Workers with high quality, high job satisfaction levels and high stability are indispensable to the sustainable development of community health services. The present research aimed to find out about the scope of job satisfaction and stability of community health workers by means of designing relevant questionnaires and sample survey and to identify the major factors affecting the scope of job satisfaction and stability. The research found that among the community health workers, those engaged in preventive healthcare were a group with the lowest job satisfaction level and there were six factors affecting the scope of job satisfaction, including working conditions, the effect of the implementation of rules and regulations, respect from and care by leaders and so on. It also found that 45.1% of the workers once had the thought of leaving their community health centers or stations and there were 5 factors affecting job stability, including environment for medical practice, doctor-patient relationship, scope for bringing one's ability into play and so forth.

Objective To study the feasibility of regional network platform for wound care technical training.Methods Micro-letter pubic number and internet technologies were used to develop a regional network platform of wound care which has one center with multiple branches,training nurses how to take care of wound by the educational column.Results There were 383 nurses had browsed the web site and took part in the learning since regional network platform was working 3 months,931 nurses paid close at-tention to Micro-letter pubic number.Performance examination was improved obviously after training,the percent of pass was 17.8% before training and 80.7% after training,the difference was with statistical significance (χ2=303.629,P<0.01).Conclu-sion The regional network platform of wound care based on micro-letter and internet technologies has a promising application.

AIM: To report the use of modified four ports pars plana vitrectomy in managing a dislocated posterior chamber intraocular lens.METHODS: A young man with bilateral pseudophakia and dislocated PC-IOLs had undergone modified four ports pars plana vitrectomy in relocating a dislocated posterior chamber intraocular lens. This procedure was surgically less tedious and demanding compared with previous methods of IOL retrieval.RESULTS: No significant intra- or post-operative complication was noted. The visual recovery of the operated eye was rapid with the best corrected visual acuity at 14 months post-operation being 0.5. In contrast, the right eye without operation due to patient refusal developed total retinal detachment with hand movement visual acuity.CONCLUSION: Modified four ports pars plana vitrectomy may be a more ophthalmic surgeon friendly alternative in the retrieval of dislocated IOL.

Objective To explore the clinical effect of laparoscopy combined with choledochoscopy on choledocholithiasis.Methods Totally 134 elderly patients with choledocholithiasis were treated in our hospital from Jan 2013 to Dec 2014, who were randomly divided into observation group and control group (n=67 for each), treated with laparoscopy combined with choledochoscopy, and traditional surgery, respectively.The operation time, bleeding volume, exhaust time, in-hospital stay, complications and residual stones rate were compared between the two groups.Results The operation time was higher in observation group than in control group [(124.6±21.2) min vs.(94.7± 17.9) min, t=8.821, P＜0.001].The bleeding volume were less in observation group than in control group[(43.8±10.4) ml vs.(113.5±37.6) ml, t=14.624, P＜0.001].The exhaust time and in hospital time were decreased in observation group than in control group[(27.6 ±5.5) h vs.(43.4±8.1) h, (7.4±2.4) d vs.(10.3±2.8) d, t=13.209 and 6.437, P＜0.001 for both].The incidences of postoperative pain and other complications were lower in observation group than in control group [6.0％ vs.28.4％, 16.4％ vs.43.3％, x2=11.810and 11.547, P=0.001 for all].Conclusions The laparoscopy combined with choledochoscopy has advantages to minimize the surgical injury, reduce the bleeding volume and promote the postoperative recovery in treating choledocholithiasis in elderly patients.

Objective To justify the clinical use of traditional Chinese materia medica (TCMM) in the treatment of influenza.Methods The literature on treatment of influenza published before December 31, 2013 was searched in MEDLINE, EMBASE, CBMdisk, Chinese National Knowledge Infrastructure (CNKI) and Wanfang Database.Results A total of 7 randomized controlled trials were identified and reviewed. Based on the meta-analysis, Yinqiao Powder prescription had similar effect to oseltamivir in defervescence [WMD=5.66, 95%CI (-32.02, 43.35), P=0.77] and viral shed-ding [WMD=-6.21, 95%CI (-84.19, 71.76), P=0.88], and Lianhuaqingwen also had similar effect in viral shed-ding [WMD=-0.24, 95%CI (-4.79, 4.31), P=0.92] but was more effective in defervescence [WMD=-4.65, 95%CI (-8.91, -0.38), P=0.03].Conclusion TCMM has a potential positive effect in the treatment of influenza.

Objective To observe the effect of leptin on glucose oxidation with increased mRNA expression of complete length long intracellular domain of leptin receptor ( OBRb) in primary cultured skeletal muscle cells. Methods Skeletal muscle cells were isolated from SD sucking rat and cultured in four groups (recombinant transfection, empty plasmid transfection, non-transfection and control).The recombinant with complete length OBRb cDNA or the empty plasmid were introduced into skeletal muscle cells by clonfectin when the cultured cells were 70% conlluency, leptin and regular insulin were applied into wells and incubated for 1 h, then D-[ U-I4C]-glucose was added into wells and incubated for 2 h. The radioactivity of collected 14CO2 was assayed by scintillation. Expression level of OBRb mRNA in transfected cells was assayed by RT-PCR. Results The ratios of OBRb intraceUular domain mRNA and p-actin mRNA in cells transfected with recombinant, transiected with empty plasimd, and non-transfected were 1.22?0.10,0.41?0.08 and 0.49?0.09, respectively.The expression of OBRb intraceUular domain mRNA in cells transfected with recombinants was significantly increased as compared to the other groups of cells (P

ObjectiveTo investigate the risk factors of early rebleeding after ruptured intracranial aneurysm embolization surgery.MethodsForty-two patients with early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery(study group) were enrolled,and 40 patients without early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery at the same period was selected randomly as control group.Single factor and multiple factors were analyzed by non-condition Logistic regression model.ResultsThe single factor analysis result showed that age ≥50,history of hypertension,diabetes history,ruptured frequency number ≥2,combined with vasospasm,postoperative anticoagulation therapy,postoperative blood pressure fluctuation ≥ 30 mm Hg (1 mm Hg =0.133 kPa),pseudoaneurysm,fatal embolism and most embolism in study group [81.0％(34/42),76.2％(32/42),66.7％(28/42),76.2％ (32/42),81.0％ (34/42),76.2％ (32/42),66.7％ (28/42),66.7％ (28/42),66.7％ (28/42) ]had statistical differences compared with those in control group [57.5％ (23/40),50.0％ (20/40),37.5％( 15/40 ),50.0％ ( 20/40 ),57.5％ ( 23/40 ),47.5％ ( 19/40 ),37.5％ ( 15/40 ),37.5％ (15/40),37.5％ ( 15/40) ](P ＜0.05).Further multiple factors analysis showed that age ≥50,history of hypertension,ruptured frequency number ≥ 2,combined with vasospasm,postoperative anticoagulation therapy,postoperative blood pressure fluctuation ≥ 30 mm Hg were the independent risk factors of early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery (P ＜0.05).ConclusionsAge ≥50,history of hypertension,ruptured frequency number ≥ 2,combined with vasospasm,postoperative anticoagulation therapy,postoperative blood pressure fluctuation ≥ 30 mm Hg are the independent risk factors of early postoperative rebleeding after ruptured intracranial aneurysm embolization surgery.The necessary interventions to these risk factors have important significance,and can lower the incidence of early postoperative ruptured rebleeding after ruptured intracranial aneurysm embolization surgery and improve the prognosis.

Abdominal Cavity ; blood supply ; Adolescent ; Angioplasty, Balloon ; Child ; Female ; Humans ; Male ; Takayasu Arteritis ; therapy

Objective To evaluate the usefulness of DiversiLab system for genotyping of Acinetobacter baumannii.Methods Fifty-eight non-duplicated clinical Acinetobacter baumannii isolated from 15 cities in China in 2005 were typed by rep-PCR-based DiversiLab system.The results were compared with those of PFGE and multilocus sequence typing. Simpson's index of diversity was used to compare the discriminatory power among DiversiLab system, PFGE and MLST.Results Fifty-eight Acinetobacter baumannii isolates were differentiated into 5 clusters and 25 unique types by DiversiLab system. MLST identified 35 distinct sequence types, which fell into one clone complex of CC22 and 35 singletons, while PFGE resolved 5 pulsotypes and 34 unique types.Simpson's diversity indices for DiversiLab system, MLST and PFGE were O.876, O.944 and 0.961, respectively.Conclusions The discriminatory power of DiversiLab system is lower than that of PFGE and MLST.But as a simple, fast and reproducible typing method, it could be used as a first-line typing tool for the analysis of a large number of isolates.

Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endotoxemia ; blood ; drug therapy ; immunology ; Humans ; Lipopolysaccharide Receptors ; blood ; Lipopolysaccharides ; blood ; Phytotherapy ; Shock, Septic ; blood ; drug therapy ; immunology