construction of a comprehensive,multifunctional and theory supported operation system is the organization basis on which occupation burnout can be scientifically and effectively interfered.Interference to occupation burnout is divided into nine subsystems by "participation" dimension which consists of organization,family and individual,and by "functional" matrix dimension which consists of the first grade prevention(development interfere),the second grade prevention(symptom interfere) and the third grade prevention(burnout interfere).Among these subsystems there exist factors of different target,content,mode and method etc.Their operation and interrelation form a complete working system via which an organization interferes occupation burnout.Promote the hospital management more scientificly and hominizaiton's in human resource.

BACKGROUND: The clinical features and classification of various anomalous synkinetic movements related to ocular muscles caused by abnormal innervations have not been fully understood.OBJECTIVE: To report and analyze the clinical features of anomalous synkinetic movements related to ocular muscles caused by abnormal innervations, as well as to classify them according to the same neuromuscular nerves.DESIGN: A retrospective case analysis.SETTING: Department of Ophthalmology, the Affiliated Hospital of the Medical College of Qingdao University.PARTICIPANTS: The study was mainly conducted in the Department of Ophthalmology, the Affiliated Hospital of the Medical College of Qingdao University. A total of 836 cases of abnormal ocular movements were found from January 1997 to January 2002. Among them 67 cases of anomalous synkinetic movements were diagnosed.METHODS: All patients were inquired of case history and their ocular movements were examined. The anomalous synkinetic movements were found and classified into congenital and acquired. All cases were analyzed according to the same neuromuscular nerves, such as between branches of oculomotor nerve, oculomotor and abducens nerve, supranucleus and other anomalous synkinetic movements.lous synkinetic movements were determined by inquiring the history of observed.RESULTS: Sixty-seven anomalous synkinetic movements (8%) of 836 abnormal ocular movements were diagnosed; congenital anomalous synkinetic movements were the most common ones (88.06%) and were often seen in patients with Duane's syndrome. Anomalous synkinetic muscles occurred the most common between lateral and medial rectus, lateral rectus and levator palpebrae muscle (36.89% respectively) in congenital cases, and those occurred between inferior rectus and levator palpebrae muscle more commonly (30%) in acquired cases.CONCLUSION: Anomalous synkinetic movements related to ocular muscles are not infrequently seen. When we find paradoxical movements between ocular muscles, or between ocular muscles and other unrelated muscles, anomalous synkinetic movements should be considered.

Objective To study the expression of Survivin protein and its relation with the expression of Bcl-2, Bax in the tropho- blasts of human normal placenta. Methods The normal placental tissues (8 -9week ,18-23 week and 37-40week) were fixed, embed- ded, sectioned, and Survivin, Bcl-2, and Bax in the trophoblasts were detected with immunnohistochemistry. Result As the gestational age advanced , the staining intensity of Survivin in the trophoblasts was significantly decreased from the first trimester group to the second trimes- ter group to the term group (PU value: 11.74±0.8,9.95±0.43,8. 83 ~ O. 67, respectively, P <0.01 ), while the staining intensity of Bcl-2 and Bax in trophoblast was significantly increased (PU value of Bcl-2 : 4.33±0.60, 5.00±0.75,6.87±0.45, respectively, P<0.01 and PU value of Bax: 9.82±1.12,16.00±1.05,27.48±2.10, respectively, P <0.01 ). Expression of Survivin in trophoblasts has no rela- tionship with the expression of Bcl-2 and Bax (P>0.05 ). Conclusion Survivin may take part in the development of human normal pla- centa through the way of suppressing the apoptesis in trophoblasts. Expression of Survivin in trophoblasts has no relationship with the expres- sion of Bcl-2 and Bax, which indicate that they regulate apoptesis of trophoblasts via different biological pathways.

Objective To discuss the method, therapeutic effect and safety of CT-guided 125I radioactive seed implantation for the treatment of cervical lymph node metastasis. Methods CT-guided 125I radioactive seed implantation was performed in 32 patients with pathologically proved cervical lymph node metastasis Results The local effective control rates of the cervical lymph node metastasis at one, 3, 6 and 12 months after the treatment were 81.3%(26/32), 84.4%(27/32), 93.7%(30/32) and 87.5%(28/32) respectively. Conclusion For the treatment of cervical lymph node metastasis, CT-guided 125I radioactive seed implantation is technically simple and clinically safe with reliable curative effect; this treatment is very effective in improving local tumor control rate.

Objective To study the effects of Vitamin D (VitD) supplementation on growth and immune function in neonatal mice.Methods A total of 120 mice were divided into four groups (30 mice in each group) according to dose of VitD.The high-dose group,medium-dose group and low-dose group was given 3.44,1.72,0.86 IU VitD drops,respectively.The control group was not treated with VitD drops.Rat body weight,level of peripheral blood 25-(OH)D3 were observed.The cellular immune function (determined by using delayed hypersensitivity reaction experiment),humoral immune function (assessed by antibody producing cells counts and HC50 determination) and mononuclear-macrophage phagocytic function (assessed by mouse peritoneal macrophage phagocytosis of chicken red blood cells test and carbon clearance test) were detected.The flow cytometry assay was carried out to differentiate T lymphocyte subsets.Results With the increase of dose of VitD,levels of peripheral blood 25-(OH)D3 and calcium ion were gradually increased,there were statistically significant differences when compared with the control group(P＜0.05);the body weight and body length were gradually increased,while no statistically significant difference was found among the groups treated with VitD(P＞0.05).Compared to the control group,the toes swelling,phagocytic percentage,number of antibody producing cells,serum soluble HC50 in the high-dose group and medium-dose group were increased significantly,while carbon clearance test phagocytic index were decreased significantly (P＜0.05).With the increase of dose of VitD,the number of CD4+,CD8+ T lymphocytes and the CD4+/CD8+ ratio were gradually increased.Conclusion VitD could promote the growth and development of offspring mice,and enhance the immune function of the body.

Objective To study effectiveness of System intervention to occupation burnout of medical staff.Methods Specimens were classified as interventional group and control group by 1:1 partnership rule.Systemic intervention,which came from organization,family and individual,was only applied to interventional group.The objective was to establish requirement and resource mechanism,continually increase response resource,and improve matching state of individual & job.It allowed full play to the first grade prevention(development intervention),the second grade prevention(symptom intervention)and the third grade prevention(burnout intervention).It determined effectiveness of intervention via indexes of occupation burnout,mental health and satisfaction within group or internal groups.Results Before systemic intervention,there was no significant difference between intervention group and control group(P＞0.05).After systemic intervention,the scores of burnout(emotion exhaustion(17.54±9.97)vs(14.30±11.87),P＜0.01;depersonalization(5.29±5.01)vs(4.63±5.65),P＜0.05;low personal accomplishment(6.47±4.89),(5.61±5.10),P＜0.01),check list-90(SCL-90),personal satisfaction in intervention group showed apparent difference compared with that in control group.But there was no significant difference in control group before and after intervention.Conclusion On the whole systemic intervention to health care staff obtains obvious achievement,effectively reduces emotional exhaustion,obsessive symptom and terror emotion,and enhances individual satisfaction.

OBJECTIVETo compare the effects of three different iodine interventions on the speed of normalization of enlarged thyroid gland.

METHODSSchoolchildren aged 8 - 10 years were randomized divided into one of three groups: group A was given iodized salt by researchers with an iodine concentration of 25 mg/kg; group B used iodized salt purchased from the market; and group C was similar to group B with additional intake of iodized oil capsules containing 400 mg iodine at the beginning of the study. Salt iodine content was measured bimonthly for 18 months and indicators of iodine deficiency were measured at baseline and 6, 9, 12 and 18 months thereafter.

RESULTSThe prevalence of goiter measured by ultrasound, based on the World Health Organization (WHO) body surface area reference > 97(th) percentile, was 18% at baseline and declined to less than 5% by 12 month in groups A and C respectively, and to 9% after 18 months in group B. Rates of goiter were similar by palpation or by ultrasound. The median urinary iodine was 94 micro g/L at baseline and increased in all groups to > 200 micro g/L at the 6-month follow-up.

CONCLUSIONSIn this sample of schoolchildren with initially low or moderate level of iodine deficiency, the group receiving salt with 25 mg/kg (group A) recovered from iodine deficient on all indicators after 18 months of study. However when the iodine content of salt was floating, as seen in group B, the sizes of thyroid did not yet achieve normal status by 18 months.

Child ; Female ; Goiter ; drug therapy ; physiopathology ; Humans ; Iodine ; therapeutic use ; Male ; Outcome Assessment (Health Care)

The healing training was an important method to improve living ability and quality of life of patients with schizophrenia.This article introduced a living skill training scheme applied in out-patients whose course of disease shorter than 5 years.

With the increasing incidence rates of metabolic diseases such as obesity and type 2 diabetes, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has also gradually increased year by year. NAFLD has complex underlying pathogeneses which have not yet been fully clarified. As the carrier of intercellular communication, exosomes play an important role in the development and progression of liver diseases. This article summarizes the mechanism of action of exosomes in the pathogenesis of NAFLD and their effect on lipid metabolism, insulin resistance, liver inflammation, and fibrosis, and it is pointed out that exosomes have great potential in the diagnosis and treatment of diseases, which will be the focus of future research.

Objective:To evaluate the efficacy and safety of combination therapy of eltrombopag, recombinant human thrombopoietin (rhTPO) , and standard immunosuppressive therapy (IST) for severe aplastic anemia (SAA) .Methods:A total of 16 cases with SAA treated with IST combined with eltrombopag and rhTPO were retrospectively analyzed.Results:At 3 months, the total response rate was 81.3%, and the complete hematological response rate was 37.5%. At 6 months, the total response rate was 87.5%, and the complete hematological response rate was 50.0%. The median time of platelet transfusion independence was 35 (16-78) days, the median time of red blood cell transfusion independence was 47.5 (15-105) days, the median platelet transfusion was 5.5 (3-20) U, and the median red blood cell transfusion was 6.5 (2-16) U.Conclusion:The combination of eltrombopag and rhTPO can improve the hematological response rate of IST for SAA and the quality of hematological remission with minimal toxic effects.