Objective To investigate the correlation between transformational leadership style and nurses' job satisfaction in emergency department.Method The survey was done among 168 emergency department nurses from 4 first class hospitals in Guangzhou by the demographic information,multifactor leadership questionnaire and Chinese nurses' job satisfaction scale to investigate the status of transformational leadership style perceived by nurses and nurses' job satisfaction in the emergency departments.Results The score of transformational leadership style perceived by the nurses in the emergency department was (50.60±14.40) and jop satisfaction was (79.80±13.30).The transformational leadership style was positively correlated with nurses' job satisfaction (P＜0.01).Conclusions The transformational leadership style is middle-high level.The nurses' job satisfaction is at low level,Nursing managers should play an active role in transformational leadership style to enhance nurses' job satisfaction in emergency departments.

Objective To investigate the main risk factors influencing the pre-hospital delay of patients with acute ischemic stroke (AIS) for preventing methods.Methods A retrieval was done across the epidemiologic studies on pre-hospital delay of AIS patients during 2004 to 2015 using the key words of ischemic stroke,prehospital delay,treatment delay.According to the inclusion and exclusion criteria,the literature was collected and the literature quality was assessed.The data were extracted for meta-analysis by RevMan software.Results Sixteen epidemiologic studies were included.Totally,there were 2,966 cases of prehospital delay and 2,468 cases of non-delay.The pooled OR values and 95％ CI by multivariate analysis were as follows:the degree of awareness of stroke was 0.5 (0.3,0.82),emergency medical service (EMS) was 0.49 (0.29,0.85),National Institute of Health Stroke scale (NHISS) score 0.58 (0.36,0.95),outpatient visit as first visit 4.28 (1.44,12.74),distance 0.76 (0.61,0.95),medical history of ischemic stroke 0.37 (0.18,0.79) (with significant differences in OR value,P＜0.05).Conclusions The protective factors for pre-hospital delay of acute ischemic stroke patients include:strengthened awareness of stroke,effective EMS,high NHISS score,short distance,medical history of ischemic stroke.The main risk factor is that their outpatient visit is their first visit for medical treatment.Therefore,we need to enhance the health education to the patients and their families about awareness of stroke,improve the use of EMS and build complete and efficient green path for the stroke patient.

Objective To evaluate the role of extracellular signal-related kinase (ERK) 1/2 signal transduction pathway at the supraspinal level in maintenance of neuropathic pain in mice.Methods Sixty-four Kunming mice,aged 2 months,weighing 18-20 g,were randomly divided into 4 groups (n =16 each):sham operation group (group S),chronic constrictive injury (CCI) group; CCI + U0126 (MEK inhibitor) group; CCI + dimethyl sulfoxide (DMSO) group.Neuropathic pain was induced by CCI.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1mmintervals with 4-0 silk thread in CCI,CCI + U0126 and CCI +DMSO groups.On 5 days after CCI,5 μg U0126 (in 5 μl of 5％ DMSO) and 5％ DMSO 5 μl were injected into the lateral cerebral ventricle over 10 s in CCI + U0126 and CCI + DMSO groups,respectively,and the time of.needle retaining was 20 s.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured before operation (baseline),before intracerebroventricular injection (T1),and at 30 min and 2,6,12 and 24h after intracerebroventricular injection (T2-6).Resuits Compared with group S,MWT was significantly decreased and TWL was shortened at T1-6 in CCI and CCI +DMSO groups,and at T1 in CCI + U0126 group (P ＜ 0.05),while no significant change in MWT and TWL was found at T2-6 in group CCI + U0126 (P ＞ 0.05).Compared with group CCI,MWT was significantly increased and TWL was prolonged at T2-6 in group CCI + U0126 (P ＜ 0.05),while no significant change in MWT and TWL was found in group CCI + DMSO (P ＞ 0.05).Conclusion ERK1/2 signaling transduction pathway at the supraspinal level is involved in maintenance of neuropathic pain in mice.

Objective To study the effects of MF59 in combination with heat-killed BCG ( hBCG) as adjuvant on the immunogenicity of Mycobacterium tuberculosis fusion protein PstS1-LEP.Methods BALB/c mice were divided into six groups from group 1 through group 6.They were immunized with PstS1-LEP+MF59 ( group 1 ) , PstS1-LEP+MF59/hBCG ( group 2 ) , PstS1-LEP+hBCG ( group 3 ) , MF59 ( group 4 ) , PstS1-LEP (group 5) and hBCG (group 6) for three times at intervals of two weeks , respectively.The mice were sac-rificed two weeks after the last immunization .The serum samples were collected for antibodies detection .The splenic lymphocytes and peritoneal macrophages were isolated and cultured with PstS 1-LEP.Indirect ELISA and sandwich ELISA were used to detect PstS 1-LEP-specific antibodies and cytokines in the supernatants of culture , respectively.Results The level of IFN-γ, IL-1β, IgG, IgG1 and IgG2a in group 1 were higher than those in groups 4, 5 and 6 (P<0.05).The level of IL-2 and IL-4 in group 1 were higher than those in groups 4 and 6 (P<0.05).The level of IFN-γ, IL-1β, IL-12, IgG, IgG1 and IgG2a in group 2 were higher than those in groups 4, 5 and 6 (P<0.05).The level of IL-2 was higher in group 2 than that in groups 4 and 6 (P<0.05). The level of IL-4 in group 3 was higher than that in group 4 ( P=0.05 ) .The level of IL-1βin group 3 were higher than that in groups 4 and 5 ( P<0.05 ) .The level of IgG was higher in group 3 than that in groups 4 and 6 (P<0.05).IgG1 level in group C was up-regulated in comparison with that in groups 4, 5 and 6 (P<0.05 ) .Conclusion hBCG as PstS1-LEP adjuvant induces a shift towards Th 2-type immune response , while MF59 induces Th1/Th2-type immune response.The combination of MF59 and hBCG inhibits the secretion of IL-4 by spleen lymphocytes , but enhances the secretion of IL-12 by macrophage .

Objective To set up an administrative system of altitude knowledge data so as to raise up the retrieval efficiency of altitude knowledge for the scientific research in hospital.Methods ACCESS 2003 was used to create the administrative system.Results Altitude literature resources could be retrieved rapidly.Conclusion The administrative system of altitude knowledge data is simple in structure,easy to operate,fast in rate and convenient to retrieve.Good result is obtained in practice.[Chinese Medical Equipment Journal,2008,29(2):62-63]

Objective To explore the relationships among nurses’intent to stay,occupational commitment and managers’ leadership styles in emergency department.Methods A total of 130 nurses in emergency department were recruited by convenience sampling method from three tertiary hospitals in Guangzhou.They were investigated by using Nurses’Intent to Stay Questionnaire, Nurses’Occupational Commitment Questionnaire and Multifactor Leadership Questionnaire(MLQ).Results The score of nurses’ intent to stay and occupational commitment were(20?19±3?74)and(76?16±12?13),respectively;both were at medium levels and occupational commitment,transformational leadership style were positively correlated with nurses’intent to stay(P<0?05).Nurses perceived their managers as transformational leaders more often than transactional leaders.Conclusions Both the current nurses’ intent to stay,occupational commitment were at medium levels.The influential factors of nurses’intent to stay in emergency department included emergency work experience,emotional commitment and normative commitment.In order to increase nurses’retention and stabilize the healthy development of nursing personnel,nurse managers should improve the level of nurses’occupational commitment.

Objective:To investigate the clinicopathological features, treatment and prognosis of patients with angioimmunoblastic T-cell lymphoma (AILT) complicated with Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 2 cases of AILT with EBV-positive DLBCL in the Fifth Medical Center of PLA General Hospital were retrospectively analyzed, and the literature was reviewed.Results:One case of complex lymphoma (CL) developed from low fever with systemic superficial lymphadenopathy, the right axillary tumor biopsy showed that AILT complicated with EBV-positive DLBCL. After 8 cycles of chemotherapy, the patient reached unconfirmed complete remission, then received maintenance treatment with chidamide and survived until the deadline. Another case of discordant lymphoma began with subcutaneous nodules and then developed progressive enlargement of superficial lymph nodes. The pathological examination of subcutaneous nodule diagnosed as DLBCL, and the pathological examination of right inguinal lymph node diagnosed as AITL. After 7 cycles of chemotherapy, the patient died of hemophagocytic syndrome.Conclusions:AILT with EBV-positive DLBCL is rare. The main clinical symptom is AITL and the immunophenotypic characteristic indicates the presence of T cells and B cells. At the same time, the prognosis is poor, and the treatment strategy mainly depends on the lymphoma type with unfavorable prognosis.

Objective The objective of this study was to investigate the underlying causes of catheter rupture in implantable venous assess ports among 4 paediatric patients and to summarise nursing experiences.Methods A total of 319 implantations of venous assess port were admitted in the Department of Paediatric Surgery of our hospital from March 2011 to January 2023,with an incidence rate of catheter fracture at 1.3%(4 cases).The ruptured catheters in all 4 paediatric patients were successfully retrieved via surgery.The reasons for catheter rupture as well as the methods for identification were analysed and summarised.Results In Case 1,a catheter rupture was located at 6 cm from the port and the ruptured catheter was not displaced.In Case 2,a linear crack was observed at 7 cm from the base of port without visible sign of catheter rupture,however,a leakage was observed from the crack when fluid was injected.In Case 3,the location of catheter rupture was identified at 11 cm from the port and again there was no evidence of displacement.However for Case 4,a catheter rupture occurred at just 1 cm away from the base of port,with a displacement along right atrium-right pulmonary artery-right inferior pulmonary artery.The causes of catheter rupture were attributed to frequent and prolonged neck and upper extremity activities in Cases 1,3 and 4,as well as an inappropriate handling of catheter in Case 2.After removal of the catheter,Cases 1,2 and 4 were kept in hospital for treatment of original illnesses,while Case 3 was discharged the day after the removal of catheter.Conclusion Catheter rupture is an extremely serious complication.It is imperative for healthcare personnel to adhere to standardised procedures and maintenance protocols,together with comprehensive health education to both parents and children.Early detection of an abnormality followed by prompt handling is crucial in ensuring the safety usage of an implantable venous assess port in paediatric patients.

Object:To investigate the impact of carbon nanoparticle tracing on the number of lymph nodes harvested in obese patients during radical gastrectomy for gastric cancer.Methods:Clinical data of 127 patients undergoing D 2 radical gastrectomy in the Affiliated Tumor Hospital of Zhengzhou University from Jan 2015 to Dec 2019 were retrospectively analyzed. According to whether the patients were injected with carbon nano particles during operation, they were divided into two groups: 64 patients without carbon nano particles during operation served as control group; 63 patients with carbon nano particles were included into experimental group. Results:The operation time of the control group was (160±31) min and that of the experimental group was (168±28) min ( t=-1.521, P=0.445). Intraoperative blood lose in the control group was (234±82) ml and that in the experimental group was (238±84) ml ( t=-0.295, P=0.846). The number of lymph nodes harvested in the first station, in the second station, the number of total lymph nodes and the number of lymph nodes with diameter <5 mm in the control group were less than those in the experimental group(10.4±3.8 vs. 24.5±10.6, t=-10.054),(6.6±2.8 vs. 16.8±7.3, t=-10.381),(17.1±6.4 vs. 41.2±17.6, t=-10.293),(3.9±2.5 vs. 21.2±9.1, t=-14.662) (all P<0.05), while the number of positive lymph nodes was not statistically different between the two groups all (5.9±6.2 vs. 4.2±3.4, t=-1.963, P>0.05). Black staining of lymph nodes in nano carbon group: 1 542 black stained lymph nodes were detected in the experimental group, the black staining rate of lymph nodes was 59.44% (1 542/2 594). Conclusion:Intraoperative application of carbon nanoparticles can significantly increase the number of harvested lymph nodes in obese (BMI≥25 kg/m 2) gastric cancer patients after radical resection.

Ulcerative colitis （UC） is a chronic non-specific digestive disease with abdominal pain， diarrhea， and blood and mucus in stool as the main clinical manifestations and inflammatory injury of colorectal mucosa and submucosa as the main pathological changes. With the change in living habits and dietary structure of people， the incidence and cancer morbidity in UC are rising rapidly all over the world， which has seriously reduced the quality of life and caused a huge social burden. Till now， the pathogenesis has not been elucidated. In western medicine， aminosalicylates， corticosteroids， and immunosuppressors are commonly used to relieve symptoms. However， the long-term application will lead to problems such as decreased efficacy and increased adverse reactions. There are more studies of traditional Chinese medicine （TCM） in the treatment of UC by reducing the inflammatory response， alleviating oxidative stress， protecting the intestinal mucosal barrier， and regulating intestinal microecological imbalance by virtue of the advantages of integrated regulation based on multiple links， levels， and targets. In view of this， the present study reviewed the effect and mechanism of active ingredients of TCM， TCM extracts， TCM pairs， classic TCM compounds， and TCM combined with chemical agents in the treatment of UC based on relevant research articles in recent 10 years to provide references for seeking effective drugs.