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.

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.

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.

AIM and METHOD:To determine the production of nitric oxide(NO) and change of NO synthase(NOS) activity in mitochondria isolated from the rat brains of the ischemia/reperfusion rat model produced by transient occlusion of middle cerebral artery on the following the points: 2 h after occlusion of artery and 30 min, 2h, 4h after reperfusion. RESULTS: After the occlusion of middle cerebral artery, the respiratory control rate(RCR) of mitochondria significantly decreased and slightly increased at 4h after reperfusion. Meantime, the production of NO in mitochondria increased significantly. But with the increase of perfusion, production of NO gradually decreased and reached normal level as in the control group. It also shows that cerebral ischemia increased NOS's activity significantly in the mitochondria and still kept a higher level than the control group although it decreased gradually after reperfusion. But the iNOS's activity did not show obvious change. The change of total NOS's activity depends on the change of cNOS's activity. CONCLUSION: The activation of NO/NOS system in the mitochondria might play an important role in the reperfusion injury during reperfusion of ischemic brain.

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 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.

Objective To assess the assistance role of three-dimensional reconstruction of stag-horn calculi by 16-slice spiral CT to percutaneous nephrolithotomy (PCNL). Methods A total of 87 patients with 104 staghorn stones underwent 24 F-tract PCNL. 16-slice spiral CT scan and three-di-mensional (3D) reconstruction by volume rendering technique were carried out before PCNL for tract placement planning, the necessity for multiple tracts and stone burden. Tract placement, tract num-ber, operation time, bleeding requiring transfusion and volume of stone cleared were recorded. KUB was taken to explore residual calculi after operation and thus stone free rate was noted. Results In-traoperative tract placement was according to preoperative planning with 3D reconstruction of calculi. Forty-three calculi were cleared by multiple accesses, while multiple accesses were supposed necessary for 47 caculi. The stone free rate of one-session operation was 87.5%, and the last stone free rate af-ter second-look procedure was 91.7%. The stone burden of 3D reconstruction of CT (19.35 ±19.24 cm3) was significantly correlated with the mean volume of cleared calculi (16.34±13.79 cm3) in oper-ation (r=0. 993, P=0. 000). Conclusion The 3D reconstruction of spiral CT for staghorn calculi could show the precise construction of calculi, which could help to plan tract placement, evaluate the necessity of multiple tracts and stone burden.

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 investigate the functional mechanism of metadherin (MTDH), hypoxia-inducible factor-1 alpha (HIF-1α) and transketolase-like gene 1 (TKTL1) and their interaction with each other in laryngeal carcinoma development. METHOD: Thirty laryngeal carcinoma samples and 20 samples of para-carcinoma tissue were taken from the patients received operation treatment. The expression levels of MTDH, HIF-1α and TKTL1 were detected in all the samples by SP immunohistochemical methods. The data were analyzed by the SPSS13.0 statistical software. RESULT: The positive expression rate of MTDH, HIF-1α and TKTL1 in the 30 cases of laryngeal carcinoma was 56.67%, 60.00% and 63.33%, respectively, which was 20.00%,10.00% and 15.00% respectively in the para-carcinoma tissue, the difference of the positive expression rate of the tested objects between these two groups was statistically significant (P < 0.05 or P < 0.01). Of the 30 cases of laryngeal carcinoma, the positive expression rate of MTDH, HIF-1α and TKTL1 in the cases with lymphnode metastasis was 84.62%, 84.62% and 79.62%, respectively, compared with the rate in those without lymph nodes metastasis, which was 35.29%, 41.18% and 35.29%. The difference of the positive expression rate of the tested objects between these two groups was statistically significant (P < 0.05). In the tissue of poorly differentiated squamons cell carcinoma verified by pathology, the positive expression rates of MTDH and HIF-1α was 73.68% and 84.21%, respectively, while that in the tissue of well differentiated squamous carcinoma was 27.27% and 18.18%. The difference of the positive expression rate of the tested objects between these two groups was statistically significant (P < 0.05 or (P < 0.01). The positive expression rate of TKTL1 in laryngeal carcinoma at stage I-II was 25.00% and that at stage III-IV was 72.22%, the difference between which was statistically significant (P < 0.05). The positive expression rate of HIF-1α in laryngeal carcinoma at stage I-II was 33.33% and that at stage III-IV was 77. 78%, the difference between which was statistically significant (P < 0.05). The expression of MTDH, HIF-1α and TKTL1 showed no relationship with age,smoking amount or the tumor location (P > 0.05). The Spearman's rank correlation analysis showed that the positive expression rates of MTDH and HIF-1α in laryngeal carcinoma had positive correlation (r = 0.384, P < 0.05); the positive expression rates of TKTL1 and HIF-1α in laryngeal carcinoma had positive correlation (r = 0.508, P < 0.01); But there was no significant correlation between the positive expression rates of MTDH and TKTL1 in laryngeal carcinoma (r = -0.107, P > 0.05). CONCLUSION It suggested that these three proteins may have close relationship with the occurrence, invasion and metastasis of the laryngeal carcinoma. MTDH and TKTL1 may be expected to be new clinical targets for laryngeal carcinoma treatment and it could offer theoretical basis for the prognosis of the laryngeal carcinoma.
Carcinoma, Squamous Cell ; diagnosis ; metabolism ; Cell Adhesion Molecules ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Laryngeal Neoplasms ; diagnosis ; metabolism ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Transketolase ; metabolism