Objective To investigate the status quo of transformational leadership,psychological empowerment,team psychological safety and team effectiveness,and test whether the supposed structural equation is tenable.Methods Totally 380 nurses completed the Transformational Leadership Questionnaire,Psychological Empowerment Questionnaire,Team Psychological Safety Questionnaire and Team Effectiveness Questionnaire,structural equation model was used to verify the relationship of the above,Bootstrapping confidential interval and product of coefficient were used to test the mediating effect.Results Significant correlations were found between transformational leadership,psychological empowerment,team psychological safety and team effectiveness (P ＜ 0.01),transformational leadership played indirect effect on team effectiveness (Z=6.195,P ＜ 0.05),psychological empowerment and psychological safety had a totally mediation effect.Conclusions Healthcare workers should make psychological empowerment and team psychological safety as the breakthrough point,fully play the advantages of transformational leadership on team effectiveness in order to increase the working ability of nurses and make them complete the clinical work effectively and with high quality.

The isolated working heart of guinea pig perfused with Tyrode's solution could work normally for at least 60 min. It was shown that berbamine ( BA ) could depress the function of isolated working heart of guinea pig in dose-dependent manner. BA 3 mol/L could decrease the left ventricular pressure, aortic pressure, -dP/dtmax, aortic blood flow and coronary blood flow, and increase left ventricular end-diastolic pressure. BA 100 mol/L could result in the ventricular asystole, however, no obvious influence the contraction of atrium.It was also demonstrated that BA could antagonise the arrhythmias induced by the adrenaline in isolated working heart of guinea Pig.

Objective To quantitatively assess severity of movement disability by analyzing physical activities recorded by an actigraph monitor in patients with neurology disorders.Methods Eighty-one patients with Parkinson' s disease(PD)and 61 patients with acute cerebral infarction(ACI)accompanying impaired upper limb motor function were included in the study.PD patients and ACI patients were treated using the international PD and ACI treatment guidelines,respectively.The patients were asked to wear an Actigraph monitor for 6 days before the treatment in both PD and ACI patient groups and at 24-38 days post-treatment in PD patients or at 28 days post-treatment in ACI patients.The recorded data was analyzed by power-law exponent(PLE)and detrended fluctuation analysis(DFA).Clinically,before and after the treatments,PD patients were evaluated using the conventional Unified Parkinson Disease Rating Scale (UPDRS),and ACI patients were evaluated by assessing upper limb motor function using Fugl-Meyer Assessment(FMA)and Functional Independence Measure(FIM).The correlation of the UPDRS scores with PLE was analyzed in PD patients,and the correlation of FMA or FIM with DFA in ACI patients.Results Both the UPDRS scores and the PLE values in PD patients were improved after the drug administration(UPDRS total:32.8 ± 16.2 and 28.8 ± 14.7,Z =2.080,P =0.038; UPDRS Ⅲ:18.6 ± 8.2 and 15.7±6.8,Z=2.155,P=0.031; PLE:0.98 ±0.25 and 0.82 ±0.21,Z=2.212,P=0.027,before and after the treatment,respectively).There were a linear correlation coefficient of 0.699 between the improvements of total UPDRS scores and the PLE values,and of 0.823 between the UPDRS Ⅲ and the PLE values.FMA,FIM scores and DFA were improved significantly than before treatment(FMA:12.39 ± 8.21 and 30.28 ±7.29,Z=3.016,P =0.004; FIM:8.98 ±7.29 and 13.21 ±7.6,Z =2.282,P=0.038; DFA:0.86 ±0.31 and 0.98 ±0.27,Z =2.360,P =0.036,before and after the treatment,respectively).It also showed linear correlations between the improvements of FMA scores and DFA(r =0.638),and between FIM scores and DFA(r =0.712,both P ＜0.05).There was no correlation between UPDRS scores and DFA values in PD patients,nor between FIM scores or FMA scores and PLE values in ACI patients.Conclusions Actigraph device can be used to monitor patients activity in movement disorders.Analysis of its PLE can provide a quantitative evaluation in PD while its DFA may provide useful specific assessment of impaired upper limb motor function in ACI patients.It can also be used in quantitatively assessing new drug efficacy.

BACKGROUND: Cervical rotation manipulation is a non-surgical method of cervical spondylosis, showing significant treatment efficacy. But the safety for patients with carotid artery atherosclerosis remains obscure. OBJECTIVE: To analyze the hemodynamic changes of atherosclerotic carotid arteries treated by cervical rotatory manipulation, and to explore the effect of cervical rotatory manipulation on the hemodynamics of atherosclerotic plaque. METHODS: Eight cases of stenosis of ramification of the carotid artery with plaque on MRI. The hemodynamic model of carotid artery atherosclerosis was established, assigned with general boundary conditions and simulated the cervical stretch during cervical rotatory manipulation. All models were grouped and stretched into 0％ (control group), 7％ and 16％ stretch to simulate the hemodynamic changes of atherosclerotic plaque. The hemodynamic parameters, including average wall shear stress, the maximum wall shear stress, the average maximum wall shear stress, the blood velocity of the plaque, and blood flow vectorgraph were compared among groups. RESULTS AND CONCLUSION: (1) All hemodynamic parameters had no significant differences between 7％ stretch and control groups (P＞ 0.05). Compared with the control group, the wall shear stress, the maximum wall shear stress, and the maximum wall shear stress in the 16％ stretch group were significantly increased (P ＜ 0.05), and other indexes showed no significant differences. (2) In summary, different stretches by cervical rotatory manipulation possess different effects on plaque, and a 16％ stretch may affect the hemodynamics of plaque.

Objective To explore the effect of the proximal femoral nail antirotation(PFNa) for the treatment of femoral intertrochanteric fracture.Methods 272 consecutive patients with femoral intertrochanteric fracture were treated with PFNa.Results The mean operative time was 55min(range 35 ～95)min.The mean blood loss was 85ml (range:20 ～200)ml.The mean follow-up was 15.6months( range:6 ～36)monthsand achieved bone healing with an average time of 14.5weeks.According to the Harris criterion for evaluation.Conclusion PFNa was more comfortable for human's biomechanism and more favorable for the healing of the fracture as well as the recovery of the hip function.It had the advantage of simple manipulation,fewer trauma,strong fixation,anti-rotation,less osclerotin.PFNa was an ideal treatment for intertrochanteric fracture,specially the unstable intertrochanteric fracture and senile osteoporosis.

Objective To investigate the risk factors related to failure of proximal femoral nail anti-rotation(PFNA)internal fixation for intertrochanteric fracture of femur.Methods A retrospective research was done on 249 cases with intertrochanteric fracture of femur after PFNA internal fixation.The failure ratios related to sex,fat,fracture pattern,osteoporosis,replace condition in operation and tip-apex distance(TAD)were calculated.And the risk factors related to failure of PFNA were statistically analysed.Results Two hundred and forty-three cases were followed up ranged from 10 months to 3 years after operation.Plain AP and lateral radiographs were obtained at each follow-up patient,13 of 243 cases resulted in failing by PFNA internal fixation.The failure ratios in PFNA internal fixation with fat,unstable fracture,TAD≥25 mm and bad replace condition in operation were 8.5％(12/141),7.8％(12/153),18.5 ％(5/27)and 26.1％(6/23),respectively,which were higher than those in PFNA internal fixation with nonobese,stable fracture,TAD ＜ 25 mm and good replace condition in operation[1.0％(1/102),1.1％(1/90),3.7％(8/216)and 3.2％(7/220),respectively](P＜0.05 or ＜0.01).Conclusions Fat,unstable fracture,TAD≥25 mm and bad replace condition in operation are the relatively independent risk factors related to failure of PFNA internal fixation for intertrochanteric fracture of femur.Furthermore,it will prevent and reduce the ratio of complications to avoid these risk factors when PFNA internal fixation is selected for treatment intertrochanteric fracture of femur.

Objective To demonstrate the clinical value of left ventricular opacification (LVO),compared to conventional echocardiography,on interpretation of apical thrombus,measuring left ventricular ejection fraction (LVEF),and monitoring the effects of anticoagulation.Methods This retrospective study included twenty-six myocardial infarction patients with suspected apical thrombus on routine echocardiography in China-Japan friendship hospital between August 2015 and October 2016.All patients underwent LVO using microbubble contrast agent (SonoVue).Six patients had repeated LVO examination 3-11 months after anticoagulant therapy.The diagnostic performance of routine echocardiography and LVO were compared using McNemar test.The interobserver agreement in measuring LVEF by conventional echocardiograph and LVO were analyzed using Bland-Altman analysis.Results Apical thrombus were diagnosed in 6 patients,excluded in 4 patients and inconclusive in 16 patients by routine echocardiography,while diagnosed in 10 patients,excluded in 15 patients and inconclusive in 1 patients by LVO.The inconclusive results were significantly improved when using LVO [96.2％(25/26) vs 38.5％(10/26)] (x2=13.067,P ＜ 0.001).Bland-Altman chart showed the mean difference of LVEF by LVO between senior and junior doctors was 1.5％[95％ CI(-9.6％,6.5％)],while the mean difference was 3.5％ [95％CI(-23.9％,16.9％)] when using routine echocardiography.The interobserver agreement in measuring LVEF was better for LVO.Six patients were followed up 3-1 1 months after anticoagulation.Of them,1 thrombus disappeared,4 diminished and 1 had no significant change.Conclusion LVO has the potential value of improving the diagnosisof apical thrombus,assessment of LVEF,and monitoring of anticoagulation in myocardial infarction patients.

Objective To detect the change of exoression level of plasma microRNA‐21(miR‐21) and TGF‐β1 in cardiac remode‐lin affer acute myocardial infarction(AMI) of the pateins .Methods 200 pateints with AMI and 100 normal controls(age ,sex matched) were enrolled .Blood samples were obtained from the normal controls and patients with AMI on the 3 days ,7 days and 14 days .Real‐time PCR was developed to detect the expression of miR‐21 and TGF‐β1 in plasma .Results The expression of miR‐21 was significantly up‐regulation in the 3 days ,7 days and 14 days in MI group than that cntrol group ,0 .74 ± 0 .21 vs .2 .62 ± 0 .23 , vs .3 .67 ± 0 .25 ,vs .4 .13 ± 0 .27 up‐regulation in the 3 days ,7 days and 14 days in MI group than that cntrol group ,0 .98 ± 0 .18 vs .2 .35 ± 0 .24 ,vs .3 .67 ± 0 .25 ,vs .4 .13 ± 0 .27 ,P<0 .05 ,respectively .The expression of miR‐21 and TGF‐β1 were up‐regulation with the change of cardiac function .Positive relationship between miRNA‐21 expression and LVDd (r=0 .757 ,P<0 .05);Positive relationship between TGF‐β1 mRNA expression and LVDd(r=0 .701 ,P<0 .05) .Conclusion The expression of miR‐21 and TGF‐β1 were up‐regulation in cardiac remodelin affer AMI of the pateins ,which involved in regulation in cardiac remodelin affer AMI .

Pneumonic plague that originated in Russian Siberia broke out in Northeast China in October 1910-March 1911. On the basis of field visits, autopsy, bacteriological identification, and close collaboration with local authorities and international colleagues, Dr. Wu Lien-Teh implemented a series of efficient antiplague measures, which successfully controlled the development of an extraordinary epidemic plague. In his subsequent work, Dr. Wu demonstrated the respiratory transmission of pneumonic plague and tarbagans' role in this spread. Dr.Wu's academic and cultural contributions are valuable in the medical progress in China.
China ; Epidemiology ; history ; History, 20th Century ; Humans ; Plague ; history ; mortality ; prevention & control ; transmission

The aim of this study was to identify antigens for a vaccine or drug target to control rabbit coccidiosis. A combination of 2-dimensional electrophoresis, immunoblotting, and mass spectrometric analysis were used to identify novel antigens from the sporozoites of Eimeria stiedae. Protein spots were recognized by the sera of New Zealand rabbits infected artificially with E. stiedae. The proteins were characterized by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF/TOF-MS) analysis in combination with bioinformatics. Approximately 868 protein spots were detected by silver-staining, and a total of 41 immunoreactive protein spots were recognized by anti-E. stiedae sera. Finally, 23 protein spots were successfully identified. The proteins such as heat shock protein 70 and aspartyl protease may have potential as immunodiagnostic or vaccine antigens. The immunoreactive proteins were found to possess a wide range of biological functions. This study is the first to report the proteins recognized by sera of infected rabbits with E. stiedae, which might be helpful in identifying potential targets for vaccine development to control rabbit coccidiosis.
Coccidiosis* ; Computational Biology ; Eimeria ; Electrophoresis ; HSP70 Heat-Shock Proteins ; Immunoblotting ; Mass Spectrometry ; Rabbits ; Sporozoites