Objective To understand head nurse's leadership behavior and analyze the influence of it on nurse's involvement and self-efficacy.Methods General information questionnaire was taken,and the data of 280 nurses to head nurse's leadership behavior,involvement and self-efficacy were investigated.Results There were differences in nurse's involvement and self-efficacy between head nurse's transformation and transaction leadership behavior (F=4.39,2.37,2.94,2.17,P ＜0.05).The transformation leadership behavior dimensions were positive correlation with nurse's involvement and self-efficacy,P＜0.05.Conclusion Head nurse should fully play a positive role of transformation leadership behavior,in order to promote involvement and improve self-efficacy.

90%) was a forepart change of gemcitabine-induced lung injury in the first month in G group, but the exudation, proliferation and fibrosis dominated in the 1,3 and 6 months in R+CG group. Hydroxyproline content of lung-irridiated tissue was increased from the 5th month and lasted to months 6,7 and 8, and its content in the R+CG group was higher than that in the other groups(P

Objective To investigate psychological health status and its change in short term among persons bit by dogs.Methods Psychological health status was evaluated with patient health questionnaire (PHQ-15) Chinese version for the 613 wounded persons bit by dogs,including 368 males and 245 females with average age of 36 years plus or minus 14 years (standard deviation),meanwhile their wounds were handled routinely at clinics,as well as health education and cognitive psychological intervention were provided for them.Results All of the 613 persons with dog bites had mild or moderate somatic syndrome in their initial visits and 478 of them (78.0%) still presented mild somatic syndrome and only 23 (3.7%)with moderate symptoms four week after dog bites by PHQ-15 scores.One hundred and fifty-two of 613 (24.8%) followed-up at their initial visits had depressive symptoms,which could remain in 61 of them (10.0%) four weeks after bites.Two hundred and eighty-four of them (46.3%) had anxiety symptoms at initial visits,and 258 (42.1%) still had mild and nine (1.5%) had moderate symptoms four weeks after bites.Conclusions Psychological symptoms were popular in wounded persons by dog bites,which can persist for a certain time.PHQ-15 can be used for evaluating their psychological status.

Objective To study the microscopic changes of white matter and the relationship between white matter changes and cognitive impairment in Alzheimer's disease (AD) using voxel-based analysis of DTI. Methods Thirty-sev?en patients with probable AD,and 32 normal controls(NC) were all examined by MMSE scores, and underwent a diffusion tensor imaging. The value of FA changes and the correlations between FA and MMSE scores were investigated. Results FA reduction was detected in the right frontal, temporal and parietal lobes as well as the thalamus, the bilateral cingu?lum, corpus callosum, precuneus, inferior parietal lobule, inferior patieto gyrus, supramaginal gyrus and hippocampus in AD. FA values in the right cingulum, left corpus callosum, left inferior temporal gyrus and the bilateral inferior parietal lobule, inferior patieto gyrus and precuneus were significantly decreased in AD than in the health control groups (P<0.05, FWE corrected). There was a positive correlation between the values of FA and MMSE scores(P<0.001,uncorrect?ed). Conclusion AD patients have significant reduction of FA values in the specific regions. There is a positive correla?tion between white matter changes and impairments of cognitive function.

Objective To observe the cognitive function and its related factors in patients with essential epilepsy.Methods The cognitive function of 70 essential epilepsy patients (epilepsy group) and 40 healthy controls(control group) were evaluated by means of Wechsler Intelligence Scale for Adult-Chinese (WAIS-RC).The relation between the cognitive dysfunction and its related factors were analyzed.Results The scores of performance intelligence quotient,verbal intelligence quotient,full intelligence quotient in epilepsy group were significantly lower than those in control group [(98.06 ± 15.24) scores vs.(113.80 ± 12.14) scores,(98.09 ± 16.06) scores vs.(120.65 ± 11.28) scores,(98.06 ± 15.80) scores vs.(119.42 ± 11.85) scores] (P ＜ 0.01).The scores of 11 numbers of rating scales were significantly lower than those in control group (P ＜ 0.01).The factors related to the cognitive function were education level,age numbers,duration of the disease,frequency of seizures attack before medication,the duration of seizures and the quantity of antiepileptics.Conclusions Many of the essential epilepsy patients have cognitive function deficit.The cognitive condition of essential epilepsy patients should be pay more attention and reduce the dangerous factors in order to improve the life quality.

OBJECTIVE: The prior functional MRI studies have demonstrated significantly abnormal activity in the bilateral superior temporal gyrus (STG) of anxiety patients. The purpose of the current investigation was to determine whether the abnormal activity in these regions was related to a loss of functional connectivity between these regions. MATERIALS AND METHODS: Ten healthy controls and 10 anxiety patients underwent noninvasive fMRI while actively listening to emotionally neutral words alternated by silence (Task 1) or threat-related words (Task 2). The participants were instructed to silently make a judgment of each word's valence (i.e., unpleasant, pleasant, or neutral). A coherence analysis was applied to the functional MRI data to examine the functional connectivity between the left and the right STG, which was selected as the primary region of interest on the basis of our prior results. RESULTS: The data demonstrated that the anxiety patients exhibited significantly increased activation in the bilateral STG than the normal controls. The functional connectivity analysis indicated that the patient group showed significantly decreased degree of connectivity between the bilateral STG during processing Task 2 compared to Task 1 (t = 2.588, p = 0.029). In addition, a significantly decreased connectivity was also observed in the patient group compared to the control group during processing Task 2 (t = 2.810, p = 0.012). CONCLUSION: Anxiety patients may exhibit increased activity of the STG but decreased functional connectivity between the left and right STG, which may reflect the underlying neural abnormality of anxiety disorder, and this will provide new insights into this disease.
Adult ; Anxiety Disorders/pathology/*physiopathology ; Case-Control Studies ; Emotions/physiology ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Temporal Lobe/pathology/*physiopathology

To provide the anatomical information for auricle replantation. Methods From March, 2016 to March, 2019, a total of 25 fresh adult cadaveric head were used, 20 of these specimens were perfused with plastic and eroded to be vascular cast mold, 5 specimens perfused with red latex for anatomy, then observed the origin, course, diameter and arteries anastomose between branches of the posterior auricular artery (PAA) and superfi-cial temporal artery (STA). Results The main blood supply to the auricle were auricle branches of PAA and STA. The auricle branches of PAA and STA both divided into superior, intermedius and inferior branches, and distributed in the auricle posterior surface and anterior surface, respectively.The auricle branches of PAA running across ear car-tilage, distributed in the anterior surface, and anastomosed with auricle branches of STA. The diameters of these branches at the initiating portion were 0.2-0.8 mm. Eighty percent of blood supply to earlobe was from the inferior branches of PAA, and 20% from the STA. Conclusion The auricle branches of PAA played an important role to the auricle replantation.The auricle branches of PAA should be the firstly selected vessle in operation, and the auricle branches of STA be the second choice.

Although surgery,radiotherapy and chemotherapy have made great progress,pancreatic cancer is still the most fatal malignant tumor,with a 5-year overall survival rate of only about 4% . Many studies have demonstrated that the local recurrence of pancreatic cancer is an important cause of high mortality,and the failure rate after local excision is still as high as 50~80% . There-fore,how to improve the local control rate of pancreatic cancer has been a hot spot of concern. Due to the adjacent organs and tissues (such as bone marrow,spinal cord,kidney,liver,intestine,etc. ),the dose of external irradiation(EBRT) is limited. Increasing local control rates and reducing treatment side effects are trends in future treatments. Intraoperative radiotherapy has the advantages of do-simetry and direct vision treatment to be increasingly used in the treatment of pancreatic cancer,becoming an important part of com-prehensive treatment. This article summarizes the clinical research results of intraoperative radiotherapy for pancreatic cancer in recent years,in order to provide the reference for clinicians.

Objective To explore the effect of virtual reality video games on gross motor skills of children with cerebral palsy.Methods The 56 patients with cerebral palsy treated in the Fifth Affiliated Hospital of Zhengzhou University from April 2015 to April 2017 were selected as the subjects.The age of the patients was (5.4 ± 1.2) years old (5-7 years old).According to the results of Gross Motor Function Classification System (GMFCS) assessment,all patients belonged to level Ⅰ-Ⅱ.All patients were randomly divided-into 2 groups:video-game group and conventional exercise group for 6 weeks of functional exercise.The evaluation criteria included the average exercise time,the 6-minute walk test (6MWT) and general motion function challenge module (GMFMS-CM) measurement and evaluation.Results The average exercise time of video games in video game group was (44.2 ± 6.1) minutes.The encouragement from the therapists in the intervention process was very important.The technical problems also had a relatively high proportion,and the technical guidance and training should be emphasized at the beginning of the study.The average score of the Likert scale showed that the practice program was suitable for the patients;GMFMS-CM in video game group was significantly higher [mean difference was 4.8,the quartile (IQP) was 4.68,Z =-2.025,P =0.035],while conventional exercise group showed an increasing trend which was not significantly different;6MWTshowed a significant increase in the mean level of video-game group (mean difference was 69.1 m,IQR was 40.2 m,Z =-2.108,P =0.045),conventional exercise group was significantly lower than the average level of subjects in video-game group and there was no significant change in the study period.Conclusion For children with cerebral palsy,routine functional rehabilitation exercise plus family-style virtual reality video game practice,on the one hand to improve patient compliance with the treatment,on the other hand can significantly improve their physical movement function,which is conducive for the patients' quality of life and self-care ability.

Objective To investigate the relationship between frailty and serum biomarkers in the elderly. Methods A total of 371 elderly individuals aged 60 years and above with complete medical data were recruited during health examinations. Frailty phenotype assessment and comprehensive geriatric assessment were conducted.Serum levels of interleukin-6 (IL-6 ) ,high sensitivity C-reactive protein(hs-CRP) ,tumor necrosis factor-α(TNF-α) ,homocysteine(Hcy) ,insulin-like growth factor-1(IGF-1) ,25-hydroxyvitamin D[25(OH)D] ,folic acid and vitamin B12(VitB12) were detected by enzyme-linked immunosorbent assays ( ELISA ) and chemiluminescence immunoassays. Associations between frailty and the above factors were analyzed. Results Serum levels of IL-6 ,TNF-α ,Hcy and IGF-1 were significantly elevated along with progressive increase in frailty severity(all P＜0.05).There were a downward trend in serum 25(OH)D levels and an upward trend in serum hs-CRP ,folic acid and VitB12 levels as frailty severity increased ,but the changes did not amount to any statistical significance(all P＞0.05).Logistic regression analysis showed that ,after adjusting for age ,gender ,body mass index (BMI)and some clinical aspects (hearing loss ,urinary incontinence ,pain ,malnutrition ,cognitive dysfunction ,decreased activities of daily living ,depression , insomnia ,and anemia) ,serum levels of IL-6(OR=1.012 ,95% CI=1.005-2.041 ,P=0.033) ,IGF-1 (OR= 1.017 ,95% CI = 1.011-1.118 ,P= 0.021)and Hcy (OR= 1.007 ,95% CI :1.002-1.073 ,P=0.047)were significantly associated with frailty status. Conclusions Serum levels of IL-6 ,Hcy and IGF-1 are related to frailty status and may be used as potential biomarkers for the assessment of frailty in older adults.