Objective To examine the mediating role of work?family enrichment between family supportive supervisor behavior and nurses'career resilience. Methods Totally 727 nurses selected by clus?ter?random?sampling were investigated by the family supportive supervisor behaviors scale( FSSBS) ,the wok?family enrichment scale( WFES) and the career resilience scale( CRS) . Results The scores of family sup?portive supervisor behavior,work to family enrichment,family to work enrichment and career resilience were (3.74±0.68),(3.36±0.77),(3.59±0.72) and (3.41±0.84) respectively. The family supportive supervisor behavior( r=0.31, P<0.01) ,work to family enrichment( r=0.32, P<0.01) and family to wok enrichment( r=0.30, P<0.01) were positively related to career resilience. The family supportive supervisor behavior posi?tively influenced career resilience(P<0.01). Work?family enrichment partially mediated the association be?tween family supportive supervisor behavior and career resilience, accounted for 37. 7% of the total effect. Conclusion Health organizations should try to build family supportive organizational climate and improve nurses'level of work?family enrichment and career resilience,then promote job performance and job satisfac?tion.

Objective To explore the clinical characteristics of the patients with schizophrenia to make troubles and accidents likely ,to provide scientific evidence for preventing and controlling these patients to make troubles and accidents effectively .Methods 100 patients with schizophrenia to make troubles and accidents likely were randomly extracted and assigned to the study group from psychiatric department of this hospital .100 ordinary patients were divided into control group .Their data on illness were sur-veyed and analyzed retrospectively .The difference of the general condition and illness data along with mental symptoms between the both group were compared .Results The proportion of patients to be man peasant ,in rural area ,no a spouse and medical insurance , to have a lower degree of culture and to be 20 - 39 years old in the study group was significantly higher than those in the control group(P< 0 .05) .The social support and economic conditions of family in the study group were significantly poorer than those in the control group(P< 0 .05) .The proportion of patients to be paranoid schizophrenia ,to have a complications and the positive score of the positive and negative syndrome scale (PANSS) in the study group were significant higher than those in the control group but the negative score of PANSS and the course of disease were significantly lower (P< 0 .05) .The proportion of patients to have posi-tive symptoms such as illusion and delusion in the study group were significantly higher than that in the control group (P< 0 .05) . But the proportion of patients to have negative symptoms such as avoid social and emotional dull in the study group were signifi -cantly lower than that in the control group(P< 0 .05) .Conclusion The positive symptoms contribute to making troubles and acci-dents in SP patients .The patients to be paranoid schizophrenia ,a man and peasant ,in prime of life ,in rural area ,no a spouse and to have a lower degree of culture maybe make troubles and accidents more likely .Having a poor social support and economic conditions of family and no medical insurance cause the probability of their making troubles and accidents increase .

Objective To observe the value of iterative model reconstruction(IMR)technique in CT pulmonary angiography (CTPA)with lower radiation dose and lower contrast medium.Methods 60 patients with clinical suspicion of pulmonary embolism underwent 256-slice CTPA were prospectively enrolled.The raw data of test group(n=30)were reconstructed by filtered back projection (FBP)(group A)and IMR technique (group B).And the raw data of control group(n=30)were reconstructed by FBP(group C).The values of volume CT dose index(CTDIvol),effective radiation dose (ED)were recorded and calculated.The image quality parameters:CT value,image noise,signal-to-noise (SNR),contrast-to-noise ratio (CNR)and subjective image score(from one to five)were measured and compared between group A and B,B and C.Results The BMI was no statistically significant difierenee between two groups(P=0.001).The CTDIvol, ED on test group were respectively lower than that on control(P<0.001).The CT value was no statistically significant difierenee between group A and B(P=0.999).The CT valueon group B was higher than that on group C(P=0.005).The image noise on group B was lower than that on group A(P<0.001),but which was higher than that on group C(P<0.096).The SNR,CNR on group B were higher than that on group A(P<0.001).The SNR,CNR did not differ significantly between B and C(P=0.831,P=0.958).The diagnosable rate and good quality rate on group B were higher than that on group A(P<0.001),and there were no significantly diferent between B and C(P=1.000).Conclusion The application of optimized IMR technique can improve image quality at lower radiation dose and lower contrast medium for CTPA.

BACKGROUND:The conditions of teenager and adult skeletons have great differences. Thus, it is dangerous to place screw on teenagers using the methods for adults.
OBJECTIVE:To observe the anatomical features of teenagers’ upper-middle thoracic vertebra images, and to provide experimental basis for pedicle nailing and pedicle-rib head unit nailing in teenagers’ upper-middle thoracic vertebrae.
METHODS:We chose 30 teenagers (13 to 18 years old) without spine lesions, and then they were scanned (0.625-1.25 mm) from T 1 to T 12 segments using CT. The original data were loaded into a three dimensional software in DICOM format for measuring related indicators. At last, we analyzed the data according to different segments.
RESULTS AND CONCLUSION:The trend between the width of pedicle and pedicle-head unit was similar, showing a“V”shape. The minimum of width was located in the T 4 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between pedicle nail road length and pedicle-rib head unit nail road length was similar, and the trend between them was gradual y increasing. The minimum of length was located in T 1 , and the maximum of length was located at T 10 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between the pedicle transverse angle and pedicle rib-head unit transverse angle was similar. The trend from T1 to T10 was on a decline, and there were significant differences in corresponding vertebrae (P<0.05). The trend of curves between pedicle sagittal angle and pedicle rib-head unit sagittal angle was similar, showing a wavy shape, and there were significant differences in corresponding vertebrae (P<0.05). These results confirmed that the same segmental pedicle rib-head unit can provide a safer nailing place than the pedicle relatively.

ObjectiveTo study the feasibility of abdominal aortic CT angiography with low dose contrast medium.MethodsThe patients who took the examinations were divided into three groups.In 34 patients of group A,the injection flow rate was 4 ml/s,and the contrast medium volume was 90 ml and 20 ml of saline was applied.The contrast medium dose and injection flow rate of the other 64 patients were determined according to the formula,injection tlow rate = patients' body mass × ratio of contrast medium dose to the body mass / (5 + exposure time).In B and C group with 32 cases each,the ratio of contrast medium dose to body mass were 0.8 to 0.9 and 0.6 to 0.7 ml/kg.The depiction and the measured intraarterial concentration of contrast medium of the abdominal aorta and the renal arteries as well as their branches were compared and evaluated on the source images and MIP images generated among three groups respectively.CT values of the abdominal aorta and its branches in each group were analyzed using singlefactor analysis of variance,while renal artery and its branches were analyzed using x2 test score.Results The abdominal aorta,the celiac trunk,the splenic artery,the superior mesenteric artery,the renal arteries and their branches were all well shown in three groups.The CT value within the abdominal aorta were (363 ±28),(362 ±28) and (334 ± 14) HU for the three groups respectively,the CT values within the celiac were (368 ±28),(367 ±28) and (338 ± 15)HU,the CT value within the renal artery were (365 ±27),(364 ± 29) and (336 ± 15) HU respectively,the CT value within the splenic artery were (373 ±28),(372 ± 28) and (343 ± 15) HU respectively,and the CT value within the superior mesenteric artery were ( 374 ± 28 ),( 372 ± 28 ) and ( 344 ± 16 ) HU respectively.There were significant differences among the three groups ( P = 0.000).There were significant differences between A group and C group,B group and C group ( P ＜ 0.01 ),while no significant difference existed between A group and B group( P ＞0.05 ).The amount of contrast agent for each patient in group A was 90 ml,while the amount of contrast agent in group B and C was (51 ± 9) and (40 ± 9) ml respectively.There were significant differences of the contrast medium volume among the three groups ( F = 537.091,P = 0.000).Results of pairwise comparisons were statistically significant(P =0.000).Image quality of renal artery in group A was rated as excellent,good,and generally for 26,7 and 1 cases,24,7 and 1 for group B,and 22,8 and 2 for group C.There were no significant differences in image quality of the renal arteries among the three groups ( x2 = 0.561,P = 0.755 ).ConclusionThe individualization of injection method in abdominal aortic CT angiography can minimize the amount of contrast agent but to meet the clinical requirements.

BACKGROUND:In the process of designing knee joint prosthesis and operating total knee arthroplasty for the Chinese people, we should not only take into account the proximal tibial anatomical characteristics and the difference of geometry, but also should pay attention to the differences between different races. OBJECTIVE:To compare the anatomical morphological differences between Mongolian and Han nationality through measuring the CT tomography scanning and three-dimensional reconstruction measurement of tibia proximal part of Han and Mongolian nationality, so as to provide the data references for prosthesis selection used for total knee arthroplasty. METHODS:Total y 60 patients who received the treatment at the Department of Joint Surgery were col ected, and divided into Han nationality and Mongolian nationality groups (n=30/group, 15 males and 15 females in each group). The age was (36.00+7.22) years old. 16-row helical CT scan (American GE Lightspeed 16) was used for spiral scanning, slice thickness 0.625 mm. Scanning images were exported in DICOM format and saved. Digital three-dimensional reconstruction measurement was conducted using Mimics 15.0 three-dimensional reconstruction software. The tibial plateau width, anteroposterior diameter of the medial tibial plateau and lateral anteroposterior diameter were measured respectively to observe whether there were any differences among sex, sides and nationality. RESULTS AND CONCLUSION:There were no significant differences in the above indicators between left and right sides (P>0.05). There were significant differences in tibial plateau width, anteroposterior diameter of the medial tibial plateau and lateral anteroposterior diameter between males and females, and Han and Mongolian nationality groups (P<0.05). Specific performed in:(1) There was significant difference in the morphological measurement parameters of proximal tibia between sex for Han and Mongolian nationality, and the mean value of male was larger compared with that of female. (2) There was certain significant difference in the part of the parameter indicators between Han and Mongolian nationality groups. These results suggest that the prosthesis should be chose and placed correctly according to the differences of morphological characteristics, gender, nationality, region of the Chinese people. (3) Digital three-dimensional reconstruction technology and individualized design can choose suitable prosthesis for different people, so as to ensure a good repair effect in patients after total knee replacement.

Objective: To investigate the effect of leader-member exchange on nurses’sense of calling in workplace based on self-determination theory. Methods: A total of 381 nurses were randomly selected from five tertiary general hospitals in Zhejiang province, China from October to December, 2016. They were subjected to a survey using the Leader-Member Exchange Scale, Job Autonomy Scale, Core Self-Evaluation Scale, and Calling Scale. The mediating effect was used to test the procedures and the data were subjected to hierarchical regression analysis. Results: The leader-member exchange was positively correlated with job autonomy, core self-evaluation, and sense of calling (r=0.471, P<0.001; r=0.373, P<0.001; r=0.475, P<0.001) ; the leader-member exchange had a positive predictive effect on job autonomy and sense of calling (β= 0.47, P<0.001; β=0.48, P<0.001) ; the job autonomy had a partial mediating effect on the relationship between leader-member exchange and sense of calling (F=66.50, P<0.001) ; the core self-evaluation negatively adjusted the positive relationship between leader-member exchange and job autonomy (F=27.81, P<0.001) . Conclusion High-quality leader-member exchange enhances the sense of calling by improving staffs’ job autonomy and the core self-evaluation reduces the positive relationship between leader-member exchange and job autonomy.

Objective:To explore the relationship of serum interleukin (IL) -9 and platelet-activating factor (PAF) levels with serum total immunoglobulin E (IgE) levels, disease severity and disease course in patients with chronic spontaneous urticaria (CSU) .Methods:A total of 60 patients with active CSU were collected from Department of Dermatology, the First Affiliated Hospital of Hebei North University from March 2018 to March 2019 (active CSU group), and divided into mild group, moderate group and severe group according to 7-day urticaria activity score (UAS7). After 28-day standard antihistamine therapy, the patients whose condition became stable were included in the stable CSU group. During the same period, 30 health examinees were included in the healthy control group. Peripheral venous blood samples were collected from the subjects in each group, enzyme-linked immunosorbent assay (ELISA) was performed to detect serum levels of IL-9 and PAF, and immunoturbidimetric assay to detect the serum total IgE level. Correlations of serum IL-9 and PAF levels with serum total IgE levels, UAS7 scores and disease courses were analyzed in patients with CSU. One-way analysis of variance was used for comparisons among multiple groups, least significant difference- t test for multiple comparisons, and Pearson correlation analysis for correlation analysis. Results:Totally, 28 males and 32 females were included in the active CSU group, their age ranged from 11 to 68 years (34.68 ± 8.62 years), and the disease duration ranged from 2 months to 7 years (1.42 ± 0.41 years). In the healthy control group, 14 were males and 16 were females, and their age ranged from 10 to 70 years (35.06 ± 7.89 years). According to UAS7, 12, 26, and 22 patients were diagnosed with mild, moderate and severe CSU respectively, and 22 were included in the stable CSU group after standard treatment. The levels of serum IL-9, PAF and total IgE significantly differed among the active CSU group, stable CSU group and healthy control group (IL-9: 144.34 ± 23.19 vs. 109.25 ± 20.77 vs. 107.23 ± 19.23 pg/ml; PAF: 362.45 ± 51.45 vs. 223.18 ± 32.46 vs. 221.23 ± 28.38 pg/ml; total IgE: 168.12 ± 32.48 vs. 24.04 ± 7.04 vs. 21.76 ± 5.95 IU/ml; F = 38.80, 148.38, 499.12, respectively, all P < 0.001), and were significantly higher in the active CSU group than in the stable CSU group and healthy control group (all P < 0.05), while there was no significant difference between the stable CSU group and healthy control group (all P > 0.05). Pearson correlation analysis showed that the serum IL-9 and PAF levels were positively correlated with serum total IgE levels and UAS7 scores (all P < 0.05), but not correlated with the disease course (both P > 0.05) . Conclusion:Serum IL-9 and PAF levels in patients with active CSU were markedly elevated along with the increase in disease severity, and closely correlated with serum total IgE levels.

Objective:To explore the correlation between serum levels of interleukin-9 (IL-9), platelet activating factor (PAF), total immunoglobulin E (IgE), interferon γ (IFN-γ), and interleukin-4 (IL-4) in patients with chronic spontaneous urticaria (CSU).Methods:Sixty CSU active phase patients admitted to the First Affiliated Hospital of Hebei North University from March 2018 to March 2019 were selected and included in the CSU active phase group. Based on the 7-day Urticaria Activity Score (UAS7), they were divided into three groups: 15 mild group, 25 moderate group, and 20 severe group; And 19 patients who entered the quiescent phase of the disease after 28 days of standardized antihistamine treatment were included in the CSU quiescent phase group. Another 30 healthy subjects who participated in the physical examination at the same time at our hospital′s physical examination center were selected to be included in the healthy control group. 5 ml of fasting elbow vein blood was collected from CSU active and stationary patients, as well as healthy subjects. The serum levels of IL-9, PAF, total IgE, IFN-γ, and IL-4 were detected using enzyme-linked immunosorbent assay. Pearson correlation test was used to analyze the correlation between serum IL-9, PAF levels and total IgE, IFN-γ, and IL-4 levels in CSU active patients.Results:The serum levels of IL-9, PAF, total IgE, and IL-4 in the CSU active phase group were higher than those in the CSU stationary phase group and healthy control group (all P<0.05), and the serum IFN-γ levels were lower than those in the CSU stationary phase group and healthy control group (all P<0.05). There was no statistically significant difference in the levels of the above indicators between the healthy control group and the CSU stationary group (all P>0.05). The serum levels of IL-9, PAF, total IgE, and IL-4 in the severe group were significantly higher than those in the mild and moderate groups (all P<0.05), and the serum IFN-γ levels were significantly lower than those in the mild and moderate groups (all P<0.05); The serum levels of IL-9, PAF, total IgE, and IL-4 in the moderate group were significantly higher than those in the mild group (all P<0.05), and the serum IFN-γ levels were significantly lower than those in the mild group ( P<0.05). Pearson correlation analysis showed that serum IL-9 and PAF levels were positively correlated with serum total IgE and IL-4 levels in CSU active phase patients (IL-9: r=0.726, 0.870, PAF: r=0.788, 0.795, all P<0.01), and negatively correlated with serum IFN-γ levels (IL-9: r=-0.831, PAF: r=-0.816, all P<0.01). Conclusions:The serum levels of IL-9 and PAF in patients with active CSU are elevated and correlated with total IgE, IFN-γ, and IL-4 levels, suggesting that IL-9 and PAF may be related to the occurrence and development of CSU.