Objective To explore the impact of authentic leadership on silence behavior of nurses and test the mediating effect of organizational support. Methods The 354 valid questionnaires were collected using the a cross-sectional survey with Authentic Leadership Questionnaire, Perceived Organizational Support Scale and Silence Behavior Scale between September to November in 2015, using the multiple line hierarchical regression analysis to test the relationship between variables. Results Authentic leadership could significantly promote the perceived organizational support of subordinate nurses (β= 0.543, P<0.01), which in turn, significantly restrain silence behavior of subordinate nurses (β=-0.323, P<0.01), the perceived organizational support completely mediate the relationship between authentic leadership and silence behavior (β=0.175, P<0.01). Conclusions By constructing the supporting work environment, authentic leadership can eliminates nurses′ voice worry, motivates the voice motivation and efficiency, in turn to break the silence. This article propose the action mechanisms from three perspectives.

Objective To observe the clinical efficacy of vacuum sealing drainage(VSD) in the treatment of large-area wound infection of earthquake casualty after amputation.Methods Seven patients with large-area wound infection of earthquake casualty after amputation received sustained VSD.Results After VSD for 7~26 days,with an average of 13 days,the wound infection in the 7 patients was controlled.No systemic toxicity was found.The result of wound bacterial culture was negative.Of the 7 patients,4 received phase Ⅱ suture,3 received phase Ⅱ skin graft,and all of the grafted skin survived.Conclusion Vacuum sealing drainage exerts certain effect in the treatment of large-area wound infection of earthquake casualty after amputation.

At present,the AIDS epidemic situation in college students is becoming more and more serious.In view of the particularity of colleges students and the lack of professional team for AIDS prevention and control in colleges and universities,there exists ethical issues when carry out the prevention and control for AIDS in colleges and universities such as the ethical issue in publicity and education,the ethical issue in AIDS behavioral intervention,the ethical issue in the consultation and detection for AIDS.This paper suggests that it should confront the current situation of AIDS prevention and control,improve the professional level of carrying out AIDS prevention and control,adhere to the necessary principles of AIDS prevention and control,and explore a new mode to construct AIDS prevention and control in colleges and universities.

This paper reviews the development of appropriate health technology policy from 1992 to 2012 in Zhejiang province.The evolvement of recent twenty years is classified into several stages and each is analysed and evaluated.This study provides reference for the establishment of appropriate health technology policy and the transformation of science and technology policy across the country.

Objective To evaluate the application of M-mode echocardiography and Doppler echocardiography in diagnosing complete atrioventricular block (CAVB) in fetus. Methods M-mode and Doppler echocardiography were used to screen the fetuses and bradycadia was established as CAVB in 10 cases. Atrial and ventricular rhythm was measured by M-mode echocardiography. Flow of mitral valve, left ventricular in-flow and out-flow tract, venous duct was measured by Doppler echocardiography. The characteristics and prognoses of CAVB fetus were compared and analyzed. Results CAVB was established as independence in rhythm of atrium and ventricle. The rhythm of atrium could be in normal range, while the rhythm of ventricle should be slower than normal. Enlarged chambers were observed in 6 cases, cardiac dysfunction in 5 cases, and pericardial effusion in 7 cases. Tricuspid regurgitation and mitral regurgitation existed in 5 and 1 case, respectively. All of the CAVB fetus in this study underwent abortions. Conclusions Fetal echocardiography is proven to be a useful tool to diagnose CAVB, which greatly influenced the cardiac function in fetuses. Clear diagnosis as early as possible is crucial to the treatment of CAVB fetus.

Objective Decline in cognitive function caused by diabetes has become a research hotpots.The article aims to explore the relationship between serums regulated upon activation normal T cell expressed and secreted(RANTES) and cognitive dysfunction of newly diognosed T2DM patients, and provide a new way of prevention and treatment for newly diagnosed T2DM patients with cognitive dysfunction.Methods We retrospectively analyzed the general information and clinical biochemical indexes of the 123 patients who were first diagnosed of T2DM from March 2015 to September 2016 in Tangshan Worker''s Hospital.The levels of serum RANTES were measured by enzyme-linked immunosorbent assay (ELISA), and the cognitive function of all patients was assessed by Mini-mental State Examinatlon(MMSE)and Repeatable Battery for the Assessment of Neuropsyehologic Status(RBANS).Finally, newly diognosed T2DM patients were divided into T2DM non-cognitive disorder group and T2DM cognitive disorder group according to the MMSE score.We analyzed whether there are differences among general information,serum RANTES level and RBANS cognitive function score of two group patients.The correlations of RANTES with general information and cognitive scores were analyzed by single factor correlation and multiple stepwise regression analysis.Results ①The level of serum RANTESin T2DM cognitive disorder group[(2.62±0.37)mmol/L] was significantly higher compared to that in T2DM noncognitive disorder group[(2.29±0.36)mmol/L], and there was significant difference(P<0.001).②The instant memory,visual span,attention,delayed memory score and RBANS score of T2DM cognitive disorder group were(70.90±14.71)、(92.90±15.50)、(87.80±16.45)、(88.02±14.28)、(82.92±11.07), which were significant declined compared to those of T2DM non-cognitive disorder group [(85.28±13.97),(104.18±12.69),(101.51±12.94),(96.42±10.30),(95.84±9.94)], and there was significant difference (P≤0.05).There was no statistically significant difference between the two groups′ verbal function score [(96.08±7.87),(99.31±9.83)] (P=0.056).③The RANTES was negatively correlated with the total score of instant memory, visual span, verbal function, delayed memory score and RBANS score in T2DM patients(the valuue of r were-3.48、-2.35、-2.01、-3.02、-4.17).Conclusion There was a significant correlation between serum RANTES level and cognitive dysfunction, and elevated serum RANTES level could be used as an important indicator for monitoring newly diognosed T2DM patients with cognitive dysfunction.

Objective To observe clinical efficacy and safety on the treatment of moderate-severe cancer pain by Fluvoxamine combined with Oxycodone. Methods 120 cancer patients with moderate pain and 120 cases with severe pain were selected, randomly divided into experimental group and control group. The control group were given oxycodone alone , and experimental group given fluvoxamine combined with oxycodone , till the pain relieved, then the degree of pain relief, oxycodone dosage, life quality and side effects were evaluated. Results The degree of pain relief in experimental group were much better than control group (P < 0.05). Oxycodone consumption were lower in experimental group than control group , and the difference was no significant difference in controlling moderate pain (P = 0.065), while statistically significant in controlling severe pain (P = 0.035). The general status, daily activity, mood, and sleep affected by cancer pain were released after treatment, especially in experimental group (P < 0.05). The most common side effects were approximative, and the incidence of constipation, nausea/vomiting, lethargy were lower in experimental group than control group (P =0.026). Conclusion Fluvoxamine combined with Oxycodone can effectively control moderate-severe cancer pain, and reduce the oxycodone dosage and some side effects, and therefore, improve the quality of life.

Objective To establish a Chinese hamster model of babesia infection, to find the changing pattern of organs and biochemical parameters in Chinese hamster infected with Babesia, and to promote the detection and treatment of babesiosis.Methods Healthy 5-week old Chinese hamsters were infected by intraperitoneal injection of blood containing Babesia.Blood samples were collected at 0, 2, 4, 6, 8, 10, 12, 14, 16, 23, 30, and 37 days after infection from 5 hamsters at each time point.Blood smears were prepared to detect the parasites using Giemsa staining.ELISA assay was employed to test the IL-2 concentration.The blood biochemical indexes were detected using an automatic biochemical analyzer.DNA was extracted from the whole blood and REAL-TIME RCR was performed to determine the reproduction of Babesia.Aftert the animals were sacrificed, the heart, lung, spleen, liver, and kidney were taken to analyze the changes of organ coefficients.Results The highest level of Babesia in the hamsters occurred on day 4 after the Babesia injection, and then showing a decreasing tendency.However, there was a transient increase on the 12th day after infection.The liver and spleen displayed most extensive response to the infection showing hepatomegaly and splenomegaly, but the variation of heart and kidneys coefficients was within the norm.There were prominent changes of blood cells, especially leucocytes, with two peaks at day 10 and 23 after the Babesia infection.The peak changes of blood biochemical indexes occurred at day 12 after infection.The concentration of serum IL-2 reached a peak on the 10th day after infection.Conclusions The Chinese hamsters display typical characteristics of tick-borne diseases such as hepatomegaly and splenomegaly.The immunological system is activated along with the infection and reaches a highest stage in the second week.Afterwards the Babesia can live in the hamster body for a long period of time.The results of this study provide useful information supporting further studies on the detection, treatment and prevention of Babesiosis.

This study was undertaken to investigate the anti-lymphocytic malignacy immunologic effects induced by TCR idiotypic DNA vaccine on BALB/c mice. CEM lymphoma cell line and BALB/c mice were used as models. The rearrangement gene fragment coding TCR Vbeta region of CEM cell line was obtained by RT-PCR technique. The PCR product was cloned into the eukaryocytic expression vector pcDNA3 to be used as DNA vaccine. The experimental animals were immunized by intramuscular injection with DNA vaccine. The specific anti-idiotypic antibody was detected by indirect immunofluorescence assay. The specific anti-idiotypic cellular immunity was detected by CTL activity assay using MTT method. The results showed that specific anti-idiotypic antibody in the immunized mice sera could be found since four weeks after immunization and came to the peak of titer on the sixth week. Using IL-6 as immunological adjuvant could significantly increase the antibody titers. It was concluded that the TCR idiotypic DNA vaccine could induce effectively the specific anti-lymphoma idiotypic antibody in BALB/c mice. Using IL-6 as immunological adjuvant could significantly increase the antibody titers induced by idiotipic DNA vaccine.

OBJECTIVETo investigate the anti-human CEM lymphoma cell activities induced by TCR idiotypic DNA vaccine containing different antigen determinants in BALB/c mice.

METHODSThe specific rearranged gene fragment encoding TCRVbeta region of CEM cell line was obtained by RT-PCR technique. The PCR product was cloned into eukaryocytic expression vector pcDNA3, which was used as DNA vaccine and template for PCR amplifying different antigen determinant. Gene fragments encoding different antigen determinant were amplified and cloned into pcDNA3, separately. The experimental mice were immunized by intramuscular injection of the DNA vaccines. The specific anti-idiotype antibodies were detected by indirect immunofluorescence assay.

RESULTSTCRbetaV of CEM cell line contains five antigen determinants. Specific anti-idiotype antibody was detected in all of the six mice immunized with DNA vaccine containing all the five determinants (the highest titer was 1:480). Although the antibody could also be detected in four of the six mice immunized with DNA vaccine containing four of the five antigen determinants, the antibody titer was lower (the highest titer was 1:80). DNA vaccine containing two of the five determinants could not induce the specific antibody.

CONCLUSIONThe idiotypic DNA vaccine containing the whole TCRbetaV five antigen determinants could induce the specific anti-lymphoma idiotypic antibody in BALB/c mice.

Amino Acid Sequence ; Animals ; Antibodies, Anti-Idiotypic ; blood ; immunology ; Base Sequence ; Complementarity Determining Regions ; genetics ; immunology ; Epitopes ; genetics ; immunology ; HL-60 Cells ; Humans ; Lymphoma ; immunology ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Receptors, Antigen, T-Cell, alpha-beta ; genetics ; immunology ; Sequence Analysis, DNA ; Tumor Cells, Cultured ; Vaccines, DNA ; genetics ; immunology