Objective To understand head nurse's leadership behavior and analyze the influence of it on nurse's involvement and self-efficacy.Methods General information questionnaire was taken,and the data of 280 nurses to head nurse's leadership behavior,involvement and self-efficacy were investigated.Results There were differences in nurse's involvement and self-efficacy between head nurse's transformation and transaction leadership behavior (F=4.39,2.37,2.94,2.17,P ＜0.05).The transformation leadership behavior dimensions were positive correlation with nurse's involvement and self-efficacy,P＜0.05.Conclusion Head nurse should fully play a positive role of transformation leadership behavior,in order to promote involvement and improve self-efficacy.

Objective To analyze the effect of the rhinoplasty on body image in the patients receiving cosmetic surgery,to investigate the change of postoperative body image disturbance(BDD)and to analyze the influencing factors of preoperative BDD in order to provide a basis for the psychological health management and reference for the diagnosis and treatment of plastic surgery.Methods A prospective study was performed on 84 patients with rhinoplasty admitted to the Affiliated Friendship Aesthetic Plastic Surgery Hospital of Nanjing Medical University from January 2015 to March 2016.The general data were investigated.The Plastic Psychological State Self-rating Scale was adopted to evaluate the patient′s body image situation,which was reexamined at postoperative 1-3 months.Results The preoperative non-BDD accounted for 60.71％,the occurrence rate of BDD was 19.05％,the other mental disorders,mental diseases or nervous system disease which had no relation with the BDD accounted for 20.24％;the occurrence rate of postoperative BDD was significantly lower than that of preoperative BDD(P＜0.05),moreover the patients with non-BDD had no postoperative BDD occurrence.The scores of question 1-10 before operation in the BDD group were higher than those in the non-BDD group,the scores of question 1-4 after operation in the non-BDD group were decreased,the scores of question 1-4,6-10 in the BDD group were decreased,while the scores of question 1,7,9-10 in the BDD group were higher than those in the non-BDD group(P＜0.05).The proportion of preoperative rhinoplasty and plastic surgery in the BDD group was higher than that in the non-BDD group,the difference was statistically significant(P＜0.05).Conclusion The occurrence rate of BDD in the patients with rhinoplasty is higher,operation is conducive to lessen the BDD,moreover operation itself will not result in new BDD.

Purpose To investigate the expression of FABP5 in oligodendroglioma and its clinic pathological significance.Methods Immunostaining of FABP5 and Ki-67 were performed in 87 oligodendrogliomas and 23 paracancerous brain tissues.The relationships between FABP5 expression and Ki-67 expression or clinic pathological parameters were statistically analyzed.Patients were followed up after operation.Results (1) The expression of FABP5 was significantly higher in oligodendroglioma [63.2％ (55/87)] than that in normal control [34.8％ (8/23)].(2)The expression of FABP5 was positively correlated with the histological grade (P =0.018,rs =0.254) and the Ki-67 expression (P =0.003,rs =0.318) in oligodendroglioma.(3) Univariate analysis showed that the expression of FABP5 protein,Ki-67 protein,age and chemotherapy were significant prognostic factors for oligodendroglioma patients.Conclusion FABP5 may play an important role in the pathogenesis and progression of oligodendroglioma,and could be used as a novel biological indicator of disease progress as well as prognosis for oligodendroglioma patients.

BACKGROUND: Fibroblasts are considered as seed cells necessary for the construction of tissue engineering skin. The ultrastructure of cells of various generations was observed under the electron microscope in the hope of providing foundation for proper selection of seed cells for tissue engineering skin.OBJECTIVE: To observe the ultrastructural changes of normal human fibroblasts during in vitro culture.DESIGN: Self-control observation.SETTING: Institute of Plastic Surgery, Weifang Medical College; Department of General Surgery affiliated to Weifang Medical College.MATERIALS: This experiment was carried out in the Institute of Plastic Surgery, Weifang Medical College, between September 2000 and September 2002. Healthy prepuce specimens were collected during posthetomy from normal boys aged 6-8 years after the informed consent was obtained from their guardians.METHODS: The normal human diploid fibroblasts were used to carry out consecutive subculture; cells were collected from different generations for morphological and ultrastructural observation under the inverted phase contrast microscope and transmission electron microscope.ture under the transmission electron microscope.microscope: Cells could pass on for 65-70 generations and survive for 280-300 days. Cells within 45 generations could grow rapidly, but gradually grew slowly after the 45th generation, and even displayed no proliferaunder the transmission electron microscope: There were no obvious changes in cell ultrastructure within 40 generations, but cells presented inward tolds of nucleus membrane from the onset of generations 41-65, with the ratio of cell nuclear/plasma reduced as well as cell surface process and microvilli also reduced.CONCLUSION: The ultrastructural change of in vitro cultured fibroblasts varied between different generations, which became obvious after the 41st generation, suggesting that fibroblasts within 40 generations are considered preferable seed cells for the construction of tissue engineering skin.

Objective To investigate the mechanism of myocardial ischemia and reperfusion-induced acute lung injury (ALl) and protective effect of ischemic postconditioning.Methods Forty SD rats were allocated to sham group,myocardial ischemia/reperfusion group (reperfusion group),ischemic postconditioning group (postconditioning group),and ischemic postconditioning + phosphatase and tensin homolog deleted on chromosome ten (PTEN) inhibiting group (inhibitor group) according to the random number table,with 10 rats per group.Myocardial ischemia/reperfusion was induced by left anterior descending coronary artery occlusion.Postconditioning was performed within 1 minute before reperfusion consisting of 3 10 s cycles of reperfusion followed by 10 s occlusion.Lung was immediately removed 120 minutes after reperfusion for HE stain,immunohistochemical detection of inflammatory factors and apoptosis factors,TUNEL assay of cell apoptosis,and Western blot of protein kinase B (Akt),phospho-Akt (p-Akt),glycogen synthase kinase-3β (GSK-3β),and phospho-GSK-3β (p-GSK-3β).Results Down-regulated B-cell lymphoma-2 (Bcl-2) and IL-10 and up-regulated Bcl-2 associated X protein (Bax),cysteinyl aspartate specific proteinase-3 (Caspase-3),IL-6 as well as IL-8 were observed in other 3 groups compared with sham group (P ＜0.01).Moreover,down-regulated Bax,Caspase-3,IL-6,IL-8 as well as TUNEL and up-regulated Bcl-2 as well as IL-10 were observed in reperfusion group compared to postconditioning group and tensor group (P ＜ 0.01).No statistical differences were found among the four groups in levels of Akt,p-Akt,and GSK-3β,but level of p-GSK-3β was significantly down-regulated in reperfusion group compared to other 3 groups(P ＜ 0.01).Conclusion Development of ALI may relate to down-regulation of p-GSK-3β evoked directly by the release of inflammation factors in early period of myocardial ischemia/reperfusion and ischemic postconditioning may attenuate the condition.

Objective To evaluate the effects of ischemic postconditioning on brain injury induced by myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods Diabetes mellitus was induced by intraperitoneal streptozotocin 60 mg/kg and confirmed by blood glucose level ＞ 16.7 mmol/L.Thirty male Sprague-Dawley rats,weighing 220-280 g,in which diabetes mellitus was successfully induced,were randomly allocated into 3 groups (n =10 each) using a random number table:group sham operation (group S),group I/R and group ischemic postconditioning (group P).Myocardial I/R was induced by occlusion of the anterior descending branch of the left coronary artery in I/R and P groups.Group P received 3 cycles of 10 s reperfusion followed by 10 s ischemia at the end of myocardial ischemia.The rats were sacrificed at 120 min of reperfusion and the brains were removed for microscopic examination and for determination of cell apoptosis (by TUNEL) and expression of interleukin-6 (IL-6),IL-8,IL-10,glycogen synthase kinase-3 beta (GSK-3β) and phosphorylated GSK-3β (pGSK-3β) (by immuno-histochemistry).Apoptotic index was calculated.Results Compared with group S,apoptotic index was significantly increased,IL-6 and IL-8 expression was up-regulated,and IL-10 and pGSK-3β expression was downregulated in I/R and P groups (P ＜ 0.01).Compared with group I/R,apoptotic index was significantly decreased,IL-6 and IL-8 expression was down-regulated,and IL-10 and pGSK-3β expression was up-regulated in group P (P＜0.01).There was no significant difference in GSK-3β expression among the 3 groups (P ＞ 0.05).The pathologic changes were significantly attenuated in group P as compared with group I/R.Conclusion Ischemic postconditioning can attenuate brain injury induced by myocardial I/R in diabetic rats,and inhition of activity of GSK-3β may be involved in the mechanism.

Objective To compare the image quality between volumetric high-resolution CT (VHRCT)and conventional high-resolution CT(CHRCT),and investigate the feasibility of VHRCT.Methotis Catphan 412 phantom was scanned with protocols of CHRCT and VHRCT on a set of GE Lightspeed VCE.The spatial-resolution(LP/cm),noise(standard deviation iu an ROI)and radiation dose (CTDI)were recorded for each CT scan.Difference of noise between CHRCT and VHRCT were evaluated by paired t test.In clinical study.32 patients were scanned with VHRCT and CHRCT protocols.The image quality of CHRCT and VHRCT was rated and compared.The quality difference between CHRCT and VHRCT was assessed by Wilcoxon paired signed rank sum test.Results In phantom study.the in-plane spatial-resolution of both VHRCT and CHRCT was 11 LP/cm for axial images and 12 LP/cm for coronal reformatted images.The noise of VHRCT and CHRCT was(69.18±2.77)HU and(54.62±2.12)HU respectively(t=-15.929.P＜0.01)at the same dose level.The radiation dose of VHRCT was 19.09 mGy higher than CHRCT at the same noise level.In clinical study.the quality assessment scores of VHRCT axial images and CHRCT axial images were 3.22 and 3.24 respectively.with no significant difference(Z=-0.319,P＞0.05).The qualily assessment scores of VHRCT coronal reformatted images and CHRCT coronal reformatted images were 3.05 and 1.88 respectively with significant difference(Z=-5.088.P＜0.01).Conclusion The image qualitv of VHRCT cross-sectional image is similar to that of CHRCT.Muhiplanar images with high resolution of VHRCT are recommended.The radiation dose of VHRCT remains to be optimized.

Objective To investigate the influence of a multifaceted stroke telehome-care (THC) on extremities function, activities of daily living (ADL) and quality of life in stroke patients with hemiplegia. Methods A total of 52 stroke survivors in department of neurology were randomized to the THC intervention or usual care. The patients in the control group received conventional care, while those in the intervention group were additionally given a THC program over 3 months. The THC intervention includes motor imagery and adaptive strategies. Data collection was undertaken using the Fugl-Meyer Motor Assessment Scale (FMA), the Barthel Index (BI), the Stroke Impact Scale (SIS) at baseline, 3 months, and 6 months. Results At baseline, the scores of FMA, BI, and SIS in the intervention group were 53.62 ± 23.52, 54.04 ± 17.44, 179.96 ± 28.51, and while the scores of the control group were 50.96 ± 19.52, 49.46 ± 15.09, 169.23 ± 28.48. There were no pre-existing differences on any scale between the two groups (t=0.443, 1.012, 1.358, P > 0.05). At 3 months, the scores of FMA, BI, SIS in the control group were 53.54 ± 17.45, 50.77 ± 14.47, 76.19 ± 27.78, and were significantly lower than 78.38 ± 12.54, 74.62 ± 11.22, 228.54±22.63 in the THC group (t=5.895, 6.641, 7.449,P<0.01). At 6 months, the scores of FMA, BI, SIS in the control group were 57.88±17.89, 59.08±13.85, 183.92±26.56, and were significantly lower than 90.58 ± 9.60, 86.54 ± 9.88, 252.19 ± 20.10 in the THC group (t=8.211, 8.233, 10.451, P < 0.01). Conclusions A telehome-care program that provide distance training and education of disabled persons resulted in greater improvements in physical functioning, ADL and quality of life.

OBJECTIVE: To explore the diagnostic value of the proposed thyroid imaging reporting and data system (TI-RADS) classification in thyroid nodules, and to investigate interobserver variability among different observers using TI-RADS classification for ultrasound. METHOD: We reviewed 667 thyroid nodules conventional ultrasound image data from 532 patients who were confirmed by Pathological diagnosis. Those ultrasound images were reviewed by 4 experienced sonographers who can independently assessed the sonographic characteristics and analyzed according to the TI-RADS classification. It is to assess the diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the TI-RADS classification. The multirater kappa statistics were used to assess the interobserver agreement among different observers. RESULT: The overall sensitivity, specificity, negative predictive value (NPV) and Accuracy were 94%, 79%, 97% and 81%, respectively. Positive predictive values (PPVs) for categories 4 and 5 were 55% and 92%. There was substantial interobserver agreement for categories 3, 4B and 5 (Kappa = 0.62, 95% CI, 0.58-0.65), and was moderate agreement for category 4A (Kappa = 0.57) and 4B(Kappa = 0.60). CONCLUSION The diagnostic criteria of TI-RADS for differentiating between benign and malignant thyroid nodules have a high diagnostic value. There was substantial interobserver agreement in different experienced sonographers. The TI-RADS diagnostic criteria have a high diagnostic value and has great practical value in making a proper and further treatment plan.
Humans ; Observer Variation ; Predictive Value of Tests ; Sensitivity and Specificity ; Thyroid Nodule ; classification ; diagnostic imaging ; Ultrasonography

Transforming growth factor-?1 (TGF-?1) was reported to play an important role in the pathogenesis of asthma in many stu-dies.It can stimulate the growth of fibroblast and give rise to fibrosis of lung tissues.Many scholars think that TGF-?1 is closely related to airway remodeling.It is a breakthrough to aim at TGF-?1 to find a way to intervene remodeling in asthma.Glucocorticoid (Dexamethasone and Budesonide) can have an impact in some extent to airway remodeling.In addition,interferon-? and some traditional chinese medicine such as ligustrazine,tripterygium wilfordii and ginkgo maybe effective,they all may ameliorate the progression of airway remodeling following redu-cing partial airway TGF-?1 expression.