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OBJECTIVE: To assess the reliability and validity of Adversity Quotient Scale in evaluating the adversity quotient among nurses. METHODS: A total of 409 nurses were selected as study subjects from three first-class hospitals in Fujian Province by cluster sampling method. The adversity quotient was investigated by Adversity Quotient Scale and its reliability and validity were tested. RESULTS: The Cronbach′s alpha coefficient, Spearman-Brown coefficient, Guttman Split-Harf coefficient and retest reliability of Adversity Quotient Scale were 0.931, 0.826, 0.823 and 0.940, respectively. The content validity ratio of Adversity Quotient Scale was 0.980. The scores of control, attribution, extension and tolerance factors were positively correlated with the total score of Adversity Quotient Scale(correlation coefficients were 0.813, 0.844, 0.874 and 0.822, respectively, P<0.05). Before model modification, the initial model fitting index of confirmatory factor analysis was χ~2/df=3.72, root mean square residual approximate(RMSEA)=0.09, the overall fitting of the model was not high. After model modification, the combined reliability of control, attribution, extension and tolerance factors were 0.780, 0.796, 0.831 and 0.871, respectively. The fitting index of the modified model was χ~2/df=3.08, RMSEA=0.07, showing a good fitting of the model. CONCLUSION: Adversity Quotient Scale has a good reliability and validity in the assessment of nurses, which can be a reliable and effective adversity quotient assessment tool.
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Objective@#To explore the effects of autologous platelet-rich plasma (PRP) in the repair of soft tissue defects of rabbits with free flap.@*Methods@#Thirty 6-month-old New Zealand white rabbits, male and female unlimited, were used to harvest blood from the heart. PRP was prepared by Aghaloo method, then free flap model with size of 5 cm×3 cm was reproduced on each ear of the rabbit. According to the random number table, one ear of each rabbit was recruited to PRP group, and the other ear was recruited to normal saline group. The base of flap on rabbit ear in PRP group was evenly spread with 1.0 mL autologous PRP, and equivalent volume of normal saline was applied to that in normal saline group. Then, the flap was replanted in situ. On post surgery day (PSD) 2, 3, 5, 7, and 14, 6 rabbits in each group were taken. The survival of flap was observed and recorded. The morphology of the basal tissue of flap was observed by hematoxylin-eosin staining. The expressions of CD31 and α smooth muscle actin (α-SMA) in the basal tissue of flap were detected by immunofluorescence method. Another 6-month-old male New Zealand white rabbit without making flap under the same experimental conditions was used for harvesting whole blood and preparing PRP. Then blood platelet count in whole blood and PRP was determined, and the content of vascular endothelial growth factor (VEGF) and transforming growth factor β (TGF-β) was detected by double-antibody sandwich enzyme-linked immunosorbent assay. Data were processed with analysis of variance of factorial design, paired sample t test, and Bonferroni correction.@*Results@#(1) On PSD 2, the flaps of wounds of rabbits in PRP group were reddish and adhered well to the basal tissue; the flaps of wounds of rabbits in normal saline group were dark red and poorly attached to the basal tissue. On PSD 3, the flaps of wounds of rabbits in PRP group were ruddy and closely adhered to the basal tissue; the flaps of wounds of rabbits in normal saline group were scattered in the plaque-like dark red and generally attached to the base. On PSD 5, the flaps of wounds of rabbits in PRP group were reddish and closely adhered to the basal tissue, and the flaps were alive; while flaps of wounds of rabbits in normal saline group were rosy and closely adhered to the basal tissue. On PSD 7, the surface of flaps of wounds of rabbits in PRP group was covered with a medium amount of rabbit hair. The color of flap was similar to that of the surrounding skin. The flaps of wounds of rabbits in normal saline group were generally attached to the base, and the surface was only covered with a small amount of fluff. On PSD 14, the incisions were healed well in PRP group, while small wounds in normal saline group were not healed. (2) On PSD 2, inflammatory cell infiltration was observed in flaps of wounds of rabbits in both groups. On PSD 3, the flaps of wounds of rabbits in PRP group showed neovascularization, with less interstitial hemorrhage; while there were less neovascularization in the flaps of wounds of rabbits in normal saline group. On PSD 5, a medium number of inflammatory cell infiltration and a small amount of new microvessels were observed in flaps of wounds of rabbits in normal saline group. Many fibroblasts, a small amount of inflammatory cells, and scattered new microvessels were observed in flaps of wounds of rabbits in PRP group. On PSD 7, the number of new microvessels in normal saline group was significantly lower than that in PRP group. On PSD 14, the new microvessels in the flaps of wounds of rabbits in PRP group gradually matured, and a large number of fibroblasts distributed around them. Some of the newly formed microvessels in the flaps of wounds of rabbits in normal saline group were mature, and the healing was slower than that of PRP group. (3) On PSD 2, 3, 5, 7, and 14, the expressions of CD31 and α-SMA in the basal tissue of flaps of wounds of rabbits in PRP group were significantly higher than those in normal saline group (t=10.133, 5.444, 9.450, 6.986, 8.394, 14.896, 10.328, 9.295, 13.902, 10.814, P<0.01). (4) The platelet count in activated PRP of rabbits was (2 863±962)×109/L, which was significantly higher than (393±49)×109/L in whole blood (t=7.690, P<0.05). (5) The content of VEGF and TGF-β in activated PRP of rabbits was (564.3±3.2) and (1 143±251) pg/mL, which was significantly higher than (99.7±0.4) and (274±95) pg/mL in whole blood, respectively (t=287.390, 9.648, P<0.05 or P<0.01).@*Conclusions@#PRP of rabbits contains high concentrations of VEGF and TGF-β. Therefore, PRP can effectively promote microvascular regeneration in free flap tissue and accelerate the survival of free flap.
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Objective To investigate the status of sleep quality and the family-related factors among elder-ly pregnant women who already have one child.Methods A total of 299 elderly pregnant women who already have one child were investigated using pittsburgh sleep quality index(PSQI),family APGAR index and a self-designed questionnaire. Results The total prevalence of poor sleep quality was 30.8% among elderly pregnant women who already have one child.PSQI score was average(6.31 ± 2.95). PSQI score were higher than the adult female norm and pregnant woman for the first time(u=16.396,5.497,P<0.05).Univariate analysis showed that the determi-nants of sleep quality included pregnancy,family support(parents),family support(husband),family support (child),family dysfunction,family right(χ2= 12.312,21.049,18.617,11.682,13.494,6.779,P < 0.05). Logistic regression analysis showed that pregnancy,family support(parents),family support(husband),family support(child)and family dysfunction were associated with sleep quality. Conclusion The poor sleep quality among elderly pregnant women who already have one child is related to low family support(parents,husband, child),obstacle of family dysfunction and late pregnancy.
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Objective To explore the effect of platelet-rich plasma (PRP) on flap graft survival.Methods Two random skin flaps were elevated on the back of the rabbits with spinal symmetry in fifteen healthy rabbits.We selected randomly one side as PRP side,another side as blank control side.And then the autologous PRP was daubed to the basement of the skin flap in PRP side,while the blank control side was treated with normal saline of the same volume.At 3 d,7 d,and 14 d after the surgical operation,the immunohistochemistry was conducted to detect the microvessel density by CD34,and the the flap graft survival rate was tested and the histological changes of the flaps were observed by HE staining.Results The survival rates of skin flap graft were that the PRP side in 3 d (74.4±4.7) ％,while the control side (65.8+6.8)％;the PRP side in 7 d (72.4±7.5)％,while the control side (58.5+7.0)％；the PRP side in 14 d (74.5±5.0)％,while the control side (65.0±5.4) ％.The inflammatory reaction became declining with the extension of time,while density of blood vessels was increasing.In 14 d inflammatory reaction was the lowest and blood vessels' density was the largest.In all the control sides inflammatory response was obvious than that of the PRP side.CD34 positive count in 3 d PRP side microvascular density (MD) was (13.9±2.0)/HP,controlled side (11.1±1.3)/HP;in 7 d PRP MD was (15.7±1.5)/HP,controlled side (12.1±1.2)/HP;in 14 d PRP MD was (19.6±1.2)/HP,controlled side (12.7±0.8)/HP.There were significant differences in the MD at 3 d,7 d,and 14 d (P＜0.05) between PRP side and control side.Conclusions Platelet-rich plasma is able to promote the survival of random rabbit flap.
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Objective The mechanism of delaying flap with the minimal invasive surgery was approached to understand its effects on the whole delayed survival of skin flaps thoroughly so as to provide the rationale for its clinical use.Methods 80 male or female Wistar rats were randomly subdivided into two groups:delayed by the minimal invasive surgery,and immediately transfer without delay.Flaps in each group delayed were cut at 1,2,3 and 4 weeks,respectively.The flap was designed at the lower back of rat,with the size of 5 cm × 1 cm,crossing the middle area for 2.5 cm and including stem of iliac branch from iliolumbar artery.2 weeks after second operation,the survival area,capillary density and content of lactic acid of the flaps in each group were examined,and the survival of the falps delayed by the minimal invasive surgery was compared.Results The longer delaying time,and the higher survival rate were observed in the experimental group.Delaying for 3 weeks and 4 weeks,the survival rate was (86.13 ±1.13) ％,(93.49 ± 1.15) ％,respectively,in the experimental group.While in control group,the survival rate was no more than 63％.The longer delaying time,the higher the capillary density were noted in two groups,but 3 weeks delayed group equally matched to the 4 weeks delayed group.In the experimental group,the content of lactic acid increased peaked in 1 week delayed group,then fell-down gradually,but kept steady in 3 and 4 weeks delayed group.The content of lactic acid in the control group kept steady.Conclusions The experimental model is selected as cross-area axial flap on the lower back of rats.The minimal invasive surgery plays the same role as in delaying flaps,which causes vasoconstriction,resulting in disorder of internal environment,ischemia and hypoxia,finally vasodilatation.The more ramus anastomosis,the more survival rate of the flap.
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Objective To describe the status of fatigue and its influencing factors among hypertension patients. Methods A total of 1253 hypertension patients were investigated with global fatigue severity subscale,family APGAR index and self-designed questionnaire. Results 36.7% of hypertension patients were fatigue.Univariate analysis showed that the determinants of fatigue among hypertension patients included older, normal marriage, rural, low educational, mental, family dysfunction (P ＜ 0.05 ). Multivariate analysis revealed that age ( OR =2. 612,95% CI = 2. 047 ～ 3. 333 ), normal marriage ( OR = 1. 754,95% CI = 1. 259 ～ 2. 445 ), manual ( OR =0.810,95 % CI = 0.698 ～ 0.939) and family dysfunction ( OR = 1.717,95 % CI = 1. 396 ～ 2.111 ) were associated with fatigue. Conclusion The rate of status is high in the hypertension patients. The behavior is related to age,marital status, labor type and family function.
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In this paper, the definition of NURBS curve and a speed-controlled interpolation in which the feed rate is automatically adjusted in order to meet the specified chord error limit were discussed. Besides those, a definition of linear interpolation error of post-processed data was proposed, which should be paid more attention to because it will not only reduce quality of the surface but also may cause interference and other unexpected trouble. In order to control the error, a robust algorithm was proposed, which successfully met a desired error limit through interpolating some essential CL data. The excellence of the proposed algorithm, in terms of its reliability and self-adaptiveness, has been proved by simulation results.
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Objective: To investigate the effects of ?-melanocyte-stimulating hormone(?-MSH) on TGF-?_1 secretion of fibroblasts from keloids so as to find a novel evidence to research etiology of keloids.Methods:Fibroblasts isolated from human keloids were cultured in DMEM medium with 15% bovine serum and treated with ?-MSH. The level of TGF-?_1 was measured with ELISA method. Results: ?-MSH at the concentration of 10 -6 mmol/L triggered the TGF-?_1 secretion of fibroblasts. Conclusion:?-MSH possesses the effect of triggering human keloid fibroblasts to secrete TGF-?_1, and its effective concentration is 10 -6mmol/L.
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<p><b>OBJECTIVE</b>To investigate the application of tourniquet in burn patients during tangential excision on the extremities.</p><p><b>METHODS</b>Seventy - nine burn patients who were arranged to receive tangential excision and skin grafting on the extremities were randomly divided into A and B groups. The patients in A group (n = 41) underwent the operation with the tourniquet applied continuously throughout the operation, while those in B group (n = 38), only with tourniquet applied during tangential excision. The amounts of blood loss and blood transfusion, the operation time and the take rate of grafted skin and the incidence of complications were investigated and recorded.</p><p><b>RESULTS</b>The amounts of blood loss and blood transfusion during operation in A group were 42% and 50% less than those in B group, respectively (P < 0.001). Moreover, the operation time on the upper and lower extremities in A group was much shorter (for 41% and 37%, respectively) than those in B group (P < 0.001). In addition, there was no difference of the take rate of skin graft and the incidence of subcutaneous hematoma between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>Continuous tourniquet application during tangential excision on the extremities in burn patients was proved to be effective in reducing operational blood loss, blood transfusion and in shortening operation time.</p>