Objective To study the clinicopathologic features and the effects of various surgical methods of urachal carcinoma,to improve the diagnosis and treatment of this disease. Methods The clinicopathologic features,diagnosis, surgical methods and effects of 9 patients diagnosed as urachal carcinoma were analyzed retrospectively. Results Among 9 patients,7 cases were diagnosed as mucinous adenocarcinoma, 1 case as nonclassified adenocarcinoma and 1 case as small cell neuroendocrine carcinoma. According to Sheldon staging system,8 cases were classified into stage Ⅲ A and 1 case into stage Ⅲ C. Eight cased underwent extensive partial cystectomy,whereas the other one underwent regular partial cystectomy. One patient died of multiple bone-metastasis at 3 months after operation, 1 patient received operation again for recurrence at 11 months after operation and 1 patient experienced recurrence in bladder neck and urethra respectively at 15 months and 24 months after operation and receivedTUR-Bt. All of the other 6 patients lived without recurrence and metastasis by follow-up survey of 6 - 42 months. Conclusions Urachal carcinoma is a rare malignant tumor,which has very poor prognosis. Clinicopathologic features recognition is very important for improving the diagnosis of this disease. The long-term disease free survival can be achieved from extensive partial cystectomy.

ObjectiveTo analyze the distribution of cerebral ischemic stroke by TOAST subtype in different gender and provide basis for prevention. MethodsAll of 463 patients with cerebral ischemic stroke from October 2007 October 2009 were involved in this study. Two hundred and seventy-nine patients were male (male group),and 184 patients were female (female group). The distribution of TOAST subtype was analyzed between the two groups. ResultsAccording to TOAST subtype, large artery atherosclerosis (LAA), small artery obstructive (SAO), cardiogenic embolism(CE),stoke of other etiology(SOE) and stoke of undetermined etiology(SUE) subtype was 54 cases( 19.4％ ,54/279), 95 cases(34.1％ ,95/279),33 cases( 11.8％ ,33/279), 9 cases(3.2％ ,9/279) and 88 cases(31.5％ ,88/279) in male group;22 cases ( 12.0％ ,22/184),66 cases (35.9％ ,66/184),35 cases ( 19.0％ ,35/184),6 cases (3.3％ ,6/184) and 55 cases (29.9％ ,55/184) in female group. The percentage of LAA was higher and the percentage of CE was lower in male group than in male group that in female group (P ＜ 0.05 ). ConclusionThedistribution of cerebral ischemic stroke in different gender by TOAST subtype exists difference.

Objective To evaluate the quality of life in children with primary nephrotic syndrome and analyze the influencing factors of the quality of life of the population.Methods The quality of life in children with primary nephrotic syndrome was assessed with Inventory of Subjective Life Quality for Children and Adolescent(ISLQ) edited by CHENG Zao-huo and compared to 55 normal children.The influencing factors were analyzed with multi-linear Logistic regression analysis.Results The total degree of satisfaction,recognition and emotion satisfaction of life of quality in patient children were significantly lower than those in healthy children.The data in each satisfaction degree in patient children were lower than those in healthy children,thereinto,the degree of satisfaction in score of home life,school life,depression practice and anxiety practice,self-cognition in patient children were significantly lower than those in healthy children.Conclusions The quality of life in patient children were significantly lower than that in healthy children,they should accept the comprehensive treatment intervention.

Objective To explore the feeling of parents of children with strabismus. Methods A semi-structured interview was conducted among 20 parents of children with strabismus. The data were analyzed based on Colaizzi phenomenotogical research methods. Result The parents' feeling was classified into 4 themes:negative emotional experience, parent-child relationship disorder, social communication disorders, and lack of support system. Conclusion According to the parents' real experience and feelings, medical staffs should pay attention to parents' psychological conditions, giving them necessary knowledge and psychological nursing so as to reduce the parents' psychological tension, improve the quality of life and promote the recovery after surgery.

Objective To investigate the biology reference intervals for five parameters of thyroid gland function(TSH,T3, T4,FT3 and FT4)in Baoji area,in order to provide evidence for effective filtration and diagnosis.Methods Refer to the files recommended by (NCCLS)C28-A2 about the description of definition,establishment and confirmation,five parameters of thyroid gland function were measured in 4 820 healthy persons by using Roche E601 electrochemical immunoassay analyzer and its assemble reagent,calibration materials and quality control,the statistical method was applied to the data processing by different gender,to establish the biology reference intervals of each parameters.And compared with National Guide to Clinical Laboratory Procedures(Third Edition).Results The range of 95% normal reference intervals of TSH,T3,T4,FT3 and FT4 in male were 0.20~4.28 mIU/L,1.22~2.46 nmol/L,64.64~149.00 nmol/L,3.00~6.04 pmol/L,11.93~22.21 pmol/L respectively,and in female were 0.20~4.52 mIU/L,1.24~2.44 nmol/L,67.60~142.40 nmol/L,2.96~5.76 pmol/L and 11.86~21.54 pmol/L,respectively.Compared the level of TSH,FT3,FT4 between male and female, differences were statistical significance(t=3.962,7.570,5.132;P=0.042,0.026,0.033).Compared the level of T3,T4 be-tween male and female,there was no statistical significance (t=0.000,1.151;P=1.000,0.120).The study compared with National Guide to Clinical Laboratory Procedures (Third Edition),the results of T3,T4,FT3 and FT4 in male were statisti-cal significance (t=9.755,4.349,114.7,79.82;P=0.000,0.003,0.000,0.000),the results of TSH,T3,FT3 and FT4 in female were statistical significance (t=5.304,9.548,128.9,72.99;P=0.002,0.000,0.000,0.000).Conclusion The in-vestigation of biology reference intervals for five parameters of thyroid gland function in Baoji area can provide more precise-ly reference data for clinical diagnosis and treatment.

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 characterize the growth curve of Brucella in Bact/Alert blood culture system which may be helpful to predict the growth of Brucella strain for earlier clinical diagnosis of brucellosis.Methods The epidemiological,clinical and labo-ratory data including growth curve of Brucella were reviewed and analyzed retrospectively for 15 cases of brucellosis as con-firmed by positive serological test and brucellosis agglutination test.Results All the 15 patients had irregular fever and history of animal exposure,even though their clinical feature and signs varied greatly.The growth curve of Brucella in blood culture showed the same chracteristics in the 15 patients,including:the time to positive alarm was about 72 hours,a longer lag phase, shorter logarithmic phase,a shorter vertical axis corresponding to the logarithmic phase,and a flat stable phase.Conclusions The clinical manifestation of brucellosis is variable and non-specific.Lack of awareness of this disease makes the clinicians mis-diagnose it easily.Therefore,blood culture is critical for clarifying the etiology in febrile patients.The growth curve of bacteria during blood culture is useful for early diagnosis of brucellosis and prevention of laboratory infections.

Analyze the problems of medical insurance real-time settlement in outpatient department.Explore the situation of stringent management of health medical insurance agencies,accuracy of the information,significant increasing costs that medical insurance agencies refused to pay and severe environment to doctors.And management strategy such as regulating doctors' behavior strictly,upgrading hospital information systems,increasing hospital staff to excavate the hospital potential and publicizing the new policy of medical insurance comprehensively.

To push on the process of the effective link between graduate education for profes-sional master degree of oral medicine and resident standardized training, a professional curricular con-struction was explored. The system contents included drawing up teaching program, writing reference books and building examination question bank. To realize the objective that combine theory study and clinical practice for graduate education and resident standardized training, the main courses were des-ignated for base professional knowledge, clinical operative skills and research progresses of oral medi-cine, by making multimedia courseware and lectures video frequency.

BACKGROUND:Mesenchymal stem cel s (MSCs) can be differentiated into vascular endothelial cel s to construct ideal blood vessel grafts in vitro that have wide prospective utility in the clinical treatment of ischemic diseases, vascular engineering and regeneration medicine.
OBJECTIVE:To review the recent research progress and related issue in biological characteristics of MSCs as wel as differentiation of MSCs isolated from different sources into vascular endothelial cel s.
METHODS:The first authors retrieved PubMed, Sciencedirect and Medline databases for relevant articles published from January 2000 to June 2015. The key words were“mesenchymal stem cel s;vascular endothelial cel;cel differentiation”in English. Initial y, 156 articles were retrieved, and final y 51 articles were included in result analysis.
RESULTS AND CONCLUSION:The MSCs sources are abundant. The research about bone marrow-derived MSCs is the earliest and maximum, but with the increasing donor age, their proliferation and differentiation ability decreases. MSCs from umbilical cord, placenta and amniotic membrane are easy to obtain, and meanwhile both neonatal and maternal does not feel any pain and psychological burden. Given these, these cel s are more acceptable for recipients, and there are no ethical, moral and legal disputes. MSCs from the umbilical cord blood are abundant with weak cel immunogenicity and low viral and bacterial contamination probability. However, the clinical application of amniotic fluid marrow-derived MSCs is limited because of its sampling methods.