Objective To describe the characteristics of organizational culture,to identify the level of quality of work life,and to explore the relationship between each dimension of organizational culture and quality of work life among nurses in tertiary hospitals in Yunnan Province,China.Methods The subjects were 416 nurses from six tertiary hospitals in Yunnan Province.Research instruments were the Organizational Culture Profile (OCP) and the Quality of Work Life Scale (QWLS).Results The results of this study showed that four dimensions of organizational culture including competitiveness (3.56 ± 0.49);performance orientation (4.08 ± 0.22);stability (3.68 ± 0.43) and social responsibility (3.95 ± 0.37) were prominent.The other 3 dimensions,namely supportiveness (3.19 ± 0.79);innovation (3.21 ±.0.62) and emphasis on rewards were perceived (2.42 ± 0.79) as less prominent.The overall mean score of quality of work life was at a moderate level (57.46 ± 15.17).Conclusion There are positive significant correlation between each dimension of organizational culture and quality of work life (P＜ 0.01).Improvement of organizational culture can enhance quality of work life among nurses,and then guarantee the nursing quality.

Objective To explore the value of temporary cardiac pacemaker therapy on children with Adam-Stoke syndrome(ASS).Methods Nine children with ASS was implanted the emporary cardiac pacemaker under X-ray or blinding inserted beside bed.Results Seven children was successfully implanted the temporary cardiac pacemaker within 1-2 d of ASS attack,and two children was successfully implanted at 10 d and 20 d after ASS attack, respectively. Five patients was cured, two children was died, and two children was implanted the permanent cardiac pacemaker. During pacing, two patients had the electrode shifted,and one patient had the cardiac murmur,and one patient had the local skin infected.Conclusion Temporary cardiac pacemaker can successfully treat children with ASS attack;the earlier the implantation,the better the prognosis.

The effect of acute ischemia on the electrophysiological characteristics of the three layers myocardium of canine in vivo was investigated. Twelve canines were divided into two groups randomly: acute ischemia (AI) group and sham operation (SO) group. By using the monophasic action potential (MAP) technique, MAP and effective refractory period (ERP) of the three layers myocardium were measured by specially designed plunge needle electrodes and the transmural dispersion of repolarization (TDR) and transmural dispersion of ERP (TDE) were analyzed. The results showed that in the AI group, MAP duration (MAPD) was shortened from 201.67 +/- 21.42 ms to 169.50 +/- 13.81 ms (P < 0.05), but ERP prolonged to varying degrees and TDE increased during ischemia. In the SO group, MAPD and ERP did not change almost. Among of the three layers myocardium of canine, MAPD was coincident in two groups. It was concluded that during acute ischemia, MAPD was shortened sharply, but there was no significant difference among of the three layers myocardium. The prolonged ERP was concomitant with increased TDE during acute ischemia, which may play an important role in the occurrence of arrhythmias induced by acute ischemia. These findings may have important implications in arrhythmogenesis.
Action Potentials/*physiology ; Electrodes ; Heart/physiopathology ; Myocardial Ischemia/*physiopathology ; Myocardium/*metabolism ; Random Allocation ; Refractory Period, Electrophysiological/*physiology

OBJECTIVEThis study aimed to observe and evaluate six 3.0 T sequences of metallic artifacts produced by metal dental crowns.

METHODSDental crowns fabricated with four different materials (Co-Gr, Ni-Gr, Ti alloy and pure Ti) were evaluated. A mature crossbreed dog was used as the experimental animal, and crowns were fabricated for its upper right second premolar. Each crown was examined through head MRI (3.0 T) with six sequences, namely, T₁ weighted-imaging of spin echo (T₁W/SE), T₂ weighted-imaging of inversion recovery (T₂W/IR), T₂ star gradient echo (T₂*/GRE), T2 weighted-imaging of fast spin echo (T₂W/FSE), T₁ weighted-imaging of fluid attenuate inversion recovery (T₂W/FLAIR), and T₂ weighted-imaging of propeller (T₂W/PROP). The largest area and layers of artifacts were assessed and compared.

RESULTSThe artifact in the T₂*/GRE sequence was significantly wider than those in the other sequences (P < 0.01), whose artifact extent was not significantly different (P > 0.05).

CONCLUSIONT₂*/GRE exhibit the strongest influence on the artifact, whereas the five other sequences contribute equally to artifact generation.

功能性电刺激（FES）这一技术打开了瘫痪运动功能重建的一个广阔领域。在临床应用的推广中，对FES的基本原理和存在的问题有充分的认识，是应用成功的关键因素之一。本文分三部分阐述FES的基本概念、设计和应用。第一部分将讨论电刺激的阈值、募集顺序等概念。第二部分将介绍肌肉电刺激的安全参数范围、组织损伤，并讨论刺激器的设计。第三部分以C5/C6患者手功能重建为例，阐明功能性电刺激系统的工作原理。

Objective To explore the prognosis and etiological treatment of cardiogenic syncope in children.Methods The cause,clinical manifestation,treatment and prognosis of 45 children with syncope were made in affiliated hospital of Qingdao medical university were su mmarized and analyzed.They were divided into arhythmia group and other groups,the former included myocarditis,dilated cardiomyopathy,and post-operation of congenital heart disease and the latter included tetralogy of fallot,pulmonary stenosis,hypertrophic cardiomyopathy,pericarclial effusion,and right atrial myxoma.Results There were 29 cases(64.44%) with arrhythmia in this group,of which there were 18 cases with complete atrioventricular block(CAVB),2 cases with second degree type Ⅱ atrioventricular block,3 cases with ventricular tachycardia,2 cases with bradycardia,2 cases with atrial flutter,1 case with supraventricular tachycardia,and 1 case with nonconducting atrial premature.There were 16 cases(35.56%) with other etiologies,of which there 8 cases with tetralogy of Fallot,2 cases with pulmonary stenosis,hypertrop-hic cardiomyopathy,pericardial effusion,and right atrial myxoma,respectively.Children with CAVB,bradycardia,or ventricular tachycardia resulted from viral myocarditis were given anti-virus medicine,protecting myocardium,neoepinephrine,and intravenous vitamin C 100-200 mg/(kg?d).Dexamethasone 1-2 mg/(kg?d) was given in earlier period for short course,and some children were given human ?-globulin.Eight cases were placed temporary pacemaker because of unsatisfactory therapeutic efficacy,and 1 case was placed permanent pacemaker.In all,38 cases(84.44%)were cured,1 case(2.22%)was improved,and 4 cases(8.88%) died.Conclusions Cardiogenic syncope is pediatric emergency and shall be treated immediately.Temporary pacemaker shall be placed at the right moment.

Objective To understand clinical distribution and antimicrobial resistance characteristics of Pseudomonas aeruginosa(P.aeruginosa)isolated from hospitalized patients, so as to provide reference for the empiric use of antimicrobial agents and control of healthcare-associated infection(HAI).Methods Clinical distribution and antimicrobial susceptibility testing results of P.aeruginosaisolated from patients in a hospital between 2012 and 2016 were analyzed retrospectively, statistical analysis were conducted based on different wards, specimen types and age groups.Results A total of 2 432 strains of P.aeruginosa were isolated from2012 to 2016, most of which were isolated from intensive care unit(ICU)(n=727, 29.89％), the main specimen was sputum(n=2 064, 84.87％). Resistance rates of P.aeruginosa to other antimicrobial agents except piperacillin/tazobactam in each year from 2012 to 2016 were significantly different(all P＜0.05).Resistance to piperacillin, ceftazidime, cefepime, imipenem, meropenem, levofloxacin, and ciprofloxacin decreased after peaked in2014;resistance rates to amikacin, gentamicin, and tobramycin were all low, showing decreased trend year by year(all P＜0.05).Except resistance rates to cefepime and tobramycin, resistance rates of P.aeruginosafrom sputum specimen were all higher than other specimens(all P＜0.05).Resistance rates of P.aeruginosaisolated from patients aged≥65 years to most antimicrobial agents were significantly higher than those isolated from patients aged＜65 years(all P＜0.05).Except resistance rates to gentamicin and tobramycin, resistance rates of P.aeruginosaisolated from ICU were higher than those isolated from other departments, which were 7.71％-66.02％.Resistance rate of P.aeruginosaisolated from department of surgery were relatively low, which were 1.69％-11.86％.Conclusion Clinical distribution of antimicrobial resistance of P.aeruginosais obviously heterogeneity, empiric antimicrobial use and formulation of HAI monitoring measures should be based on the data of antimicrobial resistance in different wards, different infection sites, and different age.

AIM:Chronic heart failure (CHF), caused by ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM), is among the leading causes of mortality and morbidity worldwide .Low-density lipoprotein receptor-related protein 6 (LRP6) plays a criti-cal role in regulating Wnt signaling .Dysregulated Wnt signaling contributes to high incidence of arrhythmias .Thus, there might be an association between genetic variations of LRP6 and sudden cardiac death ( SCD) .The objective of the study was to examine the associ-ation between common variants of LRP6 and prognosis of CHF patients .METHODS:From July 2005 to December 2009, patients with CHF referred from 10 hospitals and participants without structural heart disease in China were undergone a prospective study .The sin-gle-nucleotide polymorphism rs 2302684 was selected to evaluate the effect of LRP6 polymorphisms on the survival of the patients .RE-SULTS:A total of 1 887 patients (1 437 with CHF and 450 in the control group)were finally enrolled for the analysis.During a medi-an follow-up of 61 months, a total of 546 (38.00%) patients died, including 201(36.81%) cases with SCD and 345 (63.19%) ca-ses with NSCD.No end point event occurred in the control group .Patients carrying A allele of rs2302684 had increased risks of all-cause death (P<0.01) and SCD (P<0.01).After adjusted for the other risk factors , the associations remained significant in all-cause death (P<0.01) and SCD (P<0.01).In patients with CHF caused by ICM , those carrying A allele of rs2302684 also had in-creased risks of all-cause death (P<0.01) and SCD (P<0.01).After adjusted for the other risk factors , the associations remained significant in all-cause death (P<0.01) and SCD (P<0.01).However, there was no association between A allele of rs 2302684 and prognosis in patients with CHF caused by NICM .CONCLUSION:The SNP rs2302684 T>A in LRP6 is associated with an increased risk of all-cause death and SCD in patients with CHF in Chinese Han population , and the association is more prevalent in patients with CHF caused by ICM.Thus, LRP6 might be added as a novel predictor of SCD and could provide an attractive and direct therapeutic target in SCD prevention .

BACKGROUND: Apical sealing ability is the key to ensure the long-term curative effect of root canal therapy. The post space preparation exposes some inevitable influence on root canal sealing ability, so how to minimize this effect becomes a hot spot.OBJECTIVE: To explore the effects of immediate or delayed post space preparation on the apical sealing ability of different root canal sealers.METHODS: Forty-eight extracted human premolar teeth were obtained, and the tooth crown was cut off. The samples were randomly divided into three groups (n=16 teeth per group). Group A underwent the immediate post space preparation; group B underwent the delayed post space preparation; group C without the post space preparation. Then all groups were subdivided into two groups, and then were filled with the gutta-percha/AH-Plus (groups A1, B1 and C 1)or the gutta-percha/mineral trioxide aggregate (groups A2, B2 and C2). The depth of apical dye penetration was measured using pressure-driven system. RESULTS AND CONCLUSION: There were no significant differences in the apical microleakage between groups A1 and B1, A2 and B2, C1 and C2 (P > 0.05). The apical microleakage in the group A1 was significantly higher than that in the group A2, and the group B1 also showed higher apical microleakage than the group B2 (P < 0.05). Our findings suggest that either immediate or delayed post space preparation exposes little influence on the apical microleakage after root canal filling with gutta-percha/mineral trioxide aggregate, which exhibits better apical sealing ability than the AH-plus.

Objective To investigate the clinical characteristics of patients with polymyositis(PM) and dermatomyositis (DM), and compare the differences of PM/DM to help the understanding of clinical diagnosis and treatment. Methods One hundred and forty-five hospitalized PM/DM patients from Department of Rheumatology of the First Affiliated Hospital of Xiˊan Jiaotong University were collected from May 2008 to December 2014, and the clinical manifestations, muscle enzymes, electromyogram, muscle biopsy, treatment outcome were retrospectively analyzed. Mann-Whitney U test and χ2 test were used for statistical analysis. Results The most common initial symptom of PM was muscle weakness, accounted for 51.2%, while rash was the initial presentation in most DM patients(43.1%). The incidence of interstitial lung disease (ILD) (62.7% vs 39.5%, χ2=11.009, P=0.001), and the elevation of CRP (48.9% vs 26.8%, χ2=10.272, P=0.001) were all higher in DM than PM, while the elevation of level of CK (85.4% vs 61.8%, U=-2.668, P=0.008) and CKMB (82.9%vs 41.2%, U=-3.303, P=0.001) were more common in PM compared with DM. The pathological study showed degeneration of muscle fiber, connective tissue hyperplasia in most PM patients, and perimysium atrophy, vacuoles degeneration, muscle bundles, perivascular inflammatory cell infiltration were observed in most DM patients. During the follow-up, the clinical remission rate was 57.5%, the relapse rate and the mortality rate was 7.5%and 31.1%respectively. The mortality rate was higher in DM than PM (34.6% vs 21.4%, χ2=4.861, P=0.027). Infection and tumors were the major causes of death, and the lung was the most common site of infection. Conclusion Differences in the clinical features, muscle enzymes, CRP level, pathology and the mortality rate between PM and DM are evident, while ILD, infection and the higher mortality rate are more common in DM than in PM.