Objective Measuring job satisfaction level of community health workers,providing on the evidences for the design of the relevant policy and the evaluation of job effect.Methods 57 Community Health Service centers and 54 stations were randomly selected in 12 cities in Anhui province,and all staff on the job were investigated.The questionnaires were delivered to the working staff and anonymously filled in by them.Results The total job satisfaction average score of the staff is 110.84± 18.18.The average score of pay(10.05±2.99),welfare(10.35±3.17)and promotion(10.85±3.00)are rather low.The average score of coworkers(14.78±2.11),nature of work(14.60±2.69)and supervision (13.90±3.00)are quite high.Logistic regression analysis shows the staff's duration and title are the main factors affecting their overall job satisfaction.Conclusion The overall job satisfaction level of community health workers is not high.Establishing the reasonable system of pay,welfare mechanism and the predictable promotion space are feasible choices to promote job satisfaction of community health workers

[Abstract ] Objective The purpose of this study was to observe the effects of dl-3n-butylphthalide (NBP) sodium chloride injection post-processing on the expressions of X-inhibitor of apoptosis (XIAP) and Bcl-2/adenovirus E1B19kDa interacting protein 3 (BNIP3) in the hippocampus CA1 neurons of focal cerebral ischemia reperfusion (IR) rats, and to investigate the brain-protection mechanisms of NBP. Methods A total of65 adult male Sprague-Dawley rats were divided into five groups of equal number, sham op-eration, IR, and low-,medium -and high-dose NBP, according to the random number table. The IR models were established by modified ligation of the middle cerebral artery.The animals in the NBP groups received intra-abdominal injection of NBP at 2, 4, and 6 mg/kg, re-spectively.All the rats were sacrificed at 24 hours after modeling,neurological scores obtained by Zea Longa, the volume of infarction measured by TTC staining, the number of apoptotic cells counted by TUNEL, and the expressions of XIAP and BNIP3 detected by immunohistochemistry and real-time PCR. Results The neural function defect scores were markedly lower in low-, medium-and high-dose NBP groups than in IR model rats (P<0.05), with statis-tically significant differences among the three dose groups (P<0.05).The volume of infarction was remarkably higher in the low-dose than in the medium-and high-dose NBP groups (P<0.05).The number of apoptotic cells in the hippocampus CA1 neurons was de-creased in the NBP groups as compared with the IR models (P<0.05).The XIAP-and BNIP3-positive cells were significantly in-creased in the IR model rats as compared with the sham operation group ([22.31 ±0.94] and [60.13 ±2.59]/HP vs [3.07 ±1.43] and [5.78 ±0.44]/HP, P<0.05).In comparison with the IR models, the NBP-treated rats showed a progressively increased number of XIAP-positive cells in low-, medium-, and high-dose groups ([28.70 ±1.18], [32.79 ±0.88], and [37.01 ±1.24]/HP) (P<0.05) but a decreased number of BNIP3-positive cells in the three dose groups ([52.07 ±1.02], [40.30 ±2.00], and [31.04 ± 0.43]/HP) (P<0.05).Similarly, the expression of XIAP mRNA was up-regulated while that of BNIP3 mRNA down-regulated in the NBP treatment groups as compared with the IR model rats, both in a dose-dependent manner (P<0.05). Conclusion NBP post-processing has a neuroprotective effect on IR rats, which is associated with its impact on the expressions of XIAP and BNIP3.

Objective To investigate the effectiveness,safety of the percutaneous transluminal angioplasty and stenting(PTAS) in the management of the vertebrobasilar stenosis.Methods From April 2003 to June 2004,the PTAS was performed in 28 patients with the vertebrobasilar stenosis.Results Among the 28 patients,the unilateral significant stenosis of the dominant vertebral artery was found in 18 patients,the bilateral stenosis of the vertebral artery in 4 patients,the tandem stenosis of the vertebral artery in 1 patient,the stenosis of the basilar artery in 2 patients.According to Mori's division,the type A occurred in 24 patients,the type B in 3 patients,the type C in 1 patient.The successful rate of stent implantation was 100% without any serious complication.Twenty-eight patients underwent PTAS with a mean pre-procedural vertebrobasilar stenosis of 81.3% and the residual stenosis was less than 10%.Over a mean 6-month follow-up in 17 patients,according to Malek's scale,the scale 1 was in 15 patients,the scale 2 in 2 patients.No restenosis was in 3 patients by the cerebral angiography.Conclusion PTAS in the management of the vertebrobasilar stenosis is a safe and effective method.Meanwhile,PTAS may alleviate the vertebrobasilar ischemia and prevent stroke of the vertebrobasilar system.

To investigate the expression and significance of CD28 and CTLA4 on T cells in bone marrow of aplastic anemia (AA) mice, in vitro bone marrow mononuclear cells (BMMNCs) were activated through being incubated with PHA (15μg/mL). The expression of CD28 and CTLA4 on T cells incubated with or without PHA was detected by two-color flow cytometry. The expression of CD28 and CTLA4 was significantly increased after PHA stimulation. In the AA mice, the expression of CD28 with or without PHA stimulation was both higher than that in the normal mice (both P＜0.01), but the expression of CTLA4 with or without PHA stimulation showed no significant difference in comparison to that in the normal mice (both P＞0.05). In the AA mice, there were more activation and activated potential of T cells than the normal, and the abnormal expression of CD28 and CTLA4 may participate in immunological disorder mediated by T cells.

Objective To explore the effect of the modular teaching for nursing students based on WeChat in the comprehensive training before the practice.Methods The undergraduate students of nursing were randomly divided into 5 classes,among which class 1,2,3 as the control group,and class 4,5 as the experimental group.The control group used the traditional ‘Case Teaching Method',taking the group as a unit to practice the clinical nursing skills individually;while the experimental group took the method which integrated individual nursing skills and practical materials with humanistic qualities in clinical cases.They conducted practical training by dividing the learning module with the ‘representative patients',using WeChat as the learning and exchange platform andbuilding modular training model.After the training,the results were evaluated by the score sheet for integrated skills,a critical-thinking scale and the learning model questionnaire.The data was analyzed by T-Test and Chi-Square inspection.Results All of the nursing students were willing to use WeChat for autonomous learning.The scores of the nursing students in the experimental group were higher than those in control group in the abilities of judgement,communication,operation and introspection.The difference was statistically significant (P＜0.05).In addition to the cognitive maturity,the scores of experimental group were higher than those in control group in the searching for truth,opening mind,abilities of analysis and integration and self-confidence in critical thinking and desire for knowledge,The difference was statistically significant (P＜0.05);Also the proportion of experimental group was higher than the control group in students' attitude to study,knowledge acquisition and practical training mode.The difference was statistically significant (P＜0.05).Conclusion The implementation of nodular teaching mode based on WeChat is beneficial to improve the clinical comprehensive ability of nursing students,and help to train the high quality nursing talents who meet the needs of clinical practice.

Objective To quantitatively explore the influence of knife sharpness on forearm wounds in knife slash cases. Methods The finite element models of the upper limb and knives with 3 degrees of sharpness (with sharp blade, blunt blade, wide blade) were developed based on human CT images and prototype of slash knife. The slash by 3 kinds of knives on the forearm at velocity of 4 m/s and duration of 10 ms was simulated, so as to analyze changes in contact forces, wound dimensions and energy. Results During the slash by knives with sharp, blunt, wide blade, the blades reached the ulna at about 65, 85, 95 ms, respectively. The corresponding slash forces were 846, 1 064 and 1 865 N; the wound lengths were 135.64, 105.47 and 99.23 mm; the wound depths were 38.77, 27.81 and 18.74 mm. With the sharpness of blade decreasing, the wound formation was slowed, the length and depth decreased and the slash force increased. The model system for slash knife with sharp blade had obviously greater total energy and inner energy, but smaller kinetic energy, compared with slash knife with blunt blade and wide blade. Conclusions The method for quantitatively assessing wound formation in knife slash upon the forearm was developed. The research findings deepen the understanding of biomechanical mechanism of wound formation by knife slash, and provide new scientific means for forensic investigation and court trial of knife slash cases.