Objective To investigate the current state of nurse leaders′leadership and nurse physician cooperation, to explore the relationship between them, and to provide reference for improving nurse physician cooperation situation. Methods Totally 193 nurse leaders were recruited who were participated in Anhui nursing management training courses. A series of questionnaires were used to collect data, including general information, competency inventory for registered nurse, nurse physician cooperation scale. Results One hundred and eighty- two questionnaires were valid. The score of nurse managers′leadership was (27.85±6.27) points,while the score of nurse physician cooperation scale was (68.31±11.67) points. Hierarchical regression analysis showed that the control of general information, leadership for the interpretation of the nurse physician cooperation level increased by 27.3% (△R2 = 0.273, P = 0.000). Conclusions Hospital managers can adopt effective strategies to raise the level of nurses' leadership, which further increases the nurse physician cooperation level.

Purpose To analyze the high-frequency sonographic images of lymph nodes in mesenteric lymphadenitis of different ages. Materials and Methods 139 children with mesenteric lymphadenitis (study group) and 60 normal children (control group) were divided into 1 to 5 years, 6 to 10 years and 11 to 15 years group, the characteristics of high-frequency ultrasound sonographic images were analyzed, accuracy of longitudinal diameter (L), transverse diameter (S), aspect ratio (L/S) and color Doppler blood flow signal classification for the prediction of mesenteric lymph nodes swelling were evaluated using receiver operating characteristic (ROC) curve. Results Mesenteric lymph nodes in the control group appeared as spindle shape with sparse blood flow signals, L, and L/S increased with age increasing (F=4.047, 9.586;P<0.05). Mesenteric lymph nodes in the study group displayed as oval or teardrop-shaped with rich blood flow signals, L, S and L/S did not change significantly with age increasing (F=0.184, 1.084, 2.083; P>0.05). Compared with the control group, blood flow signals were more abundant in all age groups of the study group, L and S were also significantly higher (L:t=-13.798,-12.813,-8.089;S:t= -8.212,-13.172,-9.606, P<0.01), only in the 1 to 5 years group statistically significant difference (t=-3.208, P<0.05) was showed between the two groups. From 1 to 5 years, the sensitivity and specificity for the judgment of lymph node swelling were 95.56%and 100.00%, respectively when using L=9.85 mm as a standard;from 6 to 10 years, the sensitivity and specificity for the judgment of lymph node swelling were 95.59%and 100.00%, respectively when using L=10.25 mm as a standard;from 11 to 15 years, the sensitivity and specificity for the judgment of lymph node swelling were 92.31%and 100.00%, respectively when using S=4.40 mm as a standard. Conclusion High-frequency ultrasound is able to display the location distribution and morphological characteristics of the mesenteric lymph nodes in children, and also to accurately measure the diameters and flow signal distribution of the lymph nodes, thus will provide valuable evidence for the diagnosis of pediatric mesenteric lymphadenitis.

Objective To explore the pain beliefs and perceptions held by patients with digestive system cancer.Methods 10 patients with digestive system cancer were interviewed for exploration of their pain beliefs and perceptions.The data were collected using in-depth interview and analyzed with category approach.Results The beliefs and perceptions held by patients with digestive system cancer were presented as:negative pain beliefs,negative emotional perceptions,view social support as important resources.Conclusions The pain beliefs and perceptions in digestive system cancer pain patients are negative.Clinical medical workers should pay attention to the role of beliefs in pain management,and help patients build positive pain beliefs through utilizing social support resources effectively.

Objective:To explore the correlation between single nucleotide polymorphisms (SNPs) in Homo sapiens longevity assur-ance homologue 2 (LASS2) gene 3′-untranslated regions (UTR) and susceptibility of bladder cancer among residents of Yunnan, China. Methods:A total of 105 bladder cancer patients (bladder cancer group) and 100 nonbladder cancer patients (control group) were se-lected. PCR method and sequence for LASS2-3′-UTR were performed to identify the SNPs correlated with bladder cancer. The relation-ships between the LASS2-3′-UTR polymorphisms and bladder cancer risk were analyzed. Results:An SNP (rs8444) was identified in LASS2-3′-UTR, and the T/C allele frequencies and genotype distributions of rs8444 largely differed between the bladder cancer and control groups (χ2=10.267, P=0.006;χ2=10.634, P=0.001). Individuals that carry the rs8444 C allele or CC genotype had a remarkably lower risk of bladder cancer compared with those that carry the T allele or TT genotype (OR=0.489, 95%CI:0.309-0.772, P=0.002;OR=0.258, 95%CI:0.081-0.827, P=0.023). No significant correlations were observed between the T/C allele frequencies and genotype distri-butions of rs8444 and TNM stage, as well as histological grade and distant metastasis in bladder cancer (P>0.05). Conclusion: The rs8444 C allele or CC genotype located within LASS2-3′-UTR can lower the susceptibility of bladder cancer among the residents of Yun-nan, China. However, it is not associated with the TNM stage, histological grade, and distant metastasis.

Objective To investigate the clinical value of cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase MB(CK-MB) in early diagnosis of myocardial injury(MCI) in neonatal asphyxia.Methods The serum cTnⅠ and CK-MB in neonates [34 with asphyxia and MCI,38 with asphyxia but no MCI(NMCI)],and 30 cases of normal control(NC) were measured with direct immunoassay chemiluminometric technology and immunoinhibition enzymes-activated assay.Results The cTnⅠ level in NC group had no changes within 10 days after birth,MCI group were significantly higher than those in NMCI and NC groups(all P0.05).The diagnostic sensitivity,specificity and accuracy of cTnⅠ for neonates with MCI were 91%,88% and 89%,respectively;and of CK-MB were 85%,68% and 74%,respectively.Conclusions cTnⅠ and CK-MB can be taken as early diagnostic markers of MCI in neonates with asphyxia,(cTnⅠ) is better than CK-MB.

Critical care medicine is a study about the characteristics and regularity of any injury or disease leading to the development of the body to death, and which is also a study about treatment of severe patients on the basis of these characteristics and regularity. Informatization, as a noun, refers to the historical process of making full use of information technology, developing and utilizing information resources, promoting information and knowledge sharing, improving the quality of economic growth, and promoting the economic and social development transformation. On the other hand, as an adjective, it means the new form or state of an object or domain as a result of its intensive application of information technology. The combination of critical care medicine and informatization can be divided into three stages: (1) critical care medicine, informatization, (2) critical care medicine and informatization, and (3) information based critical care medicine. The development of informatization is to serve mankind, also to serve critical care medicine. At the same time, the improvement of critical care medicine affirms the meaning of informatization, which promotes the development of informatizatiion. From computer to internet, to internet of things, to big data and artificial intelligence, the combination of critical care medicine and informatization is constantly opening up a new chapter.

Transcription factor EB(TFEB)is a member of the MiTF/TFE family and plays an important role in cell stress,metabolism,cancer and so on.There are relatively few studies on the role of TFEB in renal diseases.TFEB was initially found to be highly expressed in TFEB-fusion renal cell carcinoma and plays a key role in the development of re-nal cell carcinoma.Blocking the downstream signaling pathway activated by TFEB would be a promising treatment for TFEB-fusion renal cell carcinoma.On the contrary,the expression of TFEB in renal intrinsic cells is decreased in diabetic kidney disease,leading to a blockage in the autophagy-lysosome pathway.TFEB enhances the ability of cell stress and self-repair,and then delays the progress of diabetic kidney disease.In cystine nephropathy,TFEB expression is reduced in re-nal tubular epithelial cells and compensatory activation is insufficient as well.TFEB over-expression effectively eliminates intracellular cystine and repairs damaged lysosome,which is expected to alleviate or cure the Fanconi syndrome.In summa-ry,TFEB plays a key role in different kidney diseases,and targeted regulation of TFEB provides new hope for the treatment of kidney diseases.

OBJECTIVETo investigate the levels of CD4+CD25+CD127(low) regulatory T cells (Tregs) and the expression of Foxp3 gene in peripheral blood of children with aplastic anemia (AA) and to study their roles in the pathogenesis of AA.

METHODSTwenty-one children with chronic AA, 9 with acute AA and 15 healthy children were enrolled. The proportion of CD4+CD25+ CD127low Tregs in CD4+ T cells was evaluated by flow cytometric analysis. The level of Foxp3 mRNA was ascertained by RT-PCR.

RESULTSThe percentage of peripheral blood CD4+T cells and CD4+CD25+ and CD4+CD25+CD127(low) Tregs in CD4+T cells in both the acute and chronic AA groups was significantly lower than that in the normal control group (P<0.05).The acute AA group had more decreased CD4+ T cells and CD4+CD25+ and CD4+CD25+CD127(low) Tregs percentage compared with the CAA group (P<0.05). The expression of Foxp3 mRNA in peripheral blood decreased obviously in the acute AA group (0.47 + or - 0.08%) compared with that in the normal control (0.71 + or - 0.12%) and the CAA groups (0.68 + or - 0.14%) (P<0.05).

CONCLUSIONSThe low expression of Tregs and Foxp3 mRNA in peripheral blood may be involved in pathogenesis of AA.The more decreased Tregs and Foxp3 mRNA expression in acute AA than chronic AA suggests their possible roles in the assessment of the severity of AA.

Adolescent ; Anemia, Aplastic ; etiology ; genetics ; immunology ; Child ; Child, Preschool ; Female ; Forkhead Transcription Factors ; genetics ; Humans ; Male ; RNA, Messenger ; blood ; T-Lymphocytes, Regulatory ; immunology

OBJECTIVETo manufacture the individual polyurethane (PUR) auricular framework using the rapid prototyping (RP) technique and to evaluate its feasibility in ear reconstruction.

METHODS3-D models of the patient's auricle were reconstructed according to the computed tomography (CT) data. The supporting and drainage structures were created. Then the individual PUR auricular frameworks were manufactured using RP technique. The frameworks were tested for the fatigue strength and elasticity. The frameworks were also put at the subcutaneous layer of rat. At 1, 2, 4, 8, 12 weeks after operation, the shape of the reconstructed ears was observed and the histological examination was performed.

RESULTSThe PUR framework had good elasticity and a much better fatigue strength than high density polyethylene (HDPE) framework. The shape of reconstructed ear matched the prototype very well. The around tissue grew into the implant pore and adhered tightly to the framework 2 weeks after implantation. Histologic examination showed integrated capsule four weeks later without lymphocytes infiltration. The shape kept very well twelve weeks later.

CONCLUSIONSPUR auricular framework manufactured by the 3D reconstruction and RP techniques has very good shape, intensity and elasticity. It can be selected to replace the autograft of rib cartilage framework.

Animals ; Computer-Aided Design ; Ear, External ; surgery ; Humans ; Otologic Surgical Procedures ; instrumentation ; Prosthesis Design ; Rats ; Rats, Wistar ; Reconstructive Surgical Procedures ; instrumentation ; Stents

BACKGROUNDThe role of the cerebral venous system (CVS) in intracranial pressure (ICP) regulation remains largely unclear. In the present study, the interaction between ICP and the cerebral venous system and its possible mechanism were investigated with respect to the biological characteristics of the cerebral venous system and its hemodynamic response under increased ICP.

METHODSWe created intracranial hypertension animal model, measured and calculated the venous flow velocity and diameter of the outflow terminal of the CVS with color ultrasonic system and recorded the vascular morphology by 3-dimensional anatomical microscopy. Patients who suffered from raised ICP underwent MRI and digital subtraction angiography (DSA) examination to show the length in the vertical direction of the wall of the bridging vein representing the diameter value. Pathological autopsy was performed from bodies of patients who had died from non-cerebral causes to observe the juncture part between the venous sinuses and tributary vertical brain veins.

RESULTSUnder increased ICP conditions, venous drainage through the outlet cuff segment, a unique structure between the bridge vein and sinus, was obstructed and in turn venous blood became congested. Therefore, the increased blood volume worsened the pre-existing ICP according to the well-accepted theory regarding volume-pressure relationship. This phenomenon was described as concurrent "venogenic intracranial hypertension", which is characterized by intracranial venous blood stasis responsive to and together with the original increased ICP.

CONCLUSIONSThe existence of this special pathophysiological process is prevalent, rather than rare, in various intracranial disorders. This finding would definitely provide new insight into the area of cerebral venous system research.

Adult ; Cerebral Veins ; pathology ; physiopathology ; Cerebrovascular Circulation ; physiology ; Female ; Hemodynamics ; physiology ; Humans ; Intracranial Hypertension ; pathology ; physiopathology ; Intracranial Pressure ; physiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult