Objective To investigate the current status of moral distress in clinical nurses,and analyze its influential factors.Methods A total of 240 clinical nurses were recruited by stratified sampling method.They were investigated with general situation questionnaire and moral distress scale.Results The average score of moral distress was (2.66±0.41).Multiple linear regression analysis showed that department of work and qualification were influencing factors on moral distress of clinical nurses.Conclusions This study found that nurses' moral distress was above the middle level.Some targeted measures should be taken by nursing managers,in order to help decrease nurses' moral distress.

Objective To find out the resistant situation and drug of Mycobacteria patients in Sichuan and offer foundation for clinical.Methods Two hundred randomized clinical isolates of Mycobacterium were determined by Roche drug sensitivity and minimum inhibitory concentration (MIC) method.Results Of the 200 clinical isolates,192 stains were Mycobacterium tuberculosis(MTB) (96.0％),8 strains (4.0％) were non-tuberculosis mycobacterium(NTM).Of the 192 MTB strains,108( 57.3％ ) sensitive strains and 84 (43.7％)stains were resistant to one or more than one drugs.Among these 84 resistant strains 23 were multi-drug resistant ( MDR,12.0％ ),4 were extensively drug resistant( XDR,2.1％ ).The anti-TB drug resistance rates were:SM(16.7％),INH(20.8％),RFP(17.2％),EMB(10.9％),PI(16.1％),LFX(8.8％),AMK ( 16.7％ ),CPM ( 6.2％ ),PTA ( 33.3％ ),respectively.Conclusion The resistance rate of tuberculosis keeps at a high level in Sichuan,especially the resistance rate of multiple (≥4) drug,we should oar attention.

To set standards for histomorphological studies on Lysimachia fortunei, an efficacious and widely applied folk medicine in this study, in order to develop its resources. Its species were identified by observing plant morphology and herbs appearance characters, preparing slices with routine methods and defining structural characters. According to the results of morphologic observation, leaves, stamen and pistil of this plant were different from the descriptions in Flora of China. The whole herb can be used in medicines, mainly including rhizomes, stems and leaves. According to the findings in the first study on microscopic structures, its rhizomes, stems and leaves were characteristic and worth identifying. The transaction tissue structures of rhizomes and stems were under developed and contained endodermis, secretory structures; Stems had sclerenchymata of different shapes of sclereids; Leaves were bifacial and had vascular bundles under midribs, which were surrounded by parenchymal sheathes. On the surface of leaves, stomata, glandular hairs and keratin lines were morphologically different in upper and lower epidermis. The herbal power had glandular hairs, sclereids and vessels. In conclusion, herbs of L. fortunei can be identified by the above histomorphological characteristics, which lays a foundation for further development and application of L. fortunei.
Medicine, Traditional ; Plant Leaves ; anatomy & histology ; growth & development ; Plant Stems ; anatomy & histology ; growth & development ; Plants, Medicinal ; anatomy & histology ; growth & development ; Primulaceae ; anatomy & histology ; growth & development

Objective To analyze the clinical efficacy of modified Xiaoqinglong Decoction with bladder ginger treatment in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of external cold and internal fluid. Methods Totally 150 cases of AECOPD were divided into Western medicine group, integrated traditional Chinese and Western medicine group, and observation group, with 50 cases in each group. Western medicine group received routine treatment, such as controlled oxygen therapy, anti-infection, triple inhalation, relieve spasm and asthma, cough and phlegm, correct water and electrolyte balance. On the basis of routine treatment, integrated traditional Chinese and Western medicine group received modified Xiaoqinglong Decoction, one dosage per day, twice a day, orally. On the basis of integrated traditional Chinese and Western medicine group, observation group received scraping the bladder at the back of the Bladder Meridian of Foot-Taiyang, putting 20–30 g fresh mashed ginger, for 15–20 min. All treatment lasted for 14 d. TCM symptom scores, the main symptoms of remission time and lung function before and after treatment in the three groups were compared. Results The differences in main symptoms scores (cough, expectoration, wheezing, shortness of breath) and total scores of the observation group were higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). The main symptoms remission time of the observation group was much shorter than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Compared with before treatment, the FEV1,FEV1/FVC and MMEF of the three groups after treatment showed an upward trend (P<0.05). The FEV1, FEV1/FVC and MMEF in observation group were significantly higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Conclusion Modified Xiaoqinglong Decoction combined with bladder ginger for the treatment of AECOPD of external cold and internal fluid has definite curative effect, and can significantly improve TCM symptoms and pulmonary function.

Objective: To investigate the isoflavones constituents from the whole plant of Crotalaria sessiliflora. Methods: The compounds were isolated by column chromatography and their structures were identified by the spectral data. Results: Twenty-one isflavones were isolated from 75% ethanol extract in the whole plant of C. sessiliflora and identified as 6,7,2'-trimethoxy-4'-hydroxyl isoflavone (1), 7,4'-dihydroxy-5-methoxy isoflavone (2), daidzein (3), 2'-hydroxyl genistein (4), genistein (5), 3'-hydroxyl daidzein (6), genistein 7-O-β-D-apiofuranosyl-(1→6)-O-β-D-glucopyranoside (7), genistein 7-O-glucoside (8), glabrone (9), alpinumisoflavone (10), barbacarpan (11), 3'-hydroxyl genistein (12), 4',7-dimethoxy-5-hydroxyl isoflavone (13), pratensein (14), 8-O-methylreyusi (15), eurycarpin A (16), prunetin (17), formononetin (18), 2'-methylalpinumisoflavone (19), hydroxyalpinumisoflavone (20), and desmoxyphllin A (21). Conclusion: Compound 1 is a new compound named sessiliflorin A, compounds 2-3, and 6-21 are isolated from the plant for the first time.

From June to November 2016, 5 patients with severe burns were admitted to our unit. Broad-spectrum antibiotic and fluconazole were used on patients as earlier empirical anti-infection therapy of bacteria and fungi. Seven to twenty-one days after injury, 5 patients developed fungal infection. Antifungal agents of caspofungin, voriconazole, and amphotericin B liposomewere were used according to the results of fungal culture, and the infected wounds were also treated with repeated debridement and dressing change. Multiple autologous skin grafts were performed after infection control of wounds. With the above antifungal infection treatment for 5 to 11 days, 2 patients′ condition tended to be stable, and no fungus was found in wound secretion after cultured for many times. The patients were discharged with wounds healed after 52 to 54 days′ hospital stay. Due to severe burns degree and or elder age, fungal infection aggravated and expanded to the trunk in the other 3 patients, then developed into burn sepsis, resulting in patients died of multiple organ failure secondary to sepsis.

Objective: To analyze the epidemiological characteristics of adult inpatients with gas burns in the Department of Burns of Hwa Mei Hospital of University of Chinese Academy of Sciences (hereinafter referred to as the author′s unit) , so as to provide evidence for the prevention of gas burn. Methods: Medical records of all inpatients with flame burns admitted to the author′s unit from January 2011 to December 2017 were collected. The percentage of adult inpatients with gas burns in total inpatients with flame burns in the same period, and their gender, age, injury season, accident place, burn severity, common compound injury, complication, population caliber, education, industry, as well as the pre-injury disease and prognosis of elderly inpatients with gas burns were retrospectively analyzed. In addition, the age, accident place, education, and industry of the floating population in the adult inpatients with gas burns were analyzed separately and compared with the total population of adult inpatients with gas burns in 7 years. Data were processed with chi-square test or Fisher′s exact probability test (Monte Carlo algorithm). Results: During the 7 years, 1 490 inpatients with flame burns were admitted to the author′s unit, among which 511 were adult inpatients with gas burns, accounting for 34.30%. The number of adult inpatients with gas burns increased gradually during the 7 years, but its percentage in the total inpatients with flame burns during the same period showed no significant difference (χ²=7.087, P>0.05). Among the 511 adult inpatients with gas burns (hereinafter referred to as the patients in this group), there were 315 males and 196 females, with a male/female ratio of 1.61 to 1.00, and the middle-aged patients were the most, up to 270 cases, accounting for 52.84%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in gender and age (χ²=54.810, 27.832, P<0.01). Among the patients in this group, most were injured in summer, totally 251 cases, accounting for 49.12%, and the accident place was mainly at home, totally 388 cases, accounting for 75.93%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in injury season (χ²=42.254, P<0.01), but not in accident place (χ²=6.782, P>0.05). The patients in this group were mainly with moderate burns (237 cases, accounting for 46.38%), and the distribution trend of burn severity of adult inpatients with gas burns was basically the same during the 7 years (χ²=19.680, P>0.05); 176 patients (34.44%) were accompanied by inhalation injury, and 30 patients (5.87%) were accompanied by blast injury of lung; post injury complications occurred in 20 patients (3.91%). In the elderly inpatients with gas burns, 44.44% (32/72) were accompanied by pre-injury basic diseases, and the proportion of death or unhealed reached 18.06% (13/72). Most of the patients in this group were permanent residents (358 cases, accounting for 70.06%) and received secondary education (304 cases, accounting for 59.49%), and the majority of them were engaged in manufacturing/construction (138 cases, accounting for 27.01%), self-employed business (90 cases, accounting for 17.61%), and catering (90 cases, accounting for 17.61%) industries. The distribution of adult inpatients with gas burns during the 7 years was significantly different in population caliber, education, and occupation (χ²=17.496, 29.898, 88.896, P<0.05 or P<0.01). Among the patients of this group, the floating population were mainly young (90 cases, accounting for 58.82%) and middle-aged (62 cases, accounting for 40.52%), with main accident place at home (97 cases, accounting for 63.40%), generally received secondary education (101 cases, accounting for 66.01%), and were mainly engaged in manufacturing/construction (71 cases, accounting for 46.41%), self-employed business (26 cases, accounting for 16.99%), and catering (20 cases, accounting for 13.07%) industries. Compared with the total adult inpatients with gas burns in 7 years, the floating population were younger, more injured in the workplace, and more concentrated in industry (χ²=42.924, 9.390, 27.819, P<0.01). Conclusions Gas burn was the leading injury cause of inpatients with flame burns in the author′s unit, which mainly occurred in summer and at home; the patients were mainly male, young and middle-aged, and permanent residents, most of which were with moderate burn, often accompanied by inhalation injury. Most of the patients were of secondary education, engaged in manufacturing/construction, self-employed business, and catering industries, among which the floating population were younger, more injured in the workplace, and more concentrated in industry. In order to prevent gas burn, we should pay more attention to the propaganda and education of gas safety among young and middle-aged men, floating population, retired old people and housewives, especially in summer, we should do a good job in gas safety inspection at home. In addition, we should urge enterprises to further strengthen the supervision of production safety.

OBJECTIVETo investigate the effect of moxibustion at Sanyinjiao (SP 6) for uterine contraction pain in labor, and evaluate the safety of the parturient and newborn.

METHODSOne hundred and seventy-four cases of singleton pregnancy and cephalic presentation primipara were single blinded and randomly divided into three groups: observation group (59 cases), placebo treated group (57 cases) and blank group (58 cases). The observation group was treated with moxibustion at Sanyinjiao (SP 6) for 30 min when the uterus cervix openning at 3 cm, the placebo treated group was treated with moxibustion at no acupoint for 30 min and the blank group was treated with routine labor nursing, the uterine contraction pain and the safety of the mother and infant were compared among three groups.

RESULTS1) The uterine contraction pain was tested by Visual Analogue Scale (VAS): the scores of VAS in the observation group were obviously decreased after 15 min and 30 min of moxibustion (both P<0.05), there were no obvious changes of the VAS scores in placebo treated group and the blank group, the scores of VAS in observation group decreased much more obviously than those in the other two groups (all P<0.05); 2) Midwife rating of the uterine contraction pain: after 30 min of moxibustion, the effective rate of labor analgesia was 69.5% (41/59) in observation group, which was higher than that of 45.6% (26/57) in placebo treated group and 43.1% (25/58) in blank group, with significant differences between them (both P<0.05); 3) The postpartum hemorrhage amount of the observation group was obviously lower than those of placebo treated group and blank group (both P<0.05); 4) The Apgar score of newborn was higher in observation group and placebo treated group than that of blank group (both P<0.05).

CONCLUSIONMoxibustion at Sanyinjiao (SP 6) can relieve the uterine contraction pain, and has no side effect to mother and infant, it is one of the safe, effective and simple non-drug analgesia methods.

Acupuncture Points ; Adult ; Female ; Humans ; Labor Pain ; physiopathology ; therapy ; Labor, Obstetric ; Moxibustion ; Pregnancy ; Treatment Outcome ; Uterine Contraction ; Young Adult

To report a case of cutaneous and subcutaneous coinfection caused by Lichtheimia corymbifera and Candida parapsilosis.A 67-year-old female peasant consulted about proliferative granuloma developing on her left forearm after topical application of a Chinese herbal drug and splint fixation for the treatment of suspected fracture of the wrist.Direct microscopic examination showed gram positive budding yeast cells in lesion secretions.Pathological study with periodic acid-Schiff (PAS) and gormori methenamine silver (GMS) staining revealed broad non-separate hyphae in the corneum and dermis.Fungal culture of lesional tissue at 35℃ grew both mould and yeast.The mould was identified as Lichtheimia corymbifera based on morphological findings and sequences of the internal transcribed space (ITS) 1-4 regions.Thermal tolerance study revealed that the isolate grew fast at 37℃ but slowly at 40℃.Under a scanning electron microscope,the acrogenous sporangia were pear-shaped with conical sporangiophores originating from the top of stolon,which were among but not opposite to the rhizoids.The yeast was identified as Candida parapsilosis by Chromagar test and D1/D2 region sequencing.As antimicrobial susceptibility test indicated,the Lichtheimia corymbifera isolate was most sensitive to terbinafine and itraconazole.The proteolytic activity of Lichtheimia corymbifera was higher than that of Candida parapsilosis.The granuloma completely subsided after surgical resection and 6-week treatment with oral itraconazole 200 mg twice a day.No recurrence was observed during a 4-year follow-up.

OBJECTIVESTo study the coexistence of androgen receptor(AR) and GnRH receptor(GnRHR), and further identify that submaxillary is a target organ of androgen and GnRH in SD Rat.

METHODSSequential deparaffinized sections of SD rat submaxillary were immunostained with SABC method. The first antibodies were rabbit anti-rat GnRH idiotypic antibodies and mouse anti-rat androgen receptor antibodies.

RESULTSAR immunoreactive cells were found in glandular epithelial cells of serous acinus and epithelial cells in all gland ducts. While the distribution of GnRHR coincides with that of AR. The immunoreactive substances were distributed in cytoplasm of all positive cells with negative nuclei.

CONCLUSIONSThe results showed that AR existed in submaxillary and was widely distributed in glandular epithelial cells with distributive pattern similar to those of GnRHR. It suggests that submaxillary is a target organ of androgen, responsible for modulating biological function of submaxillary.

Animals ; Immunohistochemistry ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Androgen ; metabolism ; Receptors, LHRH ; metabolism ; Submandibular Gland ; metabolism