The important role of nursing work environment has received much attention in the management of nursing workforce and the quality of health care services. This paper analyzed current studies on nursing work environment, and suggested that the government and hospital administrators pay more attention to the development of nursing workforce, adequate clinical nurse staffing levels and promoting healthy work environment for nurses.

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.

This study was aimed to find out the optimum parameters to decoction extraction process of Brassicae Radix cream . With methods of integrated score and uniform design , contents of the total extract and the total polysaccharide were set as the target to investigate the optimization process of extraction. The experiment showed that the optimum extraction condition was as follows: ten folds of water, four times decoction at boiling tempera-ture , one hour for each time . It was concluded that the optimum parameters to decoction extraction of Brassicae Radix were stable and feasible, which can be used for the preparation and reference for Brassicae Radix cream in Tibetan clinics .

This study was aimed to establish quality standards of fruit of Hippophae tibetana Schlechtend.. The medical material was identified by microscopy and thin layer chromatography (TLC). According to methods recorded in the Chinese Pharmacopoeia (2010 edition), the contents of moisture, total ash, acid-insoluble ash and alcohol-sol-uble extract were determined. The HPLC method was applied in the determination of quercetin, kaempferol and isorhamnetin content. The results showed that the microscopic characteristics of Tibetan medicine H. tibetana were identified. The TLC and content determination methods of quercetin, kaempferol and isorhamnetin were estab-lished. It was concluded that the established qualitative and quantitative methods can be used for quality control of the fruit of H . tib e tana.

This study was aimed to investigate the comprehensive ecological factors of Hippophae rhamnoides L. and their regional suitability in China. Based on field survey, specimen examination and literature investigation, ecologi-cal factors and appropriate production areas were analyzed by Traditional Chinese Medicine Geographic Information System (TCMGIS-II). The results showed that the proper region (with similarity of 95%~100%) of H. rhamnoides L. accounts for 737 994.71 km2, including 15 provinces/municipalities and 387 counties/cities. The largest area among them is Tibet autonomous region with area of 313 857.73 km2 (42.53%), followed by Sichuan province (223 987.02 km2, 30.35%), Gansu province (66 314.43 km2, 8.99%) and Shanxi province (4 237.79 km2, 0.57%). There are also certain appropriate production areas distributed in Liaoning province, Beijing, Chongqing and Hubei province. It was concluded that this system is much valuable to the recognition of the formation of the producing area, the division of adaptive area, introduction and acclimatization of medicinal materials. It also provided a scientific reference for the introduction and cultivation of H. rhamnoides L. Through further field study and experiments, these new areas have the potential to be developed into suitable production region of H. rhamnoides L. in the future.

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 verify and assess diagnostic value of noninvasive diagnostic model of liver fibrosis in primary biliary cirrhosis (PBC) based on conventional laboratory markers.Methods Seventythree patients with PBC diagnosed by liver biopsy between January 2003 and June 2011 in Beijing Friendship Hospital,Capital Medical University were recruited in this study.Correlation analysis and logistic regression analysis between the conventional laboratory markers and histology stages were assessed.A liver fibrosis diagnostic model was established based upon aforementioned biomarkers and verified by its sensitivity and specificity for predicting the liver fibrosis.Results The predictive model ( H index) consisting of five conventional laboratory markers,i.e.,platelet count,serum cholinesterase,albumin,HDL-C and prothrombin time activity,could predict advanced fibrosis ( stages Ⅲ-Ⅳ ) with an AUCROC of 0.861.The sensitivity of predicting the absence of advanced fibrosis using H index ＜ - 2.20 was 96.6％ and the specificity of predicting the presence of advanced fibrosis using H index ＞ 0.41 was 93.2％.Conclusion The established noninvasive diagnostic model consisting of five laboratory markers could accurately distinguish pathological changes of early stage PBC ( stages Ⅰ - Ⅱ ) from advanced stage PBC ( stages Ⅲ-Ⅳ).

Objective To investigate the influencing factors and pathways of fluid management adherence and interdialytic weight control in hemodialysis patients based on the health belief model.Methods Using convenience sampling,433 patients receiving hemodialysis were included from 4 hospitals in Guangdong province.The demographic and clinical data questionnaire,Health Belief Scale of Fluid Restriction,and Fluid Intake Adherence Scale were used.The relative-interdialytic weight gain(R-1DWG)was calculated.Results The mean score of patients'fluid management adherence was 3.08±0.97,indicating a moderate level,with 35.57％of patients exceeding the required R-IDWG standard.Regarding health beliefs,perceived benefits(β=0.161)and self-efficacy(β=0.685)of fluid restriction directly affected fluid adherence;perceived threats of poor fluid restriction indirectly affected fluid management adherence through perceptions of benefits and self-efficacy(β=0.235);perceived barriers were indirectly and negatively associated with fluid management adherence through self-efficacy(β=-0.246).Higher fluid management adherence was associated with better control of R-IDWG(β=-0.361).Regarding the coordinating factors,age,educational level,hemodialysis vintage and diabetes were influential factors of fluid management adherence(|β|:0.050-0.162)and R-IDWG control(|β |:0.049-0.309).The coefficients(β)of each path were statistically significant(P＜0.05).Conclusion Healthcare providers should comprehensively assess patients'health beliefs,focus on patients with lower educational levels and diabetes,and identify weakness in their fluid management to achieve the required R-IDWG standard.

Objective:To investigate the correlation between serum calcitonin gene-related peptide (CGRP) and the culture outcome of in vitro fertilization embryo in male patients with infertility.Methods:In this study, the randomized samples from 25 male patients who received in vitro fertilization-embryo transfer (IVF-ET) in the 1st Affiliated Hospital of Fujian Medical University from June 2019 to October 2019 were analyzed by multiple linear stepwise regression, with some important clinical outcomes, such as the logarithmic conversion index of serum CGRP, fertilization method, masturbation difficulty, age, infertility duration, and prolactin, as independent variables, while total fertilization rate, normal fertilization rate, high quality embryo rate at day 3, blastocyst formation rate as dependent variables.Results:The Pearson correlation analysis showed that the D3 high-quality embryo rate was related to the normal sperm morphology rate in the primary infertility group ( r=0.537, P=0.048), the blastocyst formation rate was correlated with sperm density ( r=0.760, P=0.002), the CGRP logarithm was correlated with the total fertilization rate ( r=0.693, P=0.006). The logarithmic conversion index of serum CGRP was related to the total fertilization rate and normal fertilization rate in the secondary infertility group ( r=0.614, P=0.042 and r=0.611, P=0.046). In the secondary infertility group, there was a linear relationship between normal fertilization rate and total sperm count, serum CGRP log conversion, and sperm normal morphology rate, with standardized regression coefficients of 0.2, -0.729, and 6.8, respectively. Conclusion:Serum CGRP level, together with total sperm count and normal sperm morphology rate may affects normal fertilization rate in male patients with infertility.

Objective:To retrieve the relevant guidelines and expert consensus on self-management of patients with high-risk foot diabetes, and analyze the content of high-quality guidelines and expert consensus recommendations, so as to provide a reference for the construction of a guidance program for self-management of patients with high-risk foot diabetes.Methods:Computer-retrieved clinical practice guidelines and expert consensus for self-management of patients with high-risk foot for diabetes from databases, guideline networks, and related professional websites. The search period was from January 1, 2012 to June 5, 2022. The quality of the included literature was evaluated and the evidence was extracted and integrated by 2 researchers. Experts were invited to evaluate the summarized evidence.Results:According to the quality of literature, a total of 12 guidelines (10 at level A and 2 at level B) and 3 expert consensus (expert discussion and decision) were included, and 8 themes were defined as regular follow-up, self-assessment, foot and decompression management, exercise management, nutrition management, indicator management, psychological management, and health education, a total of 28 recommendations. Among them, there were 23 A-level recommendations and 5 B-level recommendations.Conclusions:The quality of the guidelines and expert consensus included in this study is high,the recommended level of the summarized evidence is high. This study provides the reference and basis for the clinical staff to construct and guide the clinical practice of self-management of high-risk diabetic foot patients.