Objective:To investigate the biomechanical effect of magn et ic expansion by a new electronic speckle pattern interferometry. Methods :One fresh human skull of 12 years old with intact suture tissues and pe riodontal membrane was adopted. Magnetic expansion was loaded on the maxilla for 1,5,15,30 and 60 min respectively by magnetic force (NdFeB).Relative informa tion on the maxillary complex was acquired by electronic speckle pattern interfe rometry(ESPI). The deforming fringes was processed by the microcomputer image s ystem and the corresponding out-of plane displacement of the maxillary complex was analyzed. Results:Fringes of the maxillary complex were obs erved on monitor screen when magnetic force was loaded. From 1 min to 30 min-lo ading the fringe density was increasing, but decreased 1 h after loading. There was no fringe in the suture of the skull. Greate deformity was found on the lowe r part of maxilla. Conclusion:Magnetic force of expansion is con centrated in the deep structure of the maxillary complex.

Objective To explore the levels of serum alkaline phosphatase ( ALP) as well as its impact on the cognitive impairment in patients with subcortical ischemic vascular disease ( SIVD).Methods One hundred and fifty-eight SIVD patients were divided into two subgroups which included 86 patients with mild cognitive impairment ( SVMCI ) and 72 patients with vascular dementia ( SVaD ) according to the severity of cognitive impairment.Sixty-seven old people with normal cognitive function were selected as control qruop.Multiple lacunar infarction ( LI) or leukoaraiosis ( LA) was detected according to their MRI scan appearances and graded LA according to the severity.Serum ALP was measured by an enzymatic method as well as the Mini-Mental State Examination ( MMSE) and the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C) were used in assessments.Serum ALP was divided into 3 groups and the occurrence rate of LI , LA and cognitive impairment were compared with each other.The levels of ALP were compared in different cognitive impairment and Logistic regression was used to explore the relation between ALP and cognitive impairment.Results Both SVaD and SVMCI groups (17.00 (13.00, 20.00), 59.50 (49.00, 68.75);25.00 (25.00, 26.00), 82.50 (76.75, 89.00)) showed significantly lower scores in MMSE and CAMCOG-C than control group (28.00 (28.00, 29.00), 93.00 (89.00, 96.00); Z=187.337, P=0.000; Z=150.480, P=0.000).A positive relationship between the elevated ALP level and the severity of cognitive impairment was found after adjusting for sex , age and other confunding factors ((68.60 ±15.52), (78.76 ±13.39), (86.75 ±18.85) U/L, F=22.587, P=0.000).The occurrence rate of LI, LA and SVaD among the three groups were significantly different (χ2 =8.008, P=0.018;χ2 =17.998, P=0.000;χ2 =12.255, P=0.002).The ALP level was negatively correlated with MMSE and CAMCOG-C scores ( r=-0.350, P=0.000; r=-0.286, P=0.000 ).Logistic regression analysis revealed the relation between ALP and cognitive impairment was positive when we controlled all the vascular risk factors.However , the relation had gone when futher adjusting for the grade of LA.Conclusions The level of ALP is significantly higher in SIVD patients and positively relates with cognitive impairment especially in those whose grade of LA is severe.

Specialty English of Medical Laboratory is a comprehensive and overlapping discipline and plays a major role in multiple medical courses, including Life Science, Clinical Medicine and Laboratory Medicine.However, its teaching practices are limited due to the extensive contents, scattered basic knowledge points, complexities of language learning processes and high demanding of sophisticated teaching skills.Since internet technology′s breakout and the web-based education expanding in the past decade, personalized flipped classroom has drawn considerable attention in the education field and became a hop-spot in teaching practice system.In the present study, the concepts of flipped classroom and basic characteristics of Specialty English of Medical Laboratory were elaborated, as well as the reconstructing teaching processes, exploring the concrete plan for teachers and students in undergraduate program.

Objective To understand the status quo of foreign nursing leadership in recent 20 years,and compare and analyze the hotspots and trends of foreign nursing leadership.Methods The bibliometric analysis and cluster analysis were used for analyzing the literature of nursing leadership in PubMed from 1997 to 2006 and from 2007 to 2016,via Bicomb and gCLUTO softwares.Results A total of 482 articles were included.Bibliometric analysis showed that foreign nursing leadership literature number was increasing,which was mainly concentrated in the United States and England.The biclustering analysis showed that the research from 1997 to 2006 focused on patient safety and nursing leadership styles,education and training of nursing leadership,clinical nursing leadership models and nursing quality management;from 2007 to 2016,the research mainly focused on patient safety and nurses' psychological research,clinical nursing leadership theory,clinical nursing practice and competency training,and nnrses' role of leadership research.Conclusion The foreign nursing leadership theory has been developed well for its variety of topics and methods,and the object has been shifted from nursing administrators to clinical nurses.Future research should focus more on application of leadership in clinical nursing,and specialized leadership model and training system may be developed.

Objective:To explore the urodynamic characteristics of bladder function in patients with abnormal urination after radical hysterectomy of cervical cancer.Methods:In a prospective self-controlled study, a total of 84 patients with cervical cancer and clinical stage of ⅠB to ⅡA, meeting the preoperative inclusion criteria in our hospital from January 2016 to June 2018 were enrolled.All patients were tested for urodynamic testing 1 week before and 6 months after surgery.Patient bladder function status was observed and evaluated before and after surgery and urodynamic examination results were analyzed.Results:Of 84 study cases, the 58 patients developed abnormal urination after radical surgery, there were no urination abnormalities in 26 cases.There was no significant difference in age, clinical stage and pathological diagnosis between patients with and without urination abnormalities.Abnormal urination after radical surgery included difficulty in urinating(55%), frequent urination with a feeling of urination not complete(34%), stress urinary incontinence(7%), and urinary incontinence(4%). Among the 26 patients without urination abnormalities after radical surgery, only one case showed an abnormal urodynamic examination(abnormal bladder sensation). In patients without abnormal urination after surgery, differences in the urodynamic examination findings between pre-and post-surgery were not statistically significant(all P> 0.05). At the same time, in all cases of abnormal urination after radical hysterectomy of cervical cancer, 43 patients(74%)with bladder dysfunction had normal urination pattern before operation, but after operation, the urination abnormality required abdominal pressure.Of the patients with bladder dysfunction after surgery, the maximum flow rate(Qmax)was(12.9±10.3)ml/s, the average flow rate(Qave)was(6.0±4.2)ml/s, the voided volume was(148.0±36.8)ml, voiding time was(32.9±22.1)s, maximum flow time was(11.4±5.0)s, postvoid residual urine was(260.2±219.2)ml, maximal detrusor pressure was(12.1±8.9)cmH 2O, bladder compliance was(16.1±4.3)ml/cmH 2O, normal desire to void was(354.5±204.3)ml, maximal capacity was(587.4±152.5)ml, maximum urethral pressure was(97.6±33.1)cmH 2O, maximum urethral closure pressure was(89.9±36.4)cmH 2O, and function urethral length was(29.6±6.5)mm; In comparison, the above indexes-corresponding values at 1 week before surgery were respectively as follows: the Qmax was(25.1±11.4)ml/s, the Qave was(11.4±6.6)ml/s, the voided volume was(318.6±96.4)ml, voiding time was(29.2±18.5)s, maximum flow time was(6.7±3.9)s, postvoid residual urine was(29.9±21.5)ml, maximal detrusor pressure was(31.9±21.4)cmH 2O, bladder compliance was(78.1±33.9)ml/cmH 2O, normal desire to void was(258.2±185.5)ml, maximal capacity was(335.1±124.9)ml, maximum urethral pressure was(96.4±33.9)cm H 2O, maximum urethral closure pressure was(88.5±35.2)cmH 2O, and function urethral length was(37.2±7.2)mm.It can be seen that Qmax, Qave, voided volume, maximum detrusor pressure, bladder compliance, and functional urethral length in patients with abnormal urination are significantly lower after radical hysterectomy of cervical cancer than before the surgery.While, normal desire to void, maximum capacity, maximum flow time, and postvoid residual urine volume were higher after radical hysterectomy than before surgery( P<0.05). In addition, there was no significant difference in voiding time, maximum urethral pressure and maximum urethral closure pressure between pre-and post-operation.Besides, it is worth noting that there was no significant difference in preoperative urodynamic test results between patients without abnormal urination versus patients with abnormal urination( P>0.05), and the difference in urodynamic test results between the two groups is statistically significant( P<0.05). There was no statistically significant difference in abnormal urination and in urodynamic test results between different clinical stages and between different pathological types( P>0.05). Conclusions:The characteristics of urinary dynamics in patients with abnormal urination after radical hysterectomy of cervical cancer are mainly manifested as decreased bladder sensory function and abnormal detrusor function.And the urodynamic test can provide objective clinical indicators for early diagnosis.

Objective:To investigate the role of short-term use of mycophenolate mofetil (MMF) in EB viral infection and acute graft-versus host disease (GVHD) in patients receiving haploidentical hematopoietic stem cell transplantation (haplo-HSCT) .Method:Adult patients (≥14 years) who were diagnosed with hematological malignancies received haplo-HSCT in Peking University Institute of Hematology from May 2016 to December 2017 were retrospectively reviewed. The median age was 30 (14-60) years old. A total of 498 patients including 277 males and 221 females were enrolled. Donors' median age was 38 (8-66) years old. All patients were classified into long-term use of MMF ( n=199), which was defined as 500 mg every 12 hours from day 9 pre-transplant to 250 mg every 12 hours from day 30 after transplant then withdrawal on day 45 to 60 after transplant, and short-term use of MMF ( n=299), which was defined as 500 mg every 12 hour from day 9 pre-transplant then withdrawal till neutrophil engraftment. Kaplan-Meier model was used to analyze the cumulative incidence of EBV infection, and the Cox proportional regression model for multivariate analysis. Result:Characteristics including sex, age, disease types, mismatched HLA loci, donor-recipient relationship, donor-recipient blood type, donor age, and donor sex were comparable between two groups (all P＞0.05). According to once, the incidence of EBV viremia, defined as EBV＞10 3 copies/ml at least once, in short-term group and long-term group was 19.4% (58/299) and 27.6% (55/199) respectively ( P=0.046).Donor age and the duration of MMF prophylaxis (short-term group as reference) were associated with EBV viremia according to multivariate analysis [ HR=1.022(95% CI 1.006-1.038),1.600(95% CI 1.059-2.418); P=0.006 and 0.026, respectively]. The incidence of grade Ⅱ-Ⅳ and Ⅲ/Ⅳ acute GVHD in long-term and short-term group was 32.2% (64/199) versus 20.7% (62/299)( P=0.005) and 10.1% (20/199) versus 8.0% (24/299) ( P=0.427), respectively. Donor sex (female as reference) and duration of MMF prophylaxis (short-term group as reference) were associated with grade Ⅱ-Ⅳ acute GVHD [ HR=1.908(95% CI 1.079-3.373),1.752(95% CI 1.161-2.643); P=0.026 and 0.008, respectively].There were no statistical differences in the incidence of CMV viremia, refractory CMV viremia and hemorrhagic cystitis (all P＞0.05) between the two groups. Conclusion:Short-term use of MMF can reduce EBV viremia without increasing the development of acute GVHD in haplo-HSCT patients.