Objective To explore the effect of psychological contract on innovation behavior in nurses.Methods 266 nurses were questionnaired with Psychological Contract Scale and Innovative Behavior Scale.And then,explored the relationship between the psychological contract and innovative behavior.Results ①The average score of nurse innovative behavior was (4.58 ± 0.73),which was in the middle level.There were significant differences between the scores of innovative behavior of nurses in the different age,or work experience,or professional titles.②Pearson correlation analysis showed that nurse innovative behavior score was significantly negatively correlated with each dimension of psychological contract(r=-0.542-0.441,P＜0.05).③The multiple hnear regression analysis showed that the scores of development responsibility of hospital,realistic responsibility of hospital,personal development responsibility and personal realistic responsibility were the independent influencing factors of nurse innovative behavior.Conclusions Psychological contract is the important influencing factor of nurse innovative behavior.

Objective To survey the CT radiation dose to cancer patients,and to compare it with diagnostic reference level (DRL) provided by newly issued national standard.Methods Computed tomography dose index weighted (CTDIw) of 5 CT equipments was measured by the standard phantom with typical scanning protocol and radiation dose parameters including average computed tomography dose index volume (CTDIvol),dose length product (DLP),75％ DLP with 900 adult and 300 pediatric cancer patients were collected.According to age stage,effective dose was estimated.Results The measured CTDIw for head scanning was on the same level with DRL,while lumbar vertebra and abdominal scanning were lower than DRL.To adults,DLP of cerebrovascular enhanced scanning and effective dose of abdominal enhanced scanning were the highest.To pediatric patients,there was no significant difference in DLP among different ages.Conclusion CTDI only reflects the dose contribution from a slice,but do not reflect the cumulative dose.For the patients need multiphase scanning,because they may be exposed to high dose,national standard should provide DLP value as the diagnostic reference level.Using individual scanning protocol is an effective method to reduce radiation dose of pediatric patient.

Objective To observe the efficacy and safety of Bushen Huoxue Prescription in the treatment of kidney deficiency and blood stasis type primary osteoporosis. Methods Totally 50 patients with kidney deficiency and blood stasis type primary osteoporosis were collected. They were given Bushen Huoxue Prescription granules twice a day, taking with water, for 12 weeks. Before and after treatment, the femoral neck, Ward's area, L1–4 bone mineral density (BMD) were measured. VAS and TCM syndrome integrals were evaluated before and 4, 8 and 12 week of treatment. The level of serum osteocalcin (OC), β-C-terminal telopeptides of type I collagen (β-CTX) and osteoprotegerin (OPG) were detected before and after treatment. Hematuria routine, liver and kidney function were under safety testing before and after treatment. Results Bushen Huoxue Prescription could significantly increase BMD of left femoral neck and Ward's triangle (P=0.001, P=0.044). L1–4 BMD increased, without statistical significance (P=0.172). The total effective rate was 60.870% (28/46) for L1–4 and left femoral neck and 58.696% (27/46) for Ward's triangle. The VAS and TCM syndrome integral decreased significantly 4 weeks treatment compared with that before the treatment (P<0.01), and the scores decreased significantly with the prolongation of treatment time (F=159.690, P<0.001; F=163.970, P<0.001). After 12 weeks, treatment, the total effective rate for TCM syndromes was 78.26% (36/46). Serum levels of OC and β-CTX showed a tendency to increase, while serum levels of OPG showed a tendency to decrease, without statistical significance (P=0.087, P=0.091, P=0.419). There was no serious adverse reaction in hematuria routine and liver and kidney function. Conclusion Bushen Huoxue Prescription has obvious clinical efficacy for kidney deficiency and blood stasis type primary osteoporosis, which can improve the patients' BMD, improve bone metabolism, relive bone pain, with high level of safety.

AIM: To determine the effects of valsartan on calcium channel and sodium-calcium exchanger current in isolated ventricular myocytes of congestive heart failure (CHF) rats. METHODS: Eight weeks after coronary ligation, the rats with heart failure were confirmed by measuring the hemodynamic parameters and divided randomly into the group treating with valsartan (CHF-T, 20 mg/kg) and placebo (CHF-C). Sham-operated group rats served as negative controls (PS). Twelve weeks later, 6 rats were selected randomly for the study of ion channel. Single ventricular myocytes of rats were isolated by enzymatic dissociation. The whole-cell patch-clamp recording technique was used to record calcium channel current and sodium-calcium exchanger current. RESULTS: (1) In the hemodynamic variables, HR and blood pressure were not significantly different in three groups. Compared CHF-C with PS group, LVEDP and Cm increased, LVSP and ?d p /d t max decreased ( P 0 05). (4) Na +-Ca 2+ exchanger current in CHF-C group increased significantly. Na +-Ca 2+ exchanger current in CHF-T group was smaller significantly than that in CHF-C group. However, CHF-T group and PS group were not significantly different. CONCLUSION: Administration of valsartan is effective in preventing from cardiac function deterioration, increases calcium channel current and decreases Na +-Ca 2+ exchanger current in ventricular myocytes of heat failure rats.

ObjectiveTo observe the influence of mitochondrial cytochrome c oxidase(COX) decrease on cholinergic and dopaminergic system in brain of model rats.MethodsRats were administrated with 1mg/kg/h or 2mg/kg/h subcutaneously via an Alzet minipump for 30 days. Choline-acetyl-transfertase(ChAT) and acetylcholinesterase(AChE) activity in hippocampus and cortex of rats were measured by radiochemical method and hydroxylamine colorimetry separately. The contents of Norepinephrine(NE), dopamine, 5-hydroxytryptamine(5-HT) and their metabolic products in striatum were measured by HPLC.ResultsChAT activity was significantly inhibited in hippocampus and cortex of model rats, however, the activity of AChE increased in hippocampus and was not affected at the cortex. Therefore, the ratio of ChAT/AChE decreased in model rats. The content of NE, dopamine, 5-HT and their metabolic products in striatum were not different among all groups.ConclusionsCOX deficiency can induce abnormality of ChAT and AChE activity in model rats. Dysfunction of neurotransmitter-acetylcholine would be account for learning-memory deficiency. Model rats indicated cholinergic system deficit without any dopaminergic system abnormality, so chronic infusion of sodium azide via minipump may specially serve as a tool for developing the experimental model of Alzheimer's disease.

Objective To investigate the morbidity, relevant factors and diagnostic methods of lower extremity deep venous thrombosis (LEDVT) after gynecological pelvic surgeries. Methods A prospective study was carried out investigating the morbidity, characteristics, risk factors, the coagulation function changes and diagnostic methods of LEDVT post-gynecological pelvic operations in 141 cases. Platelet, prothrombin time, activated partial thromboplastin time, fibrinogen, thrombin time, D-dimer, antithrombin-Ⅲ, tissue plasminogen activator, plasminogen activator inhibitor were measured within 1 week before surgeries,48 hours and 5-7 days post-surgeries respectively. Color Doppler flow imaging was performed simultaneously. Results (1)Twenty-two cases were found with LEDVT, the morbidity of LEDVT after gynecological procedures was 15.6%. It occurred 2-7 days post operation.(2)The risk factors were bedfasting, coagulant prescription post-operation, cardiovascular disease, ageing, pelvic lymphadenectomy, general anesthesia, and malignancy. Multivariate regression showed only age and coagulant prescription post-operation were independent factors. (3)The level of D-dimer was (0.9?0.6) mg/L in LEDVT group, significantly higher than that of non-LEDVT group[(0.5?0.4) mg/L, P

We integrate web-based learning with team based learning,which is called WTBL method (Web-based and team-based Learning). WTBL method is constructed and applied to the teaching practice of core curriculum group courses of clinical medicine. We build some small private online courses. The students can preview online and do the case discussions by teamwork in class. The application of WTBL teaching method has realized the flipping of classroom, and helps to enhance students' self-learning ability and teamwork ability.

Objective:To explore the peer support experience of newly graduated nurses during standardized training period.Methods:Using phenomenological qualitative research methods and purposive sampling, from April to December 2020, 32 new nurses who participated in the standardized training peer support program in the Affiliated Hospital of Yangzhou University were selected. Semi-structured interview was conducted and Claizzi content analysis method was used to analyze the data.Results:Peer support during the standardized training of new graduated nurses could be summarized into four major themes and eleven sub-themes. Theme 1: cognition and attitude (emotional security, adaptive guidance, recognition of the value of peer support, positive intention to support). Theme 2: peer support needs (department-related information needs; knowledge and skills experience needs; emotional communication needs; career growth support needs). Theme 3: peer support experience (adaptive behavior changes, cognitive and emotional changes, differences in perceived expectations of supporters and support effects).Conclusions:During the standardized training, we should attach importance to the important supporting role of peer support for new nurses. By building a peer support platform for new nurses and broadening experience exchange channels, we can enhance the positive experience of peer support, so as to promote the role adaptation and career growth of new nurses.

Mild cognitive impairment (MCI), as a nosological entity referring to elderly people with MCI but without dementia, was proposed as a warning signal of dementia occurrence and a novel therapeutic target. MCI clinical criteria and diagnostic procedure from the MCI Working Group of the European Alzheimer's Disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Beijing United Study Group on MCI funded by the Capital Foundation of Medical Developments (CFMD) proposed the guiding principles of clinical research on MCI. The diagnostic methods include clinical, neuropsychological, functional, neuroimaging and genetic measures. The diagnostic procedure includes three stages. Firstly, MCI syndrome must be defined, which should correspond to: (1) cognitive complaints coming from the patients or their families; (2) reporting of a relative decline in cognitive functioning during the past year by the patient or informant; (3) cognitive disorders evidenced by clinical evaluation; (4) activities of daily living preserved and complex instrumental functions either intact or minimally impaired; and (5) absence of dementia. Secondly, subtypes of MCI have to be recognized as amnestic MCI (aMCI), single non-memory MCI (snmMCI) and multiple-domains MCI (mdMCI). Finally, the subtype causes could be identified commonly as Alzheimer disease (AD), vascular dementia (VaD), and other degenerative diseases such as frontal-temporal dementia (FTD), Lewy body disease (LBD), semantic dementia (SM), as well as trauma, infection, toxicity and nutrition deficiency. The recommended special tests include serum vitamin B12 and folic acid, plasma insulin, insulin-degrading enzyme, Abeta40, Abeta42, inflammatory factors. Computed tomography (or preferentially magnetic resonance imaging, when available) is mandatory. As measurable therapeutic outcomes, the primary outcome should be the probability of progression to dementia, the secondary outcomes should be cognition and function, and the supplement outcome should be the syndrome defined by traditional Chinese medicine. And for APOE epsilon4 carrier, influence of the carrier status on progression rate to dementia and the effect of treatment should be evaluated.

In order to provide the "guiding principles of clinical research on mild cognitive impairment (MCI) (protocol)" edited by Beijing United Study Group on MCI of the Capital Foundation of Medical Developments (CFMD) with evidence support, clinical criteria, subtypes, inclusion and exclusion of MCI, and use of rating scales were reviewed. The authors suggested that MCI clinical criteria and new diagnosis procedure from the MCI Working Group of the European Alzheimer's disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Diagnostic rating scales including Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Instrumental Activities of Daily Living (IADL) are very useful in definition of MCI but can not replace its clinical criteria. Absence of major repercussions on daily life in patients with MCI was emphasized, but the patients may have minimal impairment in complex IADL. According to their previous research, the authors concluded that highly recommendable neuropsychological scales with cut-off scores in the screening of MCI cases should include Mini-Mental State Examination (MMSE), logistic memory test such as Delayed Story Recall (DSR), executive function test such as Clock Draw Test (CDT), language test such as Verbal Category Fluency Test (VCFT), etc. And finally, the detection of biological and neuroimaging changes, including atrophy in hippocampus or medial temporal lobe in patients with MCI, was introduced.