Objective To investigate the status of social support and job satisfaction of community nurses and their relationship in Wuhan. Methods A total of 230 community nurses from 20 community health service centers in Wuhan were investigated by general information questionnaire, job satisfaction scale of community nurse and social support scale. Results The total score of job satisfaction was (96.14±14.76) points, the highest score of dimension was leadership and management (23.64±4.60) points, and the lowest was pay and welfare (10.83±3.00) points. The total score of social support was (37.17±7.05) points, the highest score of dimension was perceived social support (20.15 ± 4.48) points, the lowest was availability (8.05±1.57) points. There was a positive association between community nurses′social support and job satisfaction (r=0.248, P<0.05). Conclusions Social support is one of the predictors of job satisfaction. In order to make sure the sustainable development of community health services, it is necessary to know the status and take corresponding measures to improve the levels of social support and job satisfaction.

Objective To detect estrogen receptor and DNA index in breast cancer by flow cytometry. Methods 32 cases of fresh specimens of breast cancer resected by operation were used in this study. Single cells suspension was prepared from those specimens, and estrogen receptor expression was analyzed by flow cytometry. At the same time, the status of ploid and S phase cell ratio were determined. Results Flow cytometry analysis could measure the expression level of estrogen receptor in the fresh breast cancer specimens, which was more sensitive and needed less volume of tumor tissue compared with immuohistochemical method. The information on the status of ploid and S phase cell ratio were simultaneously obtained. Conclusion The detection of estrogen receptor in breast cancers by flow cytometry was more helpful for evaluating prognosis and selecting treatment.

Objective To study effects of tethered spinal cord on functions of bladder and urethra. Methods Thirty six patients with tethered spinal cord were evaluated by video urodynamic studies. Filling phase function of bladder was evaluated by compliance of bladder and the presence of vesicoureteral reflux; voiding phase function of bladder was evaluated by maximal detrusor pressure; the synergy between detrusor and external urethral sphincter and continence of urethra were evaluated by voiding study with synchronous X ray image and pressure flow plot. Results 50% patients was diagnosed as detrusor areflexia with low compliance bladder, which was the main type of neurogenic bladder for patients with tethered spinal cord. And 22% was diagnosed as detrusor hyperreflexia. The incidence (83%)of damage of kidney function in patients with detrsusor areflexia and low compliance was significantly higher than patients with detrusor hyperreflexia ( P

Objective To evaluate the efficacy and tolerability of midodrine (Gutron) in female patients with stress incontinence. Methods A randomized,double-blind,parallel,placebo-controlled,multicentric study was carried out.136 female patients with stress incontinence.68 cases in study group received Gutron (2.5 mg,thrice daily) for a course of 4 weeks.68 cases in control group received placebo in the same manner. Results 129 cases completed the treatment.The mean quantity of incontinent urine decreased by 9.9 g in those receiving Gutron ( n =66) and by 3.1 g in placebo ( n =63),respectively ( P 0.05). Conclusions Midodrine hydrochloride at the dose of 2.5 mg thrice daily has greater efficacy on female patients with stress incontinence than placebo, and the tolerability of midodrine was equivalent to that of placebo.

Objective To evaluate effects of acitretin on HaCaT cells cultured in hypoxic condition,and to preliminarily explore the possible therapeutic mechanisms of acitretin in psoriasis.Methods HaCaT cells were divided into several groups to be cultured in hypoxic condition with the presence of acitretin at concentrations of 10-5,10-6,10-7 and 10 8 mol/L respectively,with cells treated with dimethyl sulfoxide (DMSO) as DMSO control group and those receiving no treatment as blank control group.Cellular proliferative activity was evaluated by CCK-8 assay after 12-,24-and 36-hour hypoxic culture in vitro.The mRNA and protein expressions of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were determined by reverse transcription (RT)-PCR and Western-blot analysis,respectively,after 24-hour hypoxic culture.Results After 24-hour hypoxic culture,the cellular proliferation rate was inhibited by 13.31％ ± 1.15％,21.86％ ± 5.31％,32.05％ ± 2.99％ and 37.28％ ± 3.21％ in the 10 8-,10-7-,10-6-and 10-5-mol/L acitretin groups respectively.With the increase of culture duration and acitretin concentrations,the degree of inhibition on cellular proliferation increased gradually.Compared with the blank control group,the 10-5-mol/L acitretin group showed significantly decreased protein expression of HIF-1α (0.319 ± 0.180 vs.1.196 ± 0.088,P ＜0.05),as well as decreased mRNA and protein expressions of VEGF (mRNA:0.442 ± 0.090 vs.1.108 ± 0.073;protein:0.216 ± 0.066 vs.1.174 ± 0.186;both P ＜ 0.05).However,no significant difference was found in the mRNA expression of HIF-lα between the 10-5-mol/L acitretin group and blank control group.Conclusion Acitretin can suppress the in vitro proliferation of HaCaT cells cultured in hypoxic condition,and down-regulate the expressions of HIF-1α and VEGF proteins as well as VEGF mRNA.

Objective:To deteat N‐terminal pro B type natriuretic peptide (NT‐pro BNP) and cystatin C (Cys C) con‐tent in Kazak patients with hypertensive heart disease (HHD) complicated heart failure (HF) and analyze the corre‐lation between them .Methods :A total of 100 Kazak HHD patients were divided into hypertension complicated HF group (Complicated HF group , n=50) and pure HHD group (n=50) .Venous blood sample was taken within 24h after hospitalization for measuring serum levels of NT‐proBNP and Cys C ,then they were compared and analyzed between two groups .Results:Compared with pure HHD group ,there were significant rise in serum levels of NT‐proBNP [ (246.53 ± 165.65) ng/L vs .(4568.32 ± 2722.36) ng/L] and Cys C [ (0.82 ± 0.31) mg/L vs .(1.93 ± 2.46) mg/L] in complicated HF group , P< 0.01 both .Spearman correlation analysis indicated that serum NT‐proBNP level was positively correlated with Cys C level in complicated HF group , r=0.961 , P<0.01. Conclusion:In Kazak patients with hypertensive heart disease complicated HF ,serum NT‐proBNP and Cys C levels significantly rise and they significantly positively correlate ,so it suggest there may be slight damaged renal function also .

Objective To observe the effect of early intervention on motor and mental development in premature infants. Methods 108 cases of hospital-born premature infants were divided into early intervention group (n=57) and control group (n=51). All the cases accepted conventional treatment and health-care, and the intervention group accepted the early intervention in addition. They were assessed with psychomotor development index (PDI) and mental development index (MDI) of Bayley Scales of Infant Development when they were 1 or 2 years old. The incidence of cerebral palsy when they were 2 years old were recorded. Results 2 cases (1 for each) lost during the follow-up.The PDI and MDI were more in the intervention group than in the control group (P<0.05), both as the 1 and 2 years old. The incidence of cerebral palsy was less in the intervention group than in the control group (P<0.05). Conclusion The early intervention can promote mental and motor development in premature infants, and reduce the incidence of cerebral palsy later.

Objective To calculate the effects of thermoplastic mask on X-ray surface dose.Methods The BEAMnrc Monte Carlo Code system, designed especially for computer simulation of radioactive sources, was performed to evaluate the effects of thermoplastic mask on X-ray surface dose.Thermoplastic mask came from our center with a material density of 1.12 g/cm2. The masks without holes,with holes size of 0. 1 cm× 0. 1 cm, and with holes size of 0. 1 cm × 0. 2 cm, and masks with different depth (0.12 cm and 0.24 cm) were evaluated separately. For those with holes, the material width between adjacent holes was 0. 1 cm. Virtual masks with a material density of 1.38 g/cm3 without holes with two different depths were also evaluated. Results Thermoplastic mask affected X-rays surface dose. When using a thermoplastic mask with the depth of 0. 24 cm without holes, the surface dose was 74. 9% and 57.0% for those with the density of 1.38 g/cm3 and 1.12 g/cm3 respectively. When focusing on the masks with the density of 1.12 g/cm3, the surface dose was 41.2% for those with 0.12 cm depth without holes;57.0% for those with 0. 24 cm depth without holes;44. 5% for those with 0. 24 cm depth with holes size of 0.1 cm ×0.2 cm;and 54.1% for those with 0.24 cm depths with holes size of 0.1 cm ×0.1 cm.Conclusions Using thermoplastic mask during the radiation increases patient surface dose. The severity is relative to the hole size and the depth of thermoplastic mask. The surface dose change should be considered in radiation planning to avoid severe skin reaction.

ObjectiveTo compare the calculation precision of the collapsed cone convolution (CCC) algorithm and pencil beam convolution (PBC) algorithm in TPS in heterogeneous tissue.Methods We made two virtual lung phantoms,one is single field phantom,In this case the photon beam incident into the phantom,the other is the two fields phantom and a cubic'tumor' was placed in the centre of the phantom.two opposite photon beams incident into the phantom.We calculated the dose of the'tumor' and the lung with the CCC and PBC algorithm.We compared the results in both case with if obtained from Monte Carlo (MC) method.ResultsIn the single field phantom,the photon beam incident from the high-density tissue to the low-density lung equivalent tissue,compared with the result of MC algorithm PBC algorithm overestimated the lung equivalent tissue dose (t =3.90,P =0.012) and the result of CCC algorithm is close to it ( t =2.25,P =0.087 ).In the two fields phantom,tumor boundary dose calculated by CCC algorithm and the MC algorithm are lower than that of the PBC algorithm (t =2.43,3.18,P =0.038,0.011 ),and the difference increase when the field size decrease, the beam energy increase and the density of the inhomogeneity decrease.ConclusionsWe had better use the CCC algorithm when calculating the dose of the tumor surrounded by low-density tissue or the tumor behind the low-density tissue,such as the lung cancer,esophageal cancer etc.

Objective To investigate the production of carbapenemase and 16S rRNA methylase in five isolates of pan-drugs resistant E.cloacae recovered in Ruijin hospital.Methods MICs of the five isolates to 10 antibiotics were determined by E test.Six kinds of 16S rRNA methylase genes and a series of β- lactamase genes were amplified by PCR.Shotgun cloning was performed to detect carbapenem resistance determinant.The conjugal transfer of carbapenemase gene and 16S rRNA methylase gene was performed in broth culture with E.coli J53 as the recipient.Pulsed-field gel electrophoresis (PFGE) was carried out to analyse the genotyping.IEF was performed to detect β-1actamases.Southern blot was performed to determine the location of carbapenem resistance determinant.Results The MICs of 10 antibiotics were ＞32 mg/L.Four β-1actamases with pIs of 5.4 ( TEM-1 ),6.7 ( KPC-2 ),8.2 ( SHV-12 ),8.4 (CTX-M-14) were determined.The insertion sequence in the recombinant plasmid was blaKPC-2 flanked by a transposon.blaKPC-2 was located on a large non-conjugative plasmid whereas armA was located on an other conjugative plasmid.PFGE patterns of 5 isolates were identical.Conclusion KPC-2 was responsible for carbapenem resistance in pandrugs resistant Enterobacter cloacae.There was no relationship between blaKPC-2 and armA.Although pandrug resistant Enterobacteriaceae remain rare,the emergence of this group of organism merits monitoring.