Objective To analyze the psychosocial influential factors on job burnout and their interaction models in first aid medical staff.Method A survey was carried out concerning job burnout status,job stress,job overload,work-family conflict,overall job satisfaction,coping styles and social support in 504 first aid medical staffs,by which to seek the psychosocial influential factors of job burnout status and explore their interaction models using stepwise multivariable regression and path analysis.Result (1) The stepwise multivariable regression on the job burnout showed that job overload,work stress,work-family conflict,overall work satisfaction and negative coping style were the key social-psychological influential factors in job burnout(F =90.562,P =0.001).(2) The path analysis showed that the job overload was the major event caused the work stress,and work stress played a direct and indirect roles in the level of job burnout in first aid medical staff,and the work-family conflict and overall work satisfaction was disposition factors of job burnout with direct actions and indirect actions.The negative coping style was an intermedium link between work stress and job burnout.Conclusion Decrease of work intensity and change of bad coping styles can be effective on job burnout in first aid medical staff.

Objective To investigate the difference of serum C-reactive protein (CRP) concentrations in subjects with various glucose tolerances and the change of serum CRP concentrations in cases of impaired glucose tolerance (IGT) treated with acarbose. Methods A total of 154 subjects participated in the study and according to oral 75 g glucose tolerance test (OGTT), among them there were 44 subjects with normal glucose tolerance (NGT), 89 cases with IGT and 21 cases with type 2 diabetes (DM). Sixty IGT subjects were recruited into randomized, double-blind, placebo-controlled study. The IGT subjects received either 150 mg acarbose daily or placebo for 16 weeks. The serum CRP concentration was detected with immunoscattering assay. Results (1) The serumCRPconcentration〔median(25%, 75%)〕 was 4.60(4.10-5.25)mg/L in NGT subjects, 5.25(4.50-6.00)mg/L in IGT subjects, 5.70(5.20-7.50)mg/L in type 2 DM patients (F=157.00, P0.05). Conclusion (1) The serum CRP concentration is gradually increased with the worsening of glucose tolerence; (2) The serum CRP concentration is positively correlated with OGTT 2 h blood glucose, HbA 1C , TC, TG; (3) The serum CRP concentration is decreased in IGT subjects treated with acarbose following the improvement of hyperglycemia.

BACKGROUND:Medical glue as a biological hemostatic material shows a good diffusivity in body fluids and blood, and has a rapid polymerization reaction, which plays an ideal hemostatic effect and promotes wound healing. OBJECTIVE:To investigate the clinical value of medical glue as a hemostatic material in the open wound of the frontal plane in children. METHODS:Totaly 1 218 children with open wounds of the frontal plane treated with medical glue were enroled as observation group, and another 600 children with open wounds of the frontal plane treated with silk sutures as control group. Wound healing time, postoperative wound bleeding, suture reaction, pigmentation and scar hyperplasia were compared between the two groups. RESULTS AND CONCLUSION:Compared with the control group, the operative time, blood loss and wound healing time were al less in the observation group (P < 0.05), and the effective bleeding rate was higher in theobservation group (P < 0.05). Stage I wound healing occurred in 1 215 cases of the observation group, and 586 cases of the control group. At the end of 12-month folow-up, healed scar formed with no knot scar and needle scar, the skin color was similar and cosmetic results were good in the observation group; in the control group, there were more obvious scars, visible knot and needle scars, and erythema, induration and hypertrophic scars were found around the most wounds. The medical glue for open wounds of the frontal plane in children has good biocompatibility and cosmetic results, which is safe and convenient in clinical use.

Objective To explore a set of suitable content and methods of evaluation for nursing students' humanistic quality. Methods Using dynamic evaluation theory, from three aspects of the evaluational main body, evaluation content and evaluation way, we assessed 261 nursing students' humanistic quality of the five-year undergraduate. Results Based on students' four consecutive years of assessment,results showed that the students' spirit had obviously changed, the students' comprehensive achievements had obviously promoted, the students' employment was obviously higher than other professionals and the students' degree of satisfaction from employing unit had increased yearly. Conclusions Dynamic evaluation can evaluate the best development of students, to strengthen nursing students' humanities education, to improve level of nursing students' humanities education, it is feasible in humanities education of higher nursing profession.

Objective To discuss the diagnostic paradigm of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement.Methods Clinical features of one patient with non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement,manifesting fever of undetermined origin and refractory hyponatremia,were analyzed retrospectively.The related literature was reviewed,and experience in diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement was summarized.Results Clinical manifestations of the patient was nonspecific,and there was definite evidence to support the diagnosis of infectious and autoimmune diseases.However,the abnormal elevation of serum lactate dehydrogenase(LDH)and ?2 microglobulin,which were suggestive of the diagnosis of lymphoma.The diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland involvement was finally established by adrenal gland biopsy under CT.On the other hand,the endocrine evaluation indicated there was pituitarism even though the lesion was not obvious on the MRI image.However,18F fluorodeoxyglucose-positron emission tomography-computed tomography(18F-FDG PET-CT)clearly showed lesions in pituitary,liver and lymph node of neck.With supplementation of hydrocortisone,sodium the serum level gradually elevated to above the normal range,and the lesions in pituitary and adrenal glands disappeared after three courses of CHOP chemotherapy.The functions of pituitary and adrenal gland recovered 3 months later.Conclusions Non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement is a rare disease.Early diagnosis relies on the logical clinical evaluation and 18F-FDG PET-CT image.

OBJECTIVE: To prepare thermosensitive meloxicam hydrogel and establish its quality control method.METHODS: The hydrogel was prepared with poloxamer 407 and poloxamer 188 as base.The content of meloxicam in the thermosensitive gel was determined by UV spectrophotometry.RESULTS: The thermosensitive meloxicam hydrogel was yellowish or flavovirens in color,with its identification and tests all in conformity with the related specification stated in Chinese Pharmacopeia(2005 edition).The linear response range of meloxican was 1.956～19.56 mg?L-1(r=0.999 7).The average recovery was 98.42%(RSD=1.53%).CONCLUSION: The preparative technique is simple,and the quality of the preparation is controllable.

Objective To investigate the clinical characteristics of multiple endocrine neoplasia type 1(MEN1)patients presenting with hypoglycemic coma as chief manifestation and the related clinical experience in diagnosis and therapy.Methods We analyzed the clinical data of 4 patients who were hospitMized because of recurrent hypoglycemic coma and diagnosed as having MEN1 by endocrinolgical,radiological and pathological examinations.Results In the 4 cases of Whipple trilogy,radiological examination showed occupying lesion in the pancreas and pathological examination confirmed the diagnosis of insulinoma.In 2 cases the insulinomas were multiple.In this series,one cage was complicated with pituitary adenoma,parathyroidoma(recurrent after operation)and adrenocortical adenoma,one case with pituitary adenoma,parathyroidoma(2 tumors)and adrenal nodular hyperplasia,one case with pituitary adenoma and parathyroidoma,and the remaining one with pituitary adenoma and suspectable parathyroidoma.Conclusions For patients with insulinoma,MEN1 should be considered.In patients with MEN1,the presence of multiple or ectopic Darathymid adenomas(or hyperplasia)and insulinomas should be inspected during operation.After operation,examinations should be regularly performed to identify whether the diseases relapse or new endocrine neoplasias occur.

With the continuous glucose monitoring system, daily blood glucose profiles were compared in type 2 diabetic patients treated with glargine or neutral protamine hagedorn (NPH) at bedtime for 12 weeks. The blood glucose levels in these patients were previously not well controlled with sulfonylureas. The results suggested that combined treatment with glargine before bedtime showed less nocturnal hypoglycemia and more stable blood glucose profile with less excursion when fasting blood glucose levels were well controlled.

Clinical and imageological characteristics of Paget's disease of bone in 7 patients who were treated in our hospital from 1991 to 2007 were analyzed. The data showed (1) 6 patients had the symptoms of bone pain and bone deformity, with more long bones involved; (2) Serum alkaline phosphatase was over normal range; (3) Imageology showed that osteoclasia was usually combined with bone sclerosis; (4) All the patients were treated with bisphosphonates; (5) 2 patients with serious bone deformity were treated with orthomorphia. Paget's disease of bone is a kind of metabolic bone disease with the characteristics of osteoclasia combined with bone sclerosis. The main features are bone pain and bone abnormality. Bisphosphonates are the first choice of drugs. Patients with serious bone deformity should be treated with orthomorphia.

HepG2 ceils were treated with various concentrations of tumor necrosis factor-or (TNF-α) for 24 hours. RT-PCR and Western blot were used to measure protein tyrosine phosphatase-1 B(PTP-1B)expression, and luciferase reporter assay was used to detect NF-kB activity. The results showed that treatment of HepG2 cells with TNF-α for 24 hours led to upregulation of PTP-1B and NF-kB activity in a dose-dependent manner. Inhibition of NF-kB by PI)TC significantly attenuated TNF-α-induced PTP-IB expression in HepG2 cells. Thus, the transactivation of NF-kB seems to play an important role in the expression of PTP-1B in HepG2 cells induced by TNF-α.