Objective:To translate and culturally adjust Decisional Fatigue Scale (DFS) , and test its reliability and validity.Methods:The Chinese version of DFS was formed through the method of double translation, back translation and expert consultation. Using the convenient sampling method, 247 medical staffs from 16 departments in 76 wards of Xiangyang No.1 People's Hospital Affiliated to Hubei University of Medicine were selected as the research objects. Content validity, criterion validity and structure validity were used for validity evaluation, and internal consistency reliability, split half reliability and retest reliability were used for reliability evaluation. A total of 247 questionnaires were sent out in this study and 247 were effectively received, with effective recovery of 100.00%.Results:The total Cronbach's α coefficient of Chinese DFS was 0.933, the half-reliability coefficient was 0.849 and the retest reliability coefficient was 0.838 ( P<0.01) . Both the item content validity index and scale content validity index were 1.00, and the correlation coefficient with the total score of SRF-S was 0.729 ( P<0.01) . One common factor was extracted by exploratory factor analysis and 65.64% of the variation was explained cumulatively, which was consistent with the dimensions of the original scale. Confirmatory factor analysis showed that all fitting indexes were up to standard and the fitting degree was good. Conclusions:The reliability and validity of the Chinese version of DFS in medical staffs is good, which can be used to evaluate the degree of decision-making fatigue of Chinese medical staffs.

Objective:To analyze the incidence and high-risk factors of lymph node metastasis in the retropharyngeal region of hypopharyngeal squamous cell carcinoma based on magnetic resonance imaging (MRI), aiming to guide the delineation of clinical target area.Methods:Clinical data of patients who were pathologically diagnosed with hypopharyngeal carcinoma from January 2012 to September 2018 in our center were retrospectively analyzed. All patients received head and neck MRI before treatment. The diagnosis of lymph node metastasis and the delineation of primary gross target volume (GTV p) and lymph nodes target volume (GTV nd) were determined by all the radiation oncologists in head and neck group through twice weekly general round discussion. The cut-off points of GTV p and GTV nd were defined by establishing the receiver operating characteristic curve. All patients were divided into the high GTV p, low GTV p and high GTV nd and low GTV nd groups. Chi-square test was used for univariate analysis and logistic regression was utilized for multivariate analysis to analyze the high-risk factors of patients with retropharyngeal lymph node metastasis. Results:A total of 326 patients were included in this study, 295 of whom were diagnosed with cervical lymph node metastasis, accounting for 90.5%. The most common involved area was Level Ⅱ a, followed by Level Ⅲ, Level Ⅱ b, Level IV, Level Ⅶ a (retropharyngeal), Level V a, and Level V b. The incidence of retropharyngeal lymph node metastasis was 21.5%, and the incidence was 53.1% in patients with primary tumor located in the posterior pharyngeal wall. Univariate and multivariate analyses showed that patients with tumor originated from the posterior pharyngeal wall ( P=0.002), bilateral cervical lymph node metastasis ( P=0.020), larger GTV p (greater than 47 cm 3, P=0.003), and larger GTV nd (greater than 22 cm 3, P=0.023) were significantly associated with the occurrence of retropharyngeal lymph node metastasis. Conclusions:The incidence of retropharyngeal lymph node metastasis is high in hypopharyngeal carcinoma, especially in patients with primary tumors in the posterior pharyngeal wall, bilateral cervical lymph node metastasis and larger primary burden. Therefore, for patients with these risk factors, it is highly recommended that the clinical target area should be delineated to include the retropharyngeal lymph node drainage area.

Objective:To explore the effects of 75% ethanol pre-degreasing combined with 0.5% iodophor disinfection on the number of colonies in the surgical site of brain tumors and the postoperative healing of surgical incisions.Methods:Totally 142 patients who underwent surgery for brain tumors in the Department of Neurosurgery, Qinhuai Medical Area, General Hospital of Eastern Command Theater from January 2017 to December 2018 were selected by convenient sampling, and divided into the control group and the observation group according to the random number table. Patients in the control group received 0.5% iodophor disinfection conventionally, while the surgical site of patients in the observation group was pre-degreased with 75% ethanol prior to 0.5% iodophor disinfection. The number of skin colonies in the surgical site, the continuous exudation time of the incision and the infection of the incision were compared between the two groups.Results:The number of colonies in the observation group was (3.73±0.62) cfu/cm 2 preoperatively and (3.92±0.47) cfu/cm 2 at the end of the operation, both lower than those of the control group, and the differences were statistically significant ( t=2.684, 5.559; P<0.05) . The time of postoperative incision exudation of the observation group was (2.12±0.95) days, which was lower than that of the control group, and the difference was statistically significant ( t=5.415, P<0.05) ; 2 cases of incision infection occurred in the observation group and 9 cases in the control group, and the difference was statistically significant (χ 2=4.834, P<0.05) . Conclusions:In craniotomy for brain tumors, pre-degreasing with 75% ethanol and disinfecting with 0.5% iodophor can reduce the number of colonies in the surgical site, the duration of wound exudation, and the incidence of incision infection.

Objective: To analyze the clinical features, diagnosis and prognosis of patients with primary lymphoepithelial carcinoma of the parotid gland. Methods: Clinical data of 13 patients diagnosed with lymphoepithelial carcinoma of the parotid gland in our hospital from 2009 to 2017 were retrospectively analyzed. The median follow-up time was 38.5 months. All patients received radiotherapy after operation. Results: Of 13 patients, 9 cases were male and 4 female. The median age was 33 years. At the initial diagnosis, 9 cases had primary lesions limited to the parotid gland, and 4 cases of lymph node metastases located in Ⅰ_b and Ⅱ regions of the neck. According to UICC2010 staging, 1 case was classified as stage Ⅰ, 1 as stage Ⅱ, 6 as stage Ⅲ and 5 as stage Ⅳ, respectively. Eleven surgically pathological specimens were tested with EBER in-situ, and 10 cases were positive for EBER. No patient died in the whole group. The 3-year overall survival rate was 100%. The 3-year progression-free survival rate was 76%. The 3-year local control rate was 92%. The 3-year metastasis-free survival rate was 84%. Conclusions The incidence of lymphoepithelial carcinoma of the parotid gland is relatively low. The pathological features are associated with EB virus. It is prone to present with cervical lymph node metastasis. The possibility of lymph node metastasis of nasopharyngeal carcinoma to the parotid gland should be excluded before treatment. At present, surgery combined with postoperative radiotherapy is the main treatment. The overall survival is favorable. Local recurrence and distant metastasis are the main causes of treatment failure.

Objective? To explore the influence of nurses' self-job competence and coping style on nurses' job burnout, and to provide guidance for nurses' occupational health. Methods? From February to September of 2017, a total of 367 nurses from three hospitals of Huzhou City were recruited in a cross-sectional survey. The Chinese version of the Six Dimension (6-D) Scale of Nursing Performance was used to measure the competency of nurses. The General Coping Style Scale were used to measure the coping style of nurses. Maslash Burnout Inventory-Human Service Survey (MBI-HSS) was used to assess the job burnout of nurses, and analyze the relationship between job competency, coping style and job burnout of nurses. A total of 367 questionnaires were distributed in this study, 301 valid questionnaires were collected, and the effective recovery rate was 92.33%. Results? In general coping style scale, the positive coping score of the 301 nurses was (1.68±0.61) and the negative coping score was (1.93±0.74). The 6-D scale were negatively correlated with emotional exhaustion, depersonalization and positive coping style in MBI-HSS (P＜0.05), positively correlated with personal emotion and positive coping style (P＜ 0.05). The coping style of nurses plays a mediating role in the influence of job competency on job burnout. The path coefficient of job competency on job burnout was 0.62 (P＜0.001). Job competency could explain 57.31% of job burnout variance. The path coefficient of coping style to job burnout was -0.41.The path coefficient of coping style to job burnout was -0.41 (P＜0.001). The path coefficient of job competency to job burnout was -0.51 (P＜ 0.001). Job competency and coping style could explain 21.57% variance of job burnout. The indirect effect of job competency on job burnout through coping style was -0.25(P＜0.001). Conclusions? The coping style makes part of the mediating effect on the relationship between job competence and job burnout. Nursing managers and educators should improve the competency of nurses in various aspects such as job competency training, coping style training, and so on. These may help nurses improve their positive coping style and reduce their professional burnout.

Objective It has been confirmed that Epstein-Barr virus ( EBV) is associated with the occurrence and development of the nasopharyngeal carcinoma ( NPC ) . We investigated the clinical significance of plasma concentrations of EBV-DNA in patients with NPC. Methods Since October,2013 to December,2016,471 patients were analyzed. The significantly associated between EBV-DNA before treatment and staging, tumor burden was analyzed. The survival rate of EBV-DNA before and after treatment was calculated. Results The median copies of pretreatment plasma EBV-DNA in patients is 137 copies,( range 0-494000) ,which is correlated with T stage,N stage,M stage,clinical stage and tumor burden load and that is statistically significant. Overall survival ( OS,P=0. 007) ,progression-free survival ( PFS,P=0. 011) and distant metastasis-free survival ( DMFS,P=0. 003) were significantly lower among patients with pretreatment plasma EBV-DNA more than 1300 copies/ml. Patients with detectable plasma EBV-DNA had significantly worse OS (P=0. 016),PFS (P=0. 000) and DMFS (P=0. 000) than patients with undetectable EBV-DNA after treatment. Cox multivariate analyze suggests that T stage and EBV-DNA after treatment were independent prognostic factors for OS,however the plasma EBV-DNA after treatment ( P=0. 006,0. 001) and N stage ( P=0. 037,0. 017) were independent prognostic factors for PFS and DMFS. Conclusions The plasma EBV-DNA level was significantly correlated with staging and tumor load before treatment in patients with NPC,and the prognosis of patients with higher copies before treatment could be worse. The plasma EBV-DNA after treatment is predictive for OS,PFS and DMFS.

Objective To investigate the effect of heroin abuse on attention switching. Methods Thirty-six Heroin abusers (33 males, 3 females) and 36 controls (32 males, 4 females) were enrolled in the study. Their cognitive function was tested by using the Switching Task, including Sustained Attention trials and Switching Attention trials. The reaction time and accuracy were recorded separately by the computer. Results The accuracy or reaction times were not signifi-cantly different between Switching Attention trial and Sustained Attention trial in heroin abusers, suggesting a lower Switch Costs value compared to the healthy controls [(19.7 ± 66.8) ms vs. (85.1 ± 92.4) ms]. The healthy controls showed faster reaction speed [Sustained Attention trial (695.3 ± 95.9) ms vs. Switching Attention trial (780.3 ± 93.3) ms, P<0.05] and higher accuracy [Sustained Attention trial (98.0%±2.2%) vs. Switching Attention trial (93.8%±5.0%), P<0.05] under the Sustained Attention trial. Compared with the healthy controls, the heroin abusers showed slower reaction speed [(791.6 ± 74.3) ms vs. (695.3±95.9) ms, P<0.05] and lower accuracy [(92.5%±8.4%) vs. (98.0%±2.2%), P<0.05] in Sus-tained Attention trial, but not in Switching Attention trial. Conclusions The present study has revealed absence of Switch Costs in heroin abusers, which may be related to the damage of heroin abusers in their Sustained Attention function.

Objective To explore the verification process for the analytic performance of the quantitative project of molecular di-agnosis.Methods Based onMedical laboratory accreditation criteria for quality and competence in the field of molecular diagnos-tics application note(CL-36)(2014)and the relevant documents published by Clinical and Laboratory Standards Institute (CLSI), the performance verification methodology of PCR detection for hepatitis b virus nucleic acid was achieved.for.Results The within-run precision of DNA detection for the hepatitis b virus was 0.109 and 0.105;and the between-run precisionwas 0.1 57 and 0.137. Compared with the reference laboratory,the regression equation was Y =0.947+0.343X ,and the linear correlation coefficient was 0.990.The linear range was 5.00-1.10 and thequantitative detection limit was 500 IU/mL.Hemolysis had no effect on the detec-tion of samples.Conclusion The laboratory with molecular diagnostic program should conduct analytic performance verification,and the appropriate method should be chosen to clear performance verification.Conclusion Clearing the performance indicators of de-tection projects has a very positive role in the clinical use of detection projects..

Objective To observe and analyze the effects of pidotimod on the immunity of Treg/Th17 cells in the children with Henoch-Schonlein purpura (HSP).Methods 60 cases of HSP were selected and randomly divided into the pidotimod treatment group and the conventional treatment group,30 cases in each group.30 healthy children were selected as the control group.The con-ventional treatment group was given the routine therapy,while the pidotimod treatment group was added with oral pidotimod dis-persible tablets on the basis of the routine therapy.The ratios of Treg cell subsets and Th17 cell subsets,the plasma expression lev-els of interleukin-17 (IL-17),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)and interferon inducible protein-10 (IP-10) among 3 groups and the time for rash relief,remission rate of hematuria and proteinuria,recurrence rate within 1 month in HSP children were observed and compared.Results The ratios of Treg cell subsets and Th17 cell subsets after treatment had no statisti-cal difference between the pidotimod treatment group and the control group(P >0.05),while which had the statistical difference be-tween the conventional treatment group and the control group(P <0.05 );the plasma IL-17,IFN-γ,IP-10 and TNF-α expression levels had no statistical differences between the pidotimod treatment group and the control group(P >0.05),but the IL-17 and IFN-γexpression levels in the conventional treatment group were still significantly higher than those in the control group.the remission rate of simple hematuria in the pidotimod treatment group was significantly higher than that in the conventional treatment group, while the recurrence rate within 1 month after treatment was significantly lower than that in the conventional treatment group.Con-clusion The application of pidotimod therapy in the treatment of children with HSP can significantly correct the imbalance of Treg cell subsets and Th17 cell subset,decrease the expression levels of the cytokines such as IL-17 and IFN-γ,suppress the autoimmune reaction so as to achieve the effects of significantly alleviating the impairment of renal function and reducing the short term recur-rence rate,which is benefit for the improvement of prognosis in the children patients with HSP.

Resveratrol is a natural phytoalexin with special pharmacological and health functions. Stilbene synthase (STS) is a key and rate-limiting enzyme in the biosynthesis of resveratrol that is present only in a limited number of plants. The content of resveratrol from Polygonum cuspidatum is more than 1000 times higher than grapes and peanuts. We speculate that the catalytic ability of different STS may be one of the reasons causing differences in the content of resveratrol. To verify the above speculation, Vitis vinifera stilbene synthase gene (VvSTS) was amplified according to overlap PCR protocol with genomic DNA as template. VvSTS and PcSTS (PcPKS5) were analyzed through heterologous expression in Escherichia coli. The expression products were purified with Ni-NTA sepharose affinity chromatography and desalted through PD-10 column. The molecular weight of the two fusion proteins was about 43 kDa. Enzyme reaction and product analysis showed that the two products were resveratrol. The enzyme kinetic analysis showed that the catalyze efficiency (Kcat/Km) of PcPKS5 was 2.4 times of the VvSTS. Our findings confirms that STS from certain plants has much higher catalytic capability.
Acyltransferases ; metabolism ; Fallopia japonica ; enzymology ; Recombinant Fusion Proteins ; biosynthesis ; Stilbenes ; metabolism ; Vitis ; enzymology