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.

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

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

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.

BACKGROUND: Despite the fact that traditional Chinese medicine (TCM) has been developed and used to treat acute and urgent illness for many thousands of years. TCM has been widely perceived in western societies that TCM may only be effective to treat chronic diseases. The aim of this article is to provide some scientific evidence regarding the application of TCM in emergency medicine and its future potential. METHODS: Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) were searched using the terms: Traditional Chinese Medicine/ Chinese Medicine, Emergency Medicine, China. In addition, three leading TCM Journals in China were searched via Oriprobe Information Services for relevant articles (published from 1990—2012). Particular attention was paid to those articles that are related to TCM treatments or combined medicine in dealing with intensive and critical care. RESULTS: TCM is a systematic traditional macro medicine. The clinical practice of TCM is guided by the TCM theoretical framework – a methodology founded thousands of years ago. As the methodologies between TCM and Biomedicine are significantly different, it provides an opportunity to combine two medicines, in order to achieve clinical efficacy. Nowadays, combined medicine has become a common clinical model particular in TCM hospitals in China. CONCLUSIONS: It is evident that TCM can provide some assistance in emergency although to combine them in practice is still its infant form and is mainly at TCM hospitals in China. The future effort could be put into TCM research, both in laboratories and clinics, with high quality designs, so that TCM could be better understood and then applied in emergency medicine.

Objective: To learn the epidemiological characteristics of infectious disease related public health emergencies in Zhejiang Province from 2010 to 2018 for the prevention and control. Methods: The surveillance data was extracted from National Public Health Emergency Management Information System. Descriptive epidemiology method was used to analyze main diseases as well as distribution characteristics of time and places. Results: A total of 445 events were reported, which caused 14362 cases and 34 deaths, with a attack rate of 0.69% and mortality rate of 0.24%. There were 298 events with less than 30 cases, accounting for 66.97%. The event classification was dominated by general events ( 242 events, 54.38% ) and ungraded events ( 201 events, 45.17% ). The main diseases were chickenpox ( 134 events, 30.11% ), hand foot mouth disease ( 59 events, 13.26% ) and other infectious diarrhea ( 51 events, 11.46% ). The incidence peaked from April to June ( 129 events, 28.99% ) and from November to December ( 131 events, 29.44% ). Ningbo ranked the top in the number of reported events ( 141 events, 31.69% ). Most events ( 322 events, 72.36% ) occurred in schools. Conclusions The infectious disease related public health emergencies in Zhejiang Province from 2010 to 2018 were mainly caused by chickenpox, hand-foot-mouth disease and other infectious diarrhea. The two peaks of the emergencies occurred from April to June and from November to December. Ningbo was the main area reporting infectious diseases, and schools were the main places.

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

Objective To investigate anterior migration of spinal cord after anterior cervical decompression and reconstruction for cervical spondylosis and its mechanism.Methods Eighty-one patients with cervical spondylosis who underwent anterior decompression and reconstruction were reviewed and evaluated retrospectively.There were 44 males and 37 females,with an average age of 52.3 years (range,37-72 years).The distance from anterior margin of the spinal cord to posterior wall of the spinal canal (Da),and medium of the spinal cord to posterior wall of the spinal canal (Dm) in magnetic resonance imaging were measured preoperatively and postoperatively.The recovery rate was calculated comparing the Japanese Orthopaedic Association (JOA) scores before and after operation.Results The average following up was 20.7 months (9-48 months).According to the measure on MRI,preoperative Da and Dm were 11.11±1.59 mm and 6.30±0.84 mm respectively,which were significant different from postoperative Da 11.63±-1.47 mm and Dm 6.62±0.80 mm.The postoperative Da and Dm at C3-4,C4-5,C5-6,C6-7 levels had statistically significant differences compared to preoperative Da and Dm,except for ones at C2-3 level.The significant migration rate was 43.2％(35/81),which reached △Da ＞2 mm or △Dm ＞1.3 mm.Preoperative cervical curvature index (CCI) was 10.0％±6.3％,which was significant different from postoperative CCI 13.5％±6.5％.JOA score increased from 9.7±1.5 preoperatively to 13.7±1.1 at one week postoperatively,and 13.9±1.3 at 6 months postoperatively.But the JOA score decreased at 6 months postoperatively compared with that at 1 week postoperatively in 15 cases.Among them,14 cases got the standard of spinal cord migration based on MRI measurement.No other severe complications were found in these 81 cases.Conclusion Anterior migration of the spinal cord commonly occurred after cervical decompression and reconstruction via anterior approach,and some patients might suffer from the secondary compression of the cervical spinal cord.

To explore the model of the standardized training for health management talents by referring to the standardized training for resident-doctors.This article analyzed the necessities of the model of the standardized training for health management talents from two aspects.After that,it elaborated on the significance of standardized training.At last,it proposed some ideas about constructing the standardized training for health management talents.