Objective To explore the moves that creating magnetic work environment in hospital, in order to improve the nurses job satisfaction and reduce the turnover rate then stable the nursing team. Methods Through a series of measures such as the establishment of scientific rational allocation of human resources, implementing fair performance evaluation and allocation mechanism, carrying out the nurse grading management system to create magnetic nursing work environment, the nurse job satisfaction and turnover rate were compared before and after the measures. Results In January 2014 a total of 520 questionnaireswere issued, 519 valid questionnaires, and the effective recovery rate was 99.81%(519/520);And 559 were valid of 577 issued questionnaires, which was 96.88% (559/577). The overall score of nurses′job satisfaction increased from (3.20±0.46) points in 2013 to (3.41±0.52) points in 2014 (t=9.40, P= 0.000); The nurse turnover rate fell to 1.97%(13/661) from 5.13% (30/585) (χ2= 10.27, P= 0.003). Conclusions That is very important for remain stable and high quality nursing team to carry out scientific and fine management according to the demand of nurses, so as to create a safe, harmonious, positive, cooperative magnetic nursing work environment which have development direction and space.

Objective To investigate the effect of functional training on knee pain,functional movement screen (FMS) score and balance in Chinese elite fencing athletes with patellar tendinopathy.Methods Twenty-four fencing athletes with a diagnosed patellar tendinopathy were randomized into a treatment group (TG) and a control group (CG),each of 12.Both groups were given routine physical therapy,while TG received motor function training in addition for eight weeks.Both groups completed the numerical rating scale (NRS),FMS and balance test before and after the intervention.Results After the intervention,the average PRS and FMS of TG were 2.08± 1.24 and 16.25±0.97 respectively,which significantly outperformed those of TG before the intervention and those of CG after the intervention (P＜0.05).Moreover,TG indicated superior results in parameters of static postural balance including center of pressure,total length of swinging pathway,maximal length of swinging pathway,and area of swinging pathway when compared to TG before the intervention and CG after the intervention(P＜0.05).Conclusion The motor functiontraining is effective in improving functional movement and balance in elite fencing athletes with patellar tendinopathy.

The adsorption and activation of dimethyl carbonate on the surface of solid base were investigated by in situ FTIR, and the solid bases included magnesia, magnesium fluoride, Mg-Al mixed oxide and fluorine-modified Mg-Al mixed oxide. The FTIR results showed that dimethyl carbonate adsorbed on the surface of solid based by two modes of bidentate and unidentate complex. The bidentate was more active than the unidentate. Methoxyl group was formed from the adsorbed dimethyl carbonate on the surface of magnesia and Mg-Al mixed oxide. And fluomethyl group was formed from the adsorbed dimethyl carbonate on the surface of sodium fluoride. However, dimethyl carbonate on the surface of fluorine-modified Mg-Al mixed oxide showed preference for generating fluomethyl group. With the increasing of the treating temperature of samples, the methoxyl group was gradually formed on the surface. Accordingly, the fluorine-modified Mg-Al mixed oxide was found to be an excellent catalyst for methylation.

Objective:To explore the protective effect of vagus nerve stimulation (VNS) on the prognosis of rats suffering from cardiac arrest/cardiopulmonary resuscitation (CA/CPR) under different treatment timings.Methods:The method of percutaneous epicardial electrical stimulation was used to establish CA model of rat. Fifty-three male SD rats were randomly (random number) divided into the sham group ( n=5), CPR group ( n=12), PRE group ( n=12), POST5 group ( n=12) and POST30 group ( n=12). The sham group did not experience CA/CPR. VNS treatment was started at 30 min before CA (PRE group, n=12), 5 min after recovery of spontaneous circulation (ROSC) (POST5 group, n=12), and 30 min after ROSC (POST30 group, n=12) in different VNS-treated group, respectively. The electrical stimulation was applied to the vagus nerve for 30 min with a unified parameter. The neurological deficit scores at 24, 48, and 72 h after ROSC were recorded, and the survival rate in each group was observed. TUNEL staining was used to detect the apoptosis of cortical area and the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in brain tissue was measured by immunofluorescence at 72 h after ROSC. Variables were compared with one-way analysis of variance, and survival for Kaplan-Meier curves were tested with the log-rank test. A P value less than 0.05 was considered statistically significant. Results:Compared with the CPR group (survival rate 33.33%), both pre-treatment (survival rate 75%) and post-treatment of VNS (POST5 group survival rate 75% and POST30 group survival rate 83.33%) significantly improved the 72 h survival rate after CPR ( P<0.05), mitigated neurological deficits after ROSC, reduced the positive rate of apoptosis neurons, and up-regulated the expression of α7nAChR in cerebral cortex. There was no significant difference among the VNS-treated groups (all P>0.05). Conclusions:Both pre-treatment and post-treatment of VNS can play a protective role in rats after CA/CPR, which may be related to the activation of α7nAChR-mediated anti-inflammatory and anti-apoptosis effects.

Objective:To explore the effect of case-based learning (CBL) guided by ICF (International Classification of Functioning, Disability and Health) in rehabilitation practice teaching.Methods:Fifty-eight rehabilitation undergraduates who had practiced in the Department of Rehabilitation Medicine in The First Affiliated Hospital of Chongqing Medical University from February 2019 to December 2019 were randomized into observation group and control group. The observation group adopted ICF-guided CBL method for practice teaching, while the control group adopted traditional teaching methods. At the end of the internship, all the students were assessed in terms of their theoretical knowledge, case analysis and clinical practice ability. At the same time, questionnaires were used to conduct a satisfaction survey on the teaching method, and the results of the two groups were compared and analyzed by ttest and rank-sum test through SPSS 25.0. Results:The scores of the observation group were higher than those of the control group, with statistical significance ( P<0.05) . In the satisfaction survey, the observation group was superior to the traditional teaching method in terms of self-thinking ability and learning initiative, with statistical significance ( P<0.05). Conclusion:ICF-guided CBL method can strengthen students' independent thinking ability and learning initiative, and improve the students' clinical comprehensive ability of rehabilitation treatment.

Objective To investigate the expression of gastric and intestinal phenotypic markers in Siewert typeⅡand Ⅲ early gastroesophageal junction(GEJ) cancer, and to explore its correlation with clinic-pathological features.Methods From April 2010 to July 2015, 53 cases diagnosed as early GEJ cancer were enrolled.The gastric and intestinal phenotypic markers such as mucin5AC(MUC5AC),mucin6(MUC6),mucin2(MUC2),caudal related homeodomain transcription 2(CDX2) and cluster of differentiation 10(CD10) were detected, and then the patients were divided into gastric type, gastrointestinal type, intestinal type and non-classified type according to the results of immunohistochemical staining.Combined with Siewert classification the clinicopathological features were analyzed.Chi square test or Fisher′s exact test was performed for statistical analysis.Results In the cancer tissues of 47 patients with Siewert type Ⅱand Ⅲ early GEJ cancer, the case numbers of positive expression of MUC5AC,MUC6,MUC2, CDX2 and CD10 were 21(44.7%),19(40.4%),31(66.0%),27(57.4%) and 17(36.2%),respectively;the case numbers of gastric type, gastrointestinal type, intestinal type and non-classified type were 11(23.4%),14(29.8%),21(44.7%) and one(2.1%), respectively.The positive expression rates of MUC5AC and MUC6 in Siewert typeⅡwere 55.9%(19/34) and 50.0%(17/34),which were higher than those of Siewert typeⅢ(2/13), and the positive expression rate of MUC2 was 55.9%(19/34), which was lower than that of Siewert typeⅢ(12/13), and the differences were statistically significant (x2=6.240,4.679 and 4.053;all P<0.05).In Siewert typeⅡ, the proportion of intestinal type was 32.4%(11/34), which was lower than that of Siewert typeⅢ(10/13), and the differences were statistically significant (x2=7.142,P=0.010).In patients with Siewert typeⅡand Ⅲ early cancer, males predominated in intestinal type which were mostly well differentiated type with less submucosal carcinoma.The maximum diameter of tumor was less than those of gastric type and gastrointestinal type.In paracancerous mucosal tissues, the incidences of intestinal metaplasia in gastrointestinal type and intestinal type were 11/14 and 81.0%(17/21), which were higher than that of gastric type (3/11);the incidences of atrophy in gastrointestinal type and intestinal type were 12/14 and 85.7%(18/21),which were higher than that of gastric type (4/11),and the differences were statistically significant (Fisher′s exact test,all P<0.05).Conclusions Siewert typeⅡand Ⅲ early GEJ cancer can directly originated not only from gastric mucosa, but also from gastrointestinal and intestinal mucosa.Atrophy and intestinal metaplasia could exist before cancer genesis.

ObjectiveThis clinical study is aimed to investigate whether levetiracetam (LEV) can improve electrocorticogram (EEG) in epileptic children epilepsy patients with better clinical manifestation but abnormal EEG findings.MethodsTotally 39 children from our neurological clinic with partial or complex partial epilepsy seizure were included in present study and assigned equally into three groups receiving different treatment:control group,sodium valproate (VPA) group,and LEV group.Their clinical symptoms had been controlled for over one year by carbamazepine ( CBZ),but EEG results showed clearly abnormal.Epileptiform discharges were observed in routine EEG exams half a month before recruiting.After recruiting,they continued to receive CBZ alone (control group) or co-treated with VPA ( VPA group) or LEV (LEVgroup),respectively.Six months later,EEG was taken again and results were analyzed.ResultsImprovement rate were 9.1％ ( control group),23.1％ ( VPA group),and 66.7％ (LEV group),respectively;Overall statistical difference was reached among three groups ( P＜0.01 ) and between control group and LEV group( P＜0.012 5 ),but no statistical difference between control group and VPA group was reached ( P＞0.0125).ConclusionCo-treatment of LEV in child epilepsy patients receiving CBZ can significantly decrease abnormal EEG discharge frequency during interictal period.

Objective:The differential diagnosis of pulmonary artery sarcoma (PAS) and pulmonary embolism (PE) by double-detector spectral computerized tomography (CT) provides a new way to improve the detection rate of PAS and reduce the misdiagnosis rate.Methods:In the way of retrospective study, the Philips Nebula Workstation (ISP) was used to reconstruct electron density map, iodine density map and spectral curve in the spectral CT plain scan and enhancement of the PAS patient. In the plain scan image, the low density areas of the ascending aorta and the right pulmonary trunk were selected to measure their electronic density values. In the chest enhancement image, the iodine density of PAS area and PE area were measured respectively, and the spectral curves of PSA area and PE area were compared.Results:The electron density of the ascending aorta and the right pulmonary trunk in the low density area of the PAS patient during the plain scan of spectral CT were 104.4% EDW (relative to the percentage of the electron density of water) and 102.2% EDW, respectively, which were lower than those in the normal ascending aorta area. The fusion image of mixed energy and electron density clearly reflected the scope of the lesion. The iodine density in PAS area was 1.89 mg/ml, and the iodine density in PE area was 0.03 mg/ml during the enhancement phase. The iodine uptake in PAS area was significantly higher than that in PE area. The slope of PAS region was 2.08, and the slope of PE region was -1.86. The slopes of the two spectral curves were inconsistent.Conclusions:The electronic density, iodine density and spectral curve measured by double-detector spectral CT may provide powerful imaging basis for the diagnosis of PAS and the differentiation of PAS from PE, which is helpful for the early diagnosis of the lesions, and also provide basis for the biopsy location of the mixed lesions of PAS and PE.

Objective To measure the expression of circulating microRNA (miRNA)in patients with hepatitis B virus (HBV)-related liver failure and its relationship with disease prognosis.Methods The miRNA expressions in serum of 5 patients with HBV-related liver failure and 5 healthy control subjects were compared using Exiqon miRCURY LNATM miRNA microarray.The sera from 20 patients with chronic hepatitis B (CHB),20 patients hepatitis B related cirrhosis,50 patients with HBV-related liver failure and 40 healthy persons in Ruijin Hospital were collected.The relative expression of miRNA-595 was measured using quantitative real-time polymerase chain reaction (PCR).The relative expressions of miRNAs among groups were analyzed using student t test,the correlations were analyzed by Pearson and Spearman correlation.Results Microarray informed that 92 miRNAs changed significantly in patients with HBV-related liver failure,and miRNA-595 increased most significantly.The results of real-time PCR showed that the relative expressions of miRNA-595 ,miRNA-300 and miRNA-122 were 6.03 (t=3.134, P =0.003),3.12 (t=7.221 ,P <0.01)and 2.77 (t=2.671 ,P =0.021),which were higher compared to those in healthy control group.In the analysis of the relationship between miRNA-595 expression and disease prognosis in patients with HBV-related liver failure,the relative expressions of miRNA-595 in patients with CHB,hepatitis B related cirrhosis and HBV-related liver failure were 2.26 (t =3.780,P =0.001),3.32 (t = 6.111 ,P < 0.01)and 6.03 (t = 3.134,P = 0.003),respectively,which were all increased compared to that of the healthy control.The relative expression of miRNA-595 of patients with HBV-related liver failure was 2.66 times (t=2.450,P =0.043)higher than that of patients with CHB. When dividing patients according to prothrombin activity,miRNA-595 increased significantly in patients with early stage liver failure.When dividing patients according to model of end-stage liver disease (MELD) score,MELD score was positive correlated with the expression of miRNA-595 when MELD score was under 30 (r=0.673,P =0.004).The expression of serum miRNA-595 in survival group (11 .08,n=23) was higher than that in non-survival group (3.67,n = 27,t =4.309,P =0.041).Conclusions The expressions of miRNA595 ,miRNA-300 and miRNA-122 are all increased in patients with HBV-related liver failure,especially the expression of circulating miRNA-595 at early stage of the disease.The miRNA-595 may be used as a new serum biomarker for monitoring the severity of disease.

Objective:To explore the learning guidance model and its influencing factors of undergraduates in medical schools.Methods:Based on the developmental learning guidance theory, 1 117 undergraduates from two undergraduate medical universities were selected as the research objects, through questionnaire surveys to collect their knowledge learning, curriculum learning and other core variables, and balanced guidance, compound guidance and other outcome variables, using Smart PLS 3.0 to test the validity of the samples.Results:There were statistical significance in the path relationship affecting the core variables and the outcome variables of the learning guidance model, P<0.05, indicating that the influencing factors of the learning guidance model had a significantly positive effect on the learning guidance model construction. Conclusion:Constructing a "balanced-compound-special" learning guidance model suitable for undergraduates' learning activities in medical universities provides a reference for the application and promotion of learning guidance model in medical undergraduate stage.