Objective To investigate the occupational burnout status of rehabilitation therapists in medical institutions and analyze relat-ed factors. Methods From December, 2015 to February, 2016, a total of 264 rehabilitation therapists, selected with random cluster sampling method, were investigated with Maslach Burnout Inventory-General Survey (MBI-GS) in Bengbu, China. Results The detection rate of ther-apist burnout was 81.1%, and the average score was (3.13±1.07). There were significant differences in the score of occupational burnout and its three dimensions (P<0.05), except emotional exhaustion dimension among different ages (P>0.05). Multiple regression analysis showed that the gender, age, marital status, educational background, professional title, shift work, job demand, job autonomy, social support, de-mand-autonomy ratio and income levels were the factors related with occupational burnout. Conclusion Rehabilitation therapists generally feel occupational burnout. It is different with demographic characteristics and working conditions.

Objective To investigate the current situation and influencing factors of professional competence of master of nursing (MN)students. Methods 317 MN students were engaged in the investigation using self-designed questionnaire. Results The total score of MN student's professional competence was 72.56 ± 10.51. The time for nursing service before MN study, time for nursing internship during MN study and frequency of instructor's guidance were the main influencing factors ofprofessional competence (P<0.01). Conclusion MN student's professional competence is relatively good. Nursing educators should develop more detailed clinical study plan for those lack of clinical experience, strengthen advanced nursing practice theory study, and provide more opportunities for professional practice, make good conditions for their clinical practice and pay attention to the practical effect of specialized nursing.At the same time,the instructors of MN students should give more guidance to ensure the cultivation quality.

Objective To observe the effect of treating Diabetic Peripheral Neuropathy with Acupoint Injection. Methods 65 patient with DPN were randomly recruited into a control group and a treatment group after adjusting stage. The control group was treated with acupuncture, while the treatment group was treated with the Safflower inoculation fluid acupuncture point injects. Nerve function parameter (MDNS、 NCV) and clinical symptoms were observed after 3 therapeutic courses. Results Nerve function parameter (MDNS、 NCV) and clinical symptoms in the treatment group were apparently improved after treatment (P<0.05) . Conclusion Acupuncture point injected with Safflower inoculation fluid may improve clinical symptoms and nerve functions of DPN patients.

Objective To explore the mutation of Y-STR loci in meiotic allelic transmission in a large pedigree. Methods The oral swabs of 163 male individuals were collected froma L in pedigree. Twenty-two Y-STR genetic markers were typed with AGCUY 24 fluorescent detection kit (AGCUY 24 sys-tem), which also contained 16 Y-STR markers included in Y filerTmmultiple amplification kit (Y filer system). The genotyping results of Y-STR loci were compared between each two males in the pedigree. Results There were 20 and 30 kinds of haplotypes obtained with Y filer and AGCUY 24 systems in 163 male individuals fromthe L in pedigree, respectively. The rates referred to haplotype differences (RRHD) of these two typing systems between male pairs were 0.910 5 and 0.922 7, respectively. The average number of marker differences were 6.582 1 and 9.824 8, respectively. The RRHDincreased along with the incidents of meiosis. Conclusion Y-STR mutation leads to different Y-STR haplotypes among the male members in a paternal pedigree and the rate of difference increases along with the incidents of meiosis.

Objective:To investigate the feasibility of dynamic turbidity method for the detection of bacterial endotoxin content in influenza split vaccine. Methods: According to the bacterial endotoxin detection method described in general rule 1143 in Chinese Pharmacopoeia (2015 edition), the reliability test for standard curves of influenza split vaccine, the interference initial screening test, the interference verification test and the endotoxin content were performed or determined, and the results were compared with those by the gel method for the same batches of vaccine. Results:The results of reliability test for standard curves were accordance with the reg-ulations. In the interference initial screening test, vaccine was diluted by 160 times, 320 times and 640 times, and the recovery was between 50% and 200%, which showed no interference. The results of the interference verification test further proved that vaccine with 640 times dilution had no interference effect on test. The bacterial endotoxin contents of 10 batches of influenza split vaccine deter-mined by the turbidity method were less than the limit value of 20 EU·ml-1 , and the results were the same as those determined by the gel method. Conclusion:It is feasible to detect the content of bacterial endotoxin in influenza split vaccine by the dynamic turbidity method, which is worthy of promoted application.

Objective: To review the application of polymeric micelles as the vehicles in transdermal delivery systems.Methods: Based on the recently published papers, the researches of preparation, penetration mechanism, drug release and application of polymeric micelles in transdermal delivery systems were classified and summarized.Results: Polymeric micelles were extensively applied as drug vehicles due to the ability of solubilization and transdermal absorption enhancement.Conclusion: Polymeric micelles can be used as promising vehicles in transdermal delivery systems, which show a good application prospect.

AIM: To explore the effect of lienal polypeptide injection (LPI) on platelet production in ITP model mice with primary immune thrombocytopenia. METHODS: SPF Kunming mice were divided into groups by random number table method, and the ITP model of mice was induced by intraperitoneally injected of rabbit anti-mouse platelet serum APS every other day. At the set time, blood was collected through caudal vein to detect the changes in the number of platelets, red blood cells and white blood cells in each group. Meanwhile, the thymus and spleen indexes were calculated. Megakaryocytes were classified and counted by means of bone marrow smear. Finally, the expression levels of TPO, SCF, IL-3, IL-6, IL-11, β-TG, TGF-β1 and PF-4 in serum were detected by ELISA. RESULTS: LPI significantly increased platelets count in ITP model mice, but had no effect on red blood cells and white blood cells. Thymus and spleen index decreased significantly. The number of megakaryoblasts and thrombocytopenia megakaryocytes in the bone marrow of mice increased, but the number of promegakaryocytes, granular megakaryocytes and naked megakaryocyte did not change significantly. Serum sytokines SCF, IL-3 and IL-6 were significantly increased, while PF-4 was decreased significantly. CONCLUSION: LPI may increase the platelet count in ITP mice by up regulating the levels of IL-3, IL-6, SCF and down regulating the level of PF-4, which has guiding significance for clinical promotion application of LPI.

Objective: To evaluate the clinical value and outcomes of technical improvement of hybrid operatical clipping for large paraclinoid internal carotid artery aneurysms. Methods: A review was conducted on 18 cases of large paraclinoid internal carotid artery aneurysm which were clipped by balloon non-fluoroscopic occlusion of the parent artery via a micro-bone window frontolateral approach in hybrid operating room at Neurosurgery Department of Tianjin Medical University General Hospital from June 2014 to December 2017. There were 8 males and 10 females with age of (63±4) years. There were 6 cases of unruptured aneurysm and 12 cases of ruptured aneurysm of subarachnoid hemorrhage (6 cases of grade Ⅱ, 4 cases of grade Ⅲ and 2 cases of grade Ⅳ in Hunt-Hess classification). Frontolateral approach incision (average length of about 5 cm) and bone window about 3 cm×3 cm were performed. No incision of the neck was needed to expose the internal carotid artery for temporary occlusion. In the operation, the balloon was slowly pushed to the preset position of the internal carotid artery under non-fluoroscopy. The balloon was expanded to block the blood flow of internal carotid artery. Then aneurysm was clipped. The balloon was loosened and retraced to the guiding catheter after clipping. The clipping condition was examined by cerebral angiography. If there was residual aneurysm neck or stenosis of the parent artery, the balloon was pushed under non-fluoroscopy again to temporary occlusion and the clip was adjusted until the aneurysm neck was clamped satisfactorily. Results: Eighteen aneurysms were successfully clipped in hybrid operating room. Fourteen aneurysms showed complete occlusion of the aneurysm neck and no stenosis of the parent artery. Four cases showed residual aneurysm neck after clipping by intraoperative angiography, then aneurysms were clipped satisfy by adjusting the aneurysm clip. The patients were followed up for 3 months to 1 year. Ten patients recovered well (modifed Rankin score (mRS): 0), and 3 patients had no obvious disability (mRS: 1). Two patients with Hunt-Hess grade Ⅲ were slightly disabled (mRS: 2). 1 patients with Hunt-Hess grade Ⅲ were moderately disabled (mRS: 3). 1 patients with Hunt-Hess grade Ⅳ were severely disabled (mRS: 4). One elderly patients with Hunt-Hess grade Ⅳ were seriously disabled (mRS: 5). Conclusions Application of balloon non-fluoroscopic occlusion clipping for large paraclinoid internal carotid artery aneurysm via a micro-bone window frontolateral approach is safe, effective and minimally invasive.

Purpose: This study aimed to investigate the clinicopathologic features and mutational landscape of patients with hepatitis B virus (HBV)–related advanced hepatocellular carcinomas (HCC) undergoing transcatheter arterial chemoembolization (TACE). Materials and Methods: From January 2017 to December 2018, 38 patients newly diagnosed with HBV-related advanced HCC were enrolled in the final analysis. Their pathological tissues and corresponding blood samples before TACE treatment were collected for whole-exome sequencing. Response to TACE was evaluated at 1-3 months after two consecutive use of TACE. Predictive factors were analyzed by univariate and multivariate analyses in a bivariate Logistic regression model. Enrichment of related pathways of all driver genes were acquired using the gene set enrichment analysis (GSEA). Results: Among 38 patients, 23 (60.5%) exhibited TACE failure/refractoriness. Patients with TACE failure/refractoriness showed higher frequency of TP53 mutation than their counterparts (p=0.020). Univariate and multivariate analyses showed that only vascular invasion and TP53 mutation were significantly correlated with TACE failure/refractoriness in HBV-related advanced HCC. Of the 16 patients without vascular invasion, eight (50.0%) had TP53 mutations, and TP53 mutation was associated with TACE failure/refractoriness (p=0.041). Moreover, GSEA showed that mitogen-activated protein kinase and apoptosis pathways induced by TP53 mutation were possibly associated with TACE failure/refractoriness. Conclusion Our study suggested that TP53 mutation was independently related with TACE efficacy, which may work via mitogen-activated protein kinase and apoptosis pathways. These findings may provide evidence to help distinguish patients who will particularly benefit from TACE from those who require more personalized therapeutic regimens and rigorous surveillance in HBV-related advanced HCC.

Objective:To investigate the plasma differential protein expressions between patients with Alzheimer's disease (AD) and normal controls, and to search plasma protein markers or protein combinations with screening or diagnostic significance.Methods:Plasma samples from 98 patients with dementia of Alzheimer type (DAT), 102 patients with mild cognitive impairment (MCI) and 101 normal controls (NC) were collected from Wuxi Mental Health Center and Shanghai Mental Health Center from 2016 to 2018.The expression levels of 50 kinds of plasma proteins in all plasma samples were detected by Milliplex MAP assays(xMAP).Analysis of variance, regression analysis, discriminant analysis, and ROC analysis on the data were performed using SPSS 20.0 software.Results:(1)Compared with the NC group, 26 plasma proteins were up-regulated and 4 proteins were down-regulated in DAT group, while 6 proteins were up-regulated and 4 proteins were down-regulated in MCI group(all P<0.05).Compared with the NC group, 6 proteins were upregulated in both MIC group and DAT group, which were clusterin(Clust) (613.41(278.89), 761.76(358.60), 473.01(321.73)), cystatin C(Cys C) (691.88(441.34), 852.28(551.75), 548.64(545.28)), transthyretin(TTR) (207.10(168.60), 220.95(151.20), 152.89(162.70)), complement factor H(Com FH) (331.67(218.37), 361.69(124.64), 225.79(236.82)), soluble intercellular adhesion molecule-1(sICAM1) (109.30(49.47), 137.21(50.36), 87.06(57.59), and apolipoprotein E(APOE) (79.33(78.13), 79.31(68.85), 54.88(67.34)).The serum amyloid P component(SAP) was downregulated in both DAT and MCI groups(121.23(311.31), 92.39(156.62), 125.00(242.82)) compared with NC group.(2)Three sets of protein combination were screened by differential analysis, regression analysis, and discriminant analysis, including 8 proteins, 9 proteins and 7 proteins, respectively.And SAP, angiotensin (AGT), osteopontin (OPN), and complement C4 (Com C4) were the compared with NC group most frequently selected protein.The screening correct rate of three protein combinations were respectively 67.4%-71.4% for AD, 82.4%-88.4% for DAT, and 60.6%-63.5% for MCI. Conclusions:A variety of plasma proteins such as Clust, Cys C, TTR, Com FH, sICAM1, APOE are upregulated, while SAP is downregulated in AD patients.These differential protein combinations can help with early diagnosis of dementia with Alzheimer type.SAP, AGT, OPN and Com C4 may be potential markers for early screening or diagnosis of AD.