Objective To explore the effect of humanized management on pressure reduction of nurses and improvement of job satisfaction degree. Methods Humanized management was implemented in our hospital.120 nurses were enrolled into the study,and 100 patients before and 100 patients after the implementation were selected.The psychological stress of nurses and the satisfaction degree of patients with nursing work were compared before and after the implementation of humanized management. Results The high rate of psychological stress of nurses after humanized management was 8.3％,significantly lower than that before the implementation (57.5％).The very satisfaction degree of patients was 63.0％ after humanized management,significantly higher than that before the implementation (16.0％). Conclusions Humanized management can significantly reduce the working pressure of nurses,and at the same time can improve the satisfaction degree of patients.The effect is significant,and is worthy of promotion.

Bleeding and swelling is one of the first kinds of complications or main symptoms after tooth extraction. With the development of high quality oral treatment, the doctors and nurses of oral and maxillofacial alveolar surgery pay more and more attention to maximize reduce the postoperative tooth extraction reaction, improve patient comfort. Cold compress can effectively reduce postoperative bleeding and pain, so it has been widely used in clinical application. The mechanism of bleeding and swelling after tooth extraction and the application principle, method, material selection of cold compress are reviewed in this paper, in order to provide reference for the colleague.

Objective To constructthe nurse job satisfaction index evaluation system by analytic hierarchy process (AHP) so as to provide theoretical basis for nursing managers. Methods Semi-structured interviews and literature review were used in establishing the preliminary nurse job satisfaction evaluation index system.The Delphi method was applied in expert consultation and a three-level index system was established, the weight, the largest eigenvalue and the weight vector were all calculated. Index consistency was inspected. Results 4 first-level indicators, 13 second-level indicators and 39 third-level indicators were established.The weight was 1.630 0-3.280 0 for the first-level indicators, 0.4494-1.4723 for the second-level indicators and 0.0913-0.783 9 for the third-level indicators.The weight vector was 0.038-0.616 for the first-level indicators,0.045-0.750 for the second-level indicators and 0.041-0.875 for the third-level indicators.The max-eigenvalue was 4.231 for the first-level indicators,6.226 for the second-level indicators and 4.176 for the third-level indicators. The consistency test value of judgment matrix ranged from 0.000 to 0.077, and the consistency ratio was less than 0.1. Conclusions With distinct gradation,clear structure, reasonable weight and rich content, the index system provides a theoretical basis for the nurse job satisfaction evaluation.

Objective To select an efficient method to inhibit telomerase activity, antisenseoligodeoxynucleotide and plasmid-vector mediated RNAi against hTERT were used to inhibit telomerase activity. The inhibiting effects of the two methods were compared. Methods Against hTERT mRNA, siRNA and oligodeoxynucleotide were designed and transfected into K562 cells by liposome. Effective and specific siRNA strands were selected and then plasmid was constructed and transfected into K562 cells; followed by analysis of the results. Results hTERT mRNA were detected after the three chemo-synthesized strands were transfected. It was found that si-hTERT-1 and si-hTERT-2 were effective, but si-hTERT-3 had no effect. The inhibiting effect of hTERT mRNA lasted only 48 h and disappeared at 72 h. Two siRNA strands were sieved and plasmids were constructed and transfected into K562 cells. In the P-1 group, hTERT mRNA was 0.39±0.13 at 48 h, 0.57±0.32 at 72 h. In the P-2 group, hTERTmRNA was 0.55±0.20 at 48 h, 0.88±0.23 at 72 h.In the P-1 group, the relative telomerase activity was 0.42±0.07 at 48 h, 0.31±0.08 at 72 h. In the P-2 group was 0.49±0.27 at 48 h, 0.39±0.03 at 72 h. The best concentration of siRNA was 100 μmol/L. The best concentration of ASODN was 0.6 μ mol/L. hTERTmRNA was 0.42±0.16 at 24 h, 0.71±0.18 at 48 h. Relative telomerase activity was 0.52±0.002 at 24 h, 0.482±0.018 at 48 h. Conclusion Both ASODN and RNAi targeting hTERT can inhibit the expression of hTERT mRNA, and then inhibit telomerase activity. The inhibiting effect is closely relative to the targeting site. The inhibiting effect of RNAi is better than that of ASODN. RNAi has better efficiency and lasts for a longer time. Plasmid mediated RNAi has better inhibiting effect than the chemo-synthesized siRNA.

Objective To explore the mechanisms of individual, social and environmental factors influencing physical activity and the relationships among the factors in patients with type 2 diabetes. Methods A survey was conducted from January to July 2015 among 225 patients with type 2 diabetes using convenience sampling. The questionnaire included 9- item Patient Health Questionnaire, the International Physical Activity Questionnaire,Perceived Social Support Scale, Chinese Walkable Environment Scale, Bandura′s Exercise Self- efficacy Scale. Results The effective questionnaire recovery rate was 98.7%(222/225). Exercise self- efficacy was a mediator of factors influencing physical activity. Exercise self- efficacy and physical activity were positively correlated (β=0.24, P<0.05). Walkable environment only affected physical activity indirectly medicated by exercise self- efficacy (β=-0.26, P<0.05). Perceived social support directly associated with physical activity (β=0.14, P<0.05). Depression not only affected physical activity directly (β=-0.28, P<0.05), but also associated with physical activity indirectly medicated by exercise self-efficacy (β=-0.32, P<0.05). Conclusions Interventions should be taken to increase the perceived social support, improve depression and walkable environment, especially to enhance exercise self- efficacy, so as to improve the physical activity level of patients with type 2 diabetes.

Objective To analyze the status and influencing factors of physical activity in patients with diabetes.Methods A survey was conducted in patients with diabetes from one hospital in Tianjin city using the International Physical Activity Questionnaire, Exercise Self-efficacy Scale, 9-item Patient Health Questionnaire,Perceived Social Support Scale, Chinese Walkable Environment Scale, Visual Analogue Scale.The cumulative logits model was used to explore the influencing factors of physical activity in diabetic patients.Results The average of sitting time for diabetic patients was 6.1 hours per day.41.2％ of patients with diabetes were at high level of physical activity ,42.7％ were at moderate level of physical activity, and 16.1％ were at low level of physical activity.The cumulative logits model showed that perceived social support (β=0.029, OR=1.03, P=0.039,95％ CI=0.001-0.057) ,exercise self-efficacy (β=0.014, OR=1.01, P=0.001,95％ CI=0.005-0.023),and beautiful neighborhood surroundings(β=-0.366, OR=0.69, P=0.008,95％ CI=-0.635--0.096) were protective factors of physical activity, and depression(β=-0.093, OR=0.91, P=0.020,95％ CI=-0.172--0.015) was a risk factor of physical activity.Conclusion The physical activity status of diabetic patients are not ideal.Measures should be taken to improve the exercise self-efficacy, perceived social support and environment of surroundings, to reduce the symptoms of depression, so as to promote regular physical activities in patients with diabetes mellitus.

Objective:To evaluate the role of esophagogastric junction contractile index (EGJ-CI) in distinguishing patients with refractory gastroesophageal reflux disease (RGERD) from functional heartburn (FH).Methods:From March 2014 to January 2018, 82 patients with proton pump inhibitor (PPI) refractory heartburn and/or regurgitation, who visited the Outpatient Department of Gastroenterology at The First Affiliated Hospital with Nanjing Medical University were enrolled, among them 50 patients with RGERD (RGERD group) and 32 patients with FH (FH group). EGJ-CI of RGERD group and FH group were compared. The sensitivity and specificity of EGJ-CI to distinguish RGERD from FH patients. The correlation between EGJ-CI and high resolution esophageal manometry parameters, baseline impedance level and 24 h impedance-pH monitoring parameters were analyzed. Mann-Whitney U test, receiver operator characteristic curve analysis and Spearman correlation analysis were used for statistical analysis. Results:The EGJ-CI of RGERD group was lower than that of FH group (25.8 mmHg·cm (14.1 mmHg·cm, 35.9 mmHg·cm)(1 mmHg=0.133 kPa) vs. 39.2 mmHg·cm (23.0 mmHg·cm, 60.8 mmHg·cm)), and the difference was statistically significant ( Z=-2.833, P=0.005). When the cut-off value of EGJ-CI was 35.8 mmHg·cm, the sensitivity and specificity to distinguish RGERD from FH were 76.0% and 62.5%, respectively; area under the curve was 0.69 (95% CI 0.57 to 0.81). EGJ-CI was positively correlated with lower sphincter resting pressure, integrated relaxation pressure, distal contractile integral, distal esophageal pressure, and mean nocturnal baseline impedance ( r=0.812, 0.631, 0.451, 0.490 and 0.401, all P<0.01). EGJ-CI was negatively correlated with DeMeester score, acid exposure time, total reflux episodes, acid reflux episodes, long reflux episodes and longest reflux time ( r=-0.363, -0.372, -0.346, -0.318, -0.300 and -0.291, all P<0.01). Conclusions:EGJ-CI can help to distinguish patients with FH from RGERD.

The afsRS(cla) global regulatory genes from Streptomyces clavuligerus activate the production of two antibiotics in Streptomyces lividans. In this study, we gained an increase of 38% in the production of natamycin (3.56 g/L) in an industrial strain Streptomyces gilvosporeus TZ1401 through the integration of pHL851 that bears the afsRS(cla) global regulatory genes into its genome. We discovered by quantitive real-time reverse transcription PCR (qRT-PCR) that the expression of 6 genes of the natamycin biosynthetic gene cluster were improved from 1.9 to 2.7 times. This suggests that afsRS(cla) improve the production of natamycin through increased transcription. This study provides a good example for applying afsRS(cla) in high yield breeding of industrial antibiotic producers.
Anti-Bacterial Agents ; biosynthesis ; Genes, Regulator ; Industrial Microbiology ; Multigene Family ; Natamycin ; biosynthesis ; Streptomyces ; genetics

Objective To explore the clinical efficacy of transcutaneous autologous bone marrow transplantation in the treatment of delayed union after internal fixation of limb fracture. Methods 41 patients with delayed union after internal fixation of limb fracture with informed consent in our hospital were divided into two groups by number table,20 patients in control group were treated with conventional therapy,21 patients in observation group were treated with transcutaneous autologous bone marrow transplantation,the effects and the occurrence of complications of two groups were compared and observed. Results In observation group,excellent healing in 13 cases(61.9%),good in 7 cases(33.3%),failure in 1 case(4.8%),and in the control group,6 patients(30.0%),11 cases(55.0%),3 cases (15.0%),the difference between the two groups was statistically significant(u=4.1934,P＜0.05);the complication rate of the observation group was 9.5%,compared with 15.0% of the control group,there was no significant difference(x2=0.034,P＞0.05). Conclusion Transcutaneous autologous bone marrow transplantation in the treatment of delayed union after internal fixation of limb fracture had better efficacy and less complication.

Objective To explore the effects of biofeedback training on clinical symptom,psychological state and quality of life in patients with functional constipation (FC).Methods Forty-nine patients with FC diagnosed by Rome Ⅲ were enrolled and received biofeedback training Bowel symptom measure, Zung's self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Chinese version of the MOS 36-item short form healthy survey (SF-36) were recorded to assess the effects before and aftertreatment.Results After biofeedback training, clinical symptom of patients with FC was greatly improved:there was a very significant decrease in total and subscales scores of bowel symptom including spontaneous frequency of bowel movements, straining effort, sensation of anorectal obstruction/blockage, stool consistence and bloating.Patients with FC also improved their quality of life as well as psychological status after biofeedback.All subcategories of SF-36 including general health, physical function, bodily pain, role physical, vitality, social function, role emotion and mental health showed marked increase.Compared to the scores before biofeedback training, SAS (41.0 ±8.1 vs 46.5 ± 11.9) and SDS (44.0 ±8.2 vs 51.2 ±11.5) scores decreased significantly after biofeedback training Conclusion Biofeedback training can improve clinical symptom, psychological status and quality of life in patients with FC.