Objective To investigate the neurosurgery nurses turnover intention and the psychological contract status to analyze the relationship between them. Methods The Departure Will Scale and Questionnaire of Psychological Contract were used to survey 128 neurosurgery nurses from seven general hospitals in Lishui city. Results Of neurosurgery nurses turnover intention scale was (2.24±0.71) points, whose leaving intend was stronger;Psychological contract items was (4.17±0.67) points, which organization responsibility score wasbelow employees responsibility; Hierarchical regression analysis showed that the psychological contract in the organization responsibility (organization specification responsibility, organization, personal responsibility and organizational development responsibility) could predict neurosurgery nurses′ willingness to leave, which could be able to explain their willingness to leave 13.5%of the variation. Conclusions Neurosurgery nurses′willingness to leave is strong, and psychological contract is an important factors affecting the will of their departure.

Objective To observe the effect of application of Lamaze childbirth method in childbirth. Methods The observation group(110 cases)was trained by Lamaze childbirth method in late pregnancy period. The control group (110 cases) was not trained by Lamase childbirth method in antepartum period, and were given regular observation and nursing. Mastering of natural childbirth knowledge, pain intensity, childbirth time, mode of delivery and amount of bleeding post- childbirth 2h were observed in the two groups. Results The observation group mastered more natural birth knowledge than the control group, childbirth pain was obviously reduced, natural birth rate was higher than the control group, the first and second labor time was shorter than the control group, the amount of bleeding was obviously less than the control group 2 hours post childbirth. Conclusions Pregnant women need Lamaze childbirth method training before childbirth and instruction of maternity nurses. These may relieve pain, shorten childbirth time and reduce amount of bleeding post childbirth by application of Lamaze childbirth method.

Objective To observe the effects of 19 kinds of traditional Chinese medicine (TCM) aqueous extracts in vitro on the standard and clinical strains of propionibacterium acnes.Methods We collected lesion contents of acne vulgaris patients and conducted anaerobic cultivation of propionibacterium acnes at 35 ℃ for forty-eight hours.After tested by oxygen resistance experiment,Gram staining microscopy,catalytic test,nitrate test and sugar fermentation experiment,ANI anaerobic identification card,and VITEK fully-automatic microbe instrument,the strains were identified as propionibacterium acnes.We used AGAR dilution method to test the MIC values of various TCM aqueous extracts.Results The MIC values of Cortex phellodendri,Scutellaria baicalensis,and Rhiubarb were 25 mg/ml,respectively;the MIC values of Sophora flavescens and Honeysuckle were 50 mg/ml;the MIC values of Forsythia was 100 mg/ml.13 kinds of TCM aqueous extract did not produce bacteriostasis at the highest concentration of 200 mg/ml including Belvedere fruit,Chinese bulbul,Hedyotis diffusa,Houttuynia cordata,Purslane,Yerbadetajo herb,Radix isatidis,Lithospermum erythrorhizon,Folium isatidis,Taraxacum,Semen plantaginis,Angelica dahurica,and Fructus cnidii.Conclusions Aqueous extracts of Cortex phellodendri,Scutellaria baicalensis,Rhubarb,Sophora flavescens,Honeysuckle and Forsythia have good inhibitory effects in vitro on Propionibacterium acnes.

Objective To investigate podocyte number, the expression of nephrin and transforming growth factor-β1(TGF-β1) in adriamycin-induced-nephropathy rat model and its significance. Methods The rat adriamycin nephrosis model was constructed to detect blood and urine biochemical indicators and observe the pathological changes of renal tissues by light microscope and electron microscope. The expression levels of nephrin and TGF-β1 as well as the podocyte number were examined at different time points by immunohistochemistry. Results The pathological changes of the renal tissues were obvious. Nephrin presented a weak signal at the end of the first week (P<0.05). TGF-β1 started to increase (P<0.05) while the podocyte number started to decrease at the end of the eighth week (P<0.05). Expression of nephrin was negatively correlated with the P<0.05) and serum creatinine (r=-0.71, P<0.05). Expression of TGF-β1 was blood urea nitrogen (r=0.62, P<0.05) and serum creatinine (r=0.59, urinary protein (r=-0.63, P<0.05), blood urea nitrogen (r=-0.72, P<0.05) and serum creatinine (r=-0.76, P<0.05); it was positively correlated with nephrin (r=0.78, P<0.01) but negatively correlated with TGF-β1 (r=-0.64, P<0.05). Conclusion The acute and chronic adriamycin nephrosis models were twice every two weeks. The genesis and development of proteinuria are closely related to the abnormal expression of nephrin. Focal segmental glomerulosclerosis occurs when the podocyte number decreases and TGF-β1 accelerates it.

Objective To investigate podocyte number,the expression of nephrin and transforming growth factor-?1(TGF-?1) in adriamycin-induced-nephropathy rat model and its significance.Methods The rat adriamycin nephrosis model was constructed to detect blood and urine biochemical indicators and observe the pathological changes of renal tissues by light microscope and electron microscope.The expression levels of nephrin and TGF-?1 as well as the podocyte number were examined at different time points by immunohistochemistry.Results The pathological changes of the renal tissues were obvious.Nephrin presented a weak signal at the end of the first week(P

OBJECTIVETo observe the blood lowering effect of telmisartan and amlodipine taking on the morning or at bedtime in hypertensive patients.

METHODSA total of 108 individuals with hypertension (grade 2 or above) were randomized to receive telmisartan and amlodipine in one of the following four therapeutic schemes: Group A (26 cases): both medications taken on the morning; Group B (28 cases): both medication taken at bedtime; Group C (27 cases): telmisartan on the morning and amlodipine at bedtime; or Group D (27 cases): amlodipine on the morning and telmisartan at bedtime. ABPM was performed before and after 8 weeks treatment.

RESULTSBP was significantly reduced in 4 groups and the value of 24 hours SBP/DBP decline for each group after treatment was 29.94/16.32, 31.37/18.35, 29.49/17.30 and 25.80/15.51 mm Hg (1 mm Hg = 0.133 kPa) respectively (P < 0.05 vs. baseline). SI (smooth index) of 24 hours SBP/DBP was 1.79/1.34, 2.07/1.54, 1.70/1.43 and 1.55/1.32 respectively (P > 0.05). The night-time BP decline and the distributive difference of dipper, non-dipper, extreme dipper and reverse dipper pattern were similar among groups at both baseline and after various treatment regimens (all P > 0.05) . Morning blood pressure surge (MBPS) after treatment in group B declined more significantly than other groups (P < 0.05).

CONCLUSIONTelmisartan/amlodipine administered either on the morning or at bedtime can effectively reduce blood pressure. The efficacy of BP lowering is independent of the drug taking time. There is a trend both in better BP lowering and less BP variability when two medications are administered at bedtime.

Adult ; Aged ; Amlodipine ; administration & dosage ; Antihypertensive Agents ; administration & dosage ; Benzimidazoles ; administration & dosage ; Benzoates ; administration & dosage ; Blood Pressure Monitoring, Ambulatory ; Drug Administration Schedule ; Female ; Humans ; Hypertension ; drug therapy ; Male ; Middle Aged

Objective To study the therapeutic effect of Xuefu Zhuyu Capsule combined with sacubitril valsartan on dilated cardiomyopathy.Methods A total of 70 patients with dilated cardiomyopathy who were hospitalized in the Hospital from January to December 2020 were selected as the research objects and random-ly divided into control group and experimental group,with 35 cases in each group.The control group was only treated with sacubitril valsartan,and the experimental group was treated with Xuefu Zhuyu Capsule combined with sacubitril valsartan.According to the patient's blood pressure and renal function,sacubitril valsartan was titrated from a small dose to the maximum dose.Xuefu Zhuyu Capsule was uesd 2.4 g each time,twice a day,and the treatment time was three months.The symptoms of heart failure,glycosylated hemoglobin(HbA1c),low density lipoprotein(LDL),total cholesterol(TC),triglyceride(TG),ALT,AST,N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-systolic diameter(LVEDd),left ventricular end-dias-tolic diameter(LVEDs),ejection fraction(EF)and the incidence of arrhythmia were observed in the two groups after treatment.Results After treatment,the level of NT-proBNP in the experimental group was sig-nificantly lower than that in the control group(P＜0.05).There was no significant difference in LDL,TC,TG,LVEDd,LVEDs and EF between the two groups(P＞0.05).The incidence of atrial tachycardia and ven-tricular premature beat in the experimental group was higher than that in the control group(P＜0.05).Con-clusion Xuefu Zhuyu Capsule combined with sacubitril valsartan can significantly improve the symptoms of patients with heart failure and reduce the level of NT-proBNP,but it may increase the proportion of patients with atrial tachycardia and ventricular premature beats.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.