The field of rehabilitation medicine physical therapist (PT) training and education has been relatively weak links in China, how to build a rehabilitation therapist team, we constantly explore and get a greater progress. However, most of the time is still confined to empty the contents of most theoretical level, and some basic steps and the specific contents are lacked. How to stabilize therapists team? How to position therapists? It deserves to pay more attentions.

Objective Using Doppler ultrasound measured in femoral artery flow velocity variation rate method to predict fluid responsiveness.Methods 80 patients were measured femoral artery flow velocity variation rate (△Vpeak)by mastering the ultrasound skills of the attending physician.Passive leg raising test (PLR)stroke vol-ume variation (△SV)was used to analyze the peak value of the femoral artery flow velocity,rate of femoral artery peak velocity of respiratory changes,and the results were compared with results of PICCO monitoring to predict patients with their response to the treatment capacity,to evaluate clinical feasibility.Results Reactive groups in the PLR test before the experiment and hemodynamic changes:PLR test reaction group in before the test and test process, HR,MAP,CAP index changes were not obvious (P >0.05),but ultrasonic detection and PICCO detection showed SV and CO varied significantly (t =15.24,P =0.00;t =13.64,P =0.00),the two kinds of methods to forecast results was consistent.In the absence of the anti should patients in PLR test before the experiment and hemodynamic chan-ges:PLR test unreacted group in before the test and test process,HR,MAP,CAP,SV and CO index change were not obvious (all P >0.05).Conclusion By ultrasonic method for measuring femoral artery flow speed variation rate can exactly evaluate the capacity status of critically ill patients,and effectively predict fluid responsiveness,the prediction results and PICOO monitoring results are highly consistent.It is a safe and efficient prediction method,which is worthy of promotion in clinical intensive observation.

[Objective]To evaluate the method and curative effect of posterior internal fixation and bone grafting fusion for atlantoaxial fracture or dislocation.[Method]Posterior internal fixation and bone grafting fusion were made on 26 patients with atlantoaxial fracture or dislocation in condition of tracheal intubation anesthesia.Occipitocervieal fixation(Aixs) and bone grafting fusion were performed on patients with fracture of vertebral lamina-arch.Vertebral lamina splint fixation (Apofix) was performed on patients without fracture of vertebral lamina-arch and decompression of vertebral canal.[Result]Followed up for 5 to 60 months(averaged,16.8 months),the vertebral artery and spinal cord injury were not occurred and clinical symptom was relieved in all patients.X ray examination showed screws in vertebral articular process and occipital condyle were normotopic without laxation and fragmentation.The bone grafting transformed into osseous fusion after 3 months.[Conclusion]Aixs fixation and bone grafting fusion and Apofix fixation are effective methods for atlantoaxial fracture or dislocation.

Translational medicine is a novel concept about combination of basic research and clinical application. The aim of translational medicine is to realize the translation of basic research into clinical practice. microRNAs (miRNAs) are non-coding single-stranded RNAs with 21-25 nucleotides in length as newly discovered factors in regulating gene expression. Recently, the key regulatory role of miRNA in the cardiovascular system has been elucidated and amount of remarkable results has been achieved, particularly in the regulation of cardiac arrhythmias. A series of studies demonstrate that miRNAs are involved in the regulation of expression of a variety of proteins associated with cardiac electrical activity, and are the potential targets of occurrence of cardiac arrhythmias and anti-arrhythmic drugs. miRNAs as a therapeutic target regulate the stability of mRNAs of target genes or play an inhibitory role in the translation process. Stability of the corresponding miRNA expression levels in the target organ may be a new approach for the disease therapy. Regarding the dysfunction of miRNA, we employed miRNA re-expression strategy and anti-miRNA strategy to correct target protein function and provide a new entry for the therapy of arrhythmia. With the technology of miRNA mimics and antagomirs, miRNAs are expected to treat various cardiovascular diseases and will provide a fresh impetus to achieve transform medicine.

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.

Objective To investigate the effects of Triptolide on apoptosis of cultured rat mesangial cells treated by TGF-β1 and the role of Smac in this process. Methods The mesangial cells were pre-treated with different concentrations of Triptolide for 24 hours, then stimulated with TGF-β1 for 24 hours. Apoptotic cells were detected by TUNEL assay. Smac transcription level was determined by Real time-PCR analyses. Smac expression level was assessed using Western blot anal-yses. Localization of Smac was shown by confocal fluorescence microscopy. Results Compared with control group, TGF-β1 inhibited apoptosis and Smac transcription and expression in rat mesangial cells. By contrast, Triptolide promoted mesangial cells apoptosis. In Triptolide groups, Smac mRNA and protein levels were up-regulated. Additionally, in normal and TGF-β1 groups Smac protein was mainly localized in mitochondriawhile in Triptolide groupit was mainly localized in cytoplasm and nucleus with increased fluorescence intensity. Conclusion Triptolide could promote the effect that TGF-β1 inhibited apop-tosis of mesangial cells, through both up-regulation the expression of Smac and stimulating it translocation from mitochon-dria to cytoplasm and nucleus.

Objective To study the effects of 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) on experimental allergic encephalomyelitis (EAE) and its immune-modulating mechanisms. Methods 1,25-(OH)2D3 were given to Lewis rats immunized with myelin basic protein (MBP) in complete Freud’s adjuvant (CFA) respectively on the same day of immunization (the prevented group) and the presenting day of symptoms (the treated group). Then clinical symptoms were scored until the 13th day after immunization, when rats were sacrificed. Mononuclear cells (MNC) in draining lymph nodes were collected for the following studies: (1)Total number of MNC in the lymph nodes were counted. (2) Numbers of CD~+4CD~+ 25 cells and CD~+ 86 cells were determinated by flow cytometry. (3) The concentrations of interferon(IFN)-? and interleukin(IL)-4 in cell culture supernatant were measured by enzyme-linked immuno sorbent assay (ELISA). Results 1,25-(OH)2D3 could delay the peak EAE severity in the prevented group while it could relieve the progression of EAE and lower the peak score in the treated group (3.3?0.6 vs 4.0?0.3, P

Objective To investigate the influence on the behavior of withdrawal and relapse after deep brain stimulation of bilateral nucleus accumbens in morphine-dependent rats. Methods The rats with a strong unconditioned preference were discarded in preconditioning test, the selected rats were distributed into five groups randomly. After operation,morphine hydrochloride was injected subcutaneously into SD rats for 12 days (once every day,initial 5 mg/kg,increasing by 5 mg/kg per time,stable in 20 mg/kg ). A modified electrical circuit was used to procedure the DBS,the parameter was 130 Hz,150 A,60 s,l h/d,14 d. CPP test was used to exam the effect of DBS. A minor morphine dose (3 mg/kg) was injected to induce the behavior of relapse, and CPP was tested again after 24 h. Two-way ANOVA was performed on the data with Bonferroni posttest. Result ①After CPP training,CPP score of group morphine, morphine + sham and morphine + DBS was ( 155. 87 ± 20. 45 ) s, (107.33 ± 18.10)s,(135.45 ±22.09)s,and had significant difference with group of control( ( -70.34 ± 15.40) s)(t = 9.45,P＜0.01; t = 6.94,P＜0.01;t = 8.04,P＜0.01).②After 7 days' DBS,the CPP score in group of morphine + DBS reduced significantly compared to group of morphine( t = 4.21, P＜0.01) and morphine + sham( t=1.10, P＜0.05).0n the 14th day,there was more pronounced reduction ( t = 5. 15, P＜0.01; t = 3.92, P＜ 0.01). ③ 24 hours after the minor morphine dose was injected,the CPP score in morphine + DBS didn't increase significantly, and had significant difference with group of morphine ( t = 4.04, P＜0.01) and morphine + sham ( t= 4. 13, P＜0.01). Conclusion DBS bilateral nucleus accumbens in morphine-dependent rats can interfere the behavior of morphine-induced CPP and relapse.

Objective To investigate the combination effect of curcumin and γ-ray irradiation on PANC-1 cells in vitro.Methods PANC-1 cells were exposed to γ-rays in the presence or absence of curcumin.MTT assay was performed to evaluate cell viability.The expression of P21 was evaluated with RT-PCR and Western blot.Cell cycle distribution and apoptosis were tested by flow cytometry.Results Compared with the γ-ray irradiation group,combination treatment of curcumin and irradiation decreased the cell viability (t =6.72,P ＜ 0.01) and increased the percentage of cells in S-phase (t =4.78,P ＜ 0.05),apoptosis rate (t =6.58,P ＜ 0.01),P21 protein and mRNA expression (t =5.72,5.63,P ＜ 0.01) in PANC-1 cells.Conclusions Curcumin increases the radiosensitivity of PANC-1 cells,which may have clinical implication on radiotherapy of pancreatic cancer.

Delicacy management is an important issue to the hospital logistics mode innovation,which is the only way to realize a scientific hospital logistics management.This article proposes the practical ways to push on the hospital logistics delicacy management from many respects,such as working regulation,consumption measurement,contract supervision,cost accounting,structure control and convergence supporting.