Objective: To study the effects of bacterial invasion and artificial saliva immersion on the bond strength and nanoleakage between healthy dentin and glass ceramics-bonded specimens using three types of resin cements and provide a reference for the selection of clinical bonding materials. Methods : One hundred eight dentin blocks were selected to prepare bonded specimens with Variolink N, Multilink N, RelyX Unicem and glass ceramics blocks. The adhesive specimens of each type of resin cements were divided into three groups according to the aging method: bacterial invasiveness group (the specimens were cultured under anaerobic conditions for 14 days after inoculation with Streptococcus mutans), artificial saliva immersion group (the specimens were immersed in artificial saliva for 6 months), and control group (the immediate test group). Each group comprised 12 specimens: 6 were selected to test the bonding strength, and 6 were observed by scanning field emission scanning electron microscopy (FESEM). Results : The bond strength of Variolink N in the immediate test group was significantly higher than that of Multilink N and RelyX Unicem, and the difference was statistically significant (P < 0.05). However, no significant difference was found in the bacterial invasiveness group and artificial saliva immersion group (P > 0.05). In the bacterial invasion group, the difference in the nanoleakage of the three adhesives was statistically significant (P < 0.05), with a trend of Variolink N > Multilink N > RelyX Unicem, and pairwise comparison was statistically significant (P < 0.05). The nanoleakage of the three resin adhesives showed an increasing trend in the bacterial invasion group and artificial saliva group compared with that of the immediate test group. Conclusion Both artificial saliva soaking and bacterial invasion can reduce the sealing property of the adhesive interface of 3 types of resin cements to different degrees. The presence of Streptococcus mutans in the oral cavity may reduce the sealing performance of the resin dentine adhesive interface.

From the Government’s fully guarantee stage to the stage of independent organization of medicine, then to the market-oriented reforms and the new health care reform exploration stages, the public hospitals reform fol-lows different institutional logics, but the institutional dilemma have emerged at all stages including the little coupling between the institutional arrangements and environment, the public welfare and benefit wandering, the management system instability, and the breakdown of the financial investment and control costs mechanisms. The Government should elaborate conditions for the spontaneous public hospitals reform on the institutional environment in order to em-bed intrinsic motivation of the induced institutional change into the imposed institutional change. There should be positive interaction between the government and the market in order to form a reasonable and orderly competitive land-scape to the market of medical services. Payment should be reformed which has significant influence on internal medi-cal service system incentives.

Objective To compare the difference of training field of nurse specialist between America and China, and offer proposals to the development of Chinese nurse specialist. Methods Network information resources and citespace were used to conclude and compare training field of nurse specialist. Results The nurse specialist training in America has a mature system meanwhile it is not yet mature in China. Conclusions Reference to the mature development experience of America, combining the actual situation of China, suitable strategy should be developed for the Chinese nurse specialist training.

Objective To explore the relationships among organization climate,psychological empowerment and job embeddedness by using path analysis.Methods A total of 514 clinical nurses from 26 departments in 3 hospitals were recruited by convenience cluster sampling method and investigated with demography questionnaire,Nurses Organizational Climate Scale,Psychological Empowerment Scale and Job Embeddedness Scale.Results The mean scores of organization climate,psychological empowerment and job embeddedness was (3.01±0.46),(3.27±0.44),(3.08±0.39).The predictors of job embeddedness of nurses were resources support,work experience,human resources management,marital status,job title,management support,quality management,and self-egicacy,explained 48.9％ of its variance; organization climate,psychological empowerment had direct positive influence on nurses' job embeddedness,explained 33.3％ of its variance.Conclusions Improvement and maintenance of sound organizational climate,increase the sense of psychological empowerment of nurses,are effective ways and means to increase the degree of job embedding of nurses.

Objective:To preliminarily study the effect of Louqin Zhisou decoctions with the mechanism of clearing heat and resol-ving phlegm on the blood level of neutrophil elastase ( NE) in the rat model of acute exacerbation of chronic obstructive pulmonary dis-ease ( AECOPD) . Methods:The rat model of AECOPD was established by passive cigarette smoking, intratracheal instillation of li-popolysacchricle ( LPY) and intranasal instillation of staphylococcus aureus. Totally 60 AECOPD rats were randomly divided into 3 groups, the model control group (n=20), ambrohexel group (n=20), and Louqin Zhisou decoctions group (n=20). NE was detec-ted by ELISA. Results:Compared with that before the treatment, NE in ambrohexel group and Louqin Zhisou decoctions group was de-creased significantly(P<0. 01). Conclusion:Clearing heat and resolving phlegm method probably can decrease NE by reducing air-way mucus hypersecretion and obstruction in AECOPD rats.

Objective To study the effects of self-management of knee osteoarthritis (KOA) on the function and quality of life in old patients. Methods From October 2011 to April 2012, 100 patients with KOA from 2 communities in Tangshan, Hebei were recruited, and were as control group and intervention group based on the community. The intervention group learned a KOA self-management course, which consisted of 6 classes of 1.5 to 2 hours, once a week, taught by health professionals. The control group read the KOA self-management handbook only. They were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Arthritis Impact Measurement Scale 2nd version- Short Form (AIMS2- SF) before and 6 months after intervention. Results The score of WOMAC and AIMS2-SF improved more in the intervention group than in the control group (P<0.05). Conclusion The KOA self-management program is effective on function and quality of life in old patients with KOA in community.

Objective To explore and analyze the impact on the delivery quality of the midwife accompanied. Methods One hundred and twenty puerperal from November 2012 to November 2013 in the thematernity department of our hos-pital were selected as the research objects,they were randomly divided into the experiment group and the control group,the control group were given the normal maternal care personnel shift system, while the experiment group ma-ternal were given the one-to-one accompanied by midwives , assisting in childbirth puerperal. The women complica-tions and two modes of nursing satisfaction of two groups were compared. Results The pain, bleeding, abnormal labor, fetal asphyxia probability and negative emotions in the experiment group were significantly lower than that of the con-trol group, while the maternal satisfaction rate of the experiment group was significantly higher than that of the control group(P<0.05). Conclusion Implements of the one-to-one for maternal the whole nursing model can effectively avoid the maternal complications and more beneficial to the health of the fetus birth and improve maternal satisfaction ,it is beneficial to the improvement of the overall quality of care for maternal and infant and worty of proper clinical promo-tion.

Objective To explore the clinical application of reconstructing silicone elastomer nose prosthesis by means of selected laser sintering and wax powder PCPI. Methods Laser scanning was used to get the 3-D data of a nose model. Surfacere 10.0 etc softwares was used to reconstruct the nose by mirroring the digitalized model of absent nose. Selective laser sintering and wax powder was chosen to fabricate a wax nose model and the nose prosthesis made by silicone clastomer. Results Perfect silicone clastomer nose prosthesis was made for 2 patients. Conclusion This study suggests that the wax nose model and the new wax powder can meet the requirement of clinical expectation for maxillofacial prosthesis.

BACKGROUND:Transplantation of mesenchymal stem cells (MSCs) to multiple sclerosis (MS) is a new developed treatment to be given more and more attention.However,whether the MSCs function by cell replacement after going cross the blood-brain barricr or immune suppression needs further confirmation.OBJECTIVE:To establish a steady and effective method of Y chromosome in situ hybridization (ISH) and to detect the distribution of MSCs in a mouse model with MS.DESIGN,TIME AND SETTING:The observational study was performed at the Laboratory of Molecular Immunology,Institute of Healthy Science from September 2007 to February 2009.MATERIALS:A total of 30 C57BL/6 mice,aged 6-8 weeks and weighing 15-20 g,were selected.Female mice were used to establish experimental autoimmune encephalomyelitis (EAE).METHODS:Y chromosme specific DNA probe labled with digoxine (DIG) was designed and ISH was performed to confirm that the designed probe was Y chromosome specific and biologically sensitive.We transplanted the MSCs from male mice into the female EAE mice,and tracked the MSCs by Y chromosome ISH.MAIN OUTCOME MEASRUES:Distribution of MSCs in mice with EAE was observed under the optical and fluorescence microscope.RESULTS:The probe was confirmed to be Y chromosome specific and biologically sensitive.What's more,a steady and effective method of ISH was established.Some MSCs were detected in the periphery organs-spleen and lymph node of mice with EAE;seldom in spinal cord which indicated that MSCs might play its roles by immune suppression.CONCLUSION:Some MSCs were detected in the periphery organs-spleen and lymph node of mice with EAE,but seldom in spinal cord in the central nervous system.

Obtective The correlation between estrus cycle and the pathological changes of liver and lung in LPS-treated mice and the possible mechanisms were investigted.Methods The pathological lesion in liver and lung、 the content of E_2、P in plasma and the content of TNF-?、EGF in plasma and ovarian supernate were examined in various times after challenge with 12.5 mg/kg LPS in estrus、metestrus and diestrus respectively and the correlation among them was assessed.Results The plasma E_2 and p levels were the lowest in diestrus.When LPS was injected in diestrus,compared with control group,the levels of P and E_2 in plasma were decreased remarkely after ip LPS 10 h(P