OBJECTIVE To study the risk factors and control measures for needle injury,so that to provide relevant information for epidemiological studies of needle injury.METHODS The Needle injury of the worker′s age,type,location,operation links,workload and the spread exposed source were investigated,in the medical staff from Jan 2005 to Dec 2007 including 155 cases of needle injury(125 medical staff).RESULTS The survey showed that the risk factors of needle injury were short working age,lack understanding of needle injury,needles being putted cap back again,naked needles and busy working.CONCLUSIONS The control measures for Needle injury are to strengthen occupational training,dispose contaminated needles timely,avoid needles being naked,forbid needles being putted cap back again,and assign people reasonably.

0.05. Conclusions Radical nephrectomy remains the cardinal method for the treatment of primary renal cell carcinoma. Extensive retroperitoneal lymphadenectomy does not improve the survival.

Objective To explore the effects of psychological intervention on military personnel' s social support,coping styles and psychosomatic health and their relationships.Methods Military gymnastics were taken as intervention method in this study.A total of 812 military personnel were administered the Military Personnel Scene-Trait Coping Style Scale (MPSTCSS),the Military Personnel Social Support Scale and the Simplified version of Psychosomatic Health Questionnaire.The data was processed by using t-test,correlative analysis,stepwise linear regression analysis and path analysis in SPSS version 17.0 and Amosl7.0.Results The scores of passive coping factor,subjective support factor score,physical symptoms and mental symptom in the experimental group were significantly lower than the those of control group(respectively,74.91 ± 20.46 vs 83.03 ± 25.1,2.02 ± 3.14 vs 2.60 ± 2.71,5.58 ± 6.00 vs 26.98 ± 4.96,3.91 ± 4.80 vs 23.01 ± 4.31,P≤ 0.05).The scores of active coping factor in the experimental group (133.66 ± 23.30) were significantly higher than the those of the control group (130.07 ± 24.88,P ＜ 0.05).Passive coping of the experimental group positively correlated with all single factors of social support and psychosomatic health (r =0.410 ～ 0.512,P ＜ 0.01).Active coping of experimental group negatively correlated with all single factors of social support and psychosomatic health(r =-0.300～-0.418,P ＜ 0.01).All single factors of social support positively correlated with psychosomatic health(r=0.349 ～ 0.561,P ＜ 0.01).Regression analysis showed that social support,passive coping and active coping were entered into the regressive function(P≤0.030),accounting for 37％ of total variance.The influence of coping styles on psychosomatic health was enhanced by intervention of social support.A pathway model of social support as mediator of relationship between psychosomatic health and coping styles was established,the fitting indexes of which were as follows:x2/ df =1.799 (P =0.055),GFI =0.988,AGFI =0.965,CFI =0.996,RMSEA =0.044.Conclusion Military gymnastic could effectively improve the military personnel' s capacity for coping,subjective support,and psychosomatic health.Social support and scene-trait coping style would exert significant effects on military personnel' s psychosomatic health.Social support mediates the relationship between coping styles and psychosomatic health.

OBJECTIVE To compare and analyze the drug resistance of Chryseobacterium meningosepticum which producing metallo-?-lactamase(MBL) and extended-spectrum-?-lactamases(ESBLs) from ICU patients′ and non ICU patients′ specimens of sputa so as to guide the rational application of antibiotics.METHODS Identified the strains with VITEK 32,MBL and ESBLs were also screened by double disk synergy;the antimicrobial sensitivity of clinical isolates was tested by VITEK GNS143 and the antimicrobial sensitivity was added and tested by K-B method.RESULTS As a result the rate of producing MBL of C.meningosepticum was 49.0% from ICU patients′ specimens of sputa which was higher than the rate of 13.8% from non ICU patients′;the rate of producing ESBLs of C.meningosepticum was 37.2% from ICU patients′ specimens of sputa which was higher than the rate of 30.6% from non ICU patients′;the rate of drug resistance to AMP/SUB,TZP,CEP,CIP,and LEV from ICU patients′ was higher than that from non ICU patients.CONCLUSIONS Why the high resistance rate of C.mengingosepticum in ICU patients′ specimens of sputa might be due to the high producing ?-lactamases(MBL and ESBLs).

The mrp gene of SS2 human strain Habb was truncated and cloned into a prokaryotic expression vector pGEX4T-2,and a fusion-expressed protein MRP-GST of 61 000 was obtained in E.coli.The GST was cut from MRP-GST with thrombin protease to gain the purified MRP of 35 000 which showed a strong reaction to the SS2 positive sera in Western blotting.BALB/c mice were immunitied intraperitoneally with purified MRP protein.Murine myeloma cells were fused with the splenocytes of the immunized mice after the third immunization.An indirect ELISA coated with purified MRP was used to screen hybridomas for production of specific antibody.The six McAb recognized MRP specially.According to the results of 71 standard strains (48 SS and 34 SS2)by Sandwich ELISA,the coincidence rate was 97.2%,but for 34 SS standard serotype was 100 %.The ELISA method has a potential value for clinical and epidemiological applicationgs.

Objective To investigate the clinical curative result of the new method of postermedial deepen of the fibular groove in the treatment of chronic peroneal tendon subluxation.Methods From March 2006 to October 2012,21 patients (15 male,6 female) with chronic peroneal tendon subluxation via a novel method of postermedial deepen of the fibular groove.In this group:Ⅰ grade 5 cases;Ⅱ grade 9 cases;Ⅲ grade 5 cases;Ⅳ grade 2 cases.All patients were followed up for at least 24 months.The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale score and visual analogue score (VAS) were used to evaluate the clinical outcomes.Operation time,time to heal and complications were also recorded.Results The average operation time was 50 minutes (30-70 minutes).The blood loss was 30-60 ml,average 40 ml.All incisions healed after operation,no case of incision infection,skin necrosis and sural nerve,vascular injuryed.Mean AOFAS score was significantly increased from (55.2±7.1) preoperative to (93.6±5.6) postoperative.15 patients with excellent,good for 1 cases.The excellent and good rate was 100％ (16/16).VAS score by an average of (5.3±2.1) points down to (1.2±1.1) points postperative.All the patients can wear normal shoes postoperative,waking with normal gait.No patients had peroneal tendon tenosynovitis,tendon adhesion,fracture of lateral malleolus and other serious complications,no dislocation recurrent,strength of the peroneal muscle returns to normal.Conclusion The novel method of postermedial deepen of the fibular groove in the treatment of chronic peroneal tendon subluxation was safe and effective for ankle instability with a relatively short time.

Objectives To investigate the effects of military stress and psychological resilience on job burnout and mental health in military personnel and construct the relationship among resilience,job burnout and mental health during military stress.Methods By cluster random sampling,520 personnel in army taking part in the war-game were selected as the experimental group,and another group of 520 who not taking part in the wargame were selected as the control group.After one week of the war-game,the experimental group and control group were investigated by Military Personnel Mental Disorder Prediction Scale,Military Job Burnout Scale and Military Personnel Resilience Scale.The acquired datum were analyzed by t-test,correlation analysis,regression analysis and structural equation modeling analysis.Results (1) The total scores of mental disorder prediction and factor scores of psychosis,depression,mania,neurosis,personality disorder were((15.85±9.30),(0.36±0.91),(1.10±1.53),(2.66±1.78),(1.16± 1.57),(2.04± 1.83)) and the total scores of job burnout and its all factor scores were((23.05±9.40),(5.13±2.47),(3.19±2.18),(5.16±3.01),(1.71 ± 1.66),(3.29±2.21)) of experimental group were significantly higher than control group((11.20±6.24),(0.11 ±0.53),(0.55± 1.10),(1.89± 1.50),(0.51± 1.02),(1.10±1.13),(17.92±9.64),(4.28±2.92),(2.64±2.06),(3.84±2.46),(1.26± 1.37),(2.77±2.43),P=0.000).(2)Psychological resilience negatively correlated with job burnout and mental health(r=-0.52～-0.09,P＜0.05),and job burnout positively correlated with mental health (r=0.12 ～ 0.57,P＜0.01).(3) Under the military stress,psychological resilience was the accommodation to effect the mental health and job burnout of military personnel.(4)The analysis of structural equation modeling showed that psychological resilience had a direct effect on job burnout(the path coefficient was-0.56,P＜0.01),but it had no significant effect on mental health (the path coefficient was-0.06,P=0.302).Job burnout had a direct effect on mental health (the path coefficient was 0.73,P＜0.01),and the structural equation modeling fitted the data very well(x2/ df =3.138,GFI =0.943,AGFI =0.911,NFI =0.930,RFI =0.905,IFI =0.952,TLI =0.933,CFI =0.951,RMSEA =0.065).Conclusion Military stress can lead to job burnout and mental disorders that could be moderated by psychological resilience.Job burnout can fully mediate the relation between psychological resilience and mental health.Psychological resilience effects mental health by job burnout indirectly.

Objective To evaluate the significance of weight-bearing lateral radiographs in evaluation of malunited frac-tures of the ankle. Methods 17 patients with malunited fractures of the ankle were treated by different reconstructive operations be-tween March 2010 and October 2012, including 9 females and 8 males, aged from 17 to 64 years. According to the Takakura classifi-cation of ankle arthritis, there were 7 patients in grade 1, 4 in grade 2 and 6 in grade 3. Simple open reduction and internal fixation were performed in 5 patients, supramalleolar tibial osteotomy in 5, lengthening osteotomy of the fibula in 2, supramalleolar tibial and fibular osteotomy in 5. Tibiofibular clear space on the anteroposterior radiograph. Medial clear space, tibiofibular clear space and tib-iofibular overlap on ankle mortise radiographs were compared preoperatively and at last follow-up. Tibial lateral surface angle (TLS), the offset of the center of talar rotation from the tibial axis, and the displacement of tibiotalar articular surface center on weight-bear-ing lateral X-ray were also compared preoperatively and at last follow-up. AOFAS score was used to evaluate the function of the ankle. Results The duration of follow-up was 9 to 32 months. Bone healing was observed in all patients, and the average healing time was 11 to 14 weeks. Ankle joint degeneration grade had no exacerbation. The medial clear space, tibiofibular clear space and tibiofibular overlap had no significant difference between the pre and postoperative. Statistically significant change was seen postoperatively in the values of TLS (76.9°±4.1° vs 80.9°±5.2°). The offset of the center of rotation from the tibial axis and the displacement of tibiotalar articular surface center were changed from 10.8 ± 2.1 mm to 2.0 ± 0.5 mm and 4.5 ± 1.5 mm to 2.2 ± 1.0 mm, respectively. The average AOFAS score was improved from 45.7 ± 15.9 points preoperatively to 82.0 ± 9.9 points postoperatively. Conclusion Weight-bearing lateral radiographs can be used to judge the ankle restoration. Even if the mortise radiograph had relative good realignment, it may ap-pear obvious deformity on lateral radiographs. Good reduction of lateral radiographs requires that the mid axis of the tibia should pass through the center of talar rotation and tibiotalar articular surface be parallel on the lateral radiograph.

BACKGROUND: Adequate preparation of donors and recipients prior to living-related donor renal transplantation, short warm and cold ischemia time for donor kidney, good histocompatibility of human leukocyte antigen match, and low postoperative rejection incidence provide feasibility for use of low-dose immunosuppressive agents after living-related donor renal transplantation. OBJECTIVE: To investigate the safety and effectiveness of low-dose calcineurin inhibitors (CNI), an immunosuppressive agent, in living-related donor renal transplantation. METHODS: A total of 38 recipients who underwent living-related donor renal transplantation at the Center of Renal Transplantation of the First Affiliated Hospital of Nanjing Medical University from January 2006 to June 2008 were randomized for treatment with mycophenolate mofetil (750 mg twice a day), prednisone, and either standard-dose CNI (n=18) or low-dose CNI (n=20) during 12 months post-transplantation. Ciclosporin A was given orally (starting dose, 6 and 4 mg/kg per day, respectively) in two divided doses to achieve the 12-hour whole blood concentration as measured by fluorescence polarization immunoassay. The starting dose of tacrolimus was 0.12 and 0.08 mg/kg per day respectively, and its whole blood concentration was measured by enzyme-multiplied immunoassay technique. After transplantation, patients were followed up. Renal function, pulmonary infection, liver dysfunction, and CNI nephrotoxicity at different time periods were compared between different regimens. RESULTS AND CONCLUSION: During 12 months post-transplantation, patient death occurred in one of 18 patients (5.6%) in the CNI standard-dose group and none of 20 patients (0%) in the CNI low-dose group. There was no significant difference in renal function and acute rejection between CNI standard-dose and CNI low-dose groups (P > 0.05). The incidence of liver dysfunction and CNI nephrotoxicity was significantly lower in the CNI low-dose group than in the CNI standard-dose group (P < 0.05). In addition, a low-dose CNI regimen helped recipients to lessen the economic burdens. These findings indicate that it is effective, safe and economical to use a low-dose CNI regimen in living-related donor renal transplantation.

Objective To investigate the expression of OPN, α-SMA, E-cadherin and their correlation in the chronic allograft nephropathy (CAN) rat model, and to explore the possible role of OPN in CAN.Methods Orthotopic renal-transplantation using Fisher rats as donors and Lewis rats as recipients was done to establish CAN group, and Lewis to Lewis rats as control group. Rats in each group were sacrificed 12 weeks after the surgery. Blood and urine were collected for further test. Allograft samples were collected and sectioned for HE, Sirus-red staining, immunohistochemistry and Western blot.Results There were CAN morphological changes of the allograft in CAN group. As compared with control group, immunohistochemistry and Western blot revealed that the expression of OPN and α-SMA in CAN group was significantly increased, and that of E-Cadherin reduced. Its trend was correlated with the inflammatory response and the EMT of tubule epithelial cells.Conclusions OPN expression in rat CAN model is significantly up-regulated. OPN may play a role in CAN. OPN might affect the CAN by promoting EMT of tubule epithelial cells.