Nursing work environment impacts patient outcomes. This article summarized the concept and connotation of nursing work environment, related theories of how nursing work environment impacts patient safety outcomes and related researches conducted by foreign scholars. The effort of this review article aims to put forward new research direction.

Objective To explore the distribution of pathogens, bacterial drug resistance, clinical features and prognosis of bacterial meningitis (BM) in children.MethodsThe clinical data of children diagnosed with BM during January 2011 to July 2015 were retrospectively analyzed. Children were divided into good outcome group and poor outcome group by the outcome at discharge. The distribution of pathogens, bacterial drug resistance, clinical features, and prognosis were analyzed among different groups.ResultsThere were included 95 children diagnosed with BM,. among whom 69 (72.6%) children had Gram-positive bacterial infections with predominantStreptococcus pneumonia (43 cases, 45.3%) and 26 (27.4%) children had Gram-negative bacterial infections with predominantEscherichia coli (13 cases, 13.7%). More than 50%Streptococcus pneumonia andEscherichia coli were resisted to penicillin. The neurological complications in children with BM included subdural effusions, hydrocephalus, cerebral parenchyma injury, and hearing and visual impairment, et.al. Multivariate logistic regression analysis showed that consciousness, coma, and low level of glucose in cerebrospinal lfuid were the independent risk factors for adverse outcome at discharge.ConclusionStreptococcus pneumonia andEscherichia coli were the predominant pathogens in children with BM with high resistance rate to penicillin. BM children may have varying degrees of neurological sequelae. The unconsciousness and low level of glucose in cerebrospinal lfuid were associated with unfavorable outcomes at discharge.

Objective To describe the prevalence and change of rationing of nursing care (RNC) in medical and surgical units of level 2 and level 3 general hospitals across Guangdong province. Methods RNC were measured by asking nurses about the completion status of 12 necessary nursing care activities, and the prevalence of RNC in 2014 was compared with the study results from the China Hospital Nursing Workforce Research(CNWR) in 2009 (exclusively using the data of Guangdong province) to describe the change of RNC. Results Six activities were rationed averagely in 2014, and the most frequent activities rationed wereComfort/talk with patients accounted for 69.8% (975/1 396) andEducating patients and familiesaccounted for 67.3%(940/1 396). According to the CNWR in 2009, the average number of nursing care activities rationed was 3 which was statistically lower than the number in 2014 (P < 0.01). Conclusions RNC is prevalent in level 2 and level 3 general hospitals across Guangdong province, especially psychosocial care to the patients; the prevalence of RNC has not decreased since 2009.

Objective To probe the value of 3.0T MRI in the preoperative assessment of rectal carcinoma.Methods The study recruited 41 patients who were confirmed by biopsy of rectal carcinoma and underwent conventional MRI, high-resolution MRI and diffusion weighted imaging(DWI), the distance from the inferior part of tumor to transitional skin and the percentage of circumferential invasion were measured, the tumor's T staging, N staging,and the status of circumferential resection margin(CRM) and extramural vascular invasion(EMVI) were assessed.MRI findings were compared with endoscope and postoperative pathological results.Results MRI could accurately show the distance from the inferior part of tumor to transitional skin(P>0.05);The mean percentage of circumferential invasion for the tumor with T1-T2 and T3 were 61%,83% respectively (P>0.05);The total accuracy of T,N staging diagnose were 80.5%,75.6% respectively, which had a better consistent with pathological T,N staging(Kappa=0.564,0.634);The total accuracy of CRM and EMVI diagnose were 90.2%,73.2% respectively,which had a better or moderate consistent with pathological diagnose(Kappa=0.765,0.461).Conclusion 3.0T MRI has the unique application in the preoperative assessment of rectal carcinoma, which can provide more comprehensive information for clinic.

Objective To explore the impact of nursing work environment on the occurrence of nosocomial infections in ICU. Methods The sample consisted of 1890 nurses who provided direct care for patients in ICUs of level 2 and level 3 hospitals in mainland China. The nursing work environment of ICU was measured with a Chinese translation version of the Practice Environment Scale of Nursing Work Index (PES-NWI). Nurses were asked to estimate how frequently nosocomial infections occurred including surgical site infection, urinary tract infection, central line infection, and ventilator associated pneumonia. Results The composite score of PES-NWI of ICU nurse was 3.35(2.77, 3.81)points. The percentage of nurses who reported the 4 kinds of nosocomial infections in ICU"had happen"were 60.4%(surgical site infection,1122/1858),68.0%(urinary tract infection,1265/1859),52.9%(central line infection, 981/1856), and 66.0%(ventilator associated pneumonia, 1229/1861). Nurses who graded higher in PES-NWI would be less likely to report the 4 kinds of nosocomial infections had happen,OR:0.591(surgical site infection), 0.664(urinary tract infection), 0.573(central line infection), 0.567(ventilator associated pneumonia), all P<0.01. Conclusions A better nursing work environment is significantly related to lower occurrence of nosocomial infections in ICU.

Background Leber hereditary optic neuropathy (LHON) is mitochondrial DNA (mtDNA) disease and mainly leads to optical nerve degeneration.Its primary mechanism is synthesis disorder of DN4 protein due to variation of mtDNA 11778 locus.So to construct a vector with exogenous normal ND4 and transfect into mitochondria is a key of gene therapy for LHON.Objective This study was to investigate the in vitro transfection of adeno-associated virus (AAV)-ND4 gene into mitochondria.Methods Human renal epithelial cell lines transfected adenovirus E1A (293 cells) were regularly cultured and divided into two groups.Framework plasmids of recombinant AAV-ND4 or simple AAV2 were added to the cell medium respectively.The expression of ND4 in cells were located 12,24,36 and 48 hours after transfected by Y03 dual fluorescent quantum dots staining.The positive response for ND4 showed the green fluorescence.Results Cultured 293 cells grew well with 80％ confluence.Abundant green fluorescence particles were seen in cytoplasm in the AAV-ND4 transfected group,but only red fluorescence from mitochondrial protein was seen in the simple AAV transfected group under the fluorescence microscope.Conclusions Exogenous ND4 protein can been successfully transfected into mitochondria using the ND4 gene constructed AAV.This result provides experimental evidence for the further study on gene therapy of LHON.

Objective To explore the influencing factors of job burnout among nurses in level 2 and level 3 hospitals in Guangdong province. Methods A total of 2 066 first line nurses from 133 medical, surgical and intensive care units (ICU) of 23 level 2 and level 3 hospitals in Guangdong province were surveyed employing the questionnaire Hospital Nursing Human Resources Research during December 2013 to August 2014. Results In the multivariate logistic regression models, each additional doctor per nurse was associated with 1.34 times increase in the likelihood of high level of emotional exhaustion(EE). Nurses had a 57.4%higher risk of high level of EE when they worked overtime. Every one point increase in ancillary service score, and every one more year working as a nurse was associated with 5.4%, 2.3%increase in the likelihood of high level of EE, respectively. Nurses were 42.1%,40.9%more likely to exhibit high level of depersonalization(DP) when they worked in medical units or hospitals of level 3, compared with nurses of surgical units and hospitals of level 2. Nurses had a 29.5%higher risk of high level of DP when they worked overtime. Nurses holding higher positions had a lower likelihood(37.7%) of high level of reduced personal accomplishment(PA) compared with nurses holding lower positions. Nurses in medical units or ICUs had a 31.2%, 51.6%higher risk of high level of PA than nurses in surgical units, respectively. Conclusions Job burnout of nurses is at a quite high level in level 2 and level 3 hospitals in Guangdong province. The probability of the occurrence of burnout is related to the hospital, unit and nurse characteristics and nursing workloads.

Objective To explore renin expression in cytomegalovirus(CMV) infected juxtaglomerular cells(JG) and its biological significance. Methods JG model cell line As4.1 cells derived from kidney tissue were respectively incubated with murine CMV at multiplicities of infection(MOI) of 10, 0.1 and 0 for 5 d, and the control was mock infection with the same amount of ultraviolet inactive CMV as MOI 10, then the cells were harvested. CMV immediate early gene(IE1) mRNA in the cells was tested by RT-PCR. The renin positive cells and the renin fluorescence granules in the cells were examined by immunofluorescence stain. Whether or not re-nin antigen and CMV antigen were showed in the same cells by FITC and TRITC immunofluorescence. The renin gene expression in the cells was individually detected by real-time RT-PCR and Western blot. Results The cells infected by CMV showed typical cytopathic effect(CPE) and viral plaques in the cell monolayer. CMV IE1 mRNA was found in the viral infected cells by RT-PCR. The mass or ring granules of renin positive fluorescence appeared in the cytoplasm of the CPE cells. The renin positive cells congregated around the viral plaques. Renin positive granules and CMV positive granules showed in the same cells. Renin expression in the CMV infected cells exhibited in a dependent manner of ratio of infectious virus particles to cells. Conclusion CMV infection of the cells derived from kidney tissue induces renin expression related to a new pathogenesis of cardiovascular diseases.

A case of Streptococcus suis sepsis and streptococcal toxic shock syndrome diagnosed by metagenomic next-generation sequencing (mNGS) was presented. A 50-year old male patient visited Zengcheng Branch of Nanfang Hospital on June 25th, 2021. The patient developed fever, dizziness and shock with typical epidemiological history. mNGS revealed Streptococcus suis in blood sample. The diagnosis of Streptococcus suis sepsis and streptococcal toxic shock syndrome were made. Meropenem was given as empirical antibiotics. Antibiotics were adjusted to meropenem and clindamycin while Streptococcus suis was detecting by mNGS and downgraded to piperacillin/tazobactam and clindamycin when symptoms improved. The diagnosis was then confirmed by blood culture. The patient developed dry gangrene and sudden deafness in the later stage and was discharged after treatment. Compared with traditional diagnostic techniques, mNGS has advantages such as timeliness and accuracy, and plays a key role in the field of severe infections and rare pathogen infections. It is suggested that combining mNGS and traditional diagnostic techniques have the advantages for early diagnosis and early treatment.

In order to form the expert consensus which researched on the comprehensive individualized protocol of Tuina therapy for Knee osteoarthritis, the preliminary protocol was summarized and formed by analyzing the interviews and published paper. And then the expert consensus method was applied for the protocols of Tuina therapy for KOA. After discussions, the consensus of three protocols according to the classification of KOA main symptomes was researched. In the protocols, 75％～80％ of the entries were considered as strong recommendation, and the others were weak recommended. Thus, it is believed that the comprehensive protocols for the treatment of KOA with different Tuina manipulations is feasible and reproducible after standardization.