Objective To explore the current situation and influencing factors of moral distress among nurses.Methods 252 clinical registered nurses from 3 Grade-3 Level-A hospitals in Jinan were investigated by the Chinese version of Moral Distress Scale-Revised and Job Diagnostic Survey.Results The mean score of MDF was (1.06±0.46) points and the mean score of MDI was (1.05±0.63) points.The total score of MDS-R was (38.86+26.26) points.Futile care was the main source for the high frequency and high intensity of moral distress among nurses.There were significant differences in the level of moral distress among different groups of age,years of nursing experience,first education degree,professional title,position,department,staffing of government affiliated institutions and income.The result of multiple linear regression analysis showed that age,first education degree,department,professional title,and the importance of assignment,autonomy,collaboration of work were the influencing factors for moral distress of nurses.Contusions It suggested that nurses should strengthen the study of knowledge about ethics to improve their capacity of ethical decision-making,and nurse managers should pay attention to department management,strengthen the medical cooperation,and improve nurses' job autonomy to improve nurses' capacity of coping and decision-making and reduce the level of moral dilemmas.

The technologies that we call cell micropatterning allow the control of the shape and size of cell adhesion. Combination of micro/nano technology, surface chemistry, electrochemistry and photochemistry enables us to control the adhesion, migration, differentiation of cells and the interactions between different types of cells. These methodologies bring about a new platform for the studies of cell biology. A number of techniques for cell patterning and compares their advantages and disadvantages were reviewed in this article. The applications of cell micropatterning, including those for fundamental studies in cell biology, tissue engineering and cell-based biosensors were also discussed.

Objective To investigate the effects of electroacupuncture (EA) on spatial learning and memory ability, long-term potentiation (LTP) and synaptophysin (Syp) levels in the dentate gyrus of the hippocampus.Methods Forty Sprague-Dawley rats were randomly divided into a sham-operated control group, a model group, an EA group and a medication group. A rat model of vascular dementia (VD) was established by repeated ischemia and reperfusion after pretreatment with sodium nitroprusside. EA was applied to the rat homologues of the human "Baihui" (GV20) and "Dazhui" (DU14) acupoints of the rats in the EA group for 20 min, once daily for 10 d.Morris water maze tests were conducted for evaluating the rats,learning and memory ability. LTP in the hippocampal dentate gyrus was recorded as an electrophysiological index for evaluating learning and memory. Antigenic Syp produced in hippocampal tissue was examined with immunohistochemical assays. Results In comparison the with model group, escape latency (EL) shortened and target-platform crossing times increased significantly in the EA and medication groups. After high frequency stimulation the population spike (PS) latency shortened in the EA group compared with the model group, and the excitatory postsynaptic potential (EPSP) slope and PS amplitude increased.All of these differences were statistically significant. Syp positive cells also increased significantly in the EA-treated rats. Conclusions EA can increase Syp expression and improve the learning and memory ability of rats with this model of VD. EA could facilitate the induction and maintenance of LTP in the dentate gyrus of the hippocampus through influencing synaptic transmission.

Objective To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy (EDN).Methods 90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group (45 cases in each group).The control group was given losartan potassium tablets treatment,while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment,the fasting blood glucose (FBG), 24h urine trace albumin quantitative (UAER),24h urine protein (24h pro),serum creatinine (SCr),25 -hydroxyl vitamin D [2 5 (OH )D ],blood calcium (Ca2+),potassium (K+),glycosylated hemoglobin (HbA 1 C )and serum inflammatory factors[C-reactive protein (CRP),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6 )] were observed,and the correlation between 25 (OH)D and UAER,24h pro was analyzed.At the same time,the clinical curative effects and adverse reactions during treatment were evaluated.Results In the observation group,the total effective rate was 93.3%,which was significantly higher than 71.1% in the control group (χ2 =7.601,P<0.05).In the two groups after treatment,the FBG,HbA1c,blood Ca2+and K+had no significant changes (all P>0.05).After treatment,Scr,24h pro and UAER in the two groups were all significantly reduced compared with before treatment (P<0.05),and 24h pro and UAER in the observation group were significantly lower than those in the control group (t=6.296,11.530,all P<0.05),but Scr had no statistically significant difference between two groups (t=0.331,P>0.331).After treatment,25(OH)D in the observation group decreased significantly compared with before treatment (t=12.000,P<0.05),which was significantly higher than that in the control group after treatment (t=11.278,P<0.05).Compared with before treatment,25(OH)D in the control group had no significant change after treatment (t=0.436,P>0.436).Pearson correlation analysis showed that 25 (OH)D level was negatively correlated with 24h pro and UAER (r=0.483,0.778,all P<0.05 ).In the two groups after treatment,the CRP, TNF-αand IL-6 levels significantly reduced (P<0.05 ),which in the observation group decreased more obviously (all P<0.05).In the two groups,no serious adverse events were found,the difference was not statistically significant (χ2 =0.212,P >0.151 ).Conclusion Alfacalcidol combined with losartan potassium tablets can significantly reduce the proteinuria levels of EDN patients and inflammation,which has better clinical curative effects and higher safety.

To study the characteristics of eye signs in chronic hepatitis B patients with blood stasis syndrome and the association between blood stasis syndrome and eye signs.

Objective To evaluate the efficacy and safety of Sheng-qi-zhuang-yang formula combined with specific immunotherapy (SIT) with standardized house dust mite vaccine on allergic asthmatic children. Methods Participants were 100 children with mild to moderate allergic asthma , who were receiving SIT at Guangdong Provincial Hospital of Chinese Medicine from Jan 2011 to Dec 2013 , who were divided into treatment group and control group. Patients in the treatment group received Sheng-qi-zhuang-yang Decoction combined with SIT while patients in the control group received SIT alone. Asthma symptom scores, respiratory function and related adverse events were compared before and after treatment, between groups. Results The desensitization treatment functions was ahead of time than expected in both groups. There is no significant difference between groups in terms of respiratory function and adverse effects. Conclusion Sheng-qi-zhuang-yang decoction combined with SIT for allergic asthmatic children seems to advance clinical effect without increasing adverse events. Further large scale clinical trial is required to confirm this.

Objective To observe the effects of Qingjiefang on insulin resistance and reduction of microalbuminuria in early diabetic nephropathy.Methods A total of 64 patients with early diabetic nephropathy were randomly recruited into a control group and a treatment group.The control group(32 cases)was treated with conventional western medicine,while the treatment group(32 cases)was treated with Qingjiefang based on the control group.The changes of the fasting plasma glucose(FPG),2hBG,glycosylated hemoglobin(HbAlC),fasting Insulin(FINS),24 hours urinary albumin excretion rate (UAER).body mass index(BMI)and insulin resistance(IR)were observed before and after the treatment.Results After the treatment,FINS,IR and UAER were decreased in the treatment group,the comparison with the control group showed significant difference (P<0.05).Conclusion Qingjiefang can effectively improve insulin resistance and prevent early diabetic nephropathy.

Objective To investigate the protective effect of carbon monoxide releasing molecule (CORM-2) on severe acute pancreatitis (SAP) induced lung injury in rats.Methods Thirty male Wistar rats were randomly divided into three groups (n= 10) including sham group, SAP group and CORM-2 group.The model of SAP was induced by retrograde infusion of 3.5% sodium taurocholate into the pancreatobiliary duct.CORM-2 (8 mg/kg) was infused through the dorsal artery of penis 0.5 h after establishing the model of SAP in CORM-2 group.All animals were sacrificed 6 h after SAP in-duction.The serum level of tumor necrosis factor-α (TNF-α), pulmonary cytokine induced neutrophil chemoattractant (CINC), intercellular adhesion molecule-1 (ICAM-1) mRNA expression as well as the activity of myeloperoxidase (MPO) in the lung were examined in each group.The wet/dry ratio of the lung was also determined.The lung was scored on the basis of pathological changes.Results Compared with SAP group, pulmonary over-expression of CINC and ICAM-1 mRNA was obviously inhibited in CORM-2 group and the serum TNF-α level, the MPO activity in lung tissue, the wet/dry ratio of lung, and the pathological score of lung injury were significantly lower (P＜0.05).Conclusion Administration of CORM-2 can remarkably reduce the severity of SAP induced lung injury through in-hibiting the over-expression of CINC and ICAM-1 mRNA, down-regulating the serum TNF-α level and subsequently decreasing pulmonary neutrophil infiltration.

Objective To investigate the expression of tumor suppressor gene p16~(INK4A) in mouse endometrium during the estrus cycle and early pregnancy and its possible role in blastocyst implantation. Methods Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the expression of p16~(INK4A) mRNA,immunohistochemistry and Western blotting were applied to detect p16~(INK4A) protein in mouse endometrium tissues during the estrus cycle and early pregnancy. Results The intensity of p16~(INK4A) mRNA expression in mouse early pregnancy was higher than that in the estrus cycle.Compared with the other 3 stages, the level of p16~(INK4A) mRNA expression at estrus was obviously higher. During the early pregnancy, the level of p16~(INK4A) mRNA expression increased steadily from day 2 to day 5,reaching the maximal level on day 5,then decreasing. Both immunohistochemical and Western blotting analysis showed the same results in expression patterns of p16~(INK4A) protein for mouse endometrium tissues as those results of RT-PCR.Conclusion p16~(INK4A) is involved in the embryos penetrating into the endometrial barrier.

Objective To investigate the adjuvant effect of dimo-thylidioctyl ammonium bromide (DDA) and/or DDA-BCG polysaccharide nucleic acid( BCG-PSN), which was combined with a Mycobacterium tuberculosis fusion protein AMM ( Ag 8 5 B - MPT64190-198 - Mtb8.4 ) to boost BCG primed immunization. Methods DDA with or without BCG PSN was mixed with the fusion protein AMM to construct the boosting vaccine. Mice were immunized with BCG and then boosted twice with AMM formulated with the adjuvant DDA with or without BCG-PSN. PBS or BCG vaccination without boosting was used as control. The humoral and cell-mediated immune responses were analyzed by ELISA and ELISPOT. Moreover, the protective efficacy of BCG prime-AMM subunit vaccine boosting against Mycobacterium tuberculosis infection was analyzed. Results With in vitro stimulation of Ag85B and PPD( purified protein derivative) antigen, the number of IFN-γ secreting cells from the mice boosted twice by AMM/DDA/BCG-PSN and AMM/DDA were higher than BCG and PBS group (P <0.05). The CFU in lungs of mice boosted with AMM/DDA/BCG-PSN was less than that of PBS group(P <0.05), while the CFU of AMM/DDA-boosted mice was less than that of BCG and PBS group(P < 0.05).However, fewer lesions were seen in lungs of mice immunized with BCG alone or BCG-prime-AMM/DDA/BCG-PSN boosting than the other groups. Conclusion DDA is an idea adjuvant for tuberculosis subunit vaccine;BCG-PSN might play a role in alleviating the immunity-mediated pathology.