Objective:To seek the main incentive factors that influencing medical staff′s enthusiasm through the medical staff satisfaction survey among the grass-roots level medical staff in Shaanxi province.Methods:Choosing the north, middle and south parts of Shaanxi province and using the questionnaire survey, factor analysis method and Krukal-Wallis test were used.Results:Main drive common factor affect the enthusiasm of the staff with train-ing and development, compensation and protection level, management mode and team cooperation, working condi-tions and working environment, and different characteristics of medical staff on incentive satisfaction differences. Conclusion:In order to improve medical staff′s work enthusiasm, it is necessary to combine the Shaanxi regional specific circumstances, to establish a suitable incentive mechanism.

Objective To evaluate the curative effect and safety of dibutyl phthalate on demodicidosis. Methods A single blinded and controlled study of human demodicidosis treated with dibutyl phthalate was conducted. One hundred and forty three patients with demodicidosis, including 81 acne and 62 rosacea, randomly divided into trial and control groups. The trial group was treated with dibutyl phthalate and control group with "new fumanling" cream twice a day in the early morning and evening respectively for six weeks consecutively. Results The rates of excellent, good, and fair efficacy and total effective rate in the trial group with acne were 53\^7%, 41\^5%, 4\^9% and 100% respectively, with a significant difference to the control group (P0\^05). No complaint of side effects in the trial group was recorded. Conclusion Dibutyl phthalate is highly effective to demodicidosis without prominent adverse reactions.

Objective To observe the curative effect of 32 P-colloid on craniopharyngioma .Meth-ods Eighteen patients with craniopharyngioma ( from January 2001 to February 2006 ) were treated with in-jecting certain dose of 32 P-colloid, via the technique of three -dimensional orientation conducted by CT to indicate the location of the tumor , and draw out the cystic liquid by centesis .Results The cysts continual-ly shrank in 8 patients(about 44.4%) and vanished thoroughly in 7 patients(about 38.8%).The total ef-fective rate was 83.3% without surgical death or serious complication occurred .Conclusion The 32 P-colloid combining with the technique of three -dimensional orientation conducted by CT is a promising method to treat craniopharyngioma without obvious side -effects.

Objective To investigate the significance of galactose galectin-3(Galectin-3)and matrix metalloproteinase-2(MMP-2)expression in gliomas patients and thire role in process of gliomas' malignancy development. Methods Immunohistochemistry was used to detect Galectin-3 and MMP-2 protein expression in 5 normal brain tissue and 40 patients with different grade gliomas. According to positive cells number of Galectin-3,MMP-2 in tumor cells under a microscope,to determine the expression,and the positive index(LI)which came from the percentage of the positive cell number out of the total cell number was to expressed the number of positive cell. Results Galectin-3 and MMP-2 protein expression in normal brain tissue were negative. In glioma tissues,Galectin-3 was mainly expressed in the cytoplasm and membrane of tumor cells. In 23 glioma tissue withⅠor Ⅱ grade,9 cases(39. 13% )was positive and the LI values was(5. 65 ± 3. 47)% in terms of Galectin-3 expression. In Ⅲ,Ⅳ grade glioma specimens,the positive rate of Galectin-3 expression was 76. 47%(13 / 17), and LI value was(27. 88 ± 22. 13)% . The difference of Galectin-3 expression and LI value were significant between specimens with Ⅰ,Ⅱ grade and Ⅲ,Ⅳ significant( χ2 = 4. 101,t = 4. 105;P < 0. 05). In human gliomas,MMP-2 expression protein was mainly expressed in tumor cells and vascular basement membrane of the endothelial cell cytoplasm. In 23 glioma tissue with Ⅰor Ⅱ grade,9 cases(39. 13% )was positive and the LI values was(5. 91 ± 4. 78)% in terms of MMP-2 expression. In Ⅲ,Ⅳ grade glioma specimens,the positive rate of MMP-2 expression was 88. 24%(15 / 17),and LI value was(30. 06 ± 22. 94)% . The difference of MMP-2 expression was significant between specimens with Ⅰ,Ⅱ grade or Ⅲ,Ⅳ grade( χ2 = 7. 882,t = 4. 271;P< 0. 05). The linear correlation analysis showed that there was positively correlation between Galectin-3 and MMP-2 positive cells(r = 0. 800,P < 0. 05). Conclusion Galectin-3 and MMP-2 protein expression in Ⅰ,Ⅱgrade gliomas is significantly lower than those inⅢ,Ⅳ grade glioma,and they are positively related with the progress of malignant gliomas. Galectin-3 and MMP-2 protein can be used to evaluate or judge the malignant stage of human brain glioma.

Objective To understand the impairment and compensation mechanism of brain function in pa-tients with non-fluent aphasia after ischemic stroke. The fractional amplitude of low frequency fluctuation (fALFF) method was used to analyze the functional magnetic resonance imaging (fMRI) data in the resting state between the aphasia patients and the normal controls. Methods The scans of the resting state of fMRI were performed in 17 aphasia patients and 19 age-, education-, and sex-matched healthy control subjects. The scan sequence was single-shot echo planar image,DPARSF software was used to analyze fALFF data of the aphasia patients and the healthy controls. Results Compared to the control group, the value in right superior temporal gurus, inferior parietal lob-ule, frontal lobe cortex, and postcentral gurus were significantly increased in the aphasia group. The fALFF in bilat-eral cerebellum and right thalamus were also decreased in the aphasia group. Conclusions The fALFF values in some brain region in the aphasia group were abnormal in the resting state , indicating a few pathological change of brain function in patients with non-fluent aphasia after ischemic stroke.

Objective To evaluate the risk factors of septic shock after mini-percutaneous nephrolithotripsy (mPCNL). Methods Clinical data of 1 590 cases who underwent mPCNL from January 2013 to December 2014 were retrospectively analyzed. The x2 test and logistic regression were used to identify the key risk factors for septic shock after mPCNL. Results Of the 1 590 patients, 18 patients suffered septic shock, including 6 male patients and 12 fe﹣male patients. Their mean age was (45.6 ± 13.5) years (28 ~ 69 years). White cell in urine was 100 percent, the stone diameter ranged from 1.5 to 5.0 cm, unichannel for 15 cases while multichannel for 3 cases, the operation du﹣ration ranged from 45 to 200 min, mean (87.0 ± 56.0) min. 2 in 18 cases died in multiple organ failure, the others recovered till discharged. In x2 test, female gender (P = 0.001), (+++ ~ ++++) white cells in urine (P= 0.042), un-preoperative nephrostomy drainage (P=0.041) had significant association with septic shock after mPCNL. While in multivariate analysis, female gender ( O? = 5.471, 95 % CI: 0.756~21.452, P< 0.05) and un-preoperative nephrostomy drainage (O? =3.106, 95%CI:1.283~7.907, P<0.05) were identified as independent risk factors for septic shock after mPCNL. Conclusions Female gender and un-preoperative nephrostomy drainage are the key risk factors for septic shock after mPCNL.

Objective: To evaluate the relationship between tumor necrosis factor-alpha-induced protein 8-like 2 (TIPE2) and caspase-11 during pyroptosis in macrophages of mice. Methods: J774A.1 macrophages of mice were divided into 4 groups (n=6 each) using a random number table method: non-specific siRNA (Scr-siRNA) group (S group), Scr-siRNA plus LPS/ATP group (S+ LPS/ATP group), TIPE2-siRNA group (T group) and TIPE2-siRNA plus LPS/ATP group (T+ LPS/ATP group). The corresponding siRNA and Lipofectamine2000 transfection reagents were added to each group, and transfection was performed for 24-48 h, and in addition LPS 1.0 μg/ml was then added, cells were incubated for 5 h, then ATP 5.0 mmol/L was added, and cells were incubated for 1 h in S+ LPS/ATP and T+ LPS/ATP groups.Cells were collected to detect the expression of TIPE2, caspase-11, NOD-like receptor familypyrin domain containing 3 (NLRP3) and caspase-1 (by Western blot). The supernatant was collected for determination of lactic dehydrogenase (LDH) and myeloperoxidase (MPO) activities and concentrations of interleukin-1beta (IL-1β) and IL-18 (by enzyme-linked immunosorbent assay). Results: Compared with group S, the expression of TIPE2 was significantly down-regulated, the expression of caspase-11, NLRP3 and caspase-1 was up-regulated, and the activities of LDH and MPO and concentrations of IL-1β and IL-18 in supernatant were increased in group S+ LPS/ATP (P<0.05). Compared with group T, the expression of TIPE2 was significantly down-regulated, the expression of caspase-11, NLRP3 and caspase-1 was up-regulated, and the activities of LDH and MPO and concentrations of IL-1β and IL-18 in supernatant were increased in group T+ LPS/ATP (P<0.05). Compared with group S+ LPS/ATP, the expression of TIPE2 was significantly down-regulated, the expression of caspase-11, NLRP3 and caspase-1 was up-regulated, and and the activities of LDH and MPO and concentrations of IL-1β and IL-18 in supernatant were increased in group T+ LPS/ATP (P<0.05). Conclusion TIPE2 inhibits pyroptosis in macrophages through down-regulating the expression of caspase-11 in mice.

Objective To discuss the long term clinical effect of ileal orthotropic neobladder.Methods From 1991 to 1998,79 patients,mean age 55(41～75)years,male 74,female 6,were followed up.The serum creatinine and urea,electrolytes,blood routine,B ultrasonic scan of the neobladder residual urine and IVU or MRU of the patients were followed up.The max transverse diameter of renal pelvis and the max verticaI/level diameter of neobladder were measured in 5,10 to 14,15 years of postoperative when IVU or MRU.All results of different time were compared by the multiple comparisons.The local or distant cancer recurrence and the complications of the operation Were evaluated. Results Sixty-four cases,58 male,6 famle,were long term followed up:mean time was 167 (range,121～216)months.Seven cases died of other diseases.Seven cases had pelvic recarrence.Two cases had urethral recurrence.Three cases died of tumor metastasis.One case had ureter recurrence.Forty-eight patients were alive more than 10 years.The value of the serum creatinine,urea,electrolytes and bloods routine of the patients were normal after 5,10 to 14 and 15 vears postoperative (P＞0.05).The max transverse diameter of the renal pelvis in 5,10 to 14 and 15 years Dostoperative were 14.0 mm,14.1 mm and 13.7 mm,respectively,P＞0.05.The max vertical/level diameter of the neobladder in 5,10 to 14,15 years of postoperative were 110.4 mm/90.4 mm,111.5 mm/95.3mm and 127.0 mm/97.0 mm,respectively,P＞0.05.The residual urine of 5 cases was more than 50 ml and had not increased during follow up.Eight cases with neobladder stone were cured by the intracavitary lithothrypsis.Two cases with uretheral stricture were cured by the intracavitary therapy.Twelve cases of 14 cases with inguinal hernia were cured by reoperation,2 cases accepted conservative treatment.Only 17 cases had no complication involve of the cancer and the operation. Conclusion The upper urinary tract and neobladder of the ileal orthotopic neobladder could be stable for long time,the cure rate of tumor is satisfactory and the lifetime follow up is necessary.

Objective To evaluate the effects of dexmedetomidine on NLRP3 inflammasome during acute lung injury ( ALI ) induced by blunt chest trauma and hemorrhagic shock-resuscitation in rats. Methods Forty-five SPF healthy male Sprague-Dawley rats, weighing 200-220 g, were divided into 3 groups (n=15 each) using a random number table method: sham operation group (Sham group), ALI group and dexmedetomidine group ( Dex group) . A rat model of ALI was established by blunt chest trauma and hemorrhagic shock-resuscitation. Dexmedetomidine 5 μg·kg-1 ·h-1 was infused into the femoral vein after blunt chest trauma in Dex group. Blood samples were collected from the femoral artery at 6 h after blunt chest trauma for measurement of arterial oxygen partial pressure and concentrations of pro-inflammatory cytokines interleukin-1beta ( IL-1β) and IL-18 in serum ( by enzyme-linked immunosorbent assay ) . The oxygenation index was calculated. The rats were sacrificed and lungs were removed for examination of the pathological changes which were scored and for determination of the expression of NLRP3, caspase-1 and apoptosis-associated speck-like protein containing CARD ( ASC) in lung tissues ( by Western blot) and ac-tivities of lactic dehydrogenase ( LDH) and myeloperoxidase ( MPO) in lung tissues ( by colorimetry) . Re-sults Compared with Sham group, PaO2 and oxygenation index were significantly decreased, the expres-sion of NLRP3, caspase-1 and ASC was up-regulated, the activities of LDH and MPO were increased, and the concentrations of IL-1β and IL-18 in serum were increased in ALI group ( P＜0. 05 ) . Compared with ALI group, PaO2 and oxygenation index were significantly decreased, the expression of NLRP3, caspase-1 and ASC was down-regulated, the activities of LDH and MPO were decreased, and the concentrations of IL-1β and IL-18 in serum were decreased in ALI group ( P＜0. 05) . Conclusion Dexmedetomidine can al-leviate blunt chest trauma and hemorrhagic shock-resuscitation induced ALI in rats, and the mechanism is related to inhibition of NLRP3 inflammasome activation and reduction of inflammatory response.

Objective To understand the pathological mechanism of brain function in irritable bowel syndrome (IBS) patients by analyzing the fraction amplitude of low-frequency fluctuation (fALFF) of functional magnetic resonance imaging (fMRI) raw data in resting state.Methods The fMRI at resting state was performed in 21 IBS patients and 21 age-,education-and sex-matched normal healthy subjects,collected in our hospital from August 2010 to April 2012.The scan sequence in this study was single-shot echo planar image.The DPARSF software was used to preprocess the fMRI data,and then,the fALFF was compared between the IBS and normal control groups.Results As compared with the control group,the IBS group showed significantly increased fALFF values in the primary somatosensory cortex region and secondary somatosensory cortex region such as right temporal pole,middle temporal gyrus,precentral gyrus,postcentral gyrus and right superior frontal gyrus,and decreased fALFF values in the cerebellum.Conclusion Some somatosensory cortex regions in the IBS group are abnormal in the resting state in IBS patients,which can reflex a few pathological changes of brain dysfunction,and it also helps to understand IBS from the perspective of the brain neural activity for clinic diagnosis.