Objective To measure the effect of one-stage transplantation of reverse-flow vascular pedicle fibular grafts in treatment of infected nonunion of the distal tibia.Methods From January 2001 to December 2012,23 patients sustaining the infected nonunion of the distal tibia were transplanted with reverse-flow vascular pedicled fibular grafts in one-stage.There were 13 males and 10 females,aged 26 to 59 years (mean,38.7 years).Tibial nounion based on the Jain-Sinha classification was rated as Type A in 6 patients and Type B in 17 patients.After the operation,the patients received 2-3 weeks of intravenous antibiotic treatment and then 4-week oral antibiotic therapy.Wound healing,limb and ankle joint fucntion and outcomes in fibular transplantation were observed.Results Duration of follow-up was 16-46 months (mean,28.6 months).There were no exudates and ulcerations of the skins.Smooth healing was achieved in all the patients except that fibular fracture was noted in one patient healed after cast immobilization.Healing time ranged from 12 to 28 weeks (mean,15.6 weeks).Limb function evaluated with Ennecking system had (87 ± 11) ％ restoration.According the Olerud-Molander scoring system,ankle function was excellent in 16 patients and good in 7 patients,with the excellent-good rate of 100％.Conclusion One-stage reverse-flow vascular pedicle fibular grafting is an optional procedure for treatment of infected nonunion of the distal tibia,due to the technique is easy and effective.

Objective: To evaluate the global scientific output of PTG research and explore their hotspots、frontiers and trend from 2008 to 2018, using bibliometric methods. Methods: Based on web of science core collection database, the literature with keywords"Posttraumatic Growth or Post-traumatic Growth"in topic and time limit set between 2008 and 2018 were searched, and 1668 literature were accepted, using the CiteS pace to depict the hot keywords, cited references. Results: The subject domains of posttraumatic growth could be divided into traumatic event, growth and change, and influence factors of PTG. Keywords and references analysis indicated that the quality of life and breast cancer were the research hotspots, whereas physiological indicators and research tools of PTG were the frontiers. The United States of America ranked highest in the countries with most citations, and the leading institute was the North Carolina University. Publications were mainly in Journal of Traumatic Stress. Conclusion: Future research could focus on the exploration of PTG intervention program, such as qualitative research and longitudinal study to trace its dynamic change.

Objective:To investigate the status of professional self-efficacy and its influencing factors among postgraduates in Master of Nursing Specialist(MNS).Methods:Totally 185 postgraduates from 33 universities were chosen by convenience sampling from December 2018 to January 2019 for a cross-sectional survey. Subjects completed a questionnaire covering demographic data, Professional Self-efficacy Questionnaire for Nursing Students, the Chinese version of Proactive Personality Scale and Career Social Support Inventory for Chinese College Students.Results:The score of professional self-efficacy was (92.78±13.22) . Multiple linear regression analysis showed that the sense of achievement in clinical work, proactive personality and career decision support were the influencing factors of postgraduates professional self-efficacy, with an interpretability of 40.2%.Conclusion:Professional self-efficacy of postgraduates is at upper middle level. Schools, hospitals and other relevant institutions should further improve the postgraduates cultivation model, establish high quality clinical practice bases, encourage postgraduates to actively explore career development pathway and provide adequate advices and supports, to improve the professional self-efficacy of postgraduates.

Purpose: The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties. Methods: The Perinatal Bereavement Care Competence Scale was developed in four phases. (1) Item generation: 75 items were formulated based on a literature review and interviews with midwives. (2) Delphi expert consultation: 15 experts evaluated whether the items were clear/appropriate/relevant to the questionnaire dimensions, and the items were optimized. (3) Pilot test: The comprehensibility, acceptability, and time required to complete the questionnaire by midwives were assessed. (4) Evaluation of reliability and validity: The scale was validated by initial item analysis, exploratory and confirmatory factor analyses, and internal consistency reliability and testeretest reliability. Results: The final scale consisted of six dimensions and 25 items: maintaining belief (three items), knowing (four items), being with (six items), preserving dignity (four items), enabling (five items), and self-adjustment (three items). Exploratory factor analysis yielded a six-factor structure that was consistent with the theoretical framework and explained 70.8% of the total variance. Confirmatory factor analysis indicated a good fit for the six-factor model. Cronbach's a for the scale was 0.931, and the test eretest reliability coefficient was 0.968. Conclusion The Perinatal Bereavement Care Competence Scale is a valid and reliable instrument for measuring the competence of midwives in caring for bereaved parents who have experienced perinatal loss.

Extracellular vesicles(EVs)are nano-sized bilayer vesicles that are shed or secreted by virtually every cell type.A variety of biomolecules,including proteins,lipids,coding and non-coding RNAs,and mitochondrial DNA,can be selectively encapsulated into EVs and delivered to nearby and distant recipient cells,leading to alterations in the recipient cells,suggesting that EVs play an important role in intercellular communication.EVs play effective roles in physiology and pathology and could be used as diagnostic and therapeutic tools.At present,although the mechanisms of exosome biogenesis and secretion in donor cells are well understood,the molecular mechanism of EV recognition and uptake by recipient cells is still unclear.This review summarizes the current understanding of the molecular mechanisms of EVs'biological journey in recipient cells,from recognition to uptake and cargo release.Furthermore,we highlight how EVs escape endolysosomal degradation after uptake and thus release cargo,which is crucial for studies applying EVs as drug-targeted delivery vehicles.Knowledge of the cellular processes that govern EV uptake is important to shed light on the functions of EVs as well as on related clinical applications.

Objective: To revised the Taiwan version successful aging inventory (SAI), and verify its reliability and validity in urban elderly in mainland China. Methods: SAI was adjusted by culture and revised by pre-test to form a formal questionnaire. A sample of 600 elderly people in Guangzhou was chosen for a face-to-face questionnaire survey through convenient sampling. Half of the sample (n=300) was randomly selected for exploratory factor analysis, and the other was used to confirm the structural validity of SAI. Results: Exploratory factor analysis extracted six common factors, including health autonomy, economic security, life adaptation, society and relative relationship, study and family. The cumulative contribution rate of six common factors was 65.366%. The fitting indexes of confirmatory factor analysis were χ²/df=1.861, CFI=0.930, IFI=0.930, TLI=0.923, GFI=0.823, RMSEA=0.054, RMR=0.073. There were significant ceiling effects in the four dimensions of health autonomy, economic security, life adaptation, and family. The internal consistency coefficient (Cronbach's α) of SAI was 0.930, and the test-retest reliability was 0.943. An average score of SAI ≥ 3.95 points was considered successful aging. Conclusion Reliability and validity of SAI are good, which can be used to measure the successful aging status of Chinese elders and track the effectiveness of health promotion measures.

Objective : To study the association between single nucleotide polymorphism (SNP) in transcriptional coactivator containing PDZ binding motif (TAZ) gene and the risk of non⁃cardia gastric cancer. Methods : Among 460 patients with non⁃cardia gastric cancer and 470 normal controls , TAZ rs16861985 , rs1055153 , rs6783790, rs12490239 were genotyped by polymerase chain reaction⁃restriction fragment length polymorphism (PCR⁃RFLP) . Unconditional Logistic regression was used to evaluate the association of studied SNPs with the risk of non⁃cardia gastric cancer. Results : TAZ rs16861985 was associated with the risk of non⁃cardia gastric cancer, compared with the CC genotype carriers , the carriers of GC genotype had an increased risk of noncardia gastric cancer ( OR =1. 547 , 95% CI: 1. 145 - 2. 089) . TAZ rs1055153 was associated with the risk of non-cardia gastric cancer, compared with the GG genotype carriers , the carriers of GT + TT genotypes had a decreased risk of non-cardia gastric cancer ( OR = 0. 570 , 95% CI: 0. 400 - 0. 814) . TAZ rs6783790 and rs12490239 were not associated with the risk of non⁃cardia gastric cancer. Among the haplotypes constructed by TAZ rs16861985 , rs1055153 , rs6783790 and s12490239 , C ⁃G ⁃A ⁃A haplotype had a decreased risk of non⁃cardia gastric cancer ( OR = 0. 761 , 95% CI: 0. 612- 0. 945) , while G ⁃G ⁃A ⁃G haplotype had an increased risk of non⁃cardia gastric cancer ( OR = 1. 894 , 95% CI:1. 314 - 2. 730) . The fourth⁃order interaction of TAZ rs16861985 , rs1055153 , rs6783790 and rs12490239 was associated with non⁃cardia gastric cancer risk(P < 0. 05) . Conclusion TAZ rs16861985 and rs1055153 may play a role in the risk of non⁃cardia gastric cancer. The C ⁃G ⁃A ⁃A haplotype constructed by TAZ rs16861985 , rs1055153, rs6783790 and rs12490239 can reduce the risk of non⁃cardia gastric cancer, and G ⁃G ⁃A ⁃G haplotype can increase the risk of non⁃cardia gastric cancer. The interaction of TAZ rs16861985 , rs1055153 , rs6783790 and rs12490239 has a synergistic effect innon⁃cardia gastric cancer.

Objective To develop a MOSAIQ Integration PlatformCHN (MIP) based on the workflow of radiotherapy (RT) and to meet the actual requirements in China and the special needs for the radiotherapy department.Methods MIP used C/S (client-server) structure mode running on the local network in the hospital and its database was based on the Treatment Planning System (TPS) and MOSAIQ database.Five network servers,as the core hardware,supplied data storage and network service based on cloud services.The core software was developed based on Microsoft Visual Studio Platform using C# network programming language.The MIP server could simultaneously offer network service for about 200 workstations,including entry,query,statistics,and print of data.Results MIP had 15 core function modules,such as Notice,Appointment,Billing,Document Management (application/execution),and System Management,which almost covered the whole workflow of radiotherapy.Up to June 2016,the recorded data in the MIP were as follows:13546 patients,13533 plan application forms,15475 RT records,14656 RT summaries,567048 billing records,and 506612 workload records.Conclusions The MIP based on the RT workflow has been successfully developed and used in clinical practice.It is an important part of radiotherapy information system construction with the advantages of intuitive operation,real-time performance,data security,and stable operation.It is digital,paperless,user-friendly,and convenient for the retrieval and statistics of data as well as information sharing and department management,and can significantly improve the efficiency of the department.More functions can be added or modified to enhance its potentials in research and clinical practice.

Objective To investigate the prevalence and molecular characteristics of Anaplasma infections in sheep and goats in Anhui Province in 2020, so as to provide insights into ovine anaplasmosis prevention and control. Methods A total of 355 fresh blood samples were collected from 7 sheep and goat farms in Linquan County of Fuyang City, Lixin County of Bozhou City, Yu'an District of Lu'an City, Wangjiang County of Anqing City, Nanling County of Wuhu City, and Tianchang City and Fengyang County of Chuzhou City in Anhui Province from June to December 2020. A. bovis and A. phagocytophilum 16S ribosomal RNA (16S rRNA) gene, A. ovis major surface protein 4 (MSP4) gene and A. capra citric acid synthase (gltA) gene were amplified using PCR assay in all blood samples, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was calculated in sheep and goats. In addition, the positive amplification products were sequenced and subjected to genetic evolutionary analysis. Results The overall prevalence of Anaplasma infections was 17.5% (62/355) in sheep and goats in Anhui Province, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was 2.8% (10/355), 2.5% (9/355), 2.5% (9/355), and 7.0% (25/355), while the prevalence of A. bovis and A. phagocytophilum, A. phagocytophilum and A. ovis, A. phagocytophilum and A. capra and A. bovis, A. phagocytophilum and A. ovis co-infections was 0.8% (3/355), 1.1% (4/355), 0.3% (1/355) and 0.3% (1/355), respectively. No Anaplasma was detected in the sheep and goat farms in Fengyang County, while at least three Anaplasma species were detected in other sheep and goat farms, with co-infections of multiple Anaplasma species identified. The prevalence of Anaplasma infections was 14.7% (24/163) in goats and 19.8% (38/192) in sheep, and the prevalence of Anaplasma infections was 31.0% (31/100) in goats and sheep under 6 months of age, and 12.2% (31/255) in goats and sheep at ages of 6 months and older, respectively. A. bovis, A. phagocytophilum, A. ovis and A. capra were identified in sheep and goats of different breeds and ages. Conclusions Multiple Anaplasma species infections were commonly prevalent in goats and sheep in Anhui Province in 2020, notably A. phagocytophilum, A. ovis and A. capra, which have zoonotic risks. Improved surveillance and prevention and control of Anaplasma infections are required in sheep and goats in Anhui Province.