Objective Investigation of satisfaction of clinical nurses and analysis of the influence factors.Methods The ERG theory of Clayton Alderfer is used as the framework to design the questionnaires,for questionnaire investigation of 249 nurses in the hospital in a stratified sampling,Results The score of general satisfaction of nurses for their work is 3.40±0.58;the satisfaction of nurses for the management of their leaders and teamwork is high,as the satisfaction scores are 4.01±0.76 and 3.60±0.71 respectively;their satisfaction for salary,welfare and social identity is low,as the scores are 2.46±0.86 and 2.50±1.02 respectively.Work satisfaction varies with departments,academic levels,monthly income,work shifts,age,seniority,and objectives for their choice of nursing as profession.Conclusion Managers are prompted to enhance their work in view of the satisfaction scores on survival,mutual relations and growth,as well as factors affecting satisfaction,and take various incentives to improve overall satisfaction of nurses.

Mammalian target of rapamycin(mTOR) inhibitors have the anti-tumor ettect,which have been known early.The traditional mTOR inhibitors include rapamycin and its derivatives,which have been applied in clinical use early.Nowadays,some new small molecule inhibitors such as the PI3K/mTOR duel inhibitor,Torinl,one after another are found to play a unique role in the tumor therapy.

Carcinoma, Adenoid Cystic ; etiology ; Ear Neoplasms ; etiology ; Humans ; Male ; Middle Aged ; Tympanoplasty ; adverse effects

[Objective] To gain more insight into the presentation,diagnosis of Bertolotti's syndrome and to investigate the indications,the procedure and the early clinical results of minimally invasive transverse process plasty.[Methods]Thirteen cases(Santavirta Type I)with Bertolotti's syndrome underwent minimally invasive transverse process plasty under MED X-tube(Medtronic Sofamor)from Apr.2006 to Dec.2008.The Visual Analogue Scale(VAS),Modified Oswestry Disability Index(ODI)score and subjective sensation of patients were recorded to evaluate the function.[Results]The operation blood loss was from 120 ml to 800 ml and operative time was from 60 to 280 minutes,average 115minutes.There was no severe complication.Nine cases were followed up for 10 to18 months,average 13.6 months.The VAS decreased from(6.7?2.2)before operation to(2.2?0.7)one week after operation and(2.8?0.9)three months after operation.ODI score decreased from(27.8?3.6)before operation to(5.9?2.2)three months after operation.The results were excellent in 10 case and good in 3 cases.[Conclusion]Minimally invasive transverse process plasty is an effective method for Bertolotti's syndrome,especially for Santavirta type I.It shows less blood loss and injury and deserves to be spreaded.Disectomy is recommended in one stage if the patient is complicated with disc herniation.

Animals ; Blood Cell Count ; Blood Cells ; Decompression Sickness ; blood ; Male ; Rabbits

Objective　To study the value and limitation of CT in the damage to multiple organs in children with Langerhans cell histiocytosis (LCH). Methods　Analysis of CT manifestations was performed in 13 cases of LCH proved by clinical features, laboratory data, and pathologic changes. Localized LCH was found in 4 cases, and disseminated LCH in 9 cases. All cases were examined by plain scan in craniocerebral, chest, liver, and spleen, and four cases by contrast-enhanced CT scan. Results　The male outnumbered female in this group. Cranial bones were involved in the sequence of temporal bone(8 cases), parietal bone (3 cases), occipital bone (2 cases), and frontal bone (1 case). CT findings were very sensitive in showing the early destructions of the bones. The characteristic manifestation on CT was multiple lytic lesions of the flat bones at any sites, without reactive sclerosis and soft tissue mass accompanied with the bony lesion. Imaging findings presented later than the clinical manifestations for LCH involving the hypothalamus/pituitary axis. Involvement of the lung at various stages by LCH could be demonstrated by CT scan. Conclusion　Imaging manifestations had no characteristics in LCH involvement. The sites of predilection and related CT manifestations could be suggestive of the diagnosis. In addition, CT findings can be helpful in the classification and evaluation of the therapy and prognosis in LCH.

Objective To evaluate the actual displacement of a femoral neck fracture following close reduction under the C-arm X-ray perspective.Methods From June, 2006 to June, 2009, we managed 12 patients with femoral neck fracture by open reduction and internal fixation.They were 8 males and 4 females, aged from 23 to 65 (average, 42.3) years old.We tried close reduction of their fractures under the C-arm X-ray perspective before a temporary fixation.Next we performed open reduction, readjusted the fracture ends, and placed internal fixation.The actual displacement of the fracture measured after open reduction was carefully compared with the close reduction under the X-ray perspective.Results A substantial displacement was found after open reduction in 7 patients who had achieved anatomic reduction under the X-ray perspective.In the other 5 patients who presented with a slight displacement after close reduction under X-ray perspective, the actual displacements were larger than the X-ray observations but completely reduced after open reduction.The actual measurements after open reduction were significantly larger (3.21 ± 0.96 mm on average) in the anteroposterior displacement ( t = 11.540, P = 0.000), but insignificantly larger (0.58 ±0.93 mm on average) in the superior-inferior displacement ( t = 2.184, P = 0.346) than those after close reduction.Conclusions In general, anatomic reduction can not be achieved for a femoral neck fracture under the C-arm X-ray perspective.Consequently, open reduction may be better than close reduction in the treatment of femoral neck fracture in that improper reduction can block blood supply to the femoral neck and dissection of the capsula articularis coxae can improve blood supply as well as help decompression.

Objective In order to know the harm of indoor environment pollutants to the human health. Methods Formaldehyde, benzene, dimethylbenzene, ? radiation and radon were selected as the factors of indoor environment pollution assessment, considering about the inhale and exposure path of indoor air, assessment model which from the production of inland and overseas was used to evaluate the health risk during Mar.-Oct.2005. Results The average risk of the indoor air pollution in Jiangxi province was 1.93?10-4/a, radiation (? radiation, radon) was 1.32?10-4/a, accounted for 68%. Formaldehyde was 4.64?10-5/a, accounted for of 24%. Benzene was 1.41?10-5/a, accounted for 7%. Dimethylbenzene was 1.32?10-9/a, which could be ignored. Conclusion The health risk of indoor environmental air pollutants in each city of Jiangxi province is higher than the acceptable lever(10-5/a).

Objective: To compare the histological, immunological, and biomechanical characteristics of decellularized porcine aortic valve scaffold created by 3 different decellularization protocols and to search for a more suitable technique for creating acellular tissue-engineered cardiac valve conduit. Methods: Porcine aortic valve leaflets and whole aortic roots were decellularized by 3 different protocols. Decellularization procedure in group I involved treatment wit 0.01% trypsin, 1% Triton, and nuclease for 24 h; that in group II involved treatment with 0.01% trypsin (8 h), 1% DCA, and nuclease for 24 h; and that in group III involved treatment with 1% DCA and nuclease for 32 h. All the treatments were conducted during continuous shaking at 37°C. Porcine aortic valve leaflets and whole aortic roots treated with PBS were taken as control. The decellularization efficiencies of each protocol were assessed by H-E staining, scanning electron microscopy, and transmission electron microscopy. The biomechanical features of the acellular valve matrices were examined by stress-strain tests and tensile strength tests. The immunogenicity and inflammatory responses of the decellularized matrices, valve leaflets, and aortic wall were investigated by subcutaneous implantation of them in rats. Results: The native cells in porcine aortic valve leaflets and aortic roots were completely removed in group II, which was superior to group I and III. The values of elasticity modulus and ultimate tensile strength (UTS) of group II were greater than those in group I ([5.77±0.95] MPa vs [4.15±1.13] MPa and [7.82±1.51] MPa vs [4.65±0.85] MPa, respectively; P<0.05). The extension ratios ar 1.5 MPa and at rupture in group II were less than those in group I ([0.33±0.04] vs [0.41±0.09] and [0.45±0.02] vs [0.60±0.06]; P<0.05), but the extension ratio at rupture was similar to that of fresh porcine aortic valves ( [0.45±0.02] vs ([0.46±0.03]). Histological analysis showed only slight inflammatory responses in groupIIand the host cells grew into the matrix, rebuilding the acellular matrices gradually. Conclusion: Decellularization using 8-hour pretreatment with 0. 01% trypsin, followed by 24 hours incubation with 1% DCA plus nuclease is effective and convenient; it not only removes the cells but also decreases the immunogenicity of the aortic valve matrices, making the product an excellent material for tissue-engineered cardiac valve conduit.

Objective: To investigate the feasibility of constructing a tissue-engineered heart valve (TEHV) with endothelial cells differentiated from bone marrow mesenchymal stem cells (BMSCs) and acellular porcine aortic valve matrices. Methods: Primary ovine BMSCs were cultured in M199 medium supplemented with basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), insulin like growth factor (IGF) and heparin, and were induced to differentiate into endothelial cells with vascular endothelial growth factor (VEGF). Decellularized valve matrices were developed from porcine aortic valves treated with detergent and enzymatic procedure. TEHV was constructed by seeding differentiated endothelial cells onto acellular matrices. Morphological characteristics of TEHV were evaluated by histological and electron microscopic observations. Results: H-E staining, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) demonstrated that the surface of tissue-engineered valve leaflets and the inner surface of tissue-engineered valve conduits were confluent, covered with a monolayer of spindle-shaped cells positive of CD34 and factor VIII related antigen. Conclusion: Endothelial cells differentiated from BMSCs have the same biological characteristics as mature endothelial cells. Development of TEHV with differentiated endothelial cells (induced by BMSCs) is feasible and simple.