Objective To understand the status quo of servant leadership behavior of head nurses in military hospital and its relationship with nurses′ intention to stay, and to make suggestions for maintaining the stability of military hospital nurses. Methods A total of 501 nurses from a military hospital (top three) were surveyed by self-designed general data scale, Head Nurses′Servant Leadership Behavior Scale and Turnover Intention Scale. Results The average score of servant leadership behavior was (80.39 ± 13.79) points, and the correlation coefficient between the head nurse service and the leave intention was-0.255 (P<0.01). Conclusions The servant leadership behavior of the head nurses in a military hospital is at a moderate level and it still can be ameliorated. Training can improve head nurses′capacity of the servant leadership behavior, which can reduce the turnover intention of the nurses in military hospitals.

Objective To evaluate the significance of the mannose-binding lection (MBL) gene polymorphism at code 54 of exon 1 and MBL serum level and C-reactive protein (CRP) in the severity of community acquired pneumonia (CAP) in adults.Methods A prospective observation was conducted.104 adults Han patients with CAP hospitalized in Tianjin People's Hospital were enrolled.Frequencies of MBL54 alleles and genotypes were measured.The patients were evaluated by pneumonia severity index (PSI) score and were graded.Serum MBL was determined by enzyme linked immunosorbent assay (ELISA),and serum CRP was detected by immunoturbidimetry before and 4 days and 7 days after the treatment.100 healthy control subjects with the same region,age,gender,nationality were enrolled as control group.Serum MBL and CRP levels were compared between CAP group and the control group or among different grades of PSI,and the correlation was analyzed.Results The variation of GGC→GGC in MBL54 was found in CAP patients and controls.Similar frequencies of genotypes (x2=0.018,P=0.893) and alleles (x2=0.019,P=0.903) of MBL54 with wild type and mutant type were found between two groups.The serum MBL level (mg/L) before and 4 days and 7 days after the treatment in CAP group was increased followed by the reduction and they were 3.75 ± 1.78,4.53 ± 1.99 and 4.04 ± 1.91,respectivelv,which were significantly higher than those in control group (2.84 ± 1.41,all P＜0.01).The serum CRP levels (mg/L) in CAP group were gradually declined,and they were 66.88 ± 40.47,51.21 ± 37.54,36.91 ± 36.02,respectively,which were significantly higher than those in control group (6.96 ± 2.19,all P＜0.01).There were 12 cases with PSI grade Ⅰ,32 cases with grade Ⅱ,20 cases with grade Ⅲ,22 cases with grade Ⅳ and 18 cases with grade V in CAP patients.There was no significant difference in frequencies of MBL54 genotypes among different grades of PSI (x2=1.210,P=0.876) and between general ward and intensive care unit (x2=0.569,P=0.451).No differences in the serum MBL level before (F=1.313,P=0.279) and 4 days (F=1.705,P=0.165) and 7 days (F=1.684,P=0.170) after the treatment were found among different PSI grades.The serum MBL level 4 days after the treatment was significantly higher than that before treatment,then decreased to the level before treatment on the 7th day after treatment in CAP patients with grade Ⅱ-Ⅳ.There was significant difference in serum CRP level before (F=23.179,P=0.000) and 4 days (F=26.601,P=0.000) and 7 days (F=10.358,P=0.000) after the treatment among different PSI grades in CAP patients.The serum levels of CRP in patients with different PSI grades were gradually decreased with time prolonged,the higher the PSI grade,the more obscure the serum CRP decrease.No correlation was found between PSI grade and serum MBL before and 4 days and 7 days after the treatment (before treatment:r=-0.205,P=0.145; 4 days after treatment:r=-0.062,P=0.662; 7 days after treatment:r=-0.063,P=0.656),and positive correlation between PSI grade and serum CRP was found (before treatment:r=0.809,P=0.000; 4 days after treatment:r=0.842,P=0.000; 7 days after treatment:r=0.702,P=0.000).Conclusions The MBL54 codon genotypes had no effect on the susceptibility of CAP.The serum MBL was elevated and dynamic changes with increasing treatment time in CAP patients were shown.MBL can be used as a reaction of CAP in acute stage.But it cannot be used as an inflammatory marker for the severity of CAP.

This study was aimed to observe the influence on angiogenesis factor and expression of its receptor protein on estrogen-induced uterine fibroids rat models with Y i-Qi Xiao-Zheng (YQXZ) method, in order to explore the mechanism of this method in the inhibition of angiogenesis in the treatment of uterine fibroids. Castration and estro-gen-induced method were used in the establishment of guinea pig uterine fibroids rat model. And then, different doses of Chinese medicine of YQXZ method were given. The immunohistochemical method was used in the detection of microvessel density (MVD) and vascular endothelial growth factor (VEGF) protein expression of the uterine tissues. The RT-PCR method was used to detect the expression of VEGFR1 mRNA and VEGFR2 mRNA. Then, statistical analysis was given on indexes mentioned above. The results showed that compared with the normal control group, ex-pression of MVD, VEGF and VEGFR of uterine muscle tissues in the model group was significantly higher (P <0.01). Compared with the model group, Chinese medicine group of different doses showed different reducing. Among them, the high-dose group was the most obvious one. It showed that the high-dose Chinese medicine of YQXZ group was able to significantly inhibit the expression of MVD, VEGF and theirs receptors. It was concluded that YQXZ method can antagonize proliferation of the leiomyoma cell by inhibiting angiogenesis. Therefore, it may be one of the mechanisms of this method in the treatment of uterine fibroids.

Objective To develop a real-time electronic nursing records quality control system based on No.1 Military Medical Project to solve the existing problems in range,representativeness of detection results,information feedback,information storage and etc.Methods An integrated platform was implemented for information acquisition,integration and display on the bases of No.1 Military Medical Project as well as the interfaces with information management systems for electronic nursing records,clinical laboratory examination,medical examination,imaging and etc,which had the functions of auto monitoring of timeliness and logic of electronic nursing records,manual quality control of the connotation as well as the feedback,statistics and analysis on the problems.Results The system behaved well in stability,compatibility,and could be used for real-time and dynamic control of electronic nursing records,timely information feedback and statistical analysis.Conclusion The system contributes to the quality control of electronic nursing records,and is of great significance for its enhancement.

ObjectiveTo summarize the initial experience of transumbilical laparoendoscopic single-site surgery of urology.MethodsFrom February 2010 to March 2011,21 patients underwent laparoendoscopic single-site surgery using transumbilical single-site and common surgical instruments of laparoendoscopic.Nine patients underwent single-site laparoscopic ureterolithotomy,5 underwent transumbilical single-site laparoscopic ureteral stricture resection and anastomosis,5 underwent transumbilical single-site laparoscopic renalcyst unroofing and 2 had a nephrectomy.All of the cases were definitely diagnosed.A single umbilical incision of 1.5 cm to 2.5 cm was made for Triport.The procedures were performed according to the methods used in classical laparoscope methods using general instruments.ResultsAll the operations were successfully completed without conversion to open surgery.The mean operative time of ureterolithotomy was 143 (120-230) min,the mean operative time of ureteral stricture resection and anastomosis was 157 (120 -180) min,the mean operative time of unroofing of renal cysts was 110 (95 -132) min,and the operative time of the nephrectomy was from 95 to 120 min.The intestinal tract function recovered within 1 -2 d,the drainage tube was removed within 2 -3 d and the postoperative hospitalization duration was 4 -7 d.The symptoms were reduced or disappeared and no major intraoperative or postoperative complications occurred within 4 - 6 months.Conclusions Transumbilical laparoendoscopic single-site surgery represents a safe and feasible operation for urologic patients.With more clinical practice,laparoendoscopic single-site surgery could be generally applied.

Objective This study aims to investigate the clinical value of percutaneous vertebroplasty (PVP)combined with strontium-89 (89 Sr)on patients with spinal malignant tumor.Methods Seventy four patients who were diagnosed as spinal malig-nant tumor were divided into two groups randomly.37 patients of the control group were treated by PVP only,and 37 patients of joint group were treated by PVP and 89 Sr together.Then the clinical effect of the joint group and control group was compared after treatment.Results After treatment,the quality of life,ratio of pain relief,clinical effect and survival time in joint group were dis-tinctly better than control group (P <0.05).Conclusion PVP combined with 89 Sr can be an effective and safe treatment for pa-tients with spinal malignant tumor.

Objective To investigate the expression of human papillomavirus E2 mRNA in cervical cytologi-cal specimens as well as the role of that in cervical carcinogenesis and its clinical significance in screening and evalat-ing prognosis of cervical lesions.Methods The expression of E2 mRNA in 582 cases of cervical cytological speci-mens with high risk human papillomavirus infection and cytological diagnosis of NILM,ASCUS and LSIL,was detected by RT -PCR.Thereafter,all cases were divided into the four groups by colposcopy and histopathological confirmation, including 414 cases of cervicitis,95 cases of CINⅠ,51 cases of CINⅡ,20 cases of CINⅢ and 2 cases of invasive cervical carcinoma as well.Results The expression of HPV -E2 mRNA decreased dramatically corresponding with pathological upgrading from groups of cervicitis to invasive cervical carcinoma (χ2 =132.72,P <0.05).The sensitiv-ity,specificity,positive predictive value and negative predictive value of HPV -E2 mRNA for screening potential cervical lesions in group of NILM,ASCUS and LSIL were 77.2%,96.8%,75.6%,96.0% and 81.0%,91.7%, 79.1%,92.6% as well as 95.9%,93.4%,94.7%,95.0% respectively.Conclusion Deletion of HPV -E2 induced by genetic disruption played an important role in the early stage of malignant transformation of cervical epithe-lial cells.Therefore,detection of the levels of HPV -E2 mRNA expression might be clinically valuable for the screen-ing and evaluating of prognosis in cervical lesions.

Microwave-assisted extraction (MAE) was used for extraction of effective components of sarcandra glabra (Thunb.), and then chromatographic fingerprint of sarcandra glabra (Thunb.) was studied by high performance liquid chromatography/diode array detector (HPLC/DAD). The conditions of MAE were optimized by an orthogonal experiment, and then the authentication and validation of the chromatographic fingerprint were conducted. Nine peaks were identified as common peaks in the fingerprint chromatograms, and isofraxidin was considered as a reference compound and quantified. Relative standard deviations of retention time and peak area of each component were less than 3% and 8%, respectively. Similarity and difference analysis were conducted by use of PCA and relation coefficient. Twenty batches of sarcandra glabra (Thunb.) samples from two different producing areas could be classified into two different groups in the PCA model. The results showed that MAE-HPLC/DAD method was simple, efficient and stable for the study of complex chromatographic fingerprint of sarcandra glabra (Thunb.), which could provide more reliable and precise information for quality evaluation.

BACKGROUND:In clinic, monosegmental pedicle screw fixation via the fractured vertebrae is commonly used for the treatment of thoracolumbar fracture. Studies have confirmed that the spinal stability is strengthened through bilateral pedicle screw fixation via fractured vertebrae, but some studies suggest that monosegmental pedicle screw fixation via fractured vertebrae can increase the spinal stability, and the conclusion lacks of the supports of biomechanics.
OBJECTIVE:To evaluate the biomechanical properties of monosegmental pedicle screws fixation via fractured vertebrae for thoracolumbar fracture.
METHODS:Eight cadavers’ thoracolumbar specimens (T11-L3) were provided by the Department of Anatomy, Yangzhou University School of Medicine. Saw was used to transect 2/3 of the vertebrae in order to make complete experimental thoracolumbar specimens. Eight specimens were divided into two group;beyond-fractured vertebrae fixation group and monosegmental fixation via fracture vertebrae group. The specimens in the two groups were treated with adjacent vertebral four screw fixation beyond fractured vertebrae and adjacent vertebral four screw fixation+monosegmental pedicle screw fixation via fractured vertebrae respectively.
RESULTS AND CONCLUSION:After thoracolumbar fracture, the differences between beyond fractured vertebrae fixation and monosegmental pedicle screw fixation via fractured vertebrae were as fol ows:load-strain relationship 12%, load-displacement relationship 11%, strength 18%, axial rigidity 11%, torsional mechanical properties 11%and pul out test 1.8%, and there were no significant differences between two groups (P<0.05). The biomechanics performance of monosegmental pedicle screw fixation via fractured vertebrae was more superior to that of pedicle screw fixation beyond the fracture vertebra for thoracolumbar fracture.