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.

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.

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 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 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 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.

AIM and METHOD:To determine the production of nitric oxide(NO) and change of NO synthase(NOS) activity in mitochondria isolated from the rat brains of the ischemia/reperfusion rat model produced by transient occlusion of middle cerebral artery on the following the points: 2 h after occlusion of artery and 30 min, 2h, 4h after reperfusion. RESULTS: After the occlusion of middle cerebral artery, the respiratory control rate(RCR) of mitochondria significantly decreased and slightly increased at 4h after reperfusion. Meantime, the production of NO in mitochondria increased significantly. But with the increase of perfusion, production of NO gradually decreased and reached normal level as in the control group. It also shows that cerebral ischemia increased NOS's activity significantly in the mitochondria and still kept a higher level than the control group although it decreased gradually after reperfusion. But the iNOS's activity did not show obvious change. The change of total NOS's activity depends on the change of cNOS's activity. CONCLUSION: The activation of NO/NOS system in the mitochondria might play an important role in the reperfusion injury during reperfusion of ischemic brain.

Objectives To explore the influence of standardized treatment and technical flow improvement on the diagnosis and treatment of congenital diaphragmatic hernia (CDH) after prenatal diagnosis. Methods The clinical data of neonates diagnosed with CDH who were hospitalized in neonatal intensive care unit from January 2005 to August 2016 was analyzed retrospectively. Based on the start time of standardized treatment implementation, 93 cases of CDH hospitalized from January 2010 to August 2016 were divided into the intervention group while 15 cases of CDH hospitalized from January 2005 to December 2009 were divided into the control group. The survival rate and complications of clinical outcomes between two groups were compared. Results There was no significant difference in sex, gestational age, birth weight, Apgar score, and CDH position between two groups (P >0.05). The total survival rate was 81.7％ in the intervention group and 53.3％ in the control group, and there was statistical difference (P<0.05). The difference of mechanical ventilation mode and pneumothorax rate between two groups also had statistical difference (P >0.05). The median operation time in the control group was 4.5 h and the intervention group was 49.5 h. The postoperative survival rate was 61.5％ in the control group and 90.5％ in the intervention group, and the differences between two groups were significant (P >0.05). The first blood gas analysis of deaths cases in both groups showed that there were significant differences in pH and PCO2 values (P >0.05). Conclusions Optimization of the clinical management during perioperative period can improve the survival rate of CDH and reduce complications. However, the dead cases in the intervention group had more severe pulmonary hypoplasia.

Objective:To evaluate the efficacy and morbidity of 24F-tract percutaneous nephrolithotomy(PNL) accessed by two-step dilation.Methods:A total of 3 052 patients with 3 366 kidneys or upper ureter calculi underwent 24F-tract PNL accessed by two-step dilation between Aug.,2003 and Jan.,2008,including 108 patients with solitary kidney,68 with kidney cysts,44 with horseshoe kidney,26 with vertebral column deformity,24 with medullary sponge kidney and 1 transplanted kidney.Stone burdens were(47.2?35.6) mm in length.Results:99.4% of 3 740 operations were successful in one-session access,in which 3 348 PNLs were accessed by single tract(89.5%),366 by double tracts(9.7%) and 26 by triple tracts(0.7%).The mean operating time was(68.4?30.9) min,the mean first accessing time were(17.6?11.1) min.and the mean calculi-dealing time were(35.0?55.3) min.The stone-free rate after one session operation was 100% for single calculus and 72.3% for multiple or staghorn calculi.of all the kidneys,374(11.1%) accepted another PNL to remove the residual calculi,and the last stone-free rate of PNL was 88.6%.During and after operation,52 cases(1.4%)needed transfusion,12(0.3%)underwent selective embolization of renal artery and 1(0.03%)accepted nephrectomy for bleeding control.No injury of organs occurred except for 3 cases with pneumatothorax and 19(0.5%)with urinary extravazation.No septic shock occurred.Conclusion:24F-tract PNL accessed by two-step dilation wtih ultrasound-guided puncture is effective and safe.