The theory framework of "cognition- emotion-behavior" of the Gestalt Psychology is based on to build the conceptual model to integrate service encounter quality, customer consumption emotion and customer satisfaction. Such a model is also used to raise related hypothesis and verified against the backdrop of the medical service industry. Empirical outcomes prove the following: hospital service encounter quality consists such factors as environment dominance, doctor dominance and nurse dominance; in the course of their consumption in hospitals, patients undergo at the same time positive consumption emotion and negative consumption emotion, as the latter exerts negative impacts on the positive one; hospital service encounter quality bears significant impact on both patient' s consumption emotion and patient satisfaction; positive emotion and negative emotion both bear significant impacts on patient' s satisfaction.

Objective To investigate the pathological types and features of lymph nodes in human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)patients with superficial lymphadenectasis.Methods The tissues of lymph nodes were obtained from 151 HIV/AIDS patients with superficial lymphadenectasis for pathological examination.The pathological results were observed by light microscope after Hematoxylin-Eosin(HE),acid-fast,periodic acid-Schiff (PAS),and digested-PAS(D-PAS)staining.The pathological results of lymph nodes were described and the correlation between pathological changes and CD4+T lymphocyte count was analyzed.Chisquare test was used for the statistic analysis.Results The benign lesions were found in 145 patients (96.0%),while the malignant tumors were found in 6 patients(4.0%).The pathological findings in the 151 HIV/AIDS patients included tuberculosis(72 patients),lymph node reactive hyperplasia(34patients),lymphatic fungal infections(23 patients,including penicillium diseases in 19 cases),AIDSrelated lymphadenectasis(14 cases),non-Hodgkin lymphoma(5 cases),benign fibrous histiocytoma (1 case).In addition,there were 83 patients(55.0%)with CD4+T lymphocyte count lower than 100×106/L.The frequency of penicillium diseases was higher in patients with lower CD4+T lymphocyte count(x2=7.757,P=0.021).Conclusions The major reasons for superficial lymphadenectasis in HIV/AIDS patients are infectious diseases,such as tuberculosis and fungal infections,which are common in patients with lower CD4+T lymphocyte counts.Non-Hodgkin lymphoma is the most common malignant tumor in this patient population.

Objective To study the effects of relaxation training on blood pressure,heart rate, intraocular pressure fluctuation and time to control intraocular pressure before operation in patients with acute angle-closure glaucoma.Methods In this study,80 patients with acute angle-closure glaucoma,who were selected from January 2015 to December 2016 in Shanghai Putuo District Central Hospital,were randomly divided into control group and observation group. Patients of the control group was given routine care,while patients of the observation group was given both the routine nursing care and relaxation training. On the day of admission and before operation,heart rate,blood pressure,intraocular pressure fluctuation and preoperative control of intraocular pressure time of the two groups were measured.Results The heart rate,blood pressure, intraocular pressure fluctuation and preoperative control of intraocular pressure time of patients in the observation group were better than that in the control group (P<0.01).Conclusions The relaxation training can effectively keep the acute angle-closure glaucoma patients vital signs steady,effectively control patients intraocular pressure fluctuations before operation,reduce the number of time waiting for operation,and thus delay the progress of visual damage.

Objective To clarify the traditional Chinese medicine(TCM)constitution and TCM patterns in patients with recurrent spontaneous abortion(RSA)in Foshan area,and explore the correlation between them.Methods Totally 310 RSA patients were selected,and tongue,facial photos,and pulse diagnosis data were collected using the traditional Chinese medicine physical fitness four diagnosis instrument.The data was used to analyze the distribution and correlation of TCM constitution and TCM patterns of RSA patients in Foshan area.Results The top four constitution are Qi stagnation constitution,phlegm dampness constitution,Yin deficiency constitution,and Qi deficiency constitution,with kidney deficiency type being the most common among TCM patterns.People with Qi deficiency and Yang deficiency constitutions are prone to the syndrome of weak Qi and blood.People with yin deficiency constitution are prone to blood heat syndrome type.People with phlegm dampness and dampness heat constitution are prone to the syndrome of spleen and kidney deficiency.People with blood stasis constitution are prone to developing blood stasis syndrome types.Conclusion The TCM constitution and TCM patterns in Foshan area are obvious.TCM constitution is closely related to traditional TCM patterns,and different constitutions may affect the onset and clinical symptoms of RSA patients.

Objective To explore the status quo of nursing practice of hemophilia-specialized nurses, to find out the shortcomings of current work and to provide the basis for promoting the development of hemophilia-specialized nursing in China. Methods The nursing staff attending the National Nursing Conference on Hemophilia in Shenzhen on November 7, 2015 were investigated with questionnaires. This investigation involved more than 40 hemophilia treatment centers nationwide. The nursing staff were required to fill out the Questionnaire for Hemophilia-Specialized Nurses developed by the Nursing Council, World Hemophilia Federation on the site, which were taken back once completed. Totally 54 questionnaires were handed out, and 43 valid questionnaires were taken back. Results Totally 55.8% of the nurses engaged in hemophilia nursing for less than 5 years, and 58.1% of them spent less than 10 hours on hemophilia nursing per week. And the number of hemophilia centers whose requirement for specialized nurses was a college degree accounted for 55.8%. The major nursing practice of China's hemophilia-specialized nurses included preliminary diagnosis-related content and self-injection training (>50%), and involved less specialized nursing practice, including consultancy, education, liaison, triage, physical examination, medication management, extended care, nursing research and clinical trial (20%-50%). The functions of management and medical advice accounted for<20%, and the least nursing practice was "school visit", accounting for only 4.7%. Merely 5 hemophilia centers carried out nursing practice items that accounted for over 50%. Nurses with different working years and education backgrounds were moderately correlated with the number of carried out nursing practice items. Conclusions The hemophilia-specialized nurses in China has an uneven level, and they need to expand the nursing work, do better in information registration and health education for hemophilia patients, improve the training proportion of family treatment, and meanwhile strengthen the publicity of hemophilia in elementary and middle schools.

Objective:To investigate the clinical, histologic, immunohistochemical (IHC) and molecular genetic features of clear cell carcinoma (CCC) of salivary gland in the head and neck regions.Methods:Seven cases of CCC diagnosed in the Department of Pathology, the First Affiliated Hospital of Nanjing Medical University from 2018 to 2021 were included. The clinical and pathologic data, HE sections and IHC staining were reviewed, and EWSR1 gene translocation was detected by fluorescence in situ hybridization (FISH). The relevant literature was also reviewed.Results:There were five males and two females, with an age range of 32 to 71 years (mean 50 years). The tumors were located in the palate, base of tongue, subglottic, right submaxillary and nasopharynx. Histologically the tumors were composed of sheets, nests, and trabecular of large, monomorphic cells which possessed abundant clear and eosinophilic cytoplasm. The stroma was characterized by abundant hyalinized fibrous strands admixed with cellular fibrous (desmoplastic) tissue. The tumor growth was infiltrative. IHC staining revealed positivity for CKpan and squamous cell immunophenotypic markers (CK5/6, p63 and p40), but negativity for myoepithelial markers (SMA, calponin, GFAP and CD10). The EWSR1 gene translocation was detected by FISH. The prognosis was excellent, with the follow-up periods ranging from 8 months to 33 months. During this period, six patients survived without tumor, only one patient with cervical lymph node metastasis.Conclusions:CCC of salivary gland is rare and needs to be differentiated from various other types of tumors containing clear cells. Awareness of the histopathologic characteristics, and combined with IHC and molecular genetic examination can avoid misdiagnosis. The biological behavior of the tumor is indolent with a good overall prognosis.

Objective:To investigate the clinicopathological features and differential diagnosis of polymorphous low-grade neuroepithelial tumor of the young (PLNTY).Methods:Five cases of PLNTY diagnosed at the First Affiliated Hospital and Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China from 2019 to 2021 were collected. All cases were evaluated using clinical and imaging data, histology, immunohistochemical staining and molecular genetics. The relevant literature was reviewed.Results:There were two male and three female patients, aged 10 to 39 years, with an average age of 25 years. Clinically, the tumors were in the temporal lobe (3 cases), the lateral ventricle (1 case) and the left head of caudate nucleus (1 case). The clinical manifestations included epilepsy in 3 cases, right visual disturbance in 1 case, and post-trauma incidental finding in 1 case. Microscopically, the lesions were characterized with infiltrative growth, cellular pleomorphism (oligodendroglioma-like cells were always present, with low-grade, pleomorphic nuclei) and variable calcifications. Immunohistochemically, the tumor cells were positive for GFAP and Olig2. They also showed intense and diffuse expression of CD34 while CD34 expressing ramified neural elements were present in regional cortex. Ki-67 proliferation index was less than 3%. Molecular genetics showed the BRAF V600E mutation in 2 cases, the PAK5-Q337R missense mutation in 1 case, the FGFR2-CTNNA3 fusion in 1 case, and the FGFR2-INA and FGFR2-PPRC1 concomitant fusion in 1 case. No postoperative chemoradiotherapy was given. Follow-up intervals ranged from 3 to 29 months while no recurrence or metastasis was identified.Conclusions:PLNTY is uncommon. A definite diagnosis of PLNTY relies on histopathological examination and molecular genetics. It is important to distinguish PLNTY from high grade gliomas and avoid overtreatment. The recently reported the PAK5-Q337R missense mutation and the FGFR2-PPRC1 gene fusion in PLNTY may help diagnose and understand the pathogenesis of PLNTY.

Objective:To investigate dyslipidemia and relevant factors of AIDS patients in general hospital.Methods:From April 2017 to January 2018, 306 AIDS patients seen in Peking Union Medical College Hospital (PUMCH) were included, their general information such as demographic characteristics, underlying diseases, regimens for treatment and duration of antiretroviral therapy were recorded and dietary conditions were evaluated. General Self-Efficacy Scale (GSES), Social Support Rating Scale (SSRS), Internal Physical Activity Questionnaire (IPAQ) were adopted for the investigation.Results:Of the 306 patients, 179 had dyslipidemia. Univariate analysis suggested that singlehood, higher age and body mass index (BMI), proteinase inhibitor (PI) and non-nucleotide reverse transcriptase inhibitor (NNRTI) contained antiretroviral therapy (ART) (especially the former) were relevant risk factors. After multivariable analysis, higher age and BMI, high fat diet, high baseline CD4 counting and longer course of disease were related with dyslipidemia, whereas female and higher activity level may be associated with little benefit.Conclusions:Dyslipidemia was more common in AIDS patients than in general population, which were mainly due to the disease itself and ART regimens. Those patients were middle-aged or older, with high baseline CD4 counting, treated with PI and whose course of disease was more than two years should reserve more attention.

AIM:To observe the changes of Th17 related cytokines in tears of conjunctivochalasis(CCH)patients with liver-kidney yin deficiency treated with traditional Chinese medicine Qi Jing Mingmu decoction combined with artificial tears.METHODS:A total of 56 CCH patients(56 eyes)with liver-kidney yin deficiency of grade Ⅱ to Ⅲ were collected and randomly divided into treatment group(treated with Qi Jing Mingmu decoction combined with artificial tears)of 26 cases(26 eyes)and control group(treated with pure artificial tears)of 30 cases(30 eyes). The treatment course was 1 mo, and international ocular surface disease index(OSDI), tear film break-up time(BUT), tear meniscus height(TMH)and conjunctival congestion index of the patients were observed before and after treatment. The patients' tears were collected before and after treatment, and Th17 related cytokines in tears were detected using flow cytometry immunofluorescence luminescence method.RESULTS:After treatment, the OSDI, BUT and conjunctival congestion index of CCH patients in the treatment group and control group were significantly improved(all P<0.01). After treatment, the TMH of CCH patients in the treatment group was significantly reduced(P<0.01), while there was no statistically significant difference in TMH of the control group before and after treatment(P=0.41). After treatment, the levels of Th17 related cytokines IL-17A, IL-22, IFN-γ, IL-17F, and IL-1β in tears of CCH patients in the treatment group were significantly reduced after treatment(all P<0.01), and the changes in the treatment group were more significant(all P<0.05). There was no significant difference in the control group before and after treatment(all P>0.05). After treatment, the levels of IL-6 and TNF-α in the tears of both groups of CCH patients decreased compared to those before treatment(both P<0.05), but the changes in the treatment group were more significant(both P<0.01).CONCLUSION:Qi Jing Mingmu decoction combined with artificial tears can effectively improve the ocular surface microenvironment, enhance tear film stability, and inhibit ocular surface inflammation in CCH patients with liver-kidney yin deficiency. This may be related to its reduction in the secretion of Th17 related cytokines in tears.