Objective To investigate the job burnout of the psychiatric nurses and to explore the relationship between job burnout and self concept,self-efficacy,social support for the psychiatric nurses.Methods A total of 130 psychiatric nurses who worked in Wuhan were investigated with Maslach Burnout Inventory (MBI),Tennessee Self-Concept Scale (TSCS),General Self-Efficacy Scale (GSES) and Social Support Scale (SSRS).The SPSS17.0 software was used for statistical analysis.We employed the job burnout dimensions as the dependent variable,while the self concept,self-efficacy and social support as the independent variable to establish the regression model.Results The job burnout of psychiatric nurses in terms of gender,marital status,education and professional tides had significant differences.Emotion exhaustion had negative correlation with self concept,self-efficacy and social support,depersonalization also had negative correlation with these three dimensions,while personal achievement had positive correlation with these three dimensions.Conclusions There is job burnout in emotion exhaustion,depersonalization,and personal achievement among psychiatric nurses.Nursing managers in psychiatric departments should pay more attention to enhance nurses' own ability and improve the level of nurses’self-concept,self-efficacy and social support,in order to reduce the job burnout.

Objective To investigate the effect of treating cervical spondylotic radiculopathy with traditional Chinese medicine. Methods 110 patients with cervical spondylotic radiculopathy were treated with traditional Chinese medical pathway: Chinese herbal medicine soaking (incised notoptetygium rhizome, Chinese angelica, divaricate saposhnikovia root, safflower, dahurian angelica root, myrrh, common floweringqince fruit, and tuberculate speranskia herb, etc.)-Acupuncture-cervical traction-massage, once daily, 10 times as a course of treatment. After two courses, therapeutic effect score was analyzed. Results Of all 110 cases, 35 cases(31.82%)were cured; 53 cases(48.18%)had obvious effectiveness; 17 cases(15.45%)had effectiveness; 5 cases(4.55%)had no effectiveness. The total efficiency was 95.45%. The patient's age(χ2=0.296), sex(U=0.023), and duration of disease(χ2=0.577)had no significant effect on the efficacy(P>0.05);After the treatment, neck pain, upper extremity pain, upper extremity numbness, neck tenderness, intervertebral foramina compression test, sensory disturbances limbs, myodynamia of upper limbs, and tendon reflexes were significantly improved compared with before treatment, with significant difference(t=16.355、11.958、7.755、4.927、11.780、8.647、10.485、3.190、3.873、3.367,P<0.05). Conclusion The use of traditional Chinese medicine clinical pathway in treating cervical spondylotic radiculopathy was effective and it could improve the quality of medical care.

Objective To investigate the correlation of traditional Chinese medicine (TCM) syndrome types of chronic gastritis with Helicobacter pylori (Hp) eradication rate after anti-Hp treatment. Methods A total of 180 chronic gastritis patients with Hp infection were differentiated into spleen-stomach insufficiency syndrome, spleen-stomach dampness-heat syndrome, and liver depression and qi stagnation syndrome, and each syndrome group had 60 cases. Patients in each group were evenly divided into two subtypes, and were treated with triple therapy or quadruple therapy for 10 days respectively. After treatment, the Hp eradication rate in each group was compared. Results (1) The overall Hp eradication rate was 78.3%. No matter after triple therapy or quadruple therapy, patients with spleen-stomach insufficiency syndrome had the lowest Hp eradication rate (61.7%), which was lower than that of the patients with spleen-stomach damp-heat syndrome (88.3%) and the patients with liver depression and qi stagnation syndrome (85.0%), the difference being statistical significance (P < 0.05 or P < 0.01). However, the difference of Hp eradication rate between spleen-stomach damp-heat group and liver depression and qi stagnation group was not statistically significant (P>0.05). (2) A total of 10 cases had adverse reaction such as nausea and vomiting, stomachache, and gastric distention, 8 cases from spleen-stomach insufficiency group, one from spleen-stomach dampness-heat group, and one from liver depression and qi stagnation group. Spleen-stomach insufficiency group had higher incidence of adverse reaction than the other two groups (P < 0.05). Conclusion The Hp eradication rate after anti-Hp treatment varied in chronic gastritis patients with different TCM syndrome types, and the rate in patients with spleen-stomach insufficiency syndrome was lower than that of the patients with spleen-stomach damp-heat syndrome and the patients with liver depression and qi stagnation syndrome no matter after triple therapy or quadruple therapy.

The phenomena of attention economyand influence economypresented in news media also applies to medical library.Proposed in this paper are the ways and measures for medical libraries to realize their influence economybased on the analysis of their attention economy.

Objective:To observe the changes of left ventricular energy loss(EL) and apical wall shear stress(WSS) in patients with ventricular aneurysm by using vector flow mapping (VFM).Methods:Twenty-seven patients with ventricular aneurysm were selected as the case group, and they were divided into the ventricular aneurysm group(16 cases) and ventricular aneurysm thrombus group(11 cases) according to whether the apex of the heart was accompanied by thrombosis. Twenty healthy people were collected as the control group. Ventricular structure and cardiac function parameters were measured and the VFM offline analysis was performed. Systolic and diastolic phases were determined based on time-flow curve(T-F curve) and the open-close of valves, the corresponding left ventricular energy loss and the parameters of the WSS of the apex segment of the heart were obtainedand then compared between groups.Results:①In diastolic and systolic phases, EL values of left ventricular apical segment in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than that in control group (all P<0.05). ②In diastolic phase, the peak WSS values of septal apical, lateral apical and anterior apical segments in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group (all P<0.05), and the mean WSS of anterior apical segment in aneurysm group was lower than that in control group ( P<0.05). ③In systolic phase, the peak WSS values of anterior wall in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group, and the mean WSS of anterior wall in ventricular aneurysm group was lower than that in control group (all P<0.05). The mean WSS of anterior wall in ventricular aneurysm thrombus group was higher than that in ventricular aneurysm group( P<0.05). Conclusions:VFM technology can quantitatively evaluate the EL and WSS of patients with left ventricular aneurysm, and provide a new perspective for further understanding of intracardiac hemodynamics in patients with left ventricular aneurysm with or without thrombus.

Acute myocardial infarction (AMI) is one of the most common cardiovascular diseases. The clinical pathway is the therapeutic program for disease-specific treatment and its implementation may reduce both the duration and cost of the hospital stay. This study aims to construct and evaluate the efficacy of clinical pathways (CPs) based on integrated traditional Chinese and Western medicine for patients with AMI.

Objective To observe hemodynamic characteristics and the correlation with syndrome types of traditional Chinese medicine (TCM) in patients with septic shock, so as to direct the treatment based on syndrome differentiation. Methods A prospective observation was conducted. Sixty-eight patients with septic shock admitted to the Department of Critical Care Medicine of Dade Road General Hospital of Guangdong Hospital of TCM from January 2013 to July 2015 were enrolled. Pulse indicating continuous cardiac output (PiCCO) was used to monitor the hemodynamic changes, including heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), cardiac index (CI), global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), maximum rate of the increase in pressure (dPmax) and systemic vascular resistance index (SVRI), for assessment of hemodynamics. According to the CI, the patients were divided into two groups , i.e. high CI group (CI ≥ 50.0 mL·s-1·m-2, n = 34) and low CI group (CI < 50.0 mL·s-1·m-2, n = 34), and the clinical and hemodynamic characteristics of two groups were investigated. The TCM differentiation was conducted with four syndromes and four methods, and the hemodynamic characteristics of different syndrome types were investigated, the correlation between the TCM syndrome factors and hemodynamic parameters was analyzed. The patients were divided into survival group and death group, and clinical parameters and hemodynamic characteristics were compared between two groups. Results The acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and blood glucose of low CI group were higher than those of high CI group [APACHEⅡ score: 24.4±7.2 vs. 19.8±7.4, t = -2.279, P = 0.023; blood glucose (mmol/L): 9.7 (7.7, 14.6) vs. 6.7 (5.6, 10.0), Z = -2.257, P = 0.024], CI and GEDVI were lowered [CI (mL·s-1·m-2): 36.7±8.3 vs. 68.4±16.7, t = 10.285, P = 0.000; GEDVI (mL/m2): 689.0 (566.0, 883.8) vs. 838.5 (692.8, 1 247.3), Z = -2.711, P = 0.007], while SVRI was increased [kPa·s·L-1·m-2: 248.7 (202.1, 324.5) vs. 143.4 (102.7, 171.4), Z = -5.336, P = 0.000]. Accompanied symptoms were found to occur more commonly in septic shock patients, and the most common syndrome elements were Qi deficiency syndrome (n = 45), blood stasis syndrome (n = 40), heat-toxin syndrome (n = 37), Fushi syndrome (n = 24) and Yin deficiency syndrome (n = 10), respectively. There was no significant difference in hemodynamic parameters among patients with five types of syndrome (all P > 0.05). However, only the CI of those with Qi deficiency syndrome was significantly lower than that of heat-toxin syndrome (mL·s-1·m-2: 48.3±18.3 vs. 53.3±21.7, P < 0.05). While the results after removing the effect of accompanied symptoms showed that CI of Qi deficiency syndrome was significantly lower than that of non-Qi deficiency syndrome (mL·s-1·m-2: 48.3±18.3 vs. 61.7±21.7, t = -2.783, P = 0.007), CI of heat-toxin syndrome was significantly higher than that of non-heat-toxin syndrome (mL·s-1·m-2: 58.3±21.7 vs. 48.3±16.7, t = 2.133, P = 0.037), EVLWI of blood stasis syndrome was significantly lower than that of non-blood stasis syndrome [mL/kg: 10.0 (7.0, 15.1) vs. 14.9 (8.5, 26.8), Z = -2.075, P = 0.038]. Compared with survival group (n = 38), APACHEⅡ score in death group (n = 30) was increased (25.8±8.4 vs. 19.1±5.4, t = -3.940, P = 0.000), the proportion of continuous renal replacement therapy (CRRT) was increased [60.0% (18/30) vs. 31.6% (12/38), χ2 = 5.493, P = 0.019], HR was increased (bpm: 118.5±20.5 vs. 98.1±19.9, t = -4.157, P = 0.000), and the proportion of Qi deficiency syndrome was increased [86.7% (26/30) vs. 50.0% (19/38), χ2 = 10.070, P = 0.002]. Conclusions Patients with sepsis shock may be divided into high-output and low-resistance & low-output and high-resistance groups according to hemodynamics, with respective hemodynamic characteristics. Hemodynamic performance differed among different syndrome types, and there was a certain relationship. Hemodynamic monitoring with PiCCO was a useful supplement of TCM, which was good for the evidence-based medicine.

BACKGROUND:A preliminary experiment developed a double-chamber stirred bioreactor which can carry out osteogenic and cartilage induction at the same time.
OBJECTIVE:To explore the effects of double-chamber stirred bioreactor on the repair of goat knee cartilage defects with tissue-engineered cartilage.
METHODS:Twelve goats were selected to make bilateral femoral condyle osteochondral defects models and randomized to three groups:experimental group, implanted with the composites ofβ-tricalcium phosphate and bone marrow mesenchymal stem cells that were subjected to 2-week chondrogenic and osteogenic induction simultaneously in the double-chamber stirred bioreactor under mechanical stimulation;control group, implanted with the composites ofβ-tricalcium phosphate and bone marrow mesenchymal stem cells that were subjected to 2-week chondrogenic and osteogenic induction simultaneously in the double-chamber stirred bioreactor;blank control group, without treatment. After 12 and 24 weeks of implantation, general observation, Masson staining, II col agen immunohistochemical staining and histological scoring were performed.
RESULTS AND CONCLUSION:In the experimental and control groups, new cartilage tissue and bone tissue were visible, but the experimental group showed better repair effects than the control group (P<0.05). The blank control group had no cartilage formation. These findings indicate that under the mechanical stimulation by the double-chamber stirred bioreactor in vitro, the repair effect of tissue-engineered osteochondral complex on knee joint cartilage defects can be improved.

ObjectiveTo investigate the clinical characteristics,3-month outcome and predictive factors in the very elderly patients with ischemic stroke.MethodsA total of 305 acute ischemic patients aged 65 years and over were enrolled in the study.They were divided into two subgroups by age:80 years old and over(n =78),65-79 years old(n =227).The clinical outcome was assessed by the modified Rankin Scale (mRS) on (90 ± 7 ) days after stroke,and categorized as good ( scoring 0-2 ) or poor( scoring 3-6) outcome.Results Significantly lower BMI [ ( 23.62 ± 4.92 ) kg/m2 vs ( 25.08 ± 3.69 ) kg/m2,P =0.005],lower frequency of dyslipidemia(56.41％ vs 71.13％,P =0.006) and alcohol intake (0％ vs 6.61％,P =0.043 )were found in the very elderly group.The rates of poor functional outcome in the ≥ 80years group and the 65-79 years old group were 56.41％ (44/76) and 41.40％ (94/224) respectively,with a P value of 0.015.Multivariate logistic regression analysis showed that higher National Institute of Health stroke scale (NItISS) total score (OR 1.48,95％ CI 1.19-1.83 ) and lower albumin level (OR 0.73,95 ％ CI 0.55 -0.95 ) were associated with poor outcome in ≥ 80 year old,whereas higher NIHSS total score ( OR 1.38,95％ CI 1.24-1.53) and complications during hospital stay ( OR 2.58,95％ CI 1.07-6.19 ) were predictive factors in the 65-79 years old group.ConclusionOur study suggests that NIHSS scores,albumin level and complications during hospitalization are useful predictive factors for the short-term poor functional outcome in the patients of ≥65 years old and ≥80 years old patients have a worse prognosis.

Objective To investigate the imaging characteristics of USPIO-enhanced and Gd-enhanced MRI in atherosclerosis and to compare the detection rate of atherosclerotic plaque between them. Methods Thirty-five healthy male rabbits were assigned to experimental group (n=30) to establish a model of atherosclerosis by damaging aortic tunica intima with Foley′s tube in combination with a high fat diet and 5 to control group without any intervention. At week 12, USPIO-enhanced and Gd-enhanced MRI scanning were conducted to compare the signal changes of atherosclerotic plaque before and after enhancement with the 2 contrast media. Ninety seven pictures were randomly selected respectively from the pictures enhanced by the 2 contrast media to compare the detection rate plaque between them. Pthology examination was used for detection standard. For the control group , pictures were randomly selected. Results In the experimental group, 7 rabbits died of Foley′s tube damaging, 2 died of raising and 1 died of anesthesia. All 5 rabbits in control group survived. A total of 172 pathological sections were made with 134 plaques and 72 vulnerable plaques pathologically confirmed. In pictures enhanced by USPIO , 84 plaques were confirmed by HE staining with a detection rate of 86.6%. In pictures enhanced by Gd, 72 plaques were confirmed by HE staining with a detection rate of 74.2%. Detection rate of USPIO-enhanced MRI in atherosclerosis plaque was significantly higher than that of Gd-enhanced MRI (X2=3.96, P=0.046). Conclusion USPIO shows its superiority as a new contrast medium in detection of atherosclerosis plaque.