiography. Its image quality is better than that of the conventional group, though both can meet the diagnostic needs. 2020 Vol. 50 (11): 901-905 [Abstract] ( 634 ) HTML (1 KB)  PDF (1504 KB)  ( 827 ) 906 The protective effect of UCF-101 on neurological function of rats with subarachnoid hemorrhage CHENG Zhenyu, SHENTU Huasong, CHEN Yihua, HE Zhongping, YU Beiwei, WANG Ruiquan, FU Bin. DOI: 10.3969/j.issn.2095-9400.2020.11.009 Objective: To examine the protective effect of UCF-101 on neurological function of rats with subarachnoid hemorrhage (SAH). Methods: A total of 90 rats were randomly assigned to Sham group, SAH group and UCF-101 group, with 30 rats in each group containing. The rat SAH animal model was established via double autologous blood injection into cisterna magna. Rats in the UCF-101 group were administrated intraperitoneally with UCF-101 (3.0 μmol/kg body weight). The western-blotting assay was used to determine the expressions of pro-caspase-3, pro-caspase-9, cleaved PARP, caspase-3 and caspase-9 in brain tissues of 10 rats in each group. The TUNEL staining was performed to investigate apoptotic neuronal cells in 10 rats of each group. Escape latency via the place navigation of Morris water maze and Kaoutzanis M’s neurobehavioral score were recorded of 10 rats from each group. Results: The brain tissue expressions of pro-caspase-3, pro-caspase-9, cleaved PARP, caspase-3 and caspase-9, percentage of apoptotic neuronal cells as well as escape latency of rats in SAH group were significantly higher than those of rats in Sham group (all P<0.05); while Kaoutzanis M’s neurobehavioral score were substantially lower in SAH group than in Sham group(P<0.05). As compare with SAH group, all the preceding variables were remarkably reversed to different extents in UCF-101 group (all P<0.05). Conclusion: UCF-101 can markedly inhibit the neuronal cellular apoptosis of SAH rats, and improve their cognitive function and neurobehavioral ability, and thereby exert a protective effect on neurological function of SAH rats. 2020 Vol. 50 (11): 906-910,914 [Abstract] ( 729 ) HTML (1 KB)  PDF (1813 KB)  ( 698 ) 911 The clinical effect of balloon dilation training combined with pelvic floor muscle rehabilitation on constipation caused by cerebral stroke LI Xiaoliu, ZHAO Jing, DU Guojun, JI Jie, XU Minhuan, JIANG Lijuan, MA Li DOI: 10.3969/j.issn.2095-9400.2020.11.010 Objective: To explore the therapeutic effect of balloon dilation training combined with pelvic floor muscle rehabilitation on constipation after cerebral stroke. Methods: Totally 96 patients with constipation caused by cerebral stroke in the department of neurology of Minhang Hospital Affiliated to Fudan University were randomly divided as the treatment group and the observation group, with 48 cases in each. Both groups received conventional rehabilitation treatment, including pelvic floor muscle training and biofeedback therapy.Patients in the treatment group received balloon dilation training therapy, based on the conventional rehabilitation therapy, while the observation group did not. Before the treatment and 7 days and 15 days after treatment, all patients were evaluated by both defecation integral and RMS/iEMG assessment of anal sphincter. Results: There was no significant difference in the scores of defecation integral and RMS/iEMG of anal sphincter between the two groups before treatment (P>0.05). However, 7 days and 15 days after the balloon dilation training therapy, the scores of defecation integral and iEMG of anal sphincter in the treatment group were better than those in the observation group (P<0.01). The incidence of constipation decreased in both groups, but was higher in the observation group (31.3%) than in the treatment group (10.4%). Conclusion: The pelvic floor muscle rehabilitation combined with balloon dilatation training can significantly improve the constipation caused by cerebral stroke. 2020 Vol. 50 (11): 911-914 [Abstract] ( 657 ) HTML (1 KB)  PDF (1419 KB)  ( 663 ) 915 Investigation and analysis of RBC-irregular antibodies in hospitalized patients CHEN Bile, CAI Xuejiao, YE Yincai, LIN Shuangnyu, ZHUO Shenglin, XIE Zuoting DOI: 10.3969/j.issn.2095-9400.2020.11.011 Objective: To investigate and analyze the positive rate, distribution characteristics, specificity and immunoglobulin types of RBC-irregular antibodies in hospitalized patients. Methods: Samples of all patients in our hospital between Nov. 2017 and Oct. 2019 were collected, with irregular samples of erythrocyte blood groups screened for a statistical analysis of positive antibodies, the positive rate, distribution characteristics,specificity and immunoglobulin types of antibodies. Results: Total positive rate of RBC-irregular antibodies in hospitalized patients was 0.29%(834/287 030); the positive rate of antibody in male patients and female patients was 0.20% and 0.38% respectively. There was statistically difference between groups (P<0.05). RBC-irregular antibodies distribution had the following characteristics: the antibody-positive composition ratio of female patients was 66.99%(558/834), while that of male patients was 33.01%(276/834). The proportion of antibody-positive was 72.22%(403/588) in women with history of pregnancy but no history of blood transfusion, and that was 5.38%(30/588) in women with no history of pregnancy but history of blood transfusion; the antibody-positive ratio of female patients with history of both pregnancy and blood transfusion was 19.35%(108/588), while the antibodypositive ratio of female patients without history of either pregnancy or blood transfusion was 3.05%(17/588).RBC-irregular antibodies specificity showed that 54.80%(457/834) of antibody specificity could be determined,of which the Rh blood group system had the highest proportion of anti-E antibodies, accounting for 27.58%.Immunoglobulin types of RBC-irregular antibodies were mainly IgG antibodies, accounting for 72.90%(632/834).Conclusion: In patients with RBC-irregular antibodies positive in this hospital were mainly female patients with pregnancy history, and the specificity of irregular antibodies was most commonly IgG anti-E antibodies. 2020 Vol. 50 (11): 915-918 [Abstract] ( 662 ) HTML (1 KB)  PDF (1436 KB)  ( 746 ) 919 Qualitative study on the stress of caregiversin the ward of suspected COVID-19 SONG Fei, WU Yujie,ZHU Cong, DONG Ning, ZHANG Liping DOI: 10.3969/j.issn.2095-9400.2020.11.012 Objective: To investigate the stress of nurses in the ward of suspected COVID-19 so as to provide reference for alleviating the pressure of the clinical nurses. Methods: Phenomenological research was used.From February 2, 2020 to March 2, 2020, semi-structured interviews were conducted on 8 nurses from wards of thesuspected COVID-19 in the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, and the data were analyzed by colaizzi7-step analysis method. Results: The stress that the nurses had experienced in the suspected wards could be summarized into three major types: Type 1was work stress, which covered such three sub-typesas heavy load, high social expectations and occupational exposure; Type 2 was reduced use of social support and Type 3 was difficulty in releasing negative emotions. Conclusion: The nurses in the ward of suspected COVID-19 are underpressure from many aspects. To relieve the pressure of the nurses, it is necessary to optimize management of human resources, publicize knowledge relevant to COVID-19, timely update the protective measures and knowledge and give them more humanistic care. 2020 Vol. 50 (11): 919-921,926 [Abstract] ( 713 ) HTML (1 KB)  PDF (1440 KB)  ( 899 ) 922 Clinical violence to nursing students in Wenzhou: a cross-sectional study JIN Liya, CHEN Yumei, XU Xuexue, ZHU Ya, WANG Yi DOI: 10.3969/j.issn.2095-9400.2020.11.013 Objective: To investigate the prevalence, influencing factors of conflict reasons for clinical violence to nursing students in Wenzhou. Methods: Convenient cluster sampling and questionnaire survey were used to evaluate the characteristics of the clinical violence to nursing students from 2016-2019 in Wenzhou. Logistic regression analysis was used to analyze the independent risk factors of clinical violence to nursing students. Results: 65.7% of the nursing students suffered from work place violence during their clinical rotation.The most frequent type of violence was verbal attack (64.3%), followed by physical attack (10.4%) and sexual harassment (2.3%). There was no significant difference in the incidence of clinical violence in the past three years(P>0.05). Low education level (OR=5.788, 95%CI=3.368-9.946, P<0.001) and one-child student (OR=3.236,95%CI=1.921-5.452, P=0.008) were the independent risk factors of violence. The main causes of physical attack were communication problems and dissatisfaction with the skills of the student nurses (79.5%). The main reasons for verbal attack included communication problems, low technical level, unsatisfactory treatment effect and long waiting time (91.4%). Conclusion: The incidence of work place violence for nursing students remains high, and  is affected by factors of the education level and one-child. Communication problems and low technical level are the main causes of violence. 2020 Vol. 50 (11): 922-926 [Abstract] ( 636 ) HTML (1 KB)  PDF (1421 KB)  ( 718 )

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