Objective To investigate the correlation between transformational leadership style and nurses' job satisfaction in emergency department.Method The survey was done among 168 emergency department nurses from 4 first class hospitals in Guangzhou by the demographic information,multifactor leadership questionnaire and Chinese nurses' job satisfaction scale to investigate the status of transformational leadership style perceived by nurses and nurses' job satisfaction in the emergency departments.Results The score of transformational leadership style perceived by the nurses in the emergency department was (50.60±14.40) and jop satisfaction was (79.80±13.30).The transformational leadership style was positively correlated with nurses' job satisfaction (P＜0.01).Conclusions The transformational leadership style is middle-high level.The nurses' job satisfaction is at low level,Nursing managers should play an active role in transformational leadership style to enhance nurses' job satisfaction in emergency departments.

Objective To analysis the activity of transcriptional factors in endometrial cancer cell lines with different estrogen receptor subtypes. Methods The mRNA levels of estrogen receptor (ER) was detected by quantitative RT-PCR , and the activity of transcriptional factors was also analysed by 345-channel protein/DNA array in RL-952 ( the expression status of ERα and ERβ both positive), HEC-1A [ERα(±),while ERβ negative] and HEC-1B (ERα and ERβ both negative). The transcription factors of NFkBp65 and p38MAPK with different activity were tested by enzyme-linked immunosorbent assay(ELISA) to confirm the results of protein/DNA array. Results The mRNA levels of ERα in RL-952, HEC-1A and HEC-1B were (6780±282 ), ( 684±84 ) and ( 168±38 ) eopy/ng, respectively. Among 345 candidate transcriptional factors, there were 28 factors associated with ER status. Compared with RL-952 cells, 13 transcriptional activity factors were concomitandy up-regulation, while 15 concomitantly down-regulation in HEC-1A and HEC-1B cells. Transcriptional activities of TrF (1)-1, NRF-1, TCE were significantly correlated with the high-expression status of ERα mRNA ( r =0.523, P=0.037 ), while RFX123 and Ikaros were signitleanfly correlated with the low-expression status of ERα mRNA ( r=-0.312, P=0.041 ). Conclusion Transcriptional factors of TTF(1)-1, NBF-1, TCE may be associated with ER-mediated signal pathway, while RFX123 and Ikaros may be associated with non ER-mediatecl signal pathway in endometrial cancer.

BACKGROUND: There is no effective method to identify liver cancer stem cells until now, which has become one of the major challenges in this field. OBJECTIVE: To explore a more effective and suitable way for the identification of liver cancer stem cells in hepatocellular carcinoma cell lines. METHODS: Firstly, the single cell separation technique was used to obtain single cells, which were seeded into 96-wel plates one by one. Secondly, cell sublines derived from single cell colonies (tumorigenic colonies) were selected and obtained. At last, the cells from these clones were transplanted into the forelimb armpits of nude mice to observe the tumorigenic ability. RESULTS AND CONCLUSION: The number of holes of single cells obtained was 371 by the single cell separation technique, and the success rate was 96.4%. According to the growth of cell clone, tumorigenic colonies were selected to be transplanted to the forelimb armpits of nude mice, and the tumor formation rate of the colonies was 100%. The identification model of single-cell-transplant-tumorigenic-test for liver cancer stem cells is confirmed to be preliminarily established, which lays the technology and methodological basis for the follow-up research.

Objective To explore the relationships among nurses’intent to stay,occupational commitment and managers’ leadership styles in emergency department.Methods A total of 130 nurses in emergency department were recruited by convenience sampling method from three tertiary hospitals in Guangzhou.They were investigated by using Nurses’Intent to Stay Questionnaire, Nurses’Occupational Commitment Questionnaire and Multifactor Leadership Questionnaire(MLQ).Results The score of nurses’ intent to stay and occupational commitment were(20?19±3?74)and(76?16±12?13),respectively;both were at medium levels and occupational commitment,transformational leadership style were positively correlated with nurses’intent to stay(P<0?05).Nurses perceived their managers as transformational leaders more often than transactional leaders.Conclusions Both the current nurses’ intent to stay,occupational commitment were at medium levels.The influential factors of nurses’intent to stay in emergency department included emergency work experience,emotional commitment and normative commitment.In order to increase nurses’retention and stabilize the healthy development of nursing personnel,nurse managers should improve the level of nurses’occupational commitment.

BACKGROUND:Until now, little has been reported on establishment of pancreatic stem cell strains and lines,and the purification of pancreatic stem cells is difficult since the cell line establish rate is low.OBJECTIVE:To explore a more rational and effective technique of in vitro separation and continuous passage of pancreatic stem cells, with the hope to establish cell strains and even cell lines and to lay the foundation for the follow-up study of pancreatic stem cells in the treatment of diabetes.METHODS:Firstly, Percoll discontinuous density gradient centrifugation method was applied to separate the mouse pancreatic endocrine portion from the exocrine portion, then to obtain cell strains with highly proliferative ability and low differentiation from pancreatic endocrine portion-the islet. We used mouse embryonic fibroblasts treated with mitomycin C as a feeder layer, for in vitro continuous culture of islet-derived pancreatic stem cells under feeder layer conditions until they were transferred to the 30th passage to establish cell lines. Then pancreatic stem cell line derived from pancreatic islet was detected and identified by a series of tests including growth characteristic test, morphological observation, related molecular marker identification and differentiation characteristic identification.RESULTS AND CONCLUSION:In the continuous process of passage, pancreatic stem cells showed active proliferative ability, and maintained the typical morphological characteristics of stem cells and expression of pancreatic stem cell marker-Nestin. After induction, pancreatic stem cells showed insulin gene expression,reflecting their differentiation potential. Therefore, under the condition of feeder layer, the pancreatic stem cell line derived from Kunming mice was successfully established and the related identification was completed,which lays the foundation for the following research.

Objective To create the evaluation index system of rehabilitation service for all disabled in Shanghai.MethodsCompositive quantitative and qualitative research methods,such as literature review,focus-group discussion,questionnaire survey,specialist consultation were carried in the study.ResultsThe Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai finally comes into being includes 8 first-degree index,32 second-degree indexes and 100 third-degree index.ConclusionThe evaluation index system would be provided with directive significance to the goal of 'rehabilitation service for all disabled persons'.

Objective To explore MRI features in diagnosis of placenta accrete(PA).Methods MRI images of 19 patients with PA and 14 normal subjects were reviewed retrospectively.MRI features of the placenta and adjacent structures were analyzed and compared.Results Compared to the MRI findings of the normal subjects,abnormal uterine bulging,heterogeneous signal intensity of the placenta,and hypo-intensity intraplacental bands on T2WI were significantly higher in the patients with placenta accrete (P= 0.000,P=0.003 and P=0.015,respectively).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the three features diagnosing placenta accrete were 78.95%,85.71%,88.24%,75.00%,81.82%;84.21%,71.43%,80.00%, 76.92%,78.79%;73.68%,71.43%,77.78%,66.67% and 72.73%,respectively.Conclusion MRI has important value in diagnosing PA.The MRI features of abnormal uterine bulging,heterogeneous signal intensity within the placenta,and hypo-intensity intraplacental bands on T2WI are useful for diagnosis.

Objective To explore the effect of acute endurance exercise on the balance control,maximum contraction of the back extensor and the anticipatory postural adjustments(APAs) and compensatory postural adjustments (CPAs) of the lumbar vertebra.Methods Seventeen male students from a police college participated in this study voluntarily.Three tests were performed right before and after the 10000 meters run:the single foot standing test with eyes closed,maximum contraction test of the back extensor and arm-rising test.The maximum voluntary contraction (MVC) of the back extensor and the time of standing with eyes closed were collected.The sEMG activities of lumbar erector spinae(LES) and Lumbar multifidus(LMF) as lumbar stable muscles were recorded.The pre-activation time and integrated EMG of APAs and CPAs were calculated.Results Before and after the 10000 meters run,no significant difference was observed in MVC,but the time of single foot standing decreased significantly.On the condition of the internal postural perturbation,the LES was activated significantly earlier and the APAs IEMG of LMF decreased significantly after the run,but no significant difference was observed in the pre-activation time of LMF and APAs IEMG of LES.The CPAs IEMG of LES and LMF both decreased significantly after the run.Conclusions The acute endurance exercise of 10000 meters run does not cause fatigue of lumbar stable muscles,but it has an effect on the performance of body balance control.It has effects on the postural control strategies of the central nerve system in response to the internal sudden postural perturbation,resulting in the earlier pre-activation of LES to compensate the decreased activation magnitude of LMF.

Objective:To analyze the clinical characteristics of intracranial infection caused by Mycobacterium lentiflavum. Methods:The clinical data of a patient with intracranial infection caused by Mycobacterium lentiflavum admitted to Tianjin Haihe Hospital in May 2023 were collected. Meanwhile relevant literatures in databases were searched. Only 1 English literature (1 patient) was obtained. The clinical characteristics of this patient and the case reported in the literature were analyzed and summarized. Results:Totally 2 patients, including this case, and the patient with meningoencephalitis caused by Mycobacterium lentiflavum reported in the literature, both are females, 42 and 55 years old respectively, both manifested a chronic course, without fever, and presented progressive headache and cognitive impairment. Clinical manifestations also included abnormal mental behavior, limb weakness, and seizure. At the early stage, only intracranial pressure increased, and cerebrospinal fluid tests were negative. As the disease aggravated, there was an elevation of cerebrospinal fluid cells and protein, with normal levels of glucose and chloride. Using brain tissue obtained by biopsy for polymerase chain reaction or next-generation sequencing examination, the pathogenic microorganism was confirmed, which made accurate diagnosis possible. Antibiotic treatment had good efficacy, with a long treatment course and a good prognosis. Conclusions:Central nervous system infection caused by Mycobacterium lentiflavum is very rare, and a chronic disease course makes diagnosis very difficult. The treatment effect is significant, and the prognosis is excellent.

Objective:To analyze clinical, immunopathological, therapeutic, and prognostic features of epidermolysis bullosa acquisita (EBA) .Methods:A retrospective study was conducted on patients with confirmed EBA at the Department of Dermatology, West China Hospital, Sichuan University from January 1, 2015 to July 30, 2022. Their clinical, immunopathological, therapeutic and prognostic features were analyzed. The autoimmune bullous skin disorder intensity score (ABSIS) was used to assess the severity of lesions in patients with EBA, and the visual analogue scale (VAS) to assess itch intensity. Descriptive statistical analysis was primarily carried out, and the correlation between disease severity scores and itch scores was analyzed using Pearson correlation analysis.Results:A total of 13 patients with EBA were included, including 9 males and 4 females, with the age at the clinic visit being 49.0 ± 20.6 years and ABSIS scores being 24.2 ± 10.7 points. One patient was diagnosed with classical EBA, while the remaining 12 patients with inflammatory EBA. Mucosal involvement was observed in 6 cases, whose oral mucosae were all affected. All patients had itching to varying degrees, with VAS scores of 5.6 ± 2.2 points; 9 of the 12 inflammatory EBA patients had VAS scores of ≥ 5 points, whereas 1 classical EBA patient had a VAS score of 2 points; there was no significant correlation between the ABSIS scores and VAS scores ( r = -0.02, P > 0.05). Histopathological examination showed subepidermal cleavages or blister formation and varying degrees of perivascular inflammatory cell infiltration in the superficial dermis of patients with inflammatory EBA. Direct immunofluorescence assay demonstrated linear IgG deposits along the basement membrane zone in all 13 patients, including 12 with concomitant linear C3 deposits in the basement membrane zone, 5 with linear IgA deposits, and 2 with IgM deposits. Indirect immunofluorescence on salt-split skin showed IgG deposition on the dermal side of the salt-split skin in the 13 patients. An elevated eosinophil count in the peripheral blood was observed in 1 out of 11 patients, while increased total IgE levels were noted in 3 out of 9 patients. Among the 13 EBA patients, 11 were treated with systemic glucocorticoids (equivalent to 10 - 100 mg/d of prednisone), and the other 2 were treated with compound glycyrrhizin tablets, sulfasalazine, hydroxychloroquine sulfate, and minocycline hydrochloride alone or in combination. During the follow-up period of 34.0 (27.5, 66.0) months in the 13 patients, 8 achieved complete remission after drug withdrawal, 2 achieved complete remission on therapy, 1 achieved partial remission on minimal therapy, and 2 presented with uncontrolled condition. The time to complete remission off/on therapy was 6.0 (3.8, 17.5) months. Conclusions:The inflammatory phenotype seems to be relatively common in EBA patients, with itching to varying degrees, and oral mucosa was the most commonly involved mucosa in those with mucosal damage. After treatment with systemic glucocorticoids alone or in combination with immunomodulators, most patients could achieve complete remission.