The mediating effect of nurses′self-efficacy in palliative care between the past behavioral experience and core competence / 中国实用护理杂志

Objective:To explore the mediating effect of nurses′ self-efficacy in palliative care between the past behavioral experience of end-of-life care and core competence, and provide theoretical reference for improving the core competence of clinical nurses in palliative care.Methods:579 clinical nurses from 2 tertiary general hospitals in Shandong Province were investigated by convenience sampling method using general information questionnaire, nurses′ self-efficacy questionnaire for palliative care and palliative care nurses′ core competency questionnaire. The data were analyzed by SPSS 25.0.Results:The total score of core competence of hospice care of 579 nurses was (71.41 ± 22.74), nurses′ self-efficacy of palliative care was positively correlated with their core competence ( r = 0.648, P<0.01), past behavior experience was positively correlated with self-efficacy ( r = 0.479, P<0.01), positively correlated with core competence ( r = 0.427, P<0.01). Nurses′ self-efficacy of palliative care played a partial mediating role between the pastbehavioral experience and core competence, which accounted for 64.67% of the total effect. Conclusions:The past behavioral experience of end-stage nursing can directly or indirectly affect the core competence of nurses in palliative care through self-efficacy. It can improve the core competence of palliative care by taking active measures to enrich the past behavioral experience of end-of-life care and improve self-efficacy.

Analysis of the implementation of health impact assessment of public policies in Zhejiang province / 中华医院管理杂志

The policy implementation model of G. C. Edwards was used to analyze the public policy health impact assessment in Zhejiang province, and summarize its practice and existing problems in four aspects of policy implementation standards, policy resources, policy executors′ intention and management organization structure, so as to provide reference for promoting the national health impact assessment pilot work. The analysis results showed that Zhejiang province has initially established the public policy health impact assessment mechanism and achieved phased results, but there were still some problems, including the imperfection of policy content and implementation strategy, the inadequacy of leadership decision-making and top-level design, the difference in attitude, understanding and implementation preference of policy implementation subjects, and the ambiguity of the authority and responsibility system of each department in cooperation. In order to further promote the smooth development of public policy health impact assessment, Zhejiang province should actively promote the top-level design to strengthen policy support, integrate and optimize policy resources, gradually establish and improve the health governance mechanism of multiple and overall coordination, and promote the high-quality development of public policy health impact assessment by taking cross departmental cooperation as the path of health co-construction.

The current situation of quality control circle among nursing quality management in Shandong Province: Cross-sectional survey / 中国实用护理杂志

Objective@#To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems.@*Methods@#A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning. SPSS 23.0 software was used to analyze the data.@*Results@#Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures" , accounting for only 6.7%. The "calculation of target value" was the best for 45.1%, the best which "QCC report and evaluation" was 32.1%(72/224) in the promotion and management of hospital-level QCC, and the worst which "standardization approval" was only 4.0%(9/224). The main obstacle factors include personnel, skills and in-hospital support.@*Conclusions@#Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.

A single decline of FEV3/FVC in determine the application potential of early lung disease / 中国医师杂志

Objective To explore the application potential of forced expiratory volume in three second/forced vital capacity (FEV3/FVC) in early lung diseases,such as early airway obstruction and mild gas trap.Methods A total of 288 patients (excluding those with restrictive ventilation dysfunction) who underwent pulmonary function examination in the pulmonary function room of our hospital from January 2014 to October 2017 were collected.288 patients were divided into three groups.Group A:FEV3/FVC and forced expiratory volume in one second/forced vital capacity (FEV1/FVC) were normal;Group B:FEV3/FVC decreased alone;Group C:FEV1/FVC decreased.The general data and pulmonary function indexes of the three groups were compared.Results Compared with group A,group B had lower FEV1 ％ and diffusion capacity for carbon monoxide of the lung (DLCO％),but higher total lung capacity (TLC％),residual volume (RV％) and RV/TLC.Compared with group B,group C had higher TLC ％,RV％,RV/TLC％,while FEV1％,DLCO％ reduce more remarkably.There were significant differences in the three groups of small airway function (P ≤ 0.01).FEV3/FVC was positively correlated with max expiratory at 50％ FVC (MEF50％),max expiratory at 75％ FVC (MEF25％) and maximal mid expiratory flow (MMEF％).The correlation coefficients were respectively 0.613,0.610,0.608 (P ≤0.01).When FEV3/FVC serves as an indicator to determine airway obstruction,the specificity of it is 45.7％,sensitivity 98.5％,and negative predictive value 99％,positive predictive value 35.5％.Conclusions FEV3/FVC individual decline is the indication of early lung diseases such as mild airway obstruction,mild gas trap and diffuse disorder.

The current situation of quality control circle among nursing quality management in Shandong Province: Cross-sectional survey / 中国实用护理杂志

Objective To provide the basis for the popularization and application of QCC,we investigate the operation status of nursing quality control circle (QCC) in Shandong Province, and analyze the existing problems. Methods A self-designed questionnaire which Cronbach’s α=0.905, was used to the attendees of the annual meeting of the Nursing Committee of Shandong Hospital Quality Management Alliance by convenience sampling. The questionnaire was filled out online by mobile phone scanning.SPSS 23.0 software was used to analyze the data. Results Among 224 respondents,score of GSES was 27.71±5.58, 96.0% thought it was necessary to continue the QCC, 91.1% thought that it could solve the problems of quality management and has applicability. The worst mastery of QCC knowledge was "development and review of countermeasures", accounting for only 6.7% . The"calculation of target value"was the best for 45.1%, the best which"QCC report and evaluation"was 32.1%(72/224) in the promotion and management of hospital- level QCC, and the worst which"standardization approval"was only 4.0% (9/224). The main obstacle factors include personnel, skills and in- hospital support.Conclusions Hospital departments should establish effective quality control circle training management methods, strengthen promotion and supervision; nursing managers should pay attention to the training of QCC activities, pay attention to the unity and cooperation of different departments and doctors, and further promote the clinical application of quality management methods.

Identification of potential molecular mechanisms and candidate genes involved in the acute phase of myocardial infarction

Objective: This study used bioinformatics to determine genetic factors involved in progression of acute myocardial infarction [MI]

Materials and Methods: In this prospective study, gene expression profile GSE59867 was downloaded from the Gene Expression Omnibus database, which contained 46 normal samples obtained from stable coronary artery disease patients [n=46] who were without history of MI [control] and 390 samples from patients [n=111] who had evolving ST-segment elevation myocardial infarction [STEMI] as the MI group. These samples were divided into 4 groups based on time points. After identification of differentially expressed genes [DEGs], we conducted hierarchical clustering and functional enrichment analysis. Protein interaction and transcriptional regulation among DEGs were analysed

Results: We observed 8 clusters of DEGs that had a peak or a minimum at the t=1 time point according to gene expression levels. Upregulated DEGs showed significant enrichment in the biological process, single-organism cellular process, response to stimulus and stress, and osteoclast differentiation and lysosome. Downregulated DEGs enriched in the T-cell receptor signalling pathway and natural killer cell mediated cytotoxicity. We identified multiple genes, including signal transducer and activator of transcription 3 [STAT3]; LCK proto-oncogene, Src family tyrosine kinase [LCK]; and FYN proto-oncogene, Src family tyrosine kinase [FYN] from the protein-protein interaction [PPI] network and/or the transcriptional regulatory network

Conclusion: Cytokine-mediated inflammation, lysosome and osteoclast differentiation, and metabolism processes, as well as STAT3 may be involved in the acute phase of MI

Difference of the clinical characteristics and outcome between interstitial lung disease with dermatomyositis and idiopathic pneumonia fibrosis / 中国医师杂志

Objective To compare the clinical features and prognosis between dermatomyositis-associated interstitial lung disease (DM-ILD) and idiopathic pulmonary fibrosis (IPF).Methods Patients with interstitial lung disease with dermatomyositis (DM-ILD) or idiopathic pneumonia fibrosis (IPF) from January 2003 to March 2014 in the third affiliated hospital of Sun Yat-sen University were included.Results Among the 64 patients enrolled,44 were DM-ILD and 20 were IPF.IPF was more common in the elderly (P =0.000),men (P =0.004) and smokers (P =0.000),and its high-resolution computed tomography (CT) mostly showed grid shadow (P=0.014) and honeycomb shadow (P=0.000).DM-ILD usually had cough symptoms (P =0.025).High-resolution CT showed patchy (P =0.048) and banded (P =0.000).Glucocorticoid (P =0.000) and immunosuppressive agents (P =0.000) were commonly used in the treatment of DM-ILD.However,there was no significant difference in 90d mortality between the two groups (P ＞ 0.05).Conclusions IPF is more common in the elderly,men and smokers,and its high-resolution CT mostly shows grid shadow and honeycomb shadow,distribution is diffuse.DM-ILD often has cough symptoms,and its high resolution CT is mostly plaques and streaky shadows.Glucocorticoids and immunesuppressants are commonly used in DM-ILD,but there is no significant difference in 90-day mortality between them.

Research on the quality management mode of transitional care: Based on Three-dimensional QualityStructure Mode / 中国实用护理杂志

Objective To explore a reasonable transitional care quality management model, in order to standardize the management system of transitional care. Methods Using "three-dimensionalquality structure" mode as the theoretical framework, after reviewed relevant literatures, we established the rudiment of quality evaluation index system.Twenty-two experts were enrolled,and expert consultation was conducted using Delphimethod. The experts were evaluated by authority, positivity and degree of opinion coordination. Results The experts′authority coefficient was 0.846;the coefficient of determination was 0.891;the degree of familiarity was 0.80.The positive coefficients of the two rounds of consultation were 0.958,0.957. The evaluation system for transitional care consisted of 3 level- 1 indicators,12 level-2 indicators,and 64 level-3 indicators.The Kendall coefficients of concordance of the three level Indicators were 0.519, 0.525, and 0.432(P<0.05 for all). Conclusion The quality evaluation index system with With high reliability, providing standard reference for the work of quality management and nursing quality improvement.

TSLP promotes recruitment of myofibroblasts into airway in asthmatic mice / 中国免疫学杂志

Objective:To investigate whether thymic stromal lymphopoietin ( TSLP) participate in asthmatic airway remodeling partially by promoting myofibroblast accumulating in the lung. Methods:Twelve mice evenly were randomly divided into four groups:a saline group;an HDM-exposed group;an IgG isotype-treated group and an anti-TSLP-treated group. The supernatant of bronchoalveolar lavage fluid ( BALF) was used to analyze the levels of TSLP,IL-25 and IL-33 by ELISA. Fluorescence-labeled collagenⅠ( ColⅠ)/α-smooth muscle actin (α-SMA) -dual-positive myofibroblasts were examined by confocal microscopy. Results:Chronic allergen exposure induced obviously abnormal airway structural changes,which were inhibited by blocking TSLP. We detected a highly increased number of myofibroblasts in the sub-epithelial zone in mice from HDM-challenged group. However, TSLP neutralization significantly reduced myofibroblasts recruitment. Moreover,blocking TSLP not only decreased the level of TSLP,but also inhibited the expression levels of TGF-β1 and IL-33 in BAL fluid. Conclusion:The results suggest that orchestrating myofibroblasts recruiting into the lungs is one of the main pathogenesis that TSLP involves in airway remodeling in asthmatic mice.

Molecular characteristics of two Phi glutathione S-transferases in Selaginella moellendorffii / 生物工程学报

Glutathione S-transferase (GST) is important in plants to resist various stresses. In this study, two Phi GST genes (SmGSTF1 and SmGSTF2) were cloned from Selaginella moellendorffii. SmGSTF1 and SmGSTF2 genes encode proteins of 215 amino acid residues. Gene expression analysis showed that the two genes were expressed in roots, stems and leaves. The recombinant SmGSTF1 and SmGSTF2 proteins were overexpressed in Escherichia coli, and purified by Ni-affinity chromatography. SmGSTF1 and SmGSTF2 had the catalytic activity towards 1-Chloro-2,4-Dieitrobenzene, 4-Chloro-7-nitro-1,2,3-benzoxadiazole (NBD-Cl), and 4-Nitrobenzyl chloride substrates. SmGSTF1 also had the activity towards Fluorodifen and Cumyl hydroperoxide (Cum-OOH), whereas SmGSTF2 not. The enzyme kinetics analysis showed that SmGSTF1 and SmGSTF2 had high affinity towards glutathione, and low affinity towards 1-Chloro-2, 4-Dieitrobenzene. The enzymatic activity of SmGSTF1 and SmGSTF2 had high catalytic activity between pH 7 and 8.5, and between 45 and 55 °C. SmGSTF1 and SmGSTF2 may have an important role in the resistance of Selaginella moellendorfii against stress.

Effect of intranasal treatment with Toll-like receptor 9 ligand CpG oli-godeoxynucleotides on airway inflammation in mice with allergic com-bined airway disease / 中国病理生理杂志

[ ABSTRACT] AIM:To investigate the therapeutic effect of intranasal administration of CpG oligodeoxynucleotides (CpG-ODN), compared with intradermal administration, on lower airway inflammation in ovalbumin (OVA)-induced al-lergic combined airway disease (ACAD) mouse model.METHODS: Totally 30 female BALB/c mice aged from 6 to 8 weeks were randomly divided into control group , allergic rhinitis model group (AR group), ACAD group, ACAD intrana-sally treated with CpG-ODN group (CpG i.n.group) and ACAD intradermally treated with CpG-ODN group (CpG i.d. group).The mice were sensitized and challenged with OVA .Treatment with CpG-ODN was also performed during chal-lenge, either intranasally or intradermally .Immunologic variables and nasal symptom were studied .RESULTS:Compared with CpG i.d.group and ACAD group, the percentage of eosinophils from bronchoalveolar lavage fluid (BALF), the levels of Th2 cytokine production in BALF and supernatants of cultured splenic lymphocytes , OVA-specific IgE from blood , peri-bronchial inflammation score in the lung , and nasal symptoms were significantly reduced in CpG i .n.group.CONCLU-SION:Allergic rhinitis treated by CpG-ODN has a significant improvement on lower airway inflammation in ACAD mouse model;and it may be more effective when administrated intranasally than intradermally .

Assessment of preoperative lung function test in predicting the risk of postoperation pulmonary complications in non chest operation patients with chronic obstructive pulmonary disease / 实用医学杂志

Objective To observe the role of preoperative lung function test in predicting the risk of postoperation pulmonary complications in patients with chronic obstructive pulmonary disease (COPD) accepting non chest operations. Methods 80 patients accepting non-invasive chest operations during Oct 2006 to May 2013 in the third affiliated hospital of SYSU were studied retrospectively. All the patients accepted lung function test 1 week before operation. Based on the lung function records, patients were divided into 2 groups. 40 of them in COPD group, 40 in control group. The incidence rate of postoperation pulmonary complications in different group and the relationship between the severity of lung function decreasing and the rate of postoperation pulmonary complications were investigated. The differences of the American Society of Anesthesiologists (ASA) Physical Status Classification, body mass index, smoking index, length of stay, hospitalization costs between the 2 groups were also studied. Results The incidence rate of postoperation pulmonary disease in COPD group was 30% (12/40) while the rate in control group was 12.5% (5/40), the statistic difference was significant (P = 0.046). There was remarkable relationship between the severity of lung function decreasing and the rate of postoperation pulmonary complications(P=0.005), patients with mild to moderate lung function decreasing would be safer in operation, but patients with severe lung function decreasing would be in high risk(r=-0.451). Patients in COPD group were older than the control group, but there were no significant difference on body mass index, smoking index, length of stay, hospitalization costs between the 2 groups (P > 0.05). There was no relationship between ASA physical status classification and postoperation pulmonary complications. Conclusion Incidence of postoperation pulmonary complications in patients with COPD is high, which mainly manifests as pneumonia. It was important to test the lung function before non-invasive chest operations, especially in patients with COPD(P>0.05).

Detection of biofilm formation and analysis of biofilm-associated genes of methicillin-resistant Staphylococcus aureus in clinical isolates / 实用医学杂志

Objective To detect biofilm formation and biofilm-associated genes of methicillin-resistant Staphylococcus aureus (MRSA) in clinical isolates. Methods The biofilm were determined by microtiter plate assay (MPA) and congo red agar (CRA) and the biofilm-associated genes icaA,sarA,fnbA,fnbB were detected by PCR in 33 strains of MRSA in clinical isolates. Results Of the 33 MRSA isolates, 29(87.9%) were MPA positive, 16(48.5%) were CRA positive; The icaA gene was present in 39.4% of isolated strains. Furthermore, 69.7% of strains harboured the sarA gene, 39.4% were fnbA positive and 75.8% were fnbB positive. As many as 87.9% strains had the ability to form biofilm in vitro. 44.8% of MRSA formed biofilm in ica-dependent mechanism and 55.2% of MRSA isolates formed biofilm in ica-independent mechanism. Of the biofilm positive MRSA, 75.9% were sarA positive, 37.9% were fnbA positive and 79.3% were fnbB positive. Conclusion Most of the MRSA strains formed biofilm in ica-independent mechanism. fnbB and sarA gene shows higher frequency among the biofilm-associated genes of MRSA, it may infer that most of the MRSA strains biofilm formation are fnbB-mediated. Meanwhile, sarA may be a positive regulator of fnbB, and thus drives the biofilm formation.

An evaluation research for new nurses six dimensional scales in pre-service training / 中国实用护理杂志

Objective To investigate the feasibility of Six Dimensions Scale (6-D scale) of Nursing Performance used for evaluating the effect of standardized hospital-department training on new graduate nurses.Methods 6-D Scale of Nursing Performance was conducted to evaluate the nursing ability of 216 new graduate nurses (2013) of our hospital pre and post the three-month intervention,including the self-appraisal and appraisals by head nurses.Results The nursing ability was improved significantly after the training.The total score of self-appraisal 6-D scale were significantly higher than that before the training (142.34±19.92 vs 135.81±18.30),in which the subscales scores within the dimensions of leader-ship,critical care,teaching/collaboration,planning/evaluation,interpersonal relations/communication were increased significantly,while the increase of professional development was not significant.Six-D Scale and six subscales scores based on self-appraisal were higher than that based on the head nurses' appraisals.Conclusions The application of 6-D scale is scientific to evaluate the effect of standardized nurse training.We had demonstrated that standardized hospital-department training is of great benefit for new graduates to improve the nursing ability and adapt to the clinical circumstances.

Functional divergence of betaine aldehyde dehydrogenase genes in Populus euphratica / 生物工程学报

Plant betaine aldehyde dehydrogenase (BADH) is a physiologically important enzyme in response to salt or drought stress. In this study, two BADH genes (PeBADH1 and PeBADH2) were cloned from Populus euphratica. Both PeBADH1 and PeBADH2 genes encode the proteins of 503 amino acid residues, with a calculated molecular mass of 54.93 kDa and 54.90 kDa, respectively. Reverse transcription PCR showed the divergence of expression pattern between the PeBADH1 and PeBADH2 genes in P. euphratica. The recombinant PeBADH1 and PeBADH2 proteins were overexpressed in E. coli, and purified by Ni-affinity chromatography. The PeBADH2 protein had 1.5-fold higher enzymatic activity towards the substrate aldehyde than PeBADH1 protein. The PeBADH1 protein revealed higher thermal stability than PeBADH2 protein. These results indicated obvious functional divergence between the PeBADH1 and PeBADH2 genes.

Molecular characterizations of two dehydroascorbate reductases from Selaginella moellendorffii / 生物工程学报

Plant dehydroascorbate reductase (DHAR) is a physiologically important reducing enzyme in the ascorbate-glutathione recycling reaction. In this study, two DHARs genes (SmDHAR1 and SmDHAR2) were isolated from Selaginella moellendorffii. The SmDHAR1 and SmDHAR2 genes encode two proteins of 218 and 241 amino acid residues, with a calculated molecular mass of 23.97 kDa and 27.33 kDa, respectively. The genomic sequence analysis showed SmDHAR1 and SmDHAR2 contained five and six introns, respectively. Reverse transcription PCR revealed that the SmDHAR1 and SmDHAR2 were constitutive expression genes in S. moellendorffii. The recombinant SmDHAR1 and SmDHAR2 proteins were overexpressed in E. coli, and were purified by Ni-affinity chromatography. The recombinant SmDHAR1 showed 116-fold higher enzymatic activity towards the substrate dehydroascorbate than recombinant SmDHAR2. The recombinant SmDHAR1 showed higher thermal stability than recombinant SmDHAR2. These results indicated obvious functional divergence between the duplicate genes SmDHAR1 and SmDHAR2.

Study on Preparation Process of Syrigopicroside Dropping Pills / 中国中医药信息杂志

Objective To establish the optimum preparation process for Syrigopicroside Dropping Pills.Methods The preparation conditions,such as the proportion between the extracts and matrix,dripping temperature,the ratio of matrix,were studied with orthogonal test.The obtained results were tested by three indexes,such as the variation coefficient of weight of pill,time limit of dissolution and appearance of the dropping pills with analysis of variance.The preparation process was optimized.Results The optimal technical conditions were as follows:the ratio of PEG4000 and PEG6000 as matrix was 4∶1,the ratio of syrigopicroside to matrix was 1∶4,and the dripping temperature was 80 ℃.Conclusion The preparation technology can meet the requirement for dripping pill specified in China Pharmacopeia(2005 Edition).