Intracranial aneurysms are a severe cerebrovascular disease.Its incidences ranged from 2% to 4% in general population.With the population aging and the development of imaging technique,the prevalence of intracranial aneurysm is increasing year by year.The research of natural course of aneurysm has important significance for neurosurgeons to evaluate the validity of therapeutic measures.There are significant differences between the patients with aneurysm who have had subarachnoid hemorrhage and those who have not.The rates of ruptured intracranial aneurysms per year ranged from 0.066% to 2%.The risk factors that affect ruptured intracranial aneurysms including the size and place of aneurysm,whether it is multiple aneurysms or not,growth rate,and self-factors of patients,such as age,sex,and history of hypertension and smoking,etc.

Objective To explore the relationship of perceived professional benefit, job satisfaction, and retention willingness of nurses. Methods Convenience sampling method was adopted to investigate 493 nurses from 3 tertiary grade A hospitals in Taian. Results The mean scores of nurses′perceived professional benefit, job satisfaction, and retention willingness were 134.19 ± 19.79,121.52 ± 18.41, and 21.18 ± 4.23, respectively. Perceived professional benefit and job satisfaction were positively correlated with retention willingness (P<0.01). Job satisfaction played a partial mediation role in the relationship between perceived professional benefit and retention willingness. Conclusion Job satisfaction and perceived professional benefit have a positive influence on nurses′retention willingness .

Objective To investigate the prevalence of dermatoses affecting officers and soldiers garrisoned southeast China,and to provide enough scientific basis for prevention and treatment of those dermatoses.Methods Epidemiological investigations were carried out on 324 officers and soldiers in both Zhejiang and Fujian military Regions,respectively.In order to get the dermatoses diagnosed correctly and the number of infected men/times calculated accurately,a large scale of clinical examination was performed by 3 senior dermatologists from the authors' hospital.Some medication and management were applied in therapy for those skin disorders.The elementary medical personnel in the troops were trained with a short time-training course to raise their vocational level.Results Tinea manuum and tinea pedis,acne,pigmented nevus,tinea corporis and tinea cruris,seborrheic dermatitis,eczema,pityriasis versicolor and lichen simplex chronicus were the eight common dermatoses affecting officers and soldiers garrisoned southeast China.The prevalence of tinea manuum and tinea pedis was highest one in all the 8 common dermatoses.158 out of 324 soldiers(48.8%)suffered from skin disorder.The prevalence of acne,pigmented nevus,tinea corporis and tinea cruris,seborrheic dermatitis,eczema,pityriasis versicolor and lichen simplex chronicus were 45.4%,19.3%,10.8%,12.3%,10.2%,7.4% and 7.1%,respectively.Conclusions Skin disorder is one of the most common diseases affecting officers and soldiers.There are different occurrences in different garrisoned region.The prevelence of tinea manuum and tinea pedis in Fujian military region is higher than that in Zhejiang military region,and the prevelence of tinea corporis and tinea cruris,eczema in Fujian military region is lower than that in Zhejiang military region.No significant difference was found in the prevalence of the eight common dermatoses between the two parts of soldiers originated separately from north or south regions of China.

Objective To describe the status of nurse work engagement and to explore the relationship between work engagement and work-related flow experience.The study results provided the basis for how the nurse managers stimulate enthusiasm of nurses and let them devote themselves to work.Methods A convenience sample of 127 nurses from one major hospitals in Beijing city was recruited.Work Engagement Scale and Work-related Flow Experience Questionnaire were used in this study.Results The scores of work engagement were (3.18±0.59),at moderate level.Age,education level and professional titles were the influential factors of nurses' work engagement.The scores of work-related flow experience were (3.48±0.45),at moderate level.The scores of clear goals,focus on tasks,balance of skills and challenges were the top three dimensions of the work-related Flow Experience Questionnaire.Except for the two dimensions,the integration of action and awareness and the weakening of self-awareness,other dimensions of the work-related flow experience appeared statistically significant correlation to the scores of work engagement (P＜0.05 or P＜0.01).Most were moderate positive correlations.Conclusions Both the work engagement and the work-related flow experience are at moderate level.The nurse managers needed to take active measures to enable nurses to have more positive experiences and happiness,so as to enhance nursing work input,to improve quality of care and job satisfaction.

Objective To explore clinical effect of Chinese herbal immersion combined with Beecher's exercise for prevention and treatment of grade-0 diabetic foot.Methods A total of 107 patients who were diagnosed with grade-0 diabetic foot were selected in Department of Endocrinology of our hospital from July 2009 to October 2013.In addition to regular treatments,their feet were immersed in Chinese herbal liquid,and then were taken care by doing Beecher's exercise.The symptoms of diabetic foot were self-rated by each individual patient and mastering of knowledge about diabetic foot was evaluated both before the intervention and after three courses of treatment.Results After three courses of treatment,the self-rating symptom scored (4.37±1.45) totally,significandy lower than that before the intervention,(5.62±1.55),t=7.91,P ＜ 0.05.The mastering of six testing indexes about diabetic foot obviously improved compared between those before and after three courses of treatment [62.62％ (67/107)],23.36％ (25/107),30.84％ (33/107),46.73％ (50/107),57.94％ (62/107),50.47％ (54/107) vs.96.26％ (103/107)],86.92％ (93/107),89.72％ (96/107),85.98％ (92/107),94.39％ (101/107),87.85％ (94/107),x2=37.78,87.35,77.46,36.92,39.16,35.05,all P ＜ 0.05.Conclusions For grade-0 diabetic foot,Chinese herbal immersion treatment combined with Beecher's exercise can be applied straight forwardly on the disease focus;it's clinically safe and effective,and easy to be operated.It improves clinical symptoms of grade-0 diabetic foot by taking advantages of traditional Chinese medicine,prevent and control further development of diabetic foot and is valuable to be applied in clinical work.

Objective To explore the clinical significance of the three indicators combined detection that plasma endotoxin,pro-calcitonin (PCT)and (1,3)-β-D-glucan(BG)in pulmonary tuberculosis patients complicated with bacterial,fungal infection.Methods Retrospective investigation was conducted in 240 pulmonary tuberculosis patients,who were divided into gram negative bacteria (G- )group(39cases),gram positive bacteria (G+ )group(45 cases)including fungal,germ-free group(156 cases).Other 45 healthy people were selected into control group.The levels of plasma endotoxin,PCT and BG in the four groups were compared.Results The levels of plasma endotoxin(0.682±0.418)EU/mL,PCT(2.93±0.87)μg/L in the G- group were significant higher than those of the G+ group (0.063±0.034)EU/mL,(0.85±0.52)μg/L,the difference was significant (P <0.05).The levels of the plasma endotoxin,PCT in the G- group were higher than those of the germ-free group.The levels of plasma endotoxin,PCT and BG in the control group had no significant difference with those of the germ-free group.Conclusion The combined detection of plasma endo-toxin,PCT and BG have some clinical value on the early diagnosis of the patients with pulmonary tuberculosis complicated with G-fungal infection for the advantages of fast and sensitiveness.

It is suggested in this article that medical ethics should be conceived as the integral part of quality education for students of medical sciences,based on the high consistency of medical ethics with the quality education in higher educational institutions and its close relationship with the cultivation of the qualities of medical students.

Objective To investigate the expression and function of transforming growth factor (TGF)-β1 and Smad2 in liver fibrosis of biliary atresia (BA). Methods Liver biopsy specimens were collected from autopsy (normal group, n=5), congenital biliary dilatation (CBD group, n=10), BA patients underwent Kasai procedure (early hepatic fibrosis group, n=19) and liver transplantation (transplantation group, n=11). The first three groups were collected from January 2010 to July 2014 in Tianjin Children’s Hospital, and the last group was collected from January 2013 to January 2014 in Tianjin First Central Hospital. The hematoxylin and eosin (HE) stain were used to observe the degree of liver fibrosis of four groups. Immunohistochemistry (IHC) was used to observe expressions of TGF-β1 and Smad2 in liver tissues of these samples. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to test the quantitative mRNA of TGF-β1 and Smad2 in these samples. Results Results of HE showed that no fibrosis in autopsy group, mild fiber cell hyperplasia in CBD group, severe fibrosis in Kasai group and significant pseudolobule in transplantation group. Results of IHC showed that TGF-β1 was expressed in the cytoplasm of hepatocytes, bile duct cells, lymphocytes and neutrophils. The average optical density of TGF-β1 was the highest in Kasai group compared with that of other three groups (P < 0.05). There was no significant difference in Smad2 expression in cytoplasm of hepatocytes, bile duct cells and lymphocytes between four groups (P>0.05). Results of qRT-PCR showed that both TGF-β1 mRNA and Smad2 mRNA were the highest in early hepatic fibrosis group than those of CBD group and transplantation group (P<0.017). Conclusion In early stage of BA, TGF-β1 and Smad2 promote liver fibrosis until the formation of P-P,P-C desmosome structure. However, with BA fibrosis becomes more serious, the pro-fibrogenic function of TGF-β1 and Smad2 becomes less.

The gut-brain axis (GBA) is a nerve-endocrine mediated bidirectional communication system between the gut and brain, which links the cognition and emotion in brain to peripheral intestinal function. In recent years, many researches have showed that colonized intestinal microbiota plays an important role in the communication between gut and brain. On one hand, microbiota can influence the development and function of brain via GBA. On the other hand, brain can also change the composition of gut microbiota. These findings gradually become a novel medical research highlight, i.e. the microbiota-gut-brain axis. This paper reviews the interaction between gut microbiota and brain via GBA in order to provide supports for studying functions of gastrointestinal tract and brain, as well as the treatment of related diseases.

Objective To investigate the relationship between blood vessel invasion (BVI) and clinicopathologic features and prognosis in patients with gastric cancer,and analyze related factors affecting the prognosis of patients.Methods The clinicopathological data of 206 patients with gastric cancer who were admitted to the Nanjing Hospital Affiliated to Nanjing Medical University from January 2007 to December 2010 were retrospectively analyzed.The BVI of surgical tumor specimens in all patients was detected by immunohistochemical staininng.All the patients were followed up via outpatient examination and telephone interview up to March 2014.The count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method.The survival analysis and univariate analysis were done using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The BVI rate of 206 patients was 27.67％ (57/206).The BVI rate of tumor tissues,tumor differentiation,perineural invasion,T stage,N stage and TNM stage in all patients with gastric cancer were compared,showing significant differences (x2=14.396,9.569,15.579,43.453,30.732,P ＜ 0.05).After operation,188 patients were followed up for 6.0-60.0 months (median,34.0 months),with the follow-up rate of 91.26％ (188/206).Among 188 patients with follow-up,the median survival time and 5-year cumulative survival rate in patients with BVI and with negative BVI were 32.4 months and 19.6％,40.7 months and 42.0％,respectively,with a significant difference in the survival of patients (x2 =9.364,P ＜ 0.05).The results of univariate analysis showed that the diameter of tumor,tumor differentiation,perineural invasion,BVI,T stage,N stage and TNM stage were factors affecting the prognosis of patients with gastric cancer (x2=9.241,17.486,11.243,9.364,27.666,216.745,49.887,P ＜ 0.05).The results of multivariate analysis showed that the diameter of tumormore than 5 cm,BVI,stage T4,stage N3 and stage Ⅲ were independent risk factors affecting the prognosis of patients with gastric cancer (HR =0.502,0.456,0.052,0.001,0.735; 95％ confidence interval:0.334-0.754,0.289-0.720,0.004-0.664,0.000-0.006,0.159-3.398,P ＜ 0.05).Conclusions BVI in patients with gastric cancer is associated with the progression of tumors.The diameter of tumor more than 5cm,BVI,stage T4,stage N3 and stage Ⅲ are independent risk factors affecting the prognosis of patients with gastric cancer,and BVI may be a predictor of poor prognosis of patients with gastric cancer.