Objective To investigative the relationship of personality and coping style with subjective well-being in nurses.Methods 140 nurses were invited randomly to answer the questionnaires.123 questionnaires out of 140 were selected,with 17 papers excluded because of un-complete answer.Personality,coping style and subjective well-being were respectively estimated with Eysenck Personality Questionnaire(EPQ),Simplified Coping Style Questionnaire(SCSQ) and General Well-Being Scale(GWB).The resuits were compared with the national norm.Correlation analysis was performed in term of the correlation of personality and coping style with subjective well-being.Results Subjective well-being of nurses was associated with personality and coping style.Conclusions Personality and coping style can predict subjective well-being.The research can provide theoretical basis for psychological care to the nurse group.

Objective To perform digital 3D measurement of anatomic parameters associated with vertebral units fixed by ribs and pedicle fixation of T4-T10,providing evidence for clinical application.Methods Spiral CT scan of T4-T10 vertebrae was conducted in 15 normal adults without spinal disorder.The data were imported into computer to establish units and disc models of thoracic and rib vertebrae T4-T10 using Mimics 16.0 software and Ansys 11.0 finite element software.The following data were measured in the vertebral pedicle-rib unit fixation group (group A) by software:transverse diameter of vertebral pedicle-rib unit,length of the outside pedicle screw,inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw;the following data were also measured in the pedicle fixation group (group B) by software:pedicle transverse diameter,length of pedicle screw,inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw.The corresponding parameters were compared between groups A and B.Results In both groups,the transverse diameters and screw lengths gradually increased with the increase in the vertebral sequence while the inclination angle of pedicle screw,and maximum and minimum inclination angles of pedicle screw decreased with the increase in the vertebral sequence.All the parameters in groups A were significantly larger than the corresponding ones in group B (P ＜ 0.05).Conclusions Of the spinal segment of T4-T10,the rib vertebral unit fixation can provide greater safe screw angles and screw diameters for clinical surgery.This is of vital significance for reducing the surgical complexity and improving screw prehension.

Objective To compare 99Tcm-MIBI MPI with delayed enhancement MRI (DE-MRI) in patients with idiopathic dilated cardiomyopathy (IDCM). Methods Forty patients with IDCM were included. They underwent both rest 99Tcm-MIBI myocardial perfusion imaging and DE-MRI within 7 days. 99Tcm-MIBI MPI was performed to identify diffuse or segmental abnormal perfusion patterns including reduced or defect perfusion segments. DE-MRI images were divided into 4 categories: no delayed enhancement, septal, subendocardial and transmural delayed enhancement, x2 test was used for data analysis. Results Diffuse and segmental perfusion abnormality on 99Tcm-MIBI MPI were found in 19 (47.5%) and 21 (52.5%)patients respectively, while DE-MRI enhancement was simultaneously found in 5 patients of the former (5/19, 26.3%) and 18 (18/21, 85.7%) of the latter (x2 =14.401, P＜0. 001). For those (n=18) with both segmental perfusion abnormality and DE-MRI enhancement, the number of segments of the 4 DE-MRI respectively. A significant difference was found in the DE-MRI enhancement categories between normal and defect perfusion segments (x2 = 29. 183, P ＜0.001 ) and between reduced and defect perfusion segments as well (x2 =25. 110, P＜0. 001). Conclusions Both diffuse and segmental perfusion abnormalities on 99Tcm-MIBI MPI can be found in patients with IDCM. DE-MRI enhancement is more frequently found in patients with segmental perfusion abnormality.

BACKGROUND:At present,there is lack of relevant biomechanical model for the T6-T7-T8 rib-vertebral fix unit.In addition,there is no support of parameters of basic studies on reasons and reasonable explanation of screw breakage,poor quality of bone fusion and adjacent segment degeneration.OBJECTIVE:To develop a three-dimensional finite element model of bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8),and to analyze the stress so as to improve it.METHODS:Spiral CT data of one male patient (172 cm,71 kg,39-year-old) with T7 vertebral tuberculosis were imported into computer to develop a three-dimensional finite element model of bone graft with vertebral debridement and posterior vertebral unit fixed system through tuberculosis of T6-8 by Mimics 13.0 and Ansys 11.0 finite element software.500 N pressure and 10 N?m torque were loaded to the vertebral body by 3 kinds of physiological loads which simulated flexion,extension and lateral bending.The stress distribution of fixation devices under different loads was compared.RESULTS AND CONCLUSION: At the positions of anteflexion and extension,the stress mainly concentrated to screw tail,and the stress of upper screw was greater than the middle and lower screws.For connecting rods,the stress of the middle was always less than the lower middle and the middle stress was zero.At lateral bending position,the stresses of upper and middle screw tail were quite,and the unilateral stress of connecting rod was also equivalent.For three different dynamics at the same point,the stress of middle connecting rod increased in the lateral bending motion,and the stress of lower screw tail was equivalent.These data suggested that it is prone to fatigue fracture at upper screw tail by bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8) at the three positions of anteflexion,extension and lateral bending.The lower connecting rod at the positions of anteflexion and extension and the middle connecting rod at the position of lateral bending easily cause fatigue fracture.

Objective To evaluate the reliability of axial view of patella with the knee joint flexed at 60 and 90 degrees on imaging diagnosis of patellar subluxation with DR (digital radiography). Methods 60 cases confirmed patella subluxation were reviewed retrospectively. In addition to routine anteroposterior and lateral DR views, axial DR views of patella with the knee flexed at 60 degrees and 90 degrees were taken meanwhile. Results Of the 60 cases, 45 failed to provide any patellar problems, while the other 15 cases revealed suspicious imaging view of patella subluxation in their normal AP and lateral DR views. In the axial DR views of patella with the knee flexed at 60 degrees and 90 degrees, 50, 4 and 6 cases revealed subluxation, suspicious subluxation and normal alignment of patella. Conclusion Axial DR view of patella with the knee joint flexed at 60 and 90 degrees could provide helpful roentgenographic information in determining the existence of patella subluxation.

Objective To investigate the related factors of early adverse outcomes in young patients with ischemic stroke.Methods From January 2006 to June 2016,685 young patients (18-45 years old) with acute ischemic stroke admitted to the Department of Neurology,Nanjing General Hospital of Nanjing Military Command were enrolled retrospectively.They were diagnosed as the first onset with head CT or MRI.According to the modified Rankin scale (mRS) at 90 d,the patients were divided into a favorable outcome (mRS 0-2) group (n=554) and a poor outcome (mRS 3-6) group (n=131).The collection of clinical data were completed on the day of admission,including the risk factors for cerebrovascular disease (oral contraceptives,etc),the National Institutes of Health stroke scale (NIHSS) score on admission,the mean systolic blood pressure (>140 mmHg was analyzed) and laboratory examination.The stroke subtypes were classified with the trial of org 10172 in acute stroke treatment (TOAST) classification criteria.Univariate analysis was used to analyze the difference of clinical data between groups,and multivariate logistic regression analysis was used to analyze the risk factors for early poor outcomes.Results Compared with the favorable outcome group,the patients with the ratio of mean systolic pressure >140 mmHg in the first 3 d after hospitalization (37.4% [49/131] vs.21.7% [120/554],χ2=14.131),NIHSS score on admission (10.0 [7.0,14.0] vs.1.5 [0,3.0],Z=-15.300),white blood cell count (7.5 [6.0,9.0] ×109/L vs.6.8 [5.7,8.2] ×109/L,Z=-3.157),fasting glucose (4.9 [4.6,6.0] mmol/L vs.4.8 [4.4,5.3] mmol/L,Z=-2.726),higher fibrinogen level (2.8 [2.3,3.4] g/L vs.2.6 [2.3,3.2] g/L,Z=-2.018,blood uric acid level (291[220,346] mmol/L vs.315 [261,374] mmol/L,Z=-3.443),and plasma albumin level (43.1[40.0,45.9] g/L vs.44.8 [42.4,47.4] g/L,Z=-4.708) were decreased in the poor outcome group.There were significant differences between the two groups (all P<0.05).TOAST classification comparison:the proportion of the patients with cardioembolism in the poor outcome group was higher than that in the favorable outcome group.There was significant difference between the two groups (6.9% [9/131] vs.2.5% [14/554];χ2=4.893,P<0.05).There were no significant differences in the remaining clinical data between the two groups (all P>0.05).Multivariate logistic regression analysis showed that the higher NIHSS score on admission (OR,1.474,95%CI 1.378-1.576,P<0.01),the mean systolic pressure >140 mmHg at the first 3 d after admission (OR,2.134,95%CI 1.210-3.764,P=0.009) and the cardioembolism(OR,4.902,95%CI 1.073-22.222,P=0.040) were the risk factors for early poor outcome,and the elevated plasma albumin level (OR,0.902,95%CI 0.850-0.956,P=0.001) was a protective factor of early favorable outcome.Conclusion The higher NIHSS score at admission,the cardioembolism and the increased mean systolic blood pressure in the first 3 d after admission may result in early poor outcome in young patients with ischemic stroke,while the elevated plasma albumin level is beneficial to the early outcome.

OBJECTIVETo observe the differential effect of joint ultrasound on the syndrome differentiation of rheumatoid arthritis (RA) by observing the high frequency ultrasound performances among inactive stage and different syndromes in active stage.

METHODSTotally 83 RA patients in the active stage were assigned to the dampness heat syndrome group (DHS, 59 cases)and the cold dampness syndrome group (CDS, 24 cases) according to Chinese medicine (CM) syndrome typing. Besides, 20 RA patients in the remission stage were recruited as the control group (abbreviated as the remission group). By using high frequency ultrasound and power Doppler ultrasound technology, a comparative observation of synovitis, tenosynovitis, synovial blood flow, and bone erosion in the 2nd-5th metacarpophalangeal (MCP) joints, proximal interphalangeal (PIP) joints, wrist joints, knee joints, the second and the fifth metatarsophalangeal (MTP) joints (a total of 24 joints) was performed in all patients. Correlation analyses were performed between the ultrasound performance, laboratory indices, and the disease activity. Ultrasound data of each RA patient were analyzed by their total scores. Χ2 test was used for enumeration data. The measurement data was expressed as x ± s. One-way ANOVA was used for data of normal distribution, while non- parametric test was used for data of non-normal distribution. Correlation analysis of two variables was performed for clinical indicators and ultrasound indicators. Its significance was detected using Pearson correlation.

RESULTSCompared with the remission group, the severity degree of synovitis, tenosynovitis, synovial blood flow, and bone erosion significantly increased in the DHS group (P < 0.01). There was statistical difference in ESR, CRP, anti-CCP, DAS28 score, and the positive rate of RF (P < 0.05, P < 0.01). There was statistical difference in the severity degree of synovitis and synovial blood flow, and DAS28 score in the CDS group (P < 0.05). Compared with the CDS group, there was statistical difference in the four ultrasound indices (P < 0.05, P < 0.01), ESR, CRP, anti-CCP, DAS28 score, and the positive rate of RF in the DHS group (P < 0.05, P < 0.01). There was no statistical difference in G, IgG, IgA, or IgM among the three groups (P > 0.05). There existed positive correlation between ESR and the synovitis degree, synovial blood flow, and bone erosion in the DHS group (r = 0.444, 0.397, 0.486, P < 0.05).There existed positive correlation between ESR and the synovitis degree, bone erosion, and synovial blood flow in the DHS group (r = 0.378, 0.270, P < 0.05). There existed positive correlation between the DAS28 score and the synovitis degree and synovial blood flow in the DHS group (r = 0.304, 0.351, P < 0.05).

CONCLUSIONSThe inflammation degree was the most severe in RA patients of DHS. High frequency ultrasound could provide better evidence for Chinese medical syndrome differentiation of RA patients.

Arthritis, Rheumatoid ; diagnostic imaging ; Humans ; Medicine, Chinese Traditional ; Metacarpophalangeal Joint ; ultrastructure ; Syndrome ; Synovitis ; diagnostic imaging ; Ultrasonography

BACKGROUND:Endothelial progenitor cells are precursor cells of mature endothelial cells,which can migrate to ischemic tissues and differentiate into mature endothelial cells,and then play an important role in vascular remodeling.Endothelial progenitor cells have wide application prospects in various ischemic diseases,but the biological characteristics and identification methods are still controversial.OBJECTIVE:To investigate the methods of isolation and culture of endothelial progenitor cells from the human adipose tissue and to identify their biological features,in order to provide a sufficient source of cells for ischemic diseases.METHODS:Stromal vascular fraction cells were isolated from the human adipose tissue by enzymatic digestion,CD31+ cells were selected using immunomagnetic beads,and then cultured in endothelial basal medium-2 supplemented with the EGM-2-MV-SingleQuots.Endothelial progenitor cells were identified through detection of morphology,cell markers and cell functions.RESULTS AND CONCLUSION:(1) CD31 + cells were selected by immunomagnetic beads and then cultured and amplified in vitro,which displayed typical cobblestone-like morphology,and they maintain their proliferative ability.(2) Flow cytometry results showed that the CD31+ cells expressed CD31 (98.84％),CD34 (97.21％),VEGRR2 (64.07％),CD146 (98.42％) and CD133 (2.55％),but hardly expressed CD45 (1.1％),a hematopoietic stem cell marker.(3) The CD31 + cells were also found to incept Dil-ac-LDL and exhibit lectin binding capability.Furthermore,a lumen-like structure was formed in Matrigel,which has the ability of angiogenesis in vitro.To conclude,these results suggest that it is feasible to isolate and culture endothelial progenitor cells from the human adipose tissue by enzymatic digestion combined with immunomagnetic bead sorting.

Detection of Oncotype DX and MammaPrint has been recommended by the American Society of Clinical 0ncology.For specific populations,such as early endocrine-dependent breast cancer,under the condition of sufficient evidence in the evidence-based medicine,we can choose genetic testing in combination with clinical pathologic factors to guide clinical treatment,which has reached the goal of micro combined with macro,more detailed division of the patients,and individualized treatment.

Objective One typical case with stress cardiomyopathy was reported and the current knowledge of the syndrome was reviewed to improve relevant knowledge.Methods A 71-year-old female patient presented dyspnea and chest pain due to emotional stress.ECG,echocardiography,selective coronary artery angiography,left ventriculography,~(99)Tc~m-MIBI single photon emission computed tomography (SPECT),~(18)F-FDG SPECT and MRI were performed.Results Electrocardiogram at admission showed ST segment elevation and T wave inversion in leads V1—V4.Pathological Q wave occurred 1 week later,it disappeared 1 month later however and severe T wave inversion occurred.Normal or slightly elevated cardiac enzymes in the blood were found during the course.Left ventriculogram at admission showed left ventricular apical ballooning with LVEF of 30%.The ballooning volume was about 3/4 of left ventricular volume, without any corresponding coronary artery diseases found in coronary angiogram.The abnormal apical ballooning decreased significantly in the follow-up left ventriculogram performed one month later.The LVEF rose up to 63.6%.~(99)Tc~m-MIBI and ~(18)F-FDG SPECT showed mismatch of perfusion and metabolism in the corresponding region,indicating presence of viable myocardium.MRI showed left ventricular apical ballooning without perfusion defect and late enhancement,indicating viability of corresponding myocardium. Conclusions Emotional stress can cause transient left ventricular apical ballooning called"stress cardiomyopathy".Either ~(99)Tc~m-MIBI SPECT associated with ~(18)F-FDG SPECT or delayed enhancement MRI plays an important role in identification of myocardial viability,which can efficiently guide clinical treatment.