Objective To evaluate the depressed mood status of nurses from 2009 to 2013 in China,and to provide evidence for launching psychological health education.Methods PubMed,VIP database,the CNKI database were searched to find the published literatures about the detection of depressed mood among nurses from January 2009 to December 2013.According to exclusion criteria the studies were screened,and the qualities of included studies were evaluated and Meta-analysis software was used for Meta-analysis.Results Totally 633 literatures were included.After screening a total of 583 literatures were excluded,after further study on the full text of literature,eventually 30 literatures were included,a total of 12 626 people,6 946 cases were detected with depressed mood.The Meta-analysis results showed that the total depressed mood detection rate was 42.5％.There was no significant difference among genders,working years,and educational background; but ages may play a role in occurrence of depression.Conclusions Depressed mood of Chinese nurses was significantly higher than the general population,and older nurses were suffered from more serious depression.

ObjectiveTo explore the clinical manifestations of infant cytomegalovirus infection in different age. MethodThe clinical data of 237 infants who suffered from cytomegalovirus infection was analyzed retrospectively and divided into three groups: 0-3 months old (77 cases,group A) ,4-6 months old ( 65 cases , group B ) , 7-12 months old ( 95 cases , group C ). ResultsThe incidence of respiratory infection was the highest among all infectious organs in three groups, the numbers of patients who had wheeze in group A was less than that in the other two groups[24.7％(19/77) vs. 61.5％ (40/65), 61.1％( 58/95 )](P ＜ 0.01 ).The incidence of jaundice decreased gradually as the babies grew up[23.4％( 18/77 )→7.7％(5/65 )→1.1％( 1/95 )](P ＜ 0.05). There was no significant difference in diarrhoea and bleeding among three groups (P＞0.05 ). The proportion of alanine aminotransferase], aspartate amino transferase increasing was similar among three groups, but gamma-glutamyl transferase (GGT) was different, the proportion of GGT increasing was 77.9％ (60/77) in group A which was higher than that in the other two groups[10.8％ ( 7/65 ), 2.1％ ( 2/95 )].Granulocytopenia in group B was obviously decreased compared with the other two groups (P ＜ 0.05 ), anemia was easily occurred in group C (P ＜ 0.05 ). ConclusionThe injury of cytomegalovirus infection may be related to month old.

Objective:It is demostrated that the porous protein-mineral mechanics model could provide more accurate prediction for biomaterial properties of dentine compared with the other established models.This paper would use the model to reevaluate the mechanical properties and its interacting mechanism of human dentine.Method:By using a porous proteinmineral mechanics model,the effect from the interactions between tubules,pedtubular and intertubular matrix on dentine microstructure was discussed.Results:The dentinal micromechanical properties were dependent on the tubular direction,and the absolute values of the stresses derived from the hydraulic and gas tubular pressures increased parabolically with theincreasing diameter of the tubules.It was also found that the effective elastic constants of the dentine microstructure would vary with the aging and the distribution of mineral and collagen within peritubular and intertubular matrix of detine.Conclusions:The theoretical analyses provided in this paper demonstrated that the microstructural characteristics of tubules,peritubular and intertubular dentinal matdx could have different influences on the micromechanical properties of human dentine,which showed the validity of porous protein-mineral mechanics model,and the limitation of some models that neglected the interacting mechanism.

Objective To assess the symptoms of patients due to indwelling double ureteral stent and their impact on quality of life. Methods Sixty patients were assessed by the specific questionnaire. Average time of indwelling stent was 21.4 d. All patients finished the special questionnaire when the stent was removed by cystoscope, including specific urinary symptoms, IPSS (international prostate symptom score), VAS (visual analogic scale) and QOL (quality of life). To assess the pain feeling, the patients were divided into 3 groups by varied methods of anesthesia, including local anesthesia, balance anesthesia and general anesthesia. Results Insertion or removal of ureteral stents with local anesthesia provoked pain in 11 of 12 (91%) patients and 8 of 10 (80%) patients in balance anesthesia group. But 38 patients of general anesthesia group did not feel any pain when inserting stents. In 54 of 60 (90%) patients, the indwelling catheter provoked one or several urinary symptoms: nocturia (70%), frequency (65%), urgency (60%), tenesmus (58%), dysuria (52%), hematuria (35 % ) and incontinence (30 %). 75 % of the patients experienced pain, in the flank and lower abdomen. 29 (48 %) patients were found to be unsatisfied with their quality of life due to the indwelling stent. Among them, 18 (62%) patients demonstrated that the provoked overactive bladder symptoms were the main influence factor of QOL, compared with 5(17 %) patients complaining pain feeling. Conclusions Urinary symptoms and pain associated with indwelling double J ureteral stents could interfere the daily activities and 50 % of patients were found reduced quality of life. Overactive bladder symptoms were the main influence of QOL during the time of indwelling stent.

Objective To compare T and N staging of esophageal and cardia cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) before operation, and to evaluate clinical value of EUS.Methods Twenty-eight patients received examination of EUS and CT preoperatively, and the T and N staging was determined. The accuracy rates of both T, N staging were compared by the postoperative pathological results, at the same time, the accuracy rates of lymph node metastasis were compared, and the value of application of EUS was investigated. Results In the twenty-eight cases, the accuracy rates of EUS were higher than that of CT by 89.3% ( 25/28 ) to 46.4% ( 13/28 ) in T staging. And the difference had statistical significance( P = 0. 004 ,P ＜ 0.01 ). The N stagings of both were 82.1% (23/28) and 50.0% ( 14/28), and the difference had statistical significance ( P = 0. 035, P ＜ 0. 05 ). The accuracy rates of lymph node metastasis of both were 88.7% and 72.2% respectively, and the difference had statistical significance (χ2 = 7.031,P = 0.008, P ＜ 0. 01 ). Conclusions EUS has very important value in preoperative staging for esophageal cancer and cardia cancer, and the T staging of EUS is better than that of CT. The short axis and the ratio of short to long axis (S/L) combined with the lymph node ultrasonography image can improve the accuracy rates of lymph node metatsasis and N staging.

Objective To investigate effect of autologous periosteum transplantation in the repair of anterior cruciate ligament (ACL) injury.Methods Transected ACL injury was induced in 24 white rabbits randomly allocated to receive autologous periosteum transplantation with suture fixation (study group,n =12),isolated suture fixation (control group,n =12),and arthrotomy (blank group,n =3).Gross observation of ACL repair was performed and degeneration of knee joint was evaluated using the Markin score.ACL pathology,collagen fiber formation and insertion degenerative changes were histologically investigated using the HE staining,Masson staining and Picric-Sirius red staining.Results Twelve weeks after the operation,gross observation showed ligamentous continuity and minor joint degeneration in study group.Opposite results were seen in control group.Markin joint degeneration score calculated 7.2 ± 1.6 in study group,12.4 ± 1.8 in control group and 0.6 ± 0.4 in blank group,with significant differences between groups (P ＜ 0.05).Using the HE and Masson staining in study group,rich collagen fibers and microvessel as well as cell infiltration were found in wound tissue and the ligaments were covered with synovial membrane.However,wound tissue did not heal in control group,leaving ligament remnants with loosely disorganized fibers and rich microvessel as well as cell infiltration.And only the residual stump was wrapped with synovial membrane.Using the HE and Picric-Sirius red staining,the typical four-layer structure of ACL insertion remained intact in study group,whereas in control group the layer structure of ACL insertion in control group became disorganized and the tidemark of enthesis almost disappeared.Conclusion Autologous periosteum transplantation is effective to improve the injury healing and mitigate the degeneration of joint.

Reduction capacity ( RC ) is an important index to evaluate the redox ability of dissolved organic matter. In order to determine the RC, hydrophilic organic fractions ( HyI ) isolated from dissolved organic matter extracted from the uncomposted and composted samples were used as electron donators and mediators, and three kinds of irons were chosen as electron acceptors. The results showed that, the RC values from the composted sample were 15. 88, 13. 41 and 51. 45 mmol e -/mol C for the electron acceptors Fe2(SO4)3, Fe(NO3)3 and FeCit, respectively, which were higher than the corresponding values (13. 45, 11. 77 and 43. 16 mmol e-/mol C) from the uncomposted sample. The electron acceptor type shows a dramatic influence on the RC value of HyI. The RC value determined by FeCit was obviously higher than that measured using Fe2( SO4 ) 3 and Fe( NO3 ) 3 , and the microbial reducing capacity of the HyI was lower than the corresponding native reducing capacity. By analyzing the special absorbencies ( SUVA254 and SUVA280 ) , absorbance ratios ( A2/A3 and A4/A6 ) and integrated area from UV-vis spectra, it can be found that the RC was affected by aromatic degree, unsaturated conjugated structure, and molecular weight. Excitation-emission matrix spectra coupled with regional integration analysis showed that the relative content of humic-like substances ( humic-like acids and fulvic-like acids) was the main factor influencing the RC value of HyI. The results obtained can be used to characterize the redox properties of HyI, and reveal its role in the transformation and degradation of pollutants during composting.

Objective To explore the application of team-based learning (TBL) and problem-based learning (PBL) method in clinical teaching of laparoscopic surgery in general surgery. Methods 48 students of surgery in our department were selected as the subjects to conduct the clinical teaching study. These students were divided randomly into two groups. The experimental group (24 students) adopted the method that combined TBL and PBL method, while the control group (24 students) adopted the traditional teaching method. We compared the efficacy of two groups in term of theoretical knowledge, surgical practice, com-prehensive surgical grade, and questionnaire survey. Results The score of theoretical knowledge and sur-gical practice on clipping soybean and making suturation and instrumental tie of two groups were obviously higher than that before teaching. After finishing teaching, the score of experimental group on theoretical knowledge, making suturation and instrumental tie and comprehensive surgical grade were higher than that of control group. The score of clipping soybean was similar between two groups. In addition, in term of questionnaire survey on the consciousness of independent study, the depth and width of study, and satisfac-tions to teaching, the TBL and PBL group had a better score than the control group. Conclusion The new teaching method which combines TBL with PBL enhances the teaching effect on theoretical knowledge and laparoscopic surgery practice. It is an effective method to train medical students.

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.

Objective To investigate the expression of Aspartate Beta-Hydroxylase (ASPH) in retroperitoneal liposarcoma (RL)and evaluate its clinical significances.Methods Relevant clinical data of 69 RL cases after surgical resection were collected.The expression of ASPH in tumor tissues was detected by immunohistochemistry.The CTL epitopes of ASPH protein HLA-A2 were predicted by SYFPEITHI and NetMHCpan software.Results The overall positive rate of ASPH expression for the whole group was 81％,that for well-differentiated liposarcoma was 73％,dedifferentiated liposarcoma was 87％ (P ＜ 0.05).ASPH expression was positively correlated with the postoperative recurrence free survival rate (P ＜ 0.05).Five HLA-A2 restricted CTL epitopes (9 peptides) were screened with the method of motif prediction.Conclusions ASPH expression is positively correlated with the degree of malignancy of RL,and the ASPH expression is an independent risk factor for postoperative recurrence free survival rate of RL.Moreover,ASPH was found to have 5 HLA-A2 restricted CTL epitopes,which are expected to be used for the immunotherapy of RL.