BACKGROUND: Item response theory (IRT) is widely used in the westem world, but its use for non-cognitive measurement has been very limited in China. It is necessary to explore whether IRT is applicable in non-cognitive settings and find the optimal model.OBJECTIVE: To find the optimal IRT model for self-report questionnaire analysis with the instance of emotional competence scale (ECS) and compare the effectiveness of different models in light of model data fitting and the volume of information provision.DESIGN: A comparative study of different psychometric models tested with the same data set.SETTING: Shandong Laiwu Vocational and Technical College; Department of Psychology, Liaoning Normal University.PARTICIPANTS: Totally 617 college students of Shandong Normal University (311 males and 306 females)and 564 senior high school students of the 17 Laiwu High School (283 males and 281females) participated in the study during May 2004.METHODS: Emotional competence scale (ECS) was adopted for psychometric measurement for 5-point Likert-type items. The scale was divided into 9 subscales, namely impulse control, empathy, persistency, interpersonal intimacy, social skills, emotional regulation, emotional stability, sense of responsibility, and self-confidence. One-parameter, two-parameter and three-parameter logistic model and grade response model were used for analysis of the 9 subscales, followed by goodness of fit test (analogous to Chi-square test) and comparison of the measurement precision (reliability)of the three models.MAIN OUTCOME MEASURES: Log-likelihood ratio, average χ2 statistics and average volume of information when one-parameter, two-parameter and three-parameter Logistic model.RESULTS: Totally 1 220 questionnaires were handed out and 1 181 with valid answers were obtained. Comparison of the 3 logistic model showed that the two-parameter logistic model had the least log-likelihood with the least items whose mean square residual error were greater than 2, and the volume of test information was greater than that provided by one-parameter model and no less than the three-parameter model. Therefore, the two-parameter logistic model was the best for 2-point scoring model. But the measurement precision of two-parameter Logistic model was lower than that of multi-grade response model.CONCLUSION: When 2-point items are adopted in self-report questionnaire, 2-parameter logistic model can be applied but not 1- or 3-parameter Logistic models. But when the questionnaire uses items that have more than 2 response grades, the measurement precision can be better than that of 2-point data. Merge of the options for the items may result in lowered measurement precision.

Objective To optimize antiarrhythmic drugs in the treatment of atrial fibrillation and atrial flutter patient different duration,improve the success rate and safety of cardioversion.Methods Make a retrospective analysis of 180 atrial flutter and 180 atrial fibrillation patients data,which were divided into group ibutilide,propafenone group and amiodarone group,Each group were further divided into duration ≤ 3d ＞ 3d,n =30,cardioversion rate was compared after 1.5h,and aralyzed by SPSS16.0.Results Atrial flutter cardioversion rate of ibutilide group ≤3d and 3d was 90％ and 83.33％ ;propafenone≤3d and 3d were 76.67％ and 36.67％,amineamiodarone were 73.33％ and 33.33％,cardioversion rate of three groups had no significant difference when atrial flutter duration ≤3d,P ＞ 0.05 ;Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ＞ 3d,P ＜0.05 ;atrial fibrillation cardioversion rate of ibutilide group≤3d and 3d was 80％ and 73.33％ ;propafenone≤3d and 3d were 43.33％ and 26.67％,amineamiodarone were 50％ and 36.67％,Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ≤3d,P ＜ 0.05; Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration ＞ 3d,P ＜0.05 ;the atrial flutter,atrial fibrillation total cardioversion rate of three groups were 81.67％,45.83％,48.33％,ibutilide was significantly higher than propafenone,amiodarone (P ＜ 0.05 ) ;the atrial fluttercardioversion of ibutilide was significantly higher than the atrial fibrillation rate( P ＜ 0.05 ).Conclusion For the duration of ≤ 3d patients,atrial flutter cardioversion rate of ibutilide.oropafenone,and amiodarone did not differ significantly,but the atrial fibrillation cardioversion rate of ibutilide was significantly higher;For the duration of＞ 3d patients,the atrial flutter and atrial fibrillation cardioversion rate of Ibutilide were higher than propafenone and amiodarone,when choose ibutilide,propafenone,or amiodarone for treating atrial flutter and atrial fibrillation according to individual arrhythmia.

Objective To compare the effect of inhaled corticosteroids and montelukast in children with asthma .Methods Data were obtained from Pubmed ,Embase and Central databases ,CNKI and VIP .Only randomized controlled trials (RCT ) that evalua-ting inhaled corticosteroids and montelukast for children were included .The Cochrane collaboration risk bias tools was used to eval-uated the quality of literature .Results The patients with inhaled corticosteroids had a better effect in FEV 1% and PEF than pa-tients with montelukast ,the incidences of adverse drug reactions had no statistically significant difference .The patients with inhaled corticosteroids combined with montelukast had a better effect in FEV 1% or PEF than patients with inhaled corticosteroids only . Conclusion The effect of inhaled corticosteroids is better than montelukast ,the effect of inhaled corticosteroids combined with montelukast is better than inhaled corticosteroids only ,and has drug safety .

As an important transmembrane protein in brain microvascular endothelial cells tight junction, occludin plays important roles in regulating and maintaining blood-brain barrier permeability. Its abnormal expression can increase blood-brain barrier permeability. In order to provide some theoretical supports for the roles of studying occludin intensively in the mechanisms of blood-brain barrier permeability-related diseases and targets for pharmacological intervention, this article reviews the roles of occludin in the molecular composition and functional maintenance of blood-brain barrier tight junction, as well as the changes of cerebral microvascular permeability during hypoxia.

Objective To evaluate the value of joint inspection of rheumatoid factor ( RF) and anti-cyclic citrullinated peptide antibodies(anti-CCP antibody) in rheumatoid arthritis( RA). Methods 125 patients with rheumatic disease were selected,including RA 78 cases,non-RA 47 cases. The quantitative ELISA to detect anti-CCP antibody, latex agglutination to test RF,and the data was analyzed. Results Anti-CCP antibody positive rate was 66. 7% ,RF was 74.4% Joint detection was 62.8% , single positive rate of joint detection was not statistically significant, but the specificity of joint detection was 98.6%,positive likelihood ratio was 29.2, significantly improved compared to individual testing;Sensitivity was 49.6%,negative predictive value was 54% ,significantly lower compared to test a-lone. Conclusion Combined detection was able to improve the specificity,positive likelihood ratio and reduce sensitivity , negative predictive value. It was more useful.

Motor cortex electrical stimulation was first used in the clinical treatment of central pain in 1989.Recently,this technique has been used to treat post-stroke movement disorders and better efficacy has also been obtained.Its mechanisms may include regulating cortex-basal ganglia circuits,exciting the activation of the motor cortex on the affected side but inhibiting the activation of the motor cortex on the contralateral side.regulating the plasticity of brain and resynchronization of electric activity.This article reviews the possible mechanisms,operative methods.clinical efficacy and existing problems.

Objective To study the audiometry and otoacoustic emissions in patients with posterior circulation ischemia(PCI) .Methods Forty patients treated by neurologists were selected as the experimental group who re_ceived pure tone audiometry ,tympanometry ,otoacoustic emissions (OAE) and distortion products otoacoustic emis_sions (DPOAE) examinations .Thirty healthy objects were chosen as the control group .The data from the PCI groups and the control group were compared using the SPSS 14 .0 software .ResuIts The difference in pure tone thresholds across 125 to 8 000 Hz between the PCI group and the control group was not statistically significant (P>0 .05) .In the PCI patients ,the prevalence of TEOAE was only 47 .5% ,significantly different from that of in the control group .The prevalence of DPOAE at 0 .5~8 kHz were between 57 .9% ~77 .6% in PCI patients ,and the amplitudes of DPOAE were reduced significantly (P<0 .05) .ConcIusion Cochlear damages can occur to patients with PCI ,especially in the high frequency range .These results suggest that OAE can be used as an important diag_nostic test for patients with PCI ,and might be helpful for the location diagnosis of PCI .

Objective To explore whether PI3K/ AKT signaling pathway participates in the inhibiting effect of Ru-tin on H2 O2-induced apoptosis in human lens epithelial cells( HLEC). Methods HLEC were divided into four groups: control group,H2 O2 group,rutin group,LY294002 group. Cell survival rates were determined by a 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay; cell apoptosis rates were monitored by flow cytometry with Annexin V-FITC and propidiun iodide(PI) staining. Western blot was used to measure the expres-sion levels of AKT and p-AKT. Results H2 O2 induced HLEC apoptosis. Compared with H2 O2 group,rutin group not only increased the expression lever of p-AKT,but also reduced cell apoptosis rate(P < 0. 01). In LY294002 group, LY294002, an inhibitor of PI3K/ AKT signaling pathway,could significantly block the change of these inde-xes produced by rutin group(P < 0. 01), but no significant change compared with H2 O2 group. Conclusion Rutin inhibits H2 O2-induced cell apoptosis and may be associated with PI3K/ AKT signaling pathway.

Objective To explore the role of rescue video logical slice and interactive analysis in the continuous improvement of quality of emergency care of multiple injury. Methods To establish a management team for the rescue video interactive analysis. From May, 2015 to April, 2016, every Wednesday from 8:00-11:00 am, the data of multi-injury patients registered in our management software of critical emergency cases were selected. A typical case study of the rescue video logical slices were processed through sorting the video cases in the video surveillance system installed in the emergency room. According to the characteristics of diagnosis and treatment of multiple injury, the evaluation indexes of nursing quality in emergency treatment of multiple injury were formulated and video data was analyzed interactively by using the failure mode analysis and root cause analysis. Based on the above analyzed results, the quality of emergency care of Multiple Injury was controlled and improved. Before and after performing the rescue video logic slices and interactive analysis management, the examined results of multiple injury first-aid nursing quality index, as well as the rate of patients satisfaction and nursing defects were compared. Results Before the implementation of the above method, the time of emergency treatment for multiple injury, the rate of patients with successful rescue, the rate of patient transport defect and the rate of missing items in the rescue unit were respectively as follows:(87.1±7.4)min, 90.77%(59/65), 30.77%(20/65), 12.31%(8/65),whereas after the implementation, the relevant data were (57.5 ± 5.2) min, 100.00%(68/68), 10.29%(7/68), 2.94%(2/68). The comparative difference before and after the implementation was statistically significant (t=26.84, χ2=2.15, 2.72, 1.72, all P < 0.05). Besides, the satisfaction with the various evaluations of patients′ family members was increased and the differences were statistically significant (χ2=15.45-23.21, P<0.05). Conclusions The introduction of rescue video slices and interactive analysis can effectively reduce the patient′s rescue time, improve the success rate of patients rescues, decrease the rate of patient transport defect and missing items in the rescue unit, effectively control the quality of links, improve the management efficiency, and thus realize the standardized management under normal working condition.

Systemic lupus erythematosus is a kind of autoimmtne disease which may lead to multisystem involvement,with high mortality.As is well known,the prognosis of children is worse than that of adults.Many factors such as genetic factor,environmental factor and the self factors affect the survival of children with systemic lupus erythematosus.In order to improve the diagnosis,treatment and prognosis,this article reviews the recent research of the main factors affecting the prognosis of children with systemic lupus erythematosus.