Objective:To investigate job burnout status of doctor and nurse in China. Methods: 218 doctors and nurses were assessed by MBI-HSS. Results: 42.1% subjects got high or moderated scores on Emotional Exhaustion, 22.7% subjects got high or moderate scores on Depersonalization and 48.6% subjects got low or moderate scores on personal accomplishment. Female subjects got higher scores on Emotional Exhaustion than male subjects Compared with.subjects with higher level education, subjects with lower level education got higher scores on Emotional Exhaustion, however, lower scores on Personal Accomplishment.Conclusion:Some subjects are found to experiences job burnout. To prevent or cure job burnout, more attention should be paid to female and persons with lower level education.

Ambulatory electrocardiogram (ECG) monitoring can effectively reduce the risk and death rate of patients with cardiovascular diseases (CVDs). The Body Sensor Network (BSN) based ECG monitoring is a new and efficien method to protect the CVDs patients. To meet the challenges of miniaturization, low power and high signal quality of the node, we proposed a novel 50 mmX 50 mmX 10 mm, 30 g wireless ECG node, which includes the single-chip an alog front-end AD8232, ultra-low power microprocessor MSP430F1611 and Bluetooth module HM-11. The ECG signal quality is guaranteed by the on-line digital filtering. The difference threshold algorithm results in accuracy of R-wave detection and heart rate. Experiments were carried out to test the node and the results showed that the pro posed node reached the design target, and it has great potential in application of wireless ECG monitoring.
Algorithms ; Cardiovascular Diseases ; diagnosis ; Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Heart Rate ; Humans ; Wireless Technology ; instrumentation

Objective:To explore the relationship between work-family conflict and job burnout of doctors and nurses.Method:218 doctors and nurses were assessed by Work-Family Conflict Scale and Maslach Burnout Inventory.Result:Hierarchical regression indicated that the work-family conflict was a powerful predictor of job burnout beyond demographic variables, 37% variance of Emotional Exhaustion was explained by work-family conflict, 18% variance of Depersonalization and 12% variance of Personal Accomplishment were also explained by work family conflict. Conclusions:The work-family conflict is an important, may be the most influencing factor on job burnout in medical staffs.

Homoacetogens are a group of microorganisms with application potential to produce chemicals and biofuels by the bioconversion of synthesis gas. In this study, we collected waste activated sludge samples to screen homoacetogens by Hungate anaerobic technique, and studied the effect of pH on acetate and alcohol production from H2/CO2 gas. The mixed culture contained Clostridium ljungdahlii, Lysinibacillus fusiformis and Bacillus cereus. Acetate concentration achieved 31.69 mmol/L when the initial pH was 7. The mixed culture containing homoacetogen could converting H2/CO2 to acetate, which provides an efficient microbial resource for the bioconversion of synthesis gas.
Acetates ; chemistry ; Bacteria ; classification ; Biofuels ; Carbon Dioxide ; Hydrogen ; Sewage ; microbiology

BACKGROUND: Quiet a number of researches has reported the morphological changes of global ischemic reperfusion model. However, there are few reports on the ultrastructural changes of cortex in early reperfusion, especially the change of blood brain barrier.OBJECTIVE: To explore the changes of brain cortex neurons, glial cells and blood brain barrier in order to provide reliable evidence for clinical treatment.DESIGN: A randomized and controlled trial.SETTING: Department of Neurosurgery, Departnent of Anesthesia and Electron Microscope Room of Beijing Tiantan Hospital.MATERIALS: The experiment was conducted to 6 Wistar rats in Beijing Neurological Surgery Research Institute of Capital University of Medical Sciences during February 2003 to February 2004. The rats were randomly divided into two groups with one of ischemia-reperfusion group and sham operation group with 3 rats in each group.INTERVENTIONS: To prepare global ischemic reperfusion model of rats. Brain was removed from ischemic group in one hour of reperfusion and from sham operation group one hour after the operation. Electronic microscope technique was used to observe the ultrastructural changes of cortex.MAIN OUTCOME MEASURES: Ultrastructural changes of cortex.RESULTS: The neurons of cortex shrank to certain degree in the early stage of ischemic reperfusion(1 hour) . The glial cells were swollen with dissolved chromosome in nucleus and unclear nuclear membrane. The foot protrusions around blood vessel slightly swelled and separated from basement membrane. Mircro-tubes were partially dissolved.CONCLUSION: In early stage of reperfusion injury, the cortex neurons, glial cells, cellular framework and blood brain barrier already changed which suggested that the protective treatment such as reducing brain edema, protecting blood brain barrier should start as early as possible.

Objective To assess the additional diagnostic value of mesenteric CT angiography (MCTA) for localization of intestinal diseases detected by 64-slice helical CT. Methods Pretreatment abdominal CT data from 60 cases of intestinal diseases confirmed surgically and pathologically were analyzed retrospectively. Two radiologists blindly evaluated the images in group A (including axial and multi-plane reconstructive images) and group B (including images in group A and CT angiography). Both the localization and qualitation of intestinal diseases were evaluated by comparison of the surgical and pathological findings. Results The accuracy of localization of intestinal diseases in groups A and B was 83.3% and 98.3%, respectively. Conclusion Mesenteric CT angiography can obviously increase the accuracy in localization of intestinal diseases.

Objective To explore the capability of diffusion weighed imaging (DWI) in differentiating malignant cervical lymph nodes from benign ones in nasopharyngeal carcinoma (NPC) patients, and to assess the appropriate b value in 3.0T MR DWI. Methods Conventional MR and DWI scan were performed in 50 patients with histopathologically proven NPC and 20 healthy volunteers with GE 3.0T MR scanner, and neurovascular array 8 channels head and neck unite coil. DWI was performed with single shot spin-echo echo-planar imaging (SE-EPI) sequence at 4 different b values (600, 800, 1000,1200 s/mm~2). The apparent diffusion coefficient (ADC) values between metastatic lymph nodes of NPC patients and benign nodes of volunteers were compared. Results The mean ADC value (×10~(-3) mm~2/s) of metastatic cervical lymph nodes of NPC at different b value (600, 800, 1000, 1200 s/mm~2) was 0.808±0.112, 0.769±0.098, 0.732±0.095 and 0.696±0.083, respectively; the mean ADC value (×10~(-3) mm~2/s) of lymph nodes of volunteers was 0.993±0.172, 0.967±0.165, 0.903±0.157 and 0.855±0.122, respectively (P<0.05). When b value was 800 s/mm~2, and ROC cut-off point was 0.873×10~(-3) mm~2/s, the diagnostic sensitivity, specificity and accuracy was 88.41%, 69.43%, and 75.22%, respectively. Both the satisfying images and the accurate measurement were acquired. Conclusion As a rapid and sensitive new MR technique, DWI can offer help in discriminating benign and malignant cervical lymph nodes in NPC patients.

Objective To investigate the value of diffusion weighted imaging (DWI)in identification of different molecular sub-types for breast cancer classifications.Methods All patients with breast cancer were divided into four subtypes groups by immuno-histochemistry results including Luminal A subtype,Luminal B subtype,HER2-over expressing (HER2-OE)subtype,and triple negative breast cancer (TNBC),respectively.The means of maximum,average,and minimum ADC of the lesions in all patients were recorded.The analysis of ANOVA and least significant difference test (LSD-t )were used for the statistical evaluation.Results There were significant differences in maximum ADC,average ADC,and minimum ADC among Luminal A subtype (n=21),Lu-minal B subtype (n=22),HER2-OE subtype (n=1 7)and TNBC subtype (n=12)groups (P =0.025,0.039 and 0.041,respec-tively).However,paired comparison in mean of maximum ADC,average ADC and minimum ADC by LSD-t multiple comparisons among Luminal A,Luminal B,HER2-OE and TNBC respectively were not significantly different.Conclusion DWI may be difficult to discriminate the molecular subtypes of breast cancer classification before surgery or biopsy.

Objective To explore the risk factors of severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,and antimicrobial drug resistance among these isolates.It may help to prevent and control the disease and promote to rational use of antibiotics.Methods We conducted the case-control study in our PICU.It included 89 patients with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia as case group and 68 patients with severe pneumonia caused by Klebsiella pneumonia as control group during the same period.To compare the two groups on irrationality use of antibiotics (especial for third generation cephalosporin),length of stay,tracheal cannula,time of mechanical ventilation and underlying conditions (malnutrition,congenital heart disease,heredity and metabolic disease).Antimicrobial susceptibilities among 89 multi-drug resistant Klebsiella pneumonia isolates were analyzed.Results There were 63 cases (70.79％) for irrationality use antibiotics in case group,while there were 27 cases (39.70％) in control group (P ＜ 0.01).The cases for length of stay over 7 days in case group (48 cases,53.93％) were more than those cases with the same situation in control group (12 cases,17.65 ％) (P ＜ 0.01).Thirty-eight cases (42.69 ％) needed mechanical ventilation therapy in case group,while 16 cases (23.53％) needed mechanical ventilation therapy in control group (P ＜ 0.01).The cases for duration of mechanical ventilation over 5 days in case group (18 cases,20.22％) were more than those cases in control group (5 cases,7.35％) (P ＜0.05).The cases with underlying disease in case group (13 cases,14.61％) were more than those cases in control group (2 cases,2.94％) (P ＜ 0.05).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to carbapenems.Conclusion Several risk factors are associated with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,including irrational use of antibiotics (especial for third generation cephalosporin),long term of length of stay,endotracheal intubation,long term of mechanical ventilation,and having underlying disease (malnutrition,congenital heart disease,heredity and metabolic disease).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to Carbapenems.Carbapenems should be used as first-line drugs for severe pneumonia caused by multi-drug resistant Klebsiella pneumonia.

Objective To investigate the impact of paced QRS duration (pQRSd) on heart function in patients with right ventricular apical pacing. Methods Seventy-six patients with Ⅲ° atrioventricular block received pacemaker treatment were enrolled and randomized into group A (pQRSd < 190 ms, n = 52) and group B(pQRSd≥ 190 ms, n = 24). The concentration of brain natriuretic peptide (BNP),parameters of left atrial diameter (LAD), left ventricular ejection fracetion (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic dimension (LVEDD) were measured before operation, at 12 months and 24 months after implanting, respectively. The parameters of echocardiography assay, the concentration of BNP and the incidence of heart failure event after implantation were compared between two groups. Results At 12 months after implanting, LVEF of the patients in the group B decreased significantly compared with that of group A (P < 0.05). However, the echocardiography paramenters and the concentration of BNP were not significantly different between the two groups (P > 0.05). At 24 months after implanting, LAD、LVEDD、LVESD of group B increased significantly compared with those of group A [LAD,( 44.5 ± 6.2) mm vs (41.6 ± 5.1) mm, LVEDD, (52.7 ± 9.3) mm vs (48.2 ± 7.5) mm, LVESD, (37.5 ± 5.6) mm vs (33.8 ± 4.9)mm, each P < 0.05, respectively]. The concentration of BNP of group B increased significantly [(408.2 ± 102.1)ng / L vs (243.7 ± 92.8)ng / L, P < 0.001], and LVEF of the patients in group B decreased significantly compared with those of group A [(46.3 ± 6.8)% vs (51.6 ± 5.2)%, P < 0.001], respectively. No significant difference in the incidence of heart failure event (41.7% vs 26.9%, P > 0.05)between two groups during 24-month follow-up. Conclusion The prolonged paced QRS duration has a detrimental effect on long-term cardiac function during RVA pacing in patients with Ⅲ°atrioventricular block.