Adolescent ; Adult ; CD4-CD8 Ratio ; Cerebrospinal Fluid ; cytology ; immunology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Multiple Sclerosis ; drug therapy ; immunology ; Phytotherapy ; T-Lymphocyte Subsets ; drug effects

Objective To explore the impact of transformational leadership on nurses'professional quality of life and organizational commitment by hierarchical linear modeling (HLM).Methods A total of 44,6 clinical nurses were investigated with demography questionnaire,professional quality of life questionnaire,organizational commitment questionnaire and transformational leadership questionnaire.Results The transformational leadership had positive predict ability to the nurses'compassion satisfaction,secondary traumatic stress and organizational commitment.The transformational leadership had negative predict ability to burnout.The transformational leadership could adjust the relationship between compassion satisfaction,secondary traumatic stress and organizational commitment.Conclusions The transformational leadership provides theoretical reference for nursing managers to effectively lead the team,increase professional life quality of the nurses,and then improve the level of organizational commitment of the nurses.

Objective: To study the effect of levothyroxine replacement therapy on improving diffused left ventricular myocardial lesions and cardiac function in patients with hypothyroidism. Methods: Our research included 2 groups: Hypothyroidism group,n=20 newly diagnosed patients and Control group, n=17 normal healthy subjects. Diffused left ventricular myocardial lesions were quantitatively evaluated by non-invasive cardiac MRI T1 mapping technique. Left ventricular myocardial T1 value and left ventricular function before and after levothyroxine replacement therapy were compared; the relationship between T1 value and thyroid function and the relationship between T1 value and the indicators of left ventricular function were analyzed. Results:①Compared with Control group, Hypothyroidism group had increased left ventricular myocardial T1 value, P<0.01, while decreased cardiac index (CI) and left ventricular peak filling rate (PFR), allP<0.05.②In patients with hypothyroidism, left ventricular myocardial T1 value was negatively related to serum FT3 level (r=-0.52,P=0.0006) and PFR (r=-0.43,P=0.0085).③Compared with pre-therapeutic condition, the patients with recovered normal thyroid function showed obviously decreased left ventricular myocardial T1 value and improved CI, PFR. Conclusion: Levothyroxine replacement therapy may improve diffused left ventricular myocardial lesions in patients with hypothyroidism, and therefore improve the cardiac function.

0.5 or close to 1.0,suggesting marker retained many parts of the sigmoid colon and rectum,FOOC possibility.Normal group,constipation group colon 48,72 hour markers district retention contrast,have significant differences.TI as the STC's kinetic parameters can be used as the difference between STC and the simple and reliable indicators FOOC.17 cases in this group(accounting for 68%)FC children with TI in 48 h,72 h were 0.5,in line with the characteristics of FOOC.Conclusion The results of this study showed that colonic transit time checks can be more accurately reflect the normal function of colonic transit may be the evaluation of patients with functional constipation colonic transit weaken the seriousness of the correct and reasonable to carry out sub-type of clinical treatment of important guiding significance.

Objective To elucidate clinical pathological features of primary mediastinal B-cell lymphoma (PMBL) and its difference compared with diffuse large B-cell lymphoma,not otherwise specified (DLBCL,NOS).Methods The clinical histories and pathological datas of 24 PMBL cases and 31 cases of DLBCL,NOS as the control group were collected.Immunohistochemical staining and a follow-up study was conducted.Results The distribution of gender showed significant difference when the age of onset of PMBL patients was obviously younger with the medial age of 30 years old (P ＜ 0.001).All cases presented as a huge mass in mediastinal site with compression symptoms.PMBL was similar to DLBCL in the morphology of tumor cells but fibrosis of various degrees was common,more than 70.8 ％ (17/24) cases had the collagen bundles split.CD23 positive rate (40.0 ％,6/15) in PMBL was significantly higher than the control group (3.2 ％,1/31)(P =0.003).Conclusion PMBL frequently occurs in young female people,mostly happens in mediastinal site and adjacent area,but rarely has distant dissemination.PMBL has the characteristics of various degrees of collagen fiber hyperplasia,and CD23 positive could be used to differentiate PMBL from DLBCL,NOS.

Actins ; metabolism ; Adult ; Antigens, CD34 ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hypertension ; etiology ; Juxtaglomerular Apparatus ; pathology ; surgery ; ultrastructure ; Kidney Neoplasms ; complications ; metabolism ; pathology ; surgery ; ultrastructure ; Nephrectomy ; Vimentin ; metabolism

Objective · To investigate the effects of insulin on high glucose-cultured humanmononuclear cell line THP-1 and macrophage phenotype transformation in diabetic wounds. Methods · THP-1 cells were cultured with normal (5.6 mmol/L) and high (25 mmol/L) glucose, respectively,stimulated with PMA for differentiation, and induced to M1 macrophages with LPS. After treated with insulin for 6 h, expression changes of M1 type macrophage markers inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), and interleukin-1β (IL-1β), as well as M2 type macrophage markers arginase1 (Arg1) and IL-10 were detected using real-time PCR andWestern blotting. High fat diet feeding plus multiple intraperitoneal injections of low dose streptozotocin (STZ) were used to induce type II diabetes rat model. After blood glucose level has been stable for five weeks, two fullthickness skin wounds with the diameter of 1cm were made on the back of DM rats. Wounds were randomly assigned to being treated with insulin (0.2 U insulin /20 μL saline) or saline (20 μL saline) using the random number table. Characteristics of macrophagephenotypes were observed 3, 7, and 25days after wounds were made. Normal rats (n=3) served as controls. Results · After being cultured with high glucose, the mRNA levels of M1 markers iNOS and TNF-α were up-regulated in LPS-induced THP-1 cells, while the mRNA levels of M2 markers Arg1 and IL-10 were down-regulated.Afterbeing treated with insulin for 6 h, mRNA levels of iNOS and TNF-α weredown-regulated, protein levels of iNOS, IL-1β were down-regulated too, while mRNAand protein levels of Arg1 and IL-10 were up-regulated. In addition, the expression level of phosphorylated NF-κB-p65 was significantly increased after high glucose culture and was significantly decreased after insulin intervention. Compared to normal rat skin wounds, the expression of iNOS in macrophages was significantly increased in wounds of diabetic rats. The expression of iNOS in macrophages was high in saline treated wounds 3 and 7 days after the wounds were made and the expression of Arg1 was low 25 days after the wounds were made. In insulin treated wounds, the expression of iNOS started to decrease on day 7 after the wounds were made and the expression of Arg1 was significantly higher than that in saline treated wounds on day 25 after the wounds were made. Conclusion · Insulin can induce macrophage phenotype transformation from M1 to M2 under high glucose condition and the mechanism may be associated with the phosphorylation of NF-κB-p65.

Objective To observe the clinical efficacy ofvitrectomy combined with modified inverted internal limiting membrane (ILM) flap covering technique for complicated macular hole (MH).Methods This is a retrospective case series.Twenty-one eyes of 20 patients who underwent vitrectomy combined with modified inverted ILM flap covering technique were enrolled in this study.Among these eyes,9 eyes were idiopathic MH (IMH),with the mean basal diameter of (1 188.3 ± 155.1) μm,minimum diameter of (626.9± 86.2) μm,logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) of 1.1 ± 0.3;2 eyes were MH with high myopia,with the mean basal diameter of (696.5 ± 232.6) μm,minimum diameter of (259.0±69.3) μm,logMAR BCVA of 1.3;5 eyes were high myopia MH with retinal detachment (RD),with the mean BCVA of 1.5 ± 0.1;3 eyes were rhegmatogenous RD (RRD) with MH,with the mean logMAR BCVA of 1.6;2 eyes were MH after vitrectomy for RRD,with the mean basal diameter of(1 606.0±69.3) μm,minimum diameter of (909.0±387.5) μm,logMAR BCVA of 1.6.All patients received 23G or 25G vitrectomy after removal of posterior vitreous cortex intraoperatively.Indocyanine green staining assisted circle-wise ILM peeling was performed.ILM of diameter 1.5 disc-diameters around fovea was residual and loosened;perfluoronoctane assisted inverting superior or temporal residual ILM covering on macular hole.C3F8,gas or silicone oil tamponade was performed at the end.BCVA and hole closure were followed up for 1-4 months.C3F8,gas or silicone oil was tamponaded at the end.BCVA and hole closure were followed up for 1-4 months.Results MH of 21 eyes were closed after surgery.Nine IMH were closed at type Ⅰ,with U shape closure in 7 eyes,V shape closure in 2 eyes.Two eyes of MH with high myopia,3 eyes of RRD with MH,2 eyes of MH after vitrectomy for RRD were closed at type Ⅰ of U shape.Five eyes of high myopia MHRD including MH closure at type [of U shape 3 eyes,type Ⅱ of W shape 2 eyes.The mean logMAR BCVA of IMH,MH with high myopia,high myopia MHRD,RRD with MH,MH after vitrectomy for RRD eyes were 0.8±0.3,0.9±0.2,1.4±0.1,0.7±0.3,0.9 ± 0.2,respectively.The mean postoperative logMAR BCVA in IMH eyes was improved compared preoperative one (P=0.02).There was no obvious change of pre-and postoperative logMAR BCVA in MH with high myopia,high myopia MHRD,RRD with MH,MH after vitrectomy for RRD eyes (P=0.18,0.10,0.11,0.18).Conclusion Vitrectomy combined with inverted ILM flap covering technique for complicated MH is an effective method to improve the success rate of MH closure and the visual function.

Background Pseudoexfoliation syndrome (PEX) has a high incidence in Uygur population and usually leads to secondary glaucoma and complicated cataract.The abnormal change of lens tissue and degeneration of zonular fibers bring a lot of difficulties for phacoemulsification (phaco) with intraocular lens implantation,especially stop-and-chop phaco technique.Prechop technique is a new choping technology,but its application in PEX with cataract is less.Objective This study was to compare the efficacy and safety of pre chop phaco technique and stop-and-chop phaco technique for PEX combined cataract.Methods A randomized controlled Clinical trial was designed.Forty-one eyes of 41 patients with PEX combined cataract of Ⅲ degree of nucleus were enrolled in People's Hospital of Hetian District from March 2015 to January 2016.The patients were randomized into the prechop group and stop-and-chop group according to random nubmer table,and cystotome-assisted prechop phaco surgery and stop-and-chop phaco surgery were performed in different groups,respectively.The effective phaco duration,corneal endothelium loss rate,cornea edema eye number after operation,vision outcomes and complications were compared between the two groups.Results The mean effective phaco duration was 14.0 (13.0,16.5) minutes and 18.5 (16.5,24.0) minutes in the prechop group and stop-and-chop group,with a significant difference between them (Z =17.354,P ＜ 0.01).The corneal endothelial cells were (2 101.90 ± 209.08)/mm in the prechop group,and the number was similar to (2 002.30 ± 207.04)/mm of the stop-and-chop group (t =-1.530,P =0.134).Corneal endothelial cell lossing rate was (8.27±2.23)％ in the prechop group,which was lower than (13.09±4.26)％ in the stop-and-chop group (t =3.810,P =0.001).The BCVA was better in the prechop group than that in the stop-and-chop group in postoperative day 3 (P =0.044),and the corneal edema degree was not signigicantly different in postoperative day 1 and day 3 between the two groups (P=0.221,0.446).Intraoperative complication was rapture of zonule and occurred in 1 eye and 2 eyes in the prechop group and stop-and-chop group,respectively.Conclusions Compared with the stop-and-chop phaco technique,the prechop phaco tequnique can decrease intraoperative complication,lighten the postoperative damage of corneal endothelial cells and accelerate visual rehabilitation in PEX combined with cataract patients.

The scientific definition for the nature of medical law,the personnel training objectives and the nature of talent is the prerequisite in the construction of the course system for medical science of Law. The construction of the course system for medical science of law is playing a central role in the training of medical law professionals,and it should highlight the talent nature of medicine and law based on following unique principles of training of medical law professionals. Professional course system of medical law should operate on the basis of a variety of securities.