Intracranial aneurysms are a severe cerebrovascular disease.Its incidences ranged from 2% to 4% in general population.With the population aging and the development of imaging technique,the prevalence of intracranial aneurysm is increasing year by year.The research of natural course of aneurysm has important significance for neurosurgeons to evaluate the validity of therapeutic measures.There are significant differences between the patients with aneurysm who have had subarachnoid hemorrhage and those who have not.The rates of ruptured intracranial aneurysms per year ranged from 0.066% to 2%.The risk factors that affect ruptured intracranial aneurysms including the size and place of aneurysm,whether it is multiple aneurysms or not,growth rate,and self-factors of patients,such as age,sex,and history of hypertension and smoking,etc.

It is suggested in this article that medical ethics should be conceived as the integral part of quality education for students of medical sciences,based on the high consistency of medical ethics with the quality education in higher educational institutions and its close relationship with the cultivation of the qualities of medical students.

Objective To explore the clinical significance of the three indicators combined detection that plasma endotoxin,pro-calcitonin (PCT)and (1,3)-β-D-glucan(BG)in pulmonary tuberculosis patients complicated with bacterial,fungal infection.Methods Retrospective investigation was conducted in 240 pulmonary tuberculosis patients,who were divided into gram negative bacteria (G- )group(39cases),gram positive bacteria (G+ )group(45 cases)including fungal,germ-free group(156 cases).Other 45 healthy people were selected into control group.The levels of plasma endotoxin,PCT and BG in the four groups were compared.Results The levels of plasma endotoxin(0.682±0.418)EU/mL,PCT(2.93±0.87)μg/L in the G- group were significant higher than those of the G+ group (0.063±0.034)EU/mL,(0.85±0.52)μg/L,the difference was significant (P <0.05).The levels of the plasma endotoxin,PCT in the G- group were higher than those of the germ-free group.The levels of plasma endotoxin,PCT and BG in the control group had no significant difference with those of the germ-free group.Conclusion The combined detection of plasma endo-toxin,PCT and BG have some clinical value on the early diagnosis of the patients with pulmonary tuberculosis complicated with G-fungal infection for the advantages of fast and sensitiveness.

Objective To describe the status of nurse work engagement and to explore the relationship between work engagement and work-related flow experience.The study results provided the basis for how the nurse managers stimulate enthusiasm of nurses and let them devote themselves to work.Methods A convenience sample of 127 nurses from one major hospitals in Beijing city was recruited.Work Engagement Scale and Work-related Flow Experience Questionnaire were used in this study.Results The scores of work engagement were (3.18±0.59),at moderate level.Age,education level and professional titles were the influential factors of nurses' work engagement.The scores of work-related flow experience were (3.48±0.45),at moderate level.The scores of clear goals,focus on tasks,balance of skills and challenges were the top three dimensions of the work-related Flow Experience Questionnaire.Except for the two dimensions,the integration of action and awareness and the weakening of self-awareness,other dimensions of the work-related flow experience appeared statistically significant correlation to the scores of work engagement (P＜0.05 or P＜0.01).Most were moderate positive correlations.Conclusions Both the work engagement and the work-related flow experience are at moderate level.The nurse managers needed to take active measures to enable nurses to have more positive experiences and happiness,so as to enhance nursing work input,to improve quality of care and job satisfaction.

Objective To explore clinical effect of Chinese herbal immersion combined with Beecher's exercise for prevention and treatment of grade-0 diabetic foot.Methods A total of 107 patients who were diagnosed with grade-0 diabetic foot were selected in Department of Endocrinology of our hospital from July 2009 to October 2013.In addition to regular treatments,their feet were immersed in Chinese herbal liquid,and then were taken care by doing Beecher's exercise.The symptoms of diabetic foot were self-rated by each individual patient and mastering of knowledge about diabetic foot was evaluated both before the intervention and after three courses of treatment.Results After three courses of treatment,the self-rating symptom scored (4.37±1.45) totally,significandy lower than that before the intervention,(5.62±1.55),t=7.91,P ＜ 0.05.The mastering of six testing indexes about diabetic foot obviously improved compared between those before and after three courses of treatment [62.62％ (67/107)],23.36％ (25/107),30.84％ (33/107),46.73％ (50/107),57.94％ (62/107),50.47％ (54/107) vs.96.26％ (103/107)],86.92％ (93/107),89.72％ (96/107),85.98％ (92/107),94.39％ (101/107),87.85％ (94/107),x2=37.78,87.35,77.46,36.92,39.16,35.05,all P ＜ 0.05.Conclusions For grade-0 diabetic foot,Chinese herbal immersion treatment combined with Beecher's exercise can be applied straight forwardly on the disease focus;it's clinically safe and effective,and easy to be operated.It improves clinical symptoms of grade-0 diabetic foot by taking advantages of traditional Chinese medicine,prevent and control further development of diabetic foot and is valuable to be applied in clinical work.

Objective To explore the relationship of perceived professional benefit, job satisfaction, and retention willingness of nurses. Methods Convenience sampling method was adopted to investigate 493 nurses from 3 tertiary grade A hospitals in Taian. Results The mean scores of nurses′perceived professional benefit, job satisfaction, and retention willingness were 134.19 ± 19.79,121.52 ± 18.41, and 21.18 ± 4.23, respectively. Perceived professional benefit and job satisfaction were positively correlated with retention willingness (P<0.01). Job satisfaction played a partial mediation role in the relationship between perceived professional benefit and retention willingness. Conclusion Job satisfaction and perceived professional benefit have a positive influence on nurses′retention willingness .

Objective To investigate the prevalence of dermatoses affecting officers and soldiers garrisoned southeast China,and to provide enough scientific basis for prevention and treatment of those dermatoses.Methods Epidemiological investigations were carried out on 324 officers and soldiers in both Zhejiang and Fujian military Regions,respectively.In order to get the dermatoses diagnosed correctly and the number of infected men/times calculated accurately,a large scale of clinical examination was performed by 3 senior dermatologists from the authors' hospital.Some medication and management were applied in therapy for those skin disorders.The elementary medical personnel in the troops were trained with a short time-training course to raise their vocational level.Results Tinea manuum and tinea pedis,acne,pigmented nevus,tinea corporis and tinea cruris,seborrheic dermatitis,eczema,pityriasis versicolor and lichen simplex chronicus were the eight common dermatoses affecting officers and soldiers garrisoned southeast China.The prevalence of tinea manuum and tinea pedis was highest one in all the 8 common dermatoses.158 out of 324 soldiers(48.8%)suffered from skin disorder.The prevalence of acne,pigmented nevus,tinea corporis and tinea cruris,seborrheic dermatitis,eczema,pityriasis versicolor and lichen simplex chronicus were 45.4%,19.3%,10.8%,12.3%,10.2%,7.4% and 7.1%,respectively.Conclusions Skin disorder is one of the most common diseases affecting officers and soldiers.There are different occurrences in different garrisoned region.The prevelence of tinea manuum and tinea pedis in Fujian military region is higher than that in Zhejiang military region,and the prevelence of tinea corporis and tinea cruris,eczema in Fujian military region is lower than that in Zhejiang military region.No significant difference was found in the prevalence of the eight common dermatoses between the two parts of soldiers originated separately from north or south regions of China.

Objective To investigate the expression and function of transforming growth factor (TGF)-β1 and Smad2 in liver fibrosis of biliary atresia (BA). Methods Liver biopsy specimens were collected from autopsy (normal group, n=5), congenital biliary dilatation (CBD group, n=10), BA patients underwent Kasai procedure (early hepatic fibrosis group, n=19) and liver transplantation (transplantation group, n=11). The first three groups were collected from January 2010 to July 2014 in Tianjin Children’s Hospital, and the last group was collected from January 2013 to January 2014 in Tianjin First Central Hospital. The hematoxylin and eosin (HE) stain were used to observe the degree of liver fibrosis of four groups. Immunohistochemistry (IHC) was used to observe expressions of TGF-β1 and Smad2 in liver tissues of these samples. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to test the quantitative mRNA of TGF-β1 and Smad2 in these samples. Results Results of HE showed that no fibrosis in autopsy group, mild fiber cell hyperplasia in CBD group, severe fibrosis in Kasai group and significant pseudolobule in transplantation group. Results of IHC showed that TGF-β1 was expressed in the cytoplasm of hepatocytes, bile duct cells, lymphocytes and neutrophils. The average optical density of TGF-β1 was the highest in Kasai group compared with that of other three groups (P < 0.05). There was no significant difference in Smad2 expression in cytoplasm of hepatocytes, bile duct cells and lymphocytes between four groups (P>0.05). Results of qRT-PCR showed that both TGF-β1 mRNA and Smad2 mRNA were the highest in early hepatic fibrosis group than those of CBD group and transplantation group (P<0.017). Conclusion In early stage of BA, TGF-β1 and Smad2 promote liver fibrosis until the formation of P-P,P-C desmosome structure. However, with BA fibrosis becomes more serious, the pro-fibrogenic function of TGF-β1 and Smad2 becomes less.

BACKGROUND: Extract of astragalus mongholicus has good effects on antioxidization and oxygen free radical scavenge. Bone marrow mesenchymal stem cells (BMSCs) have multiple directional differentiation potential and superiority of autologous transplantation. This can provide a new way for treating neurodegenerative diseases.OBJECTIVE: To explore the differentiation of BMSCs of rats following astragalus mongholicus induction.DESIGN: A cytological in vitro study.MATERIALS: One clean male rats aged 6 weeks were purchased from Experimental Animal Center of Chinese Academy of Medical Sciences. Astragalus mongholicus injection (lot number 060105) were obtained from Dali Pharmaceutical Co., Ltd.METHODS: Rat BMSCs were in vitro isolated, cultured and purified by the whole bone marrow method. At the fourth passage, BMSCs at a density of 4×10<'8>/L were incubated in 12-well plate with a coverslip. After 80% 90% cells were confluent, the medium was changed. BMSCs were then incubated in DMEM, supplemented with 200 g/L astragalus mongholicus injection and 15% fetal bovine serum, for 6 days. BMSCs in the control group were not treated with astragalus mongholicus injection.MAIN OUTCOME MEASURES: Morphological changes in BMSCs were observed under the inverted microscope before and after induct.ion. Expression of specific markers was determined by immunocytochemical staining following induction.RESULTS: Primary cultured BMSCs were round. At the fourth passage, BMSCs were spindle. BMSCs after induction showed processes, which became more with prolonged time. Some processes were branch-shaped, forming a network structure. Results of immunocytochemical staining demonstrated that many cells were positive for nestin, neuron specific enolase and glial fibrillary acidic protein on day 3, and abundant cells were positive for microtubule-associated protein-2 on day 6.CONCLUSION: Astragalus mongholicus induces differentiation of BMSCs into neural stem cells, and then promotes the differentiation into neurons or glial cells, and makes differentiated cells mature and aging.

OBJECTIVE To explore the changes in gene expression in patients with allergic rhinitis(AR). METHODS 14500 gene DNA microarray(Affymetrix) was used to examine the gene expression in 6 AR nasal mucosal samples and 6 normal nasal mucosal samples.The differentially expressed genes were identified and subjected to real time RT-PCR analysis. RESULTS Compared with normal sinus tissues,161 genes were found to be differentially expressed in AR samples.Forty-seven genes were upregulated,114 genes were downregulated.The differentially expressed genes mostly involved in immune transcription regulatory molecules,signal transduction.Real-time RT-PCR results of CCL20,GPK4 were consistent with that of gene chip analysis.CONCLUSION Microarray expression profile of AR samples is differential.GPK4 and CCL20 may play an important role in cell signal transduction in mechanisms of AR.