Objective To explore the rate of return to work among a cohort of spinal cord injury (SCI) who were at least 18 months post injury and some psychosocial factors contributing to return to work. MethodsA convenient sampling method was adopted and total 161 subjects were involved. The demographic characteristic and psychosocial variable were collected by 6 self-reported questionnaires: World Health Organization Disability Assessment Schedule Ⅱ, Acceptance of Disability Scale, Rosenberg Self-Esteem Scale, Center for Epidemiologic Studies Short Depression Scale, Generalized Self-Efficacy Scale and Multidimensional Scale of Perceived Social Support. Self-administered, telephone and face-to-face interview were the manners to capture data. ResultsThe return to work rate is 31%. The result generated from Logistic regression showed that the type of SCI (paraplegia or quadriplegia) （OR=4.397）, acceptance of disability (OR=0.979), disability assessment level (OR=0.948), and the impact of belief to activities of daily living (OR=0.681) were the contributors for successful return to work. ConclusionFor those who suffering from SCI after 18 months, both psychosocial adjustment factors and physical functioning may have the great impacts for the outcomes of return to work rather than that of external factors, such as social supports.

Objective To evaluate the change of left atrial(LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) after catheter ablation using real-time tri-plane echocardiography (RT-3PE) as well as quantitative tissue velocity imaging (QTVI).Methods Eighty-two PAF patients underwent first-time RFCA were included.Routine and tri-plane ultrasound images of 1 week before and 1 month,3 months,6 months after RFCA were stored for offline analysis.A range of LA structural and functional parameters were measured off-line using the EchoPAC workstation,including LA anteroposterior diameter (LADap),LA mediolateral diameter (LADml) and LA superior-infra diameter (LADsi),early and late diastolic transmitral flow velocity and ratio (E,A and E/A),the peak velocity of pulmonary vein and ratio (S,D,Ar,S/D),the maximum volume of the left atrium (LAVmax),the volume before LA active contraction obtained at time of the P wave on the surface electrocardiogram(LAVp),the minimum volume of the left atrium (LAVmin),LA passive emptying fraction (LAPEF),LA active emptying fraction (LAAEF),LA total emptying fraction (LATEF),LA expansion index (LAexpI),average peak velocity of six wall of the left atrium (Vs,Ve,Va).Results After 3,6 months,LADap decreased significantly(P ＜ 0.05) ;3 months of follow up,peak A increased,E/A ratio decreased (P ＜0.05);6 months of follow up,peak A increased,E/A ratio reduced,peak S increased,peak D reduced,S/D increased(P ＜0.05) ;3 months of follow up,LAVmin reduced,LAAEF and LATEF increased (P ＜0.05);6 months of follow up,LA volume decreased,LAAEF and LATEF increased (P ＜0.05);3,6 months of follow up,the average Va increased(P ＜0.05).Conclusions LA reconstitution and function were recovering slowly 1 month after RFCA,and noticeable improvement can be observed 3 and 6 months after RFCA.

Objective To investigate the clinical manifestations of the febrile neutropenia cancer children,explore the relationship between the clinical data and sepsis.Methods A prospective observation study was employed,and 66 cancer children complicated with febrile and neutropenia after chemotherapy were enrolled.Sixty-six cases were divided into two groups:septic group ( n =26 ) and non-septic group ( n =40).Clinical and laboratory data were collected and compared.Results Body temperature,neutropenia duration,absolute neutrophic count ( ANC ),C-reactive protein ( CRP ),procalcitonin (PCT) and culture positive rate showed statistically differences between the septic and non-septic groups ( P ＜ 0.05 ).Body temperature ＞40 ℃,ANC ＜ 0.1 × 109/L,increases of serum CRP and PCT levels and positive culture were correlated with sepsis.Body temperature ＜ 39 ℃,neutropenia duration ＜ 5 ds,ANC ＞ 0.5 × 109/L were less correlated with sepsis.Conclusion High initial temperature,long duration of neutropenia,severely reduced ANC,increases of CRP and PCT,and culture-positive are correlated with sepsis in cancer children.

Objective To evaluate the effect of iron on the stability of fat emulsion in total nutrient admixture (TNA) in pediatrics. Methods Based on intravenous nutrition preparation and handling protocols, 0,0.25, 0.50, 0.75, and 1.00 mg iron sucrose was added in each 100 ml TNA, respectively, and each dose was prepared for 10 bags. The stability of fat emulsion was observed by electron scanning microscopy. The pH and osmolality were determined at different time points (0, 24, 48, and 72 h). Results The fat particle size, percentages of particles ＞ 0.5 μm, pH value, and osmolality were not significantly different among all the groups at different time points (all P ＞ 0.05). The mean particle sizes of the fat emulsion were ＜ 0.5 μm in all groups within 72 h.No fat particle with diameter ＞ 5 μm was seen in each group. Conclusion TNA containing iron sucrose with concentrations range 0.25-1.00 mg per 100 ml is stable.

BACKGROUND:Magnetic bone cements have been used to treat bone metastasis in Japan, which are made by adding Fe3O4 nanoparticles to bone cements. Magnetic bone cements containing micron carbonyl iron powder have not been reported.
OBJECTIVE:To prepare polymethylmethacrylate-based cements containing carbonyl iron powder, and to test the magnetic characterizations and the heat-generating abilities of al samples according to ISO 5833 standard in vitro. METHODS:The carbonyl iron powder was mixed with polymethylmethacrylate-based bone cement power to prepare magnetic bone cements containing 0%, 20%, 30%, 40%, and 50%carbonyl iron powder, respectively. The setting time, polymerization temperature, compressive strength, magnetic property and in vitro heat-generating ability were tested.
RESULTS AND CONCLUSION:The setting time and polymerization temperature were increased with the increased content of carbonyl iron powder. The highest polymerization temperature of each sample was 65-70 ℃. The increased content of carbonyl iron power could not change the highest polymerization temperature but delay its appearance. The compressive strength of each sample was higher than 60 MPa, and moreover, the compressive strength of the pure polymethylmethacrylate-based bone cement was higher than 60 MPa, which met the ISO 5833 standard. The saturation magnetic intensity was increased with the increasing of carbonyl iron power content. The heat-generating ability of magnetic bone cements had a positive correlation with the magnetic field strength and the content of carbonyl iron powder.

To evaluate the value of left ventricular diastolic function in type 2 diabetes mellitus (DM) using dual-gate Doppler and relative factors, we included 50 non-obesity and hypertension-free DM patients into the controlled group in the study along with 48 age-and-gender-matched healthy volunteer subjects. The peak early diastolic velocity (E), peak later diastolic velocity (A), deceleration time (DT), anterior mitral annulus diastolic peak velocity (e') , isovolumic relaxation time (IVRT), E/A, E/e', Tei index and T(E-e), were measured with dual-gate Doppler. 20 subjects were randomly selected for repetitive analysis. Study showed statistical difference in E/A, DT, e', E/e', IVRT, Tei index and T(E-e), between the two groups (P < 0.05). Linear regression analysis showed positive correlation between T(E-e), and IVRT, course of DM patients and T(E-e), (Beta = 0.295, P = 0.020), and HbA1c control level and T(E-e), (Beta = 0.399, P = 0.010). Repeated analysis showed good reproducibility for both within and between groups. Dual-gate Doppler has clinical value in evaluating left ventricular diastolic function in type 2 diabetes mellitus patients. The course of type 2 diabetes mellitus patients and HbA(1C) control level were both closely related with left ventricular diastolic function.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; physiopathology ; Diastole ; Echocardiography, Doppler ; Humans ; Hypertension ; Mitral Valve ; Regression Analysis ; Reproducibility of Results ; Ventricular Dysfunction, Left ; Ventricular Function, Left

Objective To explore the value of applying flipped classroom in human parasitology. Methods Totally 430 students of 5-year program were divided into experimental group and control group. The experimental class received human parasitology teaching through flipped classroom teaching mode, while the control class received traditional teaching. The effect of teaching was evaluated by questionnaire and examination. The data were analyzed through t-test. Result Meanwhile, statistical difference was found in aver age score of total between experiment group and control group [(68.2 ±8.6) vs. (66.6 ±11.0), P=0.032]. There was also statistical difference in average score of comprehensive analysis [(16.4±3.2) vs. (16.1 ±3.9), P=0.038]. Questionnaire survey of satisfaction showed that 191 students of experimental class (90.95%) felt new teaching mode could improve autonomous learning ability, 199 students (94.76%) in-creased interest in learning;185 students (88.10%) had more interactive with teachers, 178 students (84.76%) enhanced cooperation between st udents, 186 students (88.57%) approved of small group discussion learning and 165 students (78.57%) had no extra burden. Conclusion Flipped classroom teaching mode can improve students' autonomous learning ability and cultivate their abilities of independent thinking, cooperation, criti-cism, innovation, analyzing and solving problems. Thus this new teaching mode is worthy of reference and popularization.

Objective:To study the difference in anti-hepatic fiborsis components between pre-and post-processed Trionyx Sinensis Carapace to guide the clinical application of Trionyx Sinensis Carapace. Methods:SDS-PAGE gel electrophoresis was used to compare the constituents in pre-and post-processed Trionyx Sinensis Carapace, and the inhibitory effect on the proliferation of HSC-T6 was deter-mined by MTT. Results:The processed Trionyx Sinensis Carapace had much more components than the crude Trionyx Sinensis Cara-pace,and the relative molecular mass in the first-level band decreased resulting in the generation of micromolecular polypeptides. Both pre-and post-processed Trionyx Sinensis Carapace had anti-hepatic fibrosis, while the vinegar-processed Trionyx Sinensis was more ef-fective. Conclusion:The difference in the active components in pre- and post-processed Trionyx Sinensis Carapace is obvious, which provides foundation for the clinical application and further researches.

Objectives Tostudytheexpressionchangesofproproteinconvertase1(PC1)incerebral cortex nerve cells and its substrate neuropeptide Y (NPY)after focal cerebral ischemia in mice and to investigatetheeffectofPC1inneuronalischemicinjury.Methods Twenty-fourmaleC57micewere randomly allocated into a sham-operation group,an ischemia-reperfusion 4-or 24-hour group with computer (n=8 in each group). A rat model of middle cerebral artery occlusion was induced by the intraluminal suture method. Western blot and real-time quantitative nucleic acid amplification were used to detect the expression changes of PC1,NPY,and mRNA in mouse cortical neurons. Results (1)Compared with the sham operation group,the expression of PC1 mRNA of ischemic cortex brain tissue at ischemic side in the ischemia-reperfusion 4-hour group increased 2. 66 ± 0. 24 and in the ischemia-reperfusion 24-hour group expressed 2. 07 ± 0. 23 (all P<0. 05). Compared with the sham operation group,the PC1 precursor protein level increased significantly at 4 hours (P<0. 05). There was no significant difference in the 24-hour group (P >0. 05 ). (2 )Compared with the sham operation group,the preproNPY mRNA and protein level increased significantly after reperfusion in the ischemia-reperfusion 4-hour group (P < 0. 05 ),the mRNA expressed 2. 31 ± 0. 27,and the increase of precursor protein level continued until 24 hours. Conclusion TheexpressionofprecursorPC1increasedaftercerebralischemia-reperfusioninmice, thus affecting the processing activity of PC1 ,and resulting in NPY protein,an active substrate of PC1 accumulated with the form of precursors,which may be one of the underlying mechanisms of neuronal ischemic injury.

0 05) Left ventricular (LV) end diastolic pressure (LVEDP), volume (LVV), weight (LVW) and septal thickness (STh) were all higher and left ventricular pressure maximal rate of rise and fall (?d p /d t ) were lower (all P