Objective To examine the reliability and validity of the Connor-Davidson Resilience Scale (CD-RISC) in nurses in China.Methods Item analysis and confirmatory factor analysis of CD-RISC was conducted.A total of 1 084 nurses were randomly divided into 2 groups using random number table.One group was used to revise CD-RISC and the other to evaluate its reliability and validity.Results Confirmatory factor analysis of the original RSA showed thatx2/df,RMSEA,GFI,AGFI,CFI were 6.714,0.103,0.804,0.764,and 0.718,respectively.The number of item was reduced to 21 based on exploratory factor analysis results,including three factors which explained 54.034％ of the total variance.Factor loading ranged from 0.490 to 0.755.Coefficient of internal consistency ranged from 0.688 to 0.930 and the 4 week test-retest reliabilities ranged from 0.825 to 0.917.The factor scores were closely correlated with the total scores with correlation coefficient ranging from 0.683 to 0.943.The factors were closely correlated with each other with correlation coefficient ranging from 0.564 to 0765.The confirmatory factor analysis of the revised CD-RISC showed that x2/df,RMSEA,GFI,AGF,CFI were 3.304,0.065,0.902,0.878,and 0.913 respectively.The total scores and all factors were negatively correlated with depression and anxiety and somatization.Conclusions The revised CD-RISC has good psychometric properties and can be used to measure the resilience of nurses.

Humans ; Liver Diseases ; Practice Guidelines as Topic ; Prognosis

Objective To explore the application value of quantitative analysis of tissue diffusion by ultrasound elastography in evaluating the evolution of achilles tendinopathy and indirectly reflecting the feature of tendon biomechanics.Methods Rabbits underwent 0.1 ml (group M) or 0.3 ml (group S)collagenase or 0.2 ml saline (group C) injection.The percentage of area displaying blue (％AREA) in the area of interest was measured by the diffusion quantitative technique of ultrasound elastography at baseline and 1,3,7 and 14 days after model.The achilles tendon was obtained for pathological examination to observe the changes of collagen fibers and tested to measure the maximum tensile load by the universal testing machine.Results (1) The ％AREAs in group M and S at 1,3,7 and 14 days after model were smaller than those in group C (P ＜0.05),and reached its lowest value at 3 days after model.％ AREA in groupSwas significant lower than that in group M at 3 or 7 days after model (P ＜0.05).(2) The maximum tensile loads in group M at 1,3 and 7 days after model were smaller than those in group C (P ＜0.05),but there was no significant difference between group M and C at 14 days after model (P ＞0.05).The maximum tensile load in group S was significant lower than those in group M and C after model (P ＜0.05),and arrived its lowest point at 3 days after model.(3) The ％AREA was positively associated with the maximum tensile load of achilles tendon (r =0.87,P ＜0.001).Conclusions Ultrasound elastography can dynamically monitor the evolution of achilles tendinopathy and reflect the biomechanical state of achilles tendon.

This paper presents some ideas and practices to realize the homogeneity quality management process within the Beijing Children Hospital Group,the largest specialized medical group in the country.This research aims at providing references and thoughts on homogeneity quality management for trans-regional medical unions in the country.

Aim To observate the effect of chemokine receptor(CXCR4) gene transfection on biological behavior of bone marrow mesenchymal stem cells in vitro.Methods Firstly, bone marrow mesenchymal stem cells were divided into three groups:GFP(transfected GFP into MSCs), CXCR4+(transfected CXCR4+ into MSCs) and CXCR4-(transfected CXCR4-into MSCs) group.Then, their capacity of proliferation, differentiation and migration ability (in vitro) was assessed with immunofluorescence cytochemistry method, flow cytometry assay and Transwell cell chemotaxis test.Results The high or low expression of CXCR4 had no effect on their ability of proliferation and differentiation into lung tissue.Compared with GFP group, however, CXCR4+-MSCs group significantly increased the number of migrating cells, while CXCR4——MSCs group showed no change in the number of migrating cells.Conclusions The proliferation and differentiation capacities are not affected by the high or low expression of CXCR4.The high expression of CXCR4 can significantly enhance the migration ability of MSCs to inflammatory lesions, and the low one has no effect on the migration of the cells.After the transplantation of MSCs, CXCR4′s high expression will access to the lesion area to participate in tissue repairing rapidly and largely, significantly enhancing the therapeutic efficacy.

Objective To investigate the abnormal functional connectivity (FC) between the substantia nigra (SN) and the brain motor area in rapid eye movement sleep behavior disorder (RBD) by Unified Parkinson′s Disease Rating Scale (UPDRS), Hoehn-Yahr Scale and resting state functional magnetic resonance imaging (rfMRI).Methods A total of 34 subjects (14 with RBD (RBD group), 12 with Parkinson′s disease (PD group), and 8 age, sex-matched normal controls (control group)) recruited in the Department of Neurology, Henan Provincial People′s Hospital from 2014 to 2015 were enrolled in this study according to international diagnosis criteria.All subjects were examined by UPDRS, Hoehn-Yahr Scale and rfMRI.Results UPDRS scores and Hoehn-Yahr staging were 0.00 (0.00, 3.75) and 0.00 (0.00, 0.50) respectively in the RBD group, which were significantly different from that in the PD group (30.5 (18.75, 33.00) and 1.75 (1.50, 2.50), respectively;Z=-3.782, P<0.05 and Z=-2.963, P<0.05), whereas not significantly different from that in the control group (0.00 (0.00, 0.00),0.00 (0.00, 0.00), respectively;Z=1.16, P>0.05 and Z=1.10, P>0.05).The FC analysis showed alterations from the right SN to bilateral cerebellum respectively among the three groups (Fright cerebellum=12.975, Fleft cerebellum=6.144;P<0.05);furthermore, there were significant increases in the RBD group compared with the PD group (t=-4.602,-5.080, P<0.005).The FC analysis showed reduced correlation from the right SN to the left prefrontal cortex in the RBD and the PD groups compared with the control group (t=-4.899,-3.500, P<0.005), but there was no statistically significant difference between the RBD and the PD groups (t=2.035, P>0.05).Conclusions There was abnormal FC from the SN to motor areas in RBD patients, and partial alterations were similar as PD patients.rfMRI provided an evidence that RBD might be presymptom of PD.

Objective: The cross-sectional study examined associations between gross motor competence and physical fitness in 3-5 years old children. Methods: A convenient sampling method was used to select 201 children aged 3-5 years, to assess gross motor competence, each child accomplished the Test of Gross Motor Development-3(TGMD-3). The level of physical fitness was measured by National Physical Fitness Test, comprising eight different tasks including height, weight, flexibility(sit-and-reach test), balance (walking on a balance beam), explosive force(Standing long jump), strength(Tennis ball throwing), agility(10-shuttle-run test), strength and coordination(Continuous foot jump). Results: With the increase of age, the scores of locomotor skills，object control skills, gross motor competence, height, weight, walking on a balance beam, continuous foot jump, tennis ball throwing and standing long jump were better(P<0.01). Significant differences were not found in the gross motor competence, locomotor skills, 10-shuttle-run test, continuous foot jump, standing long jump and walking on a balance beam(P>0.05). In the object control skills and tennis ball throwing, the boys showed a greater performance(P<0.01). In the sit-and-reach test, girls showed a greater performance(P<0.01). The results revealed a significant relationship between gross motor competence and the following items: 10-shuttle-run test, continuous foot jump, standing long jump, walking on a balance beam, tennis ball throwing(P<0.05). There were no associations among gross motor competence, BMI(r=0.02), sit-and-reach test(r=0.07). There were no associations between gross motor competence and physical fitness in 3-5 years old(r=-0.13-0.21), except for 5 years old children’s object control skills and continuous foot jump(r=0.42). Sex, age, height , BMI (R2=0.05,F=2.62, P>0.05) as well as gross motor competence(△R2=0.04, F=2.00, P>0.05) did not predict physical fitness. Conclusion The results indicated a relationship between motor competence and physical fitness in 3-5 years old. In order to increase the level of physical fitness, the educators should pay attention to the development of children’s gross motor.

Objective: To explore the hot issues and developing trend of the research of campus bulling,and to provide a reference for the research on campus bullying. Methods: The power of research, high-impact authors, highly cited journals, high-frequency keywords, and burst terms related to school bullying from the Web of Science database were analyzed using CiteSpace software. The data collection time was May 9, 2018. Results: A total of 3 561 literature data were obtained. The results showed that the country with the highest number of publications was the United States; England had the highest centrality and was in a critical position in the research. The University of Turku in Finland was the core research institution. Salmivalli C was the author of the highest publication, Olweus D was the most frequent cited author. The high-impact journal was Aggressive Behavior. In terms of high-frequency keywords, the core vocabulary such as bully, adolescence, and victim were listed. Middle school students were the most frequently studied; in the form of bullying, the frequency of violence, aggression, and cyberbully was more common; depression, mental health and health appeared more frequently in terms of bullying outcomes. Mutant words including school children, bullying, victimization, relational aggression were more common. Conclusion The research hotspots on campus bullying during the past decade include violence, gender, social support, and mental health. Bullying among college students will be a hot research topic in the future. Continued efforts should be carried out in the field of campus bullying in China.

An increasing number of clinical studies have shown that effective etiological therapy might achieve the reversal of liver fibrosis/early cirrhosis. An accurate assessment of fibrosis reversal is of great importance for treatment decision-making and prognosis prediction. At present, the “gold standard” for the histological evaluation of liver fibrosis/cirrhosis reversal remains to be perfected, and there is still a controversy over the noninvasive assessment of fibrosis reversal. Long-term cohort studies are needed to observe whether it can improve clinical hard endpoint, and the clinical effect of new anti-fibrotic drugs needs to be further confirmed.

Objective To investigate the association between bicuspid aortic valve ( BAV ) morphologic findings ( raphe vs nonraphe) ,the degree of valve dysfunction and prognosis . Methods Clinical and echocardiographic data in 317 BAV patients were analyzed retrospectively . According to the Sievers classification ,the morphologic BAV findings were categorized into no raphe ( type 0) ,one raphe ( type 1) and two raphes ( type 2 ) . T he patients with type 1 were further divided into three subtypes ,including R‐L subtype ( fusion of the left and right coronary cusps ) ,R‐N subtype ( fusion of the right and noncoronary cusps) and L‐N subtype ( fusion of the left and noncoronary cusps ) . Results Of the 317 patients ,there were 83 ( 26 .2% ) of type 0 ,232 ( 73 .2% ) of type 1 and 2 ( 0 .6% ) of type 2 .Among the 232 patients of type 1 ,there were 126 ( 54 .3% ) of R‐L subtype ,88 ( 37 .9% ) of R‐N subtype and 18 ( 7 .8% ) of L‐N subtype . BAV with raphe had a significantly higher prevalence of aortic valve calcification [ 120 ( 51 .3% ) vs 19 ( 22 .9% ) , P ＜ 0 .001 ] ,with significantly higher frequencies of aortic stenosis [ 164 ( 70 .1% ) vs 6 ( 7 .2% ) , P＜ 0 .001 ] ,aortic regurgitation [ 168 ( 71 .8% ) vs 40 ( 48 .2% ) , P ＝ 0 .001 ] ,increased left ventricular mass[ ( 253 .4 ± 113 .7) g vs ( 176 .4 ± 69 .3) g , P ＜0 .001] and left heart failure [ 34 ( 14 .5% ) vs 3 ( 3 .6% ) , P ＝0 .009] . Furthermore ,the dilation of aortic root and ascending aorta in BAV patients with raphe were significantly higher than those without raphe ( P ＜0 .01 ) ,however ,ascending aortic aneurysm rates were not significant between BAV with and without raphe[ 23( 9 .8% ) vs 4( 4 .8% ) , P ＝0 .251] . T he patients in R‐N subtype had a significantly higher proportion of aortic valve calcification than those in R‐L and L‐N subtype [ 55 ( 62 .5% ) vs 57 ( 45 .2% ) vs 6 ( 33 .3% ) , P ＝ 0 .01 ] ,with a significantly higher frequency of severe aortic stenosis [ 50 ( 56 .8% ) vs 21 ( 16 .7% ) vs 3 ( 16 .7% ) , P ＜0 .001 ] . However , there was no significant difference among different subtypes in other complications( P ＞0 .05).Conclusions T he presence of raphe is associated with a higher frequency of significant aortic valve calcification ,aortic valve dysfunction ,and increases left ventricular mass and left heart failure .T he R‐N type is also associated with aortic valve calcification and severe aortic stenosis .