Objective To investigate the occupational burnout status of rehabilitation therapists in medical institutions and analyze relat-ed factors. Methods From December, 2015 to February, 2016, a total of 264 rehabilitation therapists, selected with random cluster sampling method, were investigated with Maslach Burnout Inventory-General Survey (MBI-GS) in Bengbu, China. Results The detection rate of ther-apist burnout was 81.1%, and the average score was (3.13±1.07). There were significant differences in the score of occupational burnout and its three dimensions (P<0.05), except emotional exhaustion dimension among different ages (P>0.05). Multiple regression analysis showed that the gender, age, marital status, educational background, professional title, shift work, job demand, job autonomy, social support, de-mand-autonomy ratio and income levels were the factors related with occupational burnout. Conclusion Rehabilitation therapists generally feel occupational burnout. It is different with demographic characteristics and working conditions.

Along with clinical medicine improvement and imageology development, The early diagnosis and treatment of uterine cervical cancer becomes possible. Especially computer tomography(CT) and magnetic resonance imaging(MRI) as well as positron emission tomography/computed tomography(PET/CT) are widespread applied in clinical medicine. These imaging examinational means supply important bases for diagnosis, staging and therapeutic means to uterine cervical cancer.

Objective To prepare adriamycin gelatin microballoons and identify its characteristics,and to study the feasibility of utilizing the microballoon to block the conduction of peripheral nerves.Methods Adriamycin was embedded in gelatin by means of emulsify-cross link,and its physical-chemical property was tested.Thirty male SD rats were randomly divided into 3 groups including control group(group N),adriamycin group(group A)and adriamycin gelatin microballoon group(group M).0.1% Tween saline,0.5% adriamycin and the suspension of adriamycin gelatin microballoons were dropped separately onto the surface of denuded right sciatic nerve.The pain threshold of right hind limb,sciatic nerve function index(SFI)and pathological change were observed.Result The optimal proportion of drug and carrier was 1∶10.The microballoon was round in shape with perfect dispersibility.90% of the active ingredient could be released from the microballoons within 240 minutes.The pain thresholds in both groups A and M were elevated obviously,and the value of SFI was decreased markedly.These phenomena lasted only 60 days in group A,whereas over 90 days in group M.Conclusions The adriamycin gelatin microballoons possess a good appearance and a satisfactory performance of delayed release.It can damage eperipheral nerve,and may be used as a long acting neurolytic agent.

Objective　To modify the Guy's stone score system and evaluate the validation of the modified score system in grading the complexity of percutaneous nephrolithotomy (PCNL) and predicting the stone-free rate after PCNL.　Methods　The modified system comprises 4 grades:grade Ⅰ,solitary stone in mid/lower pole or solitary stone in the pelvis with simple anatomy; grade Ⅱ,solitary stone in upper pole or multiple stones (located in 2 or more 2 calyces) in a patient with simple anatomy or a solitary stone in a patient with abnormal anatomy; grade Ⅲ,multiple stones in patients with abnormal anatomy or stones in a caliceal diverticulum or partial staghorn calculus; grade Ⅳ,staghorn calculus or any stone in a patient with spinal injury or spine malformation ( e.g.spina bifida,scoliosis,lordosis) ; kidney dysplasia ( e.g.duplex kidney,horseshoe kidney).It was validated on a database of 145 PCNL procedures performed by a single surgeon in a stone center.The clinical outcomes were retrospectively assessed with multivariate analysis.Results Of the 145 PCNL patients,according to Guy's stone score system and the modified score system,there were 22 G1 cases (15.2％) and 22 SFR cases (100.0％) ; 27 G2 cases (18.6％) and 25 SFR cases (92.6％); 36 G3 cases (24.8％) and SFR(31,86.1％); 60 G4 cases (41.4％) and 49 SFR cases ( 81.7％ ).Showing that the modified Guy's stone score was more accurate in predicting stone-free rate after PCNL ( P ＜ 0.05 ).　Conclusions　The modified Guy' s stone score system can accurately predict the stone-free rate after PCNL than the old system.

Objective To discuss the clinical features and significance of the difference between the preoperative plan and the actual procedure of the treatment of staghorn calculi with standard access PCNL under ultrasound guidance.Methods From Feb 2011 to May 2011,56 patients withsimple staghorn calculi after standard PCNL under ultrasound guidance were enrolled.The same urologist made the operation plan preoperatively and performed the procedure.The difference between the preoperative plan and the actual procedure were analyzed.The factors leading to the difference were evaluated.Results First puncture calyx,the number of access and stage were changed in 9 (16.1％),15 (26.8％),and 10 (17.9％) patients,respectively.The factors leading to the changes include:flexible,compliance,local inflammation of calyx and texture of stone,efficiency of fragmentation.Conclusions The factors which cannot be clearly known preoperatively may change the procedure of PCNL,which is important to know the clinical features and significance of these factors.

Objective To evaluate the ability of 64-slice spiral CT(64-MSCT) in demonstrating the coronary collateral circulation(CCC).Methods Patients undergoing 64- MSCT coronary angiography with relatively good image quality from August 2005 to April 2007 were entered into the study according to following requirements: patients underwent a traditional coronary artery angiography (CAG) after the coronary CT imaging; the CAG showed there was stenosis greater than 90% in at least one major coronary artery.The CCCs were assessed in CAG by the Rentrop grading, and the CAG served as the gold standard to determine the accuracy of 64-MSCT angiography in detecting collateral circulations.All CCCs were grouped angiographieally into three groups of CC0, CC1 ,and CC2 by Werner collateral collection(CC) grading.In the 64-MSCT coronary angiography imaging, a new grading(MSCT-CC) was used to evaluate CCCs.The consistency between these two grading standards was analyzed by Kappa test.Resalts A total of 97 patients were entered into the study, among whom at least one CCC was found by CAG in 37 patients and at least one CCC was detected by 64-MSCT angiography.Taken the CAG results as the reference standard, the sensitivity and specificity of the 64-MSCT angiography in detecting patients with the CCCs were 89.2% (33/37) and 93.8% (60/64) respectively.The sensitivity of the 64-MSCT angiography detecting the CCCs was 75.8% (47/62). All the CCCs detected by CAG and 64-MSCT angiography were grouped into three groups according to Werner grading: 4 in CC0 group, 24 in CC1 group and 19 in CC2 group.The CCCs were grouped into three groups according to MSCT-CC: 7 in MSCT-CC0 group, 22 in MSCT-CC1 group and 18 in MSCT-CC3 group.The consistency of the two grading criteria was relatively high (Kappa = 0.857, P < 0.01).Conclusion 64-MSCT angiography can accurately evaluate the coronary collateral circulation.

Objective To assess the assistance role of three-dimensional reconstruction of stag-horn calculi by 16-slice spiral CT to percutaneous nephrolithotomy (PCNL). Methods A total of 87 patients with 104 staghorn stones underwent 24 F-tract PCNL. 16-slice spiral CT scan and three-di-mensional (3D) reconstruction by volume rendering technique were carried out before PCNL for tract placement planning, the necessity for multiple tracts and stone burden. Tract placement, tract num-ber, operation time, bleeding requiring transfusion and volume of stone cleared were recorded. KUB was taken to explore residual calculi after operation and thus stone free rate was noted. Results In-traoperative tract placement was according to preoperative planning with 3D reconstruction of calculi. Forty-three calculi were cleared by multiple accesses, while multiple accesses were supposed necessary for 47 caculi. The stone free rate of one-session operation was 87.5%, and the last stone free rate af-ter second-look procedure was 91.7%. The stone burden of 3D reconstruction of CT (19.35 ±19.24 cm3) was significantly correlated with the mean volume of cleared calculi (16.34±13.79 cm3) in oper-ation (r=0. 993, P=0. 000). Conclusion The 3D reconstruction of spiral CT for staghorn calculi could show the precise construction of calculi, which could help to plan tract placement, evaluate the necessity of multiple tracts and stone burden.

-Objective To evaluate the efficacy and morbidity of standard tract percu taneousnephrolithotomy (PCNL) for patients with open surgery history of kidney and upper ureter. Meth odsEleven patients with open surgery history of kidney and upper ureter underwent standard tract (24 F)PCNL. Five patients had open nephrolithotomy,3 had pyeloplasty,2 had open ureterolithotomy and 1had partial nephrectomy. Five calculi were in left kidney and 6 in right side. Two cases had single cal culus,5 had multiple,and 4 had staghorn calculi. The stone burden was 1.7 47.1 cm3. ResultsAll patients were successfully operated in one session procedure. Nine PCNLs were accomplished bysingle and 2 by double accesses. The mean operating time was 86.2±34.2 min,the mean first access ing time was 14.14±11.0 min. The stone free rate after one session operation was 91% (10/11). Nocomplication occurred. Conclusion Standard tract PCNL for patients with open surgery history ofkidney and upper ureter could be effective and safe.

Objective To compare the effects of nitinol alloy memorial stent with silastic tube in treating the stenosis of the rabbit.Methods 16 rabbits with external ear canal(EEC) stenosis were randomly divided into two groups.One group was implanted with skin on the EEC wound while the other not.By self-comparison method nitinol alloy memorial stem was implanted in a rabbit's one ear and the silastic tube in the other.After days 5,15,30,and 60 later,the diameters of the external ear canal (with two materials planted) were measured respectively in the skin-planting group.In the naked group scar tissues were harvested and tested separately according to the planting material.HE coloration were used to study fibroblast hyperplasty while RT-PCR were applied to detecting the TGFβ1mRNA expression.The two brackets were compared according to their effect to scar hyperplasty.Results The EEC diameters using nitinol alloy memorial stem were found more spacious than using silastic tube.HE coloration showed the fibroblast hyperplasia was more mitigatory by using the nitinol alloy memorial stent.RT-PCR also found the TGFβ1mRNA expression was low by using same material.Conclusion The nitinol alloy memorial stent shows obvious superiority over silastic tube in external ear canal stenosis therapy.

OBJECTIVE: To investigate the functional mechanism of metadherin (MTDH), hypoxia-inducible factor-1 alpha (HIF-1α) and transketolase-like gene 1 (TKTL1) and their interaction with each other in laryngeal carcinoma development. METHOD: Thirty laryngeal carcinoma samples and 20 samples of para-carcinoma tissue were taken from the patients received operation treatment. The expression levels of MTDH, HIF-1α and TKTL1 were detected in all the samples by SP immunohistochemical methods. The data were analyzed by the SPSS13.0 statistical software. RESULT: The positive expression rate of MTDH, HIF-1α and TKTL1 in the 30 cases of laryngeal carcinoma was 56.67%, 60.00% and 63.33%, respectively, which was 20.00%,10.00% and 15.00% respectively in the para-carcinoma tissue, the difference of the positive expression rate of the tested objects between these two groups was statistically significant (P < 0.05 or P < 0.01). Of the 30 cases of laryngeal carcinoma, the positive expression rate of MTDH, HIF-1α and TKTL1 in the cases with lymphnode metastasis was 84.62%, 84.62% and 79.62%, respectively, compared with the rate in those without lymph nodes metastasis, which was 35.29%, 41.18% and 35.29%. The difference of the positive expression rate of the tested objects between these two groups was statistically significant (P < 0.05). In the tissue of poorly differentiated squamons cell carcinoma verified by pathology, the positive expression rates of MTDH and HIF-1α was 73.68% and 84.21%, respectively, while that in the tissue of well differentiated squamous carcinoma was 27.27% and 18.18%. The difference of the positive expression rate of the tested objects between these two groups was statistically significant (P < 0.05 or (P < 0.01). The positive expression rate of TKTL1 in laryngeal carcinoma at stage I-II was 25.00% and that at stage III-IV was 72.22%, the difference between which was statistically significant (P < 0.05). The positive expression rate of HIF-1α in laryngeal carcinoma at stage I-II was 33.33% and that at stage III-IV was 77. 78%, the difference between which was statistically significant (P < 0.05). The expression of MTDH, HIF-1α and TKTL1 showed no relationship with age,smoking amount or the tumor location (P > 0.05). The Spearman's rank correlation analysis showed that the positive expression rates of MTDH and HIF-1α in laryngeal carcinoma had positive correlation (r = 0.384, P < 0.05); the positive expression rates of TKTL1 and HIF-1α in laryngeal carcinoma had positive correlation (r = 0.508, P < 0.01); But there was no significant correlation between the positive expression rates of MTDH and TKTL1 in laryngeal carcinoma (r = -0.107, P > 0.05). CONCLUSION It suggested that these three proteins may have close relationship with the occurrence, invasion and metastasis of the laryngeal carcinoma. MTDH and TKTL1 may be expected to be new clinical targets for laryngeal carcinoma treatment and it could offer theoretical basis for the prognosis of the laryngeal carcinoma.
Carcinoma, Squamous Cell ; diagnosis ; metabolism ; Cell Adhesion Molecules ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Laryngeal Neoplasms ; diagnosis ; metabolism ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Transketolase ; metabolism