Objective To analyze the clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in the patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis.Methods From Apr.2013 to Aug.2015,120 feet with severe hallux valgus were treated by operation in Beijing Friendship Hospital,Capital Medical University.Before operation,measured some angles,such as hallux valgus angle,intermetatarsal angle,proximal articular surficial intrinsic angle and so on in the two groups.And evaluated the patients condition by Maryland scale at the same time.Through the date,we make sure that there was no significant difference between the two groups before operation.According to the order of hospitalization,all patients were randomly divided into experimental group (n =60) and control group (n =60).The cases of experimental group were treated by Ludloff osteotomy and artificial joint replacement.The cases of control group were treated by Ludloff osteotomy and Akin osteotomy.We used the visual analogue scale,the core quality of life scale-36 and Maryland scale to record the date,such as pain,the range of motion and appearance of the metatarsophalangeal joint and the ability of daily life and sports before and after operation.Compared above categorical variables using paired T-test between before and after operation and using T-test between the two groups.Compared the rate of operative complications by Fisher's exact test between the two groups.Results Through the Maryland scale,the total excellent rate of the experimental group (91.7％) was higher than the total excellent rate of the control group (75.0％),with statistically significant (P ＜ 0.05).The operative complication rate of experimental group (1.7％) was lower than the control group (8.3％),but without statistically significant (P ＞0.05).The scores of quality of life of the experimental group after treatment were significantly higher than those of the control group,with statistically significant (P ＜ 0.05).The visual analogue scale pain score (1.61 ± 0.12) of the experimental group was significantly lower than the control group (3.68 ± 0.58),with statistically significant (P ＜ 0.05).Conclusion The clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis is better,high safety,less trauma and faster recovery.It is worthy of promotion and use.

0.05, while the differences between 2 groups in cooling effects on the points of cooling 2.5 hours and 4.0 hours were significant, F

Objective To develop the Occupational Embeddedness Scale for Nurses and test its re liability and validity.Methods The original scale was designed according to document analysis,openlabel questionnaire and interview results.After 3 sampling tests,the first predicted sample (n=368) was conducted with item analysis and exploratory factor analysis (EFA),the second predicted sample (n=306) was conducted with EFA,and then the formal tested sample (n=372) was conducted with confirmatory factor analysis (CFA).Another sample of 55 nurses was tested and retested two weeks later.The intestine emendatory Turnover Intention Scale was used to test its criterion validity.Results The final scale had 18 items and 3 dimensions,including fit,link and Sacrifice.Occupational Embeddedness Scale revealed good model fit indices (x2/df =2.563,RMR=0.048,TLI=0.914,CFI=0.925).The total scores was negatively correlated with the Turnover Intention Scale scores.The Cronbach's α coefficients of the whole scale was 0.917,and range 0.800～0.834 for each dimension.The test-retest reliability was 0.890,and ranged 0.732～0.873 for each dimension.Conclusions It suggests that the Occupational Embeddedness Scale for Nursing has good reliability and validity,and can be used to assess the occupational embeddedness status of nursing in China.

Objective To investigate the expression and signification of B-cell lymphoma/leukemia-2(bcl-2),bax and ER proteins in epithelial cells in different depth of adenomyosis.Methods Expression and correlation of bcl-2,bax and ER proteins were detected by immunohistochemistry staining in 36 adenomyosis cases with superficial (＜ 1/2 depth of penetration) and deep (≥ 1/2 depth of penetration)ectopic endometrium and eutopic endometrial tissues matched with 30 cases with benign ovarian tumor,uterine septum,pelvic floor dysfunction without adenomyosis as controls.Results (1) The expression of ER protein in superficial and deep ectopic tissues (5.04 ±0.24,4.91 ±0.16) were found significantly lower than 6.06 ± 0.36 in eutopic tissues (P ＜ 0.01) and higher than 3.70 ± 0.58 in control group (P ＜ 0.05).There was no statistical difference of ER expression in superficial and deep ectopic endometrium (P ＞ 0.05).(2) The level of bcl-2 protein of 5.6 ± 0.4 in superficial and 6.0 ± 0.3 in deep myometrium of ectopic tissues were significantly higher than 3.6 ± 0.4 in eutopic tissues and 1.9 ± 0.4 in control group (P ＜ 0.01).(3) The level of bax protein of 3.50 ± 0.28 in superficial and 4.80 ± 0.29 in deep myometrial ectopic and 4.43 ± 0.37 in eutopic tissues were significantly lower than 6.18 ± 0.65 in control groups (P ＜0.05).The expression of bax in superficial myometrium is significantly lower than deep myometrium in ectopic tissues (P ＜0.01).(4) The positive correlation between the expression of ER and bcl-2 protein at superficial myometrium of ectopic tissues (r =0.720,P ＜ 0.01).And there was no significant correlation with the expression of ER and bax protein at superficial myometrium (r =0.008,P ＞ 0.05).As well as,there was not significant correlation with the expression of bcl-2,bax and ER protein at deep myometrium (r =0.089,r =-0.023,P ＞ 0.05).The expression of bax protein in ectopic endometrium was positive correlation with the depth of adenomyosis penetration (r =0.736,P ＜ 0.01).There was positive correlation between the expression of ER and bcl-2 protein at normal endometrium (r =0.453,P ＜ 0.05).And there was negative correlation between the expression of ER and bax protein at control group (r =-0.514,P =0.05).Conclusion The bax protein expression of ectopic endometrium in deep adenomyosis was higher than superficial adenomyosis.

Calcium Channel Blockers ; pharmacology ; Cell Survival ; drug effects ; Drug Antagonism ; Humans ; Kidney ; cytology ; drug effects ; Lead ; toxicity

Patients in intensive care unit were more critically ill, and often accompanied by dottiness and restless. In order to avoid the adverse events and self-injury, body constraints were often used on the patients. Therefore, this paper would discuss the ethics of body constraints and give the suggestions. According to the literature review and the analysis of the clinical nursing experience of relevant ethical principles, data was collected. The principle of informed consent, respect, and harmless was hard to decide on the issue of body constraints for patients in ICU. Nurses might pay attention to the application of ethical principles, and strengthen the humanistic care. On the issue of body constraints for ICU patients, nurses might pay special attention to the application of possible ethics principles in nursing process and reduce the application of the body constraints, and promote the physical and mental comfort of patients. It reflected the progress of the humanistic solicitude in the current clinical nursing and important value.

AIM:To assess changes of tear film function in patients after pterygium excision combined with amniotic membrane transplantation.
METHODS:Totally 126 patients with pterygium excision with amniotic membrane transplantation from January 2011 to November 2013 were entered in the study. The tear breakup time ( BUT) , the Schirmer I test ( SⅠt) and tear ferning test ( TFT ) were elevated in the patients before and after pterygium excision combined with amniotic membrane transplantation. The examnation times were 1d before surgey, 1wk, 1, 2mo after surgery. Operation eyes were studied group, while opposite healthy eyes as control group.
RESULTS: Compared with the control group, BUT and TFT were significantly different in the eyes with pterygium (P<0. 05); However, no obvious difference was detected in the results of SⅠt (P>0. 05). The results of BUT and TFT at 1mo after surgery in study group were significantly better than 1wk (P<0. 05), while no significant difference compared with 2mo (P>0. 05); The tear film stability in the study group at 1wk after surgery was still inferior to the control group (P<0. 05) and there was no significant difference at 1, 2mo after surgery (P all>0. 05). SⅠt results did not differ between the different examination times(P>0. 05).
CONCLUSION:Tear film stability was broken in the eyes with pterygium. Pterygium excision combined with amniotic membrane transplantation can obviously restore the tear film function into normal state, and the tear film function could reach steady-state 1mo after surgery.

AIM: To determine the association between subfoveal choroidal thickness before therapy and therapeutic activity in diabetic macular edema.
METHODS: The current study was a retrospective study, which included 32 patients ( 32 eyes ) diagnosed with diabetic retinopathy and macular edema. All the patients were firstly treated with intravitreal injections of ranibizumab. Main outcome measures were included the subfoveal choroidal thickness, central macular thickness and best-corrected visual acuity ( BCVA) at preoperation and postoperative visit at 3mo.
RESULTS: After 3 monthly intravitreal injections of ranibizumab, the BCVA was significantly higher than that before therapy and accompanied with significantly reduced thickness of subfoveal choroid and central fovea of macula. Spearman analysis was revealed that a greater baseline subfoveal choroidal thickness was associated with a better BCVA (rs=0. 544, P=0. 036).
CONCLUSION:In the therapy of intravitreal injections of ranibizumab on diabetic macular edema, there seems to be a better BCVA in the patients with a greater baseline subfoveal choroidal thickness. Therefore, baseline subfoveal choroidal thickness may be a useful predictor for the therapy of diabetic macular edema.

Objective To determine the allelic frequency distribution and genetic parameters of nine non-CODIS DNA index systems of the short tandemrepeat (STR ) loci (D2S1772, D6S1043, D7S3048, D8S1132, D11S2368, D12S391, D13S325, D18S1364, and GATA198B05). Methods A total of 353 blood samples were collected, extracted, amplified, and analyzed fromunrelated healthy individuals of Han na-tionality in Hunan Province, China. Results O ne hundred and fourteen alleles were observed in the pop-ulation with corresponding allelic frequencies ranged from0.001 0 to 0.323 0. For all the nine non-CODIS STR loci, the observed genotypic data showed no significant deviations fromthe Hardy-W einberg equi-librium. The Ho, He, PIC, D P, and PE of the studied non-CODIS STR loci ranged from0.108 0 to 0.195 0, 0.805 0 to 0.892 0, 0.770 0 to 0.860 0, 0.925 0 to 0.966 0 and 0.607 0 to 0.780 0, respectively. Conclusion N ine non-CODIS STR loci have high degrees of polymorphisms, which may be useful in in-dividual forensic identification and parentage testing in forensic practice.