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 prepare adriamycin gelatin microballoons and identify its characteristics,and to study the feasibility of utilizing the microballoon to block the conduction of peripheral nerves.Methods Adriamycin was embedded in gelatin by means of emulsify-cross link,and its physical-chemical property was tested.Thirty male SD rats were randomly divided into 3 groups including control group(group N),adriamycin group(group A)and adriamycin gelatin microballoon group(group M).0.1% Tween saline,0.5% adriamycin and the suspension of adriamycin gelatin microballoons were dropped separately onto the surface of denuded right sciatic nerve.The pain threshold of right hind limb,sciatic nerve function index(SFI)and pathological change were observed.Result The optimal proportion of drug and carrier was 1∶10.The microballoon was round in shape with perfect dispersibility.90% of the active ingredient could be released from the microballoons within 240 minutes.The pain thresholds in both groups A and M were elevated obviously,and the value of SFI was decreased markedly.These phenomena lasted only 60 days in group A,whereas over 90 days in group M.Conclusions The adriamycin gelatin microballoons possess a good appearance and a satisfactory performance of delayed release.It can damage eperipheral nerve,and may be used as a long acting neurolytic agent.

Along with clinical medicine improvement and imageology development, The early diagnosis and treatment of uterine cervical cancer becomes possible. Especially computer tomography(CT) and magnetic resonance imaging(MRI) as well as positron emission tomography/computed tomography(PET/CT) are widespread applied in clinical medicine. These imaging examinational means supply important bases for diagnosis, staging and therapeutic means to uterine cervical cancer.

BACKGROUND:Damage to nasal ciliated epithelial cels can lead to a severe injury in nasal biological function. Compared with other adult stem cels, human umbilical cord blood stem cels have better differentiation potential.
OBJECTIVE: To explore the feasibility of human umbilical cord blood stem cels differentiating into nasal ciliated epithelial cels through in vitro culture and induction techniques.
METHODS:Normal and healthy umbilical cord blood samples were colected to isolate human umbilical cord blood stem cels, folowed by identification and subculturein vitro. Umbilical cord blood stem cels at passage 3 were infected with recombinant adeno-associated virus carrying enhanced green fluorescent protein and cultured using air liquid interface culture method. Thereafter, PCR assay was employed for detecting MUCS expression in cultured stem cels at 1 and 2 weeks after induction, and immunofluorescent staining for FOXJ1 was performed at 3 weeks.
RESULTS AND CONCLUSION:After subculture, passage 3 umbilical cord blood stem cels that could express stem cel surface markers were visible in a uniform shape and had good refraction. After 3 hours of gene transfection, green fluorescence issued from the passage 3 cels were visible, and the cel positive rate was up to 96.2% until 48 hours, indicating good transfection efficiency. RT-PCR findings showed that MUC8 mRNA had no expression in the umbilical cord blood stem cels, but expressed strongly in the nasal ciliated epithelial cels, whose expression was weak at 1 week of culture and increased at 2 weeks. Additionaly, the positive expression of FOXJ1 red fluorescence was observed under the transfection of green fluorescent protein. These results suggest that human umbilical cord blood stem cels could differentiate into nasal epithelial cels under suitable conditions.

Objective:To evaluate the efficacy and morbidity of 24F-tract percutaneous nephrolithotomy(PNL) accessed by two-step dilation.Methods:A total of 3 052 patients with 3 366 kidneys or upper ureter calculi underwent 24F-tract PNL accessed by two-step dilation between Aug.,2003 and Jan.,2008,including 108 patients with solitary kidney,68 with kidney cysts,44 with horseshoe kidney,26 with vertebral column deformity,24 with medullary sponge kidney and 1 transplanted kidney.Stone burdens were(47.2?35.6) mm in length.Results:99.4% of 3 740 operations were successful in one-session access,in which 3 348 PNLs were accessed by single tract(89.5%),366 by double tracts(9.7%) and 26 by triple tracts(0.7%).The mean operating time was(68.4?30.9) min,the mean first accessing time were(17.6?11.1) min.and the mean calculi-dealing time were(35.0?55.3) min.The stone-free rate after one session operation was 100% for single calculus and 72.3% for multiple or staghorn calculi.of all the kidneys,374(11.1%) accepted another PNL to remove the residual calculi,and the last stone-free rate of PNL was 88.6%.During and after operation,52 cases(1.4%)needed transfusion,12(0.3%)underwent selective embolization of renal artery and 1(0.03%)accepted nephrectomy for bleeding control.No injury of organs occurred except for 3 cases with pneumatothorax and 19(0.5%)with urinary extravazation.No septic shock occurred.Conclusion:24F-tract PNL accessed by two-step dilation wtih ultrasound-guided puncture is effective and safe.

Objective　To modify the Guy's stone score system and evaluate the validation of the modified score system in grading the complexity of percutaneous nephrolithotomy (PCNL) and predicting the stone-free rate after PCNL.　Methods　The modified system comprises 4 grades:grade Ⅰ,solitary stone in mid/lower pole or solitary stone in the pelvis with simple anatomy; grade Ⅱ,solitary stone in upper pole or multiple stones (located in 2 or more 2 calyces) in a patient with simple anatomy or a solitary stone in a patient with abnormal anatomy; grade Ⅲ,multiple stones in patients with abnormal anatomy or stones in a caliceal diverticulum or partial staghorn calculus; grade Ⅳ,staghorn calculus or any stone in a patient with spinal injury or spine malformation ( e.g.spina bifida,scoliosis,lordosis) ; kidney dysplasia ( e.g.duplex kidney,horseshoe kidney).It was validated on a database of 145 PCNL procedures performed by a single surgeon in a stone center.The clinical outcomes were retrospectively assessed with multivariate analysis.Results Of the 145 PCNL patients,according to Guy's stone score system and the modified score system,there were 22 G1 cases (15.2％) and 22 SFR cases (100.0％) ; 27 G2 cases (18.6％) and 25 SFR cases (92.6％); 36 G3 cases (24.8％) and SFR(31,86.1％); 60 G4 cases (41.4％) and 49 SFR cases ( 81.7％ ).Showing that the modified Guy's stone score was more accurate in predicting stone-free rate after PCNL ( P ＜ 0.05 ).　Conclusions　The modified Guy' s stone score system can accurately predict the stone-free rate after PCNL than the old system.

Objective To investigate the expression of placental growth factor (PlGF) protein and mRNA in lungs of neonatal rats exposed to 85%hyperoxia, and to establish the relationship between PlGF and bronchopulmonary dysplasia (BPD). Methods Forty-eight Sprague–Dawley neonatal rats were randomly exposed to air (control group)(n=24) and 85% hyperoxia (hyperoxia group)(n=24)within 12 h after birth. The rats were sacrificed at 3, 5 and 7 days after exposure (eight at each time) and their lungs were sampled. PlGF protein and mRNA expression in the lungs were determined by Western blot and real-time polymerase chain reaction (PCR) at 3, 5 and 7 days. Left lung tissue was used for morphological and histological observation with hematoxylin and eosin staining. Terminal air spaces and the secondary septa were counted manually under microscope. T-test was applied for statistics. Results Compared with the control group, morphological and histological analysis in the hyperoxia group revealed inflammatory cell infiltration, simplified alveolar structure, less alveolar, alveolar cavity expansion and thickened alveolar septum. Morphometric measurements showed that terminal air spaces and secondary septa were significantly fewer in the hyperoxia rats than those in the control group at 5 and 7 days (terminal air spaces:23.6±8.2 vs 33.1±6.2 and 28.5±9.2 vs 38.4±10.1, t=1.91, 2.53, all P<0.05;secondary septa:56.0±12.2 vs 78.3±8.2 and 75.4±12.2 vs 126.1±10.2, t=2.14, 2.72, all P<0.05). Real-time PCR showed that expression of PlGF mRNA increased significantly on day 3, 5 and 7 in the hyperoxia group compared with the control group (1.16±0.17, 1.34±0.15 and 1.65±0.19 vs 0.65±0.21, 0.47±0.11 and 0.46±0.17, respectively, t=1.93, 2.55, 2.79, all P<0.05). Western blot also showed that expression of PlGF protein on day 3, 5 and 7 in the hyperoxia group increased compared with the control group, but only being significant on day 3 (0.24±0.17 vs 0.09±0.01, t=2.44, P<0.05). Conclusions Hyperoxia (85%) exposure could increase PlGF protein and mRNA expression in the lungs of neonatal rats, likely contributing to pathogenesis of BPD, and might lead to pulmonary vascular developmental disorders in BPD.

Objective To discuss the clinical features and significance of the difference between the preoperative plan and the actual procedure of the treatment of staghorn calculi with standard access PCNL under ultrasound guidance.Methods From Feb 2011 to May 2011,56 patients withsimple staghorn calculi after standard PCNL under ultrasound guidance were enrolled.The same urologist made the operation plan preoperatively and performed the procedure.The difference between the preoperative plan and the actual procedure were analyzed.The factors leading to the difference were evaluated.Results First puncture calyx,the number of access and stage were changed in 9 (16.1％),15 (26.8％),and 10 (17.9％) patients,respectively.The factors leading to the changes include:flexible,compliance,local inflammation of calyx and texture of stone,efficiency of fragmentation.Conclusions The factors which cannot be clearly known preoperatively may change the procedure of PCNL,which is important to know the clinical features and significance of these factors.

Objectives To explore the influence of standardized treatment and technical flow improvement on the diagnosis and treatment of congenital diaphragmatic hernia (CDH) after prenatal diagnosis. Methods The clinical data of neonates diagnosed with CDH who were hospitalized in neonatal intensive care unit from January 2005 to August 2016 was analyzed retrospectively. Based on the start time of standardized treatment implementation, 93 cases of CDH hospitalized from January 2010 to August 2016 were divided into the intervention group while 15 cases of CDH hospitalized from January 2005 to December 2009 were divided into the control group. The survival rate and complications of clinical outcomes between two groups were compared. Results There was no significant difference in sex, gestational age, birth weight, Apgar score, and CDH position between two groups (P >0.05). The total survival rate was 81.7％ in the intervention group and 53.3％ in the control group, and there was statistical difference (P<0.05). The difference of mechanical ventilation mode and pneumothorax rate between two groups also had statistical difference (P >0.05). The median operation time in the control group was 4.5 h and the intervention group was 49.5 h. The postoperative survival rate was 61.5％ in the control group and 90.5％ in the intervention group, and the differences between two groups were significant (P >0.05). The first blood gas analysis of deaths cases in both groups showed that there were significant differences in pH and PCO2 values (P >0.05). Conclusions Optimization of the clinical management during perioperative period can improve the survival rate of CDH and reduce complications. However, the dead cases in the intervention group had more severe pulmonary hypoplasia.

Objective To study the effects of high concentration oxygen exposure on the Sox17 expression of vascular endothelial cells of neonatal mice lungs,and to explore the pathogenesis of blocked lung vascular development.Methods Thirty two C57B1/6J newborn mice within six hours after birth were randomly divided to hyperoxia group (n=16) and room air group (n=16).Mice of hyperoxia group were exposed to 85％ oxygen.Eight mice of either group were sacrificed at 7 and 14 days after birth respectively to observe the lung morphology and calculate radial alveolar counts (RAC),which is the number of alveoli on the straight line from the center of respiratory bronchioles to the nearest fibrous septa or the pleura.Sox 17 expression in the pulmonary vessels was detected by immunohistochemical staining.Sox17 mRNA was measured by reverse transcription polymerase chain reaction.Sox17 protein level was measured by Western blot.Two independent samples t-test was used for statistical analysis.Results Compared with day 7,the lung structures matured with more uniformed alveoli and the septas became thinner on day t4 in room air group.However,the lungs developed slowly with simplified and non-uniformed alveoli on day 14 in hyperoxia group.The Sox17 protein was positive on endothelial cells of pulmonary arteries,veins and alveolar capillarys,as well as the alveolar epithelial cells.The RAC on day 7 and day 14 in hyperoxia group were both lower than that in room air group (3.7±0.7 vs 5.0±0.8,5.3±0.6 vs 8.3±0.9,respectively,t=3.057 and 8.148,both P ＜ 0.01).Sox17 mRNA on day 7 and day 14 in hyperoxia group were both lower than that in room air group (0.62±0.10 vs 0.88±0.11,0.44±0.06vs 0.90±0.15,t=3.607 and 6.926,both P ＜ 0.01).Sox17 protein level on day 7 and day 14 in hyperoxia group were both lowered than that in room air group (0.32±0.04 vs 0.76±0.04,0.36±0.07 vs 0.96±0.06,t=3.102 and 8.421,both P ＜ 0.01).Conclusions Exposure of high concentration of oxygen may cause impairment of lung vascular development by inhibiting Sox17 expression in lungs of neonatal mice.