Objective To investigate the present situation and to analyze related factors of nursing practice environment among 22 public hospitals in Shanghai area.Methods We investigated 1 600 nurses from the 22 hospitals with general information questionnaire and the Chinese version of Practice Environment Scale,and also analyzed related factors by single and multiple factor analysis.Results 1 582questionnaires were taken back.49％ were dissatisfied with their working environment,and 28.1％ were evaluated to have nice practice conditions.Nurse concerned with workforce management and adequate resources were widespread.Logistic analysis indicated that hospital's level,the nurse's age,educational background and seniority were main factors influencing nurses' satisfaction.Nurse work in tertiary hospitals reported lower satisfaction.Conclusions More attention should be paid on improving nursing practice environment.

Objective: To study the relationship between the individual psychological characteristic of medical students and the way parents bring up them. Methods: Data on SCL-90, 16PF,EMBU of 1550 medical students were analysed. Results: It is showed that girl students have experienced more of the parents' emotion, understanding and favouritism, while the boy students have experienced more of their parents' refusal, deny, punishment, severity and excessive interference. There are more only-one-children who experience parents' emotion, understanding, interference and excessive protection. Conclusions: Parents' bad breeding attitude and behavior influence children's psychological health and forming of the individual characteristic directly or indirectly

Objective To investigate the increased expression of microRNA-146a(miR-146a) in peripheral blood mononuclear cells (PBMC) of patients with chronic immune thrombocytopenic purpura (ITP) and its clinical significance. Methods Twenty-eight patients with chronic ITP and 28 healthy controls matched with age and gender were enrolled in this study. Fluorescent quantitative PCR reaction was used to detect the relative expression of miR-146a in their PBMC. The serum concentration of TNF-α, IL-2,IL-1 β and IFN-γ were measured by ELISA. CCK-8 method was used to detect the proliferation ability of PBMC , which transfected with miR-146a mimics or inhibitor and then stimulated with platelet . Results The relative expression of miR-146a in ITP patients was higher than that of healthy controls. The increased expression of miR-146a was negatively correlated with the serum TNF-α, IL-2 and IFN-γ. The PBMC transfected with miR-146a mimics had reduced expression of IL-2 and proliferation when stimulated with platelet.In contrast, the opposite effect was observed with the miR-146a inhibitors transfection. Conclusion MiR146a was involved in the pathogenesis of chronic ITP by controlling IL-2 production and PBMC proliferation.Thus, it may be a potential therapy target for chronic ITP.

Objective To investigate the relationship between polymorphisms of interleukin-4 receptor (IL-4R) gene (E375A, C406R, Q576R) and childhood asthma in Harbin. Methods Ninety-one (91) children with asthma were included, and 42 healthy children were enrolled as control. The genotype polymorphisms of IL-4R were determined by polymerase chain reaction-restriction fragment length polymorphism analysis. Results There was no significant difference in the distributions of the genotypes at both 1 124 A/C polymorphic sites (i.e. E375A polymorphism) and 1 902 A/G polymorphic site (i.e. Q576R polymorphism) in IL-4R between asthmatic group and control group (P > 0.05). There was significant difference in the distributions of the genotypes (CC, CR, RR) on 1 216 T/C polymorphic site (i.e. C406R polymorphism) in IL-4R between the two groups (P < 0.05). The R allele frequency was 22.94% in asthmatic group and 6.58% in control group, with significant difference between the two groups (P < 0.05), but the allele frequencies at this site did not satisfy Hardy-Weinberg equilibrium (P < 0.05). Conclusions Our data suggest that the E375A and Q576R polymorphisms in IL-4R is not associated with the development of asthma in children in Harbin. Further study is needed on the relationship between C406R polymorphism and asthma.

Objective The aim of the study is to explore the sexual life situation of adult males with continuous ambulatory peritoneal dialysis (CAPD).Methods Data of experience about sexual life of 12 male CAPD patients was collected using in-depth interview and were analyzed with category approach.Results Five themes were sublimated:declined sexual desire,decreased self-confidence to get and to maintain an erection,restraint of sexual life,changes in sexual and marriage satisfaction,and urgent desire for sexual knowledge.Conclusions There are varying degrees of sexual dysfunction in adult male CAPD patients.Nurses should pay attention to and supply the education of sexual knowledge.

Objective:To study the clinical effect and safety of aerosol inhalation of recombinant human interferon α-2b( P. puti-da) in the children with viral upper respiratory tract infection ( VURI) . Methods: Totally 100 children diagnosed as viral upper re-spiratory tract infection were randomly divided into the observation group and the control group with 50 cases in each. The two groups of children were both given symptomatic and supportive treatment, and the observation group was given IFN-α2b (P. putida) 150 000 IU·kg-1 ·d-1 in 2-4 ml 0. 9% sodium chloride injection with aerosol inhalation, qd, 5-10 min each time, and the control group was given ribavirin 10-15 mg·kg-1 ·d-1 in 5% glucose injection 150 ml, ivd, and a course of treatment was continuous 5 d. The fever, cold symptoms ( catarrh, cough, malaise) and clinical efficiency of the two groups were compared. Results:The defervescence effect of the observation group was significantly higher than that of the control group after the treatment(P<0. 05). The effect in the children with mild and moderate cough in the observation group was better than that in the control group, and the changes were statistically sig-nificant difference(P<0. 01). The heat range, cough fading time, catarrh symptom and systemic symptom disappearance time in the observation group were significantly better than those in the control group(P<0. 05). The clinical efficient rate of the observation group was 96. 0%, which was significantly higher than that (84. 0%) in the control group(P<0. 05) . Conclusion: Combined with the conventional therapy, aerosol inhalation of IFN-α2b can be effectively and safely used for treating viral upper respiratory tract infec-tion in children, which is worthy of popularized use in clinics.

OBJECTIVETo study the chemical changes of salvianolic acid B and lithospermic acid of Salvia miltiorrhiza under the conditions of high temperature and high pressure and explore the reaction mechanism.

METHODS. miltiorrhiza extracts, salvianolic acid B and lithospermic acid were put in the reactor under the conditions of high temperature and high pressure (120 degrees C, 0.2 MPa), and the chemical changes and stability was studied.

RESULTSalvianolic acid A was the primary product in salvianolic acid B and lithospermic acid's conversion process, and lithospermic acid was an intermediate in the conversion process of salvianolic acid B. Compared with salvianolic acid B, lithospermic acid could convert into more salvianolic acid A and fewer other products in the same conditions. Salvianolic acid A was not stable under the conditions of high temperature and high pressure, and could sequentially convert into other small molecules.

CONCLUSIONReferring to the chemical conversion of salvianolic acid B and lithospermic acid, a method of large-scale preparation of salvianolic acid A can be developed.

Benzofurans ; analysis ; Caffeic Acids ; analysis ; Depsides ; analysis ; Hot Temperature ; Lactates ; analysis ; Pressure ; Salvia miltiorrhiza ; chemistry

Objective: To observe the effectiveness of mini-clinical evaluation exercise (Mini-CEX) on the standardized training of residents in the department of nephrology. Methods: Mini-CEX was used to evaluate the 80 residents who received clinical standardized training in the department of nephrology from March 2017 to March 2018 in our hospital. The assessment mainly contained seven aspects: medical history taking, physical examination, clinical diagnosis, therapeutic regimen, doctor-patient communication, humanistic care, and overall clinical ability. Meanwhile, a Mini-CEX questionnaire was conducted among 9 teachers and 80 residents, including their viewpiont and satisfaction degree on Mini-CEX. The SPSS 21.0 was used for statistical analysis and the independent sample t-test was used for comparison between the two groups. Results: Through the Mini-CEX assessment, every aspect of clinical competence of residents at the end of this program was significantly higher than that at the early period, and the difference was statistically significant (P<0.05). The most obvious improvement in residents was their treatment plan, overall clinical ability and physical examination. About the assessment of therapeutic regimen, the average score at the end of the training was (7.525±1.062), which was better than before (5.175±1.035), and the difference was statistically significant (P=0.000). Besides, clinical diagnosis and humanistic care were significantly better than those at the beginning (P<0.05). About the assessment of clinical diagnosis, the average score after the training was (6.925±1.071), which was better than before (5.425±1.238), and the difference was statistically significant (P=0.000). According to results of Mini-CEX questionnaire, teachers thought that Mini-CEX was a better way of assessment (88.9%) and could promote self-learning (77.8%), while residents believed that Mini-CEX was close to clinical practice and the ward-or-practice-based assessment was relatively comprehensive, which could significantly improve clinical skills (85.0%) and comprehensive quality (87.5%), with a satisfaction degree of 92.5%. Conclusion Mini-CEX is applied in the standardized training of residents in the department of nephrology, which can effectively improve clinical comprehensive ability of residents and improve Self-learning of teachers.

OBJECTIVETo assess the safety of repeated invasive prenatal diagnosis primarily due to failed culture of amniotic cells.

METHODSBetween January 2000 and October 2012, 167 cases required repeated invasive prenatal diagnosis among a total of 5304 amniocentesis cases. Clinical outcome and karyotypes were analyzed to calculate the rate of fetal loss.

RESULTSFor the 167 re-sampled cases, the indications have included failed amniocyte culture (121 cases), chromosome mosaicisms (23 cases), failed amniocentesis (21 cases), and request for confirmation (2 cases). No fetal loss has occurred. All samples were cultured successfully. Fourteen cases (8.38%) have been found with an abnormal karyotype. Four mosaic trisomic cases (2 mosaic trisomy 16, 1 mosaic trisomy 20, and 1 mosaic trisomy 8) were verified to be normal.

CONCLUSIONRepeated invasive prenatal diagnosis does not increase the rate of fetal loss. It can be recommended to cases with failed amniocyte culture. Caution should be undertaken when counseling prenatally detected mosaicism trisomies.

Adult ; Amniocentesis ; Female ; Fetal Diseases ; diagnosis ; genetics ; Humans ; Karyotyping ; methods ; Middle Aged ; Pregnancy ; Prenatal Diagnosis ; methods ; Trisomy ; Young Adult