Objective To explore the influence of organizational climate and job burnout on turnover tendency among contract nurses, and establish a model of this influence. Methods Totally 450 nurses were selected and investigated with Organizational Climate Questionnaire(OCQ), Maslach job burnout inventory(MBI) and Turnover Intention Scale(TIS). Results The total score of OCQ was 2.71 ± 0.58, the emotional exhaustion was 25.99 ± 13.89, the depersonalization was 10.21 ± 5.37,the personal accomplishment was 21.92 ± 9.27, and the score of TIS was 2.66 ± 0.94. Emotional exhaustion and depersonalization were significantly and negatively correlated to OCQ(r=-0.26,-0.22 ,P<0.01),and positively correlated to TIS(r=0.27,0.25,P<0.01). The personal accomplishment was positively correlated to OCQ(r=0.26,P<0.01), and negatively correlated to TIS(r=- 0.26,P<0.01).OCQ was negatively correlated to TIS(r=-0.37,P<0.01).Multiple linear regression analysis showed that OCQ and personal accomplishment could negatively predict nurses′ turnover tendency(β=-0.43,-0.14,P<0.01), and emotional exhaustion could negatively predict nurses′ turnover tendency(β=-0.10,P<0.01). The path analysis showed organizational climate negatively influenced nurses′ turnover tendency via job burnout, and the value of mediating effect was 23.8%(-0.10/-0.42). Conclusions Turnover tendency is significantly correlated with organizational climate and job burnout among contract nurses. The relationship between organizational climate and nurses′ turnover tendency among contract nurses is mediated in part by job burnout.

For the preparation of implementing IEC 60601-1 Ed. 3.1 in advance, this paper analyzes the main difference between IEC 60601-1 Ed. 3.1 and GB 9706.1-2007, and discusses the possible influence to medical device designing and testing.
Equipment Design ; standards ; Equipment and Supplies ; standards

OBJECTIVETo compare clinical outcomes of bilateral transpedicular balloon kyphoplasty for the treatment of ordinary osteoporotic vertebral compressive fracture (OVCF) and severe osteoporotic vertebral compressive fracture.

METHODSFrom Junary 2009 to Febuary 2011, 60 patients (70 vertebrae) with osteoporotic vertebral compressive fracture were included. All patients were treated by bilateral transpedicular balloon kyphoplasty combined with postural reduction, including 10 males and 50 females aged from 59 to 90 years old with an average of 72.1 years old. In ordinary osteoporotic vertebral compressive fracture group, there were 38 patients (44 vertebrae) including 7 males and 31 females aged from 59 to 87 years old with an average of (71.8±6.1) years old. There were 6 patients with two vertebral fractures, 1 vertebra in T9, 5 vertebrae in T10, 7 vertebrae in T11, 13 vertebrae in T12, 9 vertebrae in L1, 4 vertebrae in L2, 4 vertebrae in L3, 1 vertebra in L4. While in severe osteoporotic vertebral compressive fracture group, there were 22 patients (26 vertebrae) including 3 males and 19 females aged from 63 to 90 years old with an average of (72.6±7.2) years old. There were 4 patients with two vertebral fractures, 1 vertebra in T9, 2 vertebrae in T10, 3 vertebrae in T11, 9 vertebrae in T12, 6 vertebrae in L1, 3 vertebrae in L2, 2 vertebrae in L3. Operative time, volume of bone cement injection, and vertebral height and changes of Cobb angle before and after operation were observed and compared. Postoperative average recovery rate of vertebral height and correct degree of Cobb angle were caculated and compared, VAS scoring were used to evaluate therapeutic effect.

RESULTSAll operations were completed sucessfully, and pain were relieved at 72 h after operation. All patients were followed up from 6 to 13 months with an average of 10.1 months. Postoperative vertebral height, Cobb angle and VAS score were improved better than that of before operation (P<0.05). Operative time in ordinary group was shorter than severe group, while volume of bone cement injection was more than that of severe group. Average recovery rate of vertebral height and correct degree of Cobb angle in ordinarty group was better than that of in severe group (P<0.05). There was no significant differences between two groups in VAS scores before and after operation (P> 0.05). Three cases (3 vertebrae) ocurred bone cement leakage in ordinarty group, while 5 cases (5 vertebrae) ocurred bone cement leakage in severe group, and there was no meaning between two groups (P>0.05).

CONCLUSIONKyphoplasty could receive satisfied curative effect in treating ordinary and servere patients with osteoporotic vertebral compressive fracture, but recovery of vertebral height and correct degree of Cobb angle in ordinary gourp was better than that of in servere group.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Spinal Fractures ; surgery

Micro-implant anchorage was used for orthodontic intervention of 3 patients with buccal impacted maxillary canine,good clinical outcome was obtained.The micro-implant anchorage may provided a new approach for the treatment of this kind of teeth.

Objective To explore the clinical features and diagnosis of primary immunodeifciency disease caused byTyk2 gene mutations.Methods Clinical data from the ifrst case in China diagnosed of primary immunodeifciency disease caused by Tyk2 gene mutation were retrospectively analyzed, and related literature was reviewed.Results One year and 3 month old boy suffered with repeated pulmonary infection, chronic otitis media, intractable eczema like rash, repeated skin abscess, HSV infection, intracellular bacterial infection, and remarkedly increased total IgE. It was detected that compound heterozygous mutations of c.2269C>G in No. 16 exon and c.149delC in No. 3 exon inTyk2 gene. Literature searching found other 8 cases (5 males and 3 females) of immune deifciency patients caused byTyk2 gene defects, all of which hadTyk2 gene homozygous mutations and presented with repeated infection of paranasal sinus and lung. In the 8 cases 6 cases were combined with mycobacterium tuverculosis infection, 4 cases had repeated virus infection, 4 cases had meningonecephalitis, 3 cases had intractable eczema like rash, 2 cases had salmonella enteritis, 1 case had remarkedly increased total IgE, one case had elevated eosinophils, 5 cases were born in intermarriage family and 1 case died of meningitis caused by unknown etiology.Conclusions When patients have repeated paranasal sinus infection and lung infection, combined with intracellular bacterial infection (including mycobacterium tuberculosis infection), and repeated virus infection or intractable eczema like rash, with or without increased total IgE, immunodeifciency disease caused by Tyk2 gene defection should be considered. Gene sequence analysis can assist in early diagnosis.

OBJECTIVETo evaluate a expanded reverse island flap with a saphenous neuro-vascular pedicle for repairing the defects of the feet and ankles.

METHODSAn expanded reverse island skin flap, with the Six saphenous neuro-vascular pedicle, was designed to repair the skin defects on the feet and ankles.

RESULTSpatients with the defects of the feet and ankles were treated with the expanded saphenous island flap and all of the The expanded reversed island skin flaps were survived. The largest flap size was 12 cm x 10 cm.

CONCLUSIONSflap could be a good option for repairing the defects of the feet and ankles.

Adolescent ; Adult ; Ankle Injuries ; surgery ; Child ; Female ; Femoral Nerve ; surgery ; Graft Survival ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation ; Young Adult

Deafness ; diagnosis ; genetics ; Genetic Counseling ; Humans

Adult ; Chemical and Drug Induced Liver Injury ; Chronic Disease ; Critical Illness ; Dimethylformamide ; poisoning ; Humans ; Male ; Middle Aged ; Occupational Diseases ; chemically induced ; Occupational Exposure

Chronic Disease ; Graft Rejection ; therapy ; Humans ; Integrative Medicine ; Kidney Diseases ; etiology ; therapy ; Kidney Transplantation ; adverse effects

Objective To investigate the distribution pattern of the ADAS-Cog scores among the elderly in Beijing and to evaluate the application of ADAS-Cog in distinguishing patients with mild Alzheimer's disease (AD) and healthy elderly. Methods In total, 1616 healthy elderly (NC), 125 elderly patients with non-AD disorders (ND), and 310 patients with probable AD including 201 patients with mild AD and 109 patients with moderate AD (by NINCDS-ADRDA criteria) were recruited in the study and their cognitive performance was measured by the ADAS-Cog.Results In NC group, those older than 80 years and those with less than 5 years schooling scored highest. There was statistically significant correlation between the total scores of the ADAS-Cog and age and duration of schooling in NC group (F=14.34, 113.27,both P<0.01). No correlation was suggested in the mild AD group. The total score of ADAS-Cog was significantly associated with duration of schooling in both moderate AD and ND groups (F=4.18, 8.72, both P<0.05). The total score of ADAS-Cog differentiated the patients with mild AD from NC healthy elderly with AUC ranging from 0.69 to 0.82 in each subgroup by age, and from 0.75 to 0.88 in subgroups by durations of schooling with the highest AUC of 0.88 in the subgroup having more than 15 years of schooling education. Conclusions The ADAS-Cog score in the healthy elderly is significantly associated with age and duration of schooling education. The ADAS-Cog can be applied in the cognitive assessment of Chinese AD patients. The total score of ADAS-Cog could efficiently differentiate patients with mild AD from healthy elderly, especially in subjects with higher education level.