Objective:To observe the effect of emotional resilience training on compassion fatigue and psychological resilience of intensive care unit nurses.Methods:A total of 70 intensive care unit nurses were randomly divided into experiment group and control group, each of 35 cases. Control group nurses were given routine psychological guidance intervention, in addition, the experiment group was carried out 8 weeks of emotional resilience training. The effect of intervention was assessed by Chinese version of the compassion fatigue scale and Connor-Davidson resilience scale before and after intervention.Results:After intervention, the average scores of compassion satisfaction, secondary traumatic stress and total compassion fatigue scores were (26.46±4.99)pionts, (17.80±4.05)pionts and (69.14±5.70)pionts, significantly lower than in the control group (28.86±4.14)pionts, (20.11±4.38)pionts and (75.51±10.32)pionts, the difference was statistically significant ( t value was 2.190, 2.296, 3.197, P<0.05). After intervention, the average scores of tenacity, power, optimism and total resilience scores were (34.23±6.06)pionts, (25.77±5.01)pionts, (14.31±3.22)pionts and (74.31±9.55)pionts, significantly higher than in the control group (30.86±6.23)pionts, (23.31±3.29)pionts, (12.11±2.04)pionts and (66.29±7.28)pionts, the difference was statistically significant ( t value was 2.295-3.956, P<0.05). Conclusion:Emotional resilience training can effectively reduce the compassion fatigue and improve psychological resilience of intensive care unit nurses.

Objective To describe the expressions of programmed death-1 (PD-1) and its ligand PD-L1 on the surface of peripheral blood lymphocytes in patients with tuberculosis.Methods A total of 77 cases of pulmonary tuberculosis were recruited,of which 27 were single infection,41 were coincident with bacterial or fungal infection and 9 patients with diabetes mellitus.Twenty-nine healthy donors were also enrolled as control group.The expressions of PD-1/PD-L1 on the peripheral blood lymphocytes and mononuclear cells were detected using immunostaining and flow cytometry.Collected data were analyzed with t-test statistics.Results Among the three groups of tuberculosis including pulmonary tuberculosis,pulmonary tuberculosis coincident with infection and pulmonary tuberculosis with diabetes mellitus,the percentages of CD4+ CD25+ T cells as well as CD4+ CD25high T cell subsets were both significantly higher than those in healthy controls (t=4.892,4.635,4.974,5.407,4.660,5.279,all P＜0.01).The expression of PD-1 was up regulated on the surface of CD8+ T cells in the groups of tuberculosis as compared with the control group (t=6.392,8.249,7.072,all P＜0.01).The proportions of PD-L1 expressed on the monocytes in each group were (42.51 ± 7.54) ％,(49.42± 6.29) ％ and (48.46 ± 14.58)％,respectively.The difference was significant in contrast to the control group,which was (17.91 ±3.03)％ (t=5.168,6.854,5.665,all P＜0.01).PD-L1 expression was also up-regulated on B cells in each group and much higher than that of the control group (51.51±7.32)％,(50.85±7.09)％,(55.66±14.29)％ vs (40.11±4.25)％ (t=2.562,2.046,2.766,all P＜0.05).Conclusion PD-1/ PD-L1 co-inhibitory pathway could be closely related to the development of tuberculosis and its complications,which is involved in the attenuation of anti-tuberculosis and anti infection immune responses.

Cordyceps sinensis is an expensive and tonic-valuable famous herb in China. Due to a narrow growing distribution, a low parasitic rate and a harsh living environmental condition, its wild recourse is not abundant. In re-cent years, with the improvement of living standards, people’s awareness of health care has increased strongly. That is because of people’s over-excavation need;and the natural resources are becoming increasing scarcity. In order to meet the demand for Cordyceps, domestic researchers conducted vigorous studies. Since 1987, four or five cul-tured Cordyceps species have been developed, namely fermented Cordyceps sinensis. Through subsequent unceasing research, they were put into a lot of production, bringing a certain benefits for income and society. Currently, there are four commercial brands on the market. They are Bailing, Jinshuibao, Xinganbao and Ningxinbao. This paper summarized the studies of its chemical compositions and clinical applications on fermented Cordyceps militaris in the recent five years. It will let scholars understand its value of the cultured Cordyceps militaris more comprehen-sively and supply more information for scholars in its further research.

Objective To analyze sonographic imagings of traumatic neuromas of peripheral nerves,and to investigate the applied values of uhrasonography in the traumatic neuroma of peripheral nerve. Methods The sonographic imagings of 38 patients who had evidences of traumatic neuromas in peripheral nerves were retrospectively reviewed by the last diagnostic results of operations. Results Among 38 cases, 2 incomplete traumatic neuromas were not detected, and 1 incomplete traumatic neuroma was misdiagnosised as neurilemoma by ultrasonography. The coincidence of uitrasonography in incomplete traumatic neuroma and complete severed neuroma was 82.4% and 100%. With regard to the echogenicity of 38 traumatic neuromas of peripheral nerves, the sonographic characteristics of neuromas were all hypoechoic. Thirty-three neuromas appearanced like shuttles and 5 neuromas appearaneed like humps. Conclusions The traumatic neuroma has distinctive ultrasonic appearance. Ultrasonography is useful to direct the diagnosis and treatment of traumatic neuroma.

Objective To investigate protective effect of tribulus terrestris L (TTL) on photoreceptor in the model of light-induced retinal degeneration.Methods BALB/c mice were exposed to bright light at the intensity of 10 000 lux for 30 minutes to establish the retinal light damage models.The BALB/c mice were divided into normal control group,model group and treatment group,6 cases in each group.TTL decoction was intraperitoneally administered to mice 30 minutes prior to illumination in the treatment group.Saline vehicle was administered in the normal control group and model group.Photoreceptor protection of TTL was assessed by optical coherence tomography (OCT) at 3 hours and 7 days after illumination.Gross histology and immunohistochemistry approaches were also taken to examine the retinal protection conferred by TTL at 7 days after bright light exposure.Results Compared to normal retinal morphology in the normal control group,prominent photoreceptor loss and diminished rod and cone photoreceptors evidenced by attenuated retinal expression of rhodopsin and M-opsin were observed in the model group.In contrast,TTL treatment resulted in significant protection against bright light-induced photoreceptor degeneration and remarkable preservation of rod and cone photoreceptor cells.The outer retinal nuclear layer in the model group was thinner than that in the normal control group (P ＜ 0.05),but the treatment group was thicker than the model group (P ＜ 0.05).Conclusion Bright light induces obviously degeneration in photoreceptors in BALB/c mice.Moreover,TTL is shown for the first to significantly protect the photoreceptors from bright light-induced degeneration.

Objective:This study was to analyze the changes of CD4~+ T lymphocytes and their subtypes,Th1 and Th2 cells,in the peripheral blood of patients with pulmonary tuberculosis disease and to investigate their clinical significance in the pathologic process of pulmonary tuberculosis.Methods:For polarization measurement of T-helper cells,1∶100 diluted Ionomycin and 1∶10 diluted Monensin were added in sequence into the equivalent volume mixture of heparin anti-coagulated whole blood and RPMI-1640 culture liquid.After being well mixed,the mixture was incubated at 5% CO_2,37℃ for 4 hours or overnight.To 100 μl of the mixture and in sequence,the antibodies of CD3-PerCP,CD8-APC,mIgG1-FITC,Rat IgG1-PE,IL-4-PE or IFN-γ-FITC were added.The stained CD4~+ IL-4~+ (Th2) and CD4~+ IFN-γ~+ (Th1) were analyzed by flow cytometry.Results:Compared with those from healthy controls,the peripheral blood of pulmonary tuberculosis patients contained significantly fewer Th1 (P＜0.01) but significantly more Th2 cells (P＜0.05).Th1 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis were obviously fewer (P＜0.05) than in infiltrative pulmonary tuberculosis patients.The amount of Th2 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis was significantly more (P＜0.05) than in either infiltrative pulmonary tuberculosis or tuberculous pleurisy patients.The ratio of CD4~+/CD3~+ tended to decrease in all these patients,and it was much lower (P＜0.05) in the patients of miliary pulmonary tuberculosis than in infiltrative pulmonary tuberculosis patients.Patients suffering from both pulmonary tuberculosis and diabetes had significantly lower levels of Th1 cells and CD4~+/CD3~+ (P＜0.05) and more Th2 cells,compared with those of pulmonary tuberculosis patients without diabetes.Levels of Th1 and Th2 cells restored significantly (P＜0.05) in 15 severe pulmonary tuberculosis patients after receiving tuberculosis chemotherapy and microcalorie theropy for three months.Patients with positive sputum examination tended to have decreased Th1 and CD4~+/CD3~+ (P＞0.05) and significantly increased Th2 (P＜0.05).Conclusion:Immunosuppression existed,in different extents,in patients of infiltrative pulmonary tuberculosis,tuberculous pleurisy,miliary pulmonary tuberculosis as well as patients with both pulmonary tuberculosis and diabetes.Analysis of Th1,Th2 and CD4~+/CD3~+ may be benefit for the judgments of disease conditions and therapeutic effects.

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Objective To evaluate the application of high-resolution ultrasonography in the diagnosis of nerve root lesion of cervical vertebra intervertebral foramen part. Methods Twenty-seven patients with root avulsion injury of brachial plexus intervertebral part and 8 patients with schwannoma of brachial plexus root were examined with high-resolution ultrasonography. Thirty healthy volunteers were involved for the sonographic imagings of normal brachial plexus intervertebral part. The ultrasound findings of the patients before operation were compared with surgical outcomes. Results The normal intervertebral part of brachial plexus were shown as hypoechoic tubular strucuture, which could be identified with cervical artery and transverse process used as landmarks for the intervertebral part of brachial plexus root. The detection ratios of normal intervertebral part for C5-C8 and outside part of braehial plexus were 100％. In 27 patients with root avulsion injury of intervertebral brachial plexus, the intervertebral nerve root were enlarged as hypoechoic area, with nerve dissected partly or disappearing, distal nerve parts outside the intervertebral foramen swelling, edema,or cerebrospinal fluid assembling as cystic masses. In 8 patients with schwannoma of brachial plexus root part, the spinal ganglia outside intervertebral foramen were shown as tumor-like hypoechoic mass, with blood supply shown inside. Conclusions High-resolution ultrasonography is of great value for early and convenient diagnosis of root avulsion injury and mass of brachial plexus intervertebral part, especially in community hospitals,which could provide important information for clinical therapy.

Objective:To explore the effect of peer support system on social anxiety and resilience among new graduate nurses. Methods:Totally 36 new graduate nurses entry in 2014 who's Interaction Anxiousness Scale (IAS) score were ＞43 were selected as control group. Totally 39 new graduate nurses entry in 2015 who's IAS score were ＞ 43 were as experimental group. The control group accepted routine standardized training. The experimental group received peer support, which consisted on conduct group intervention and twining intervention (6 months). IAS and Connor-Davidson Resilience Scale(CD-RISC) were used to investigate the nurses'social anxiety and resilienceat 3 months and 6 months after intervention. The scores were analyzed by using repeated ANVOA Results: Repeated measures analysis of variance of IAS showed that, there were significant differences on the IAS scores for interaction between measure time and group processing (P ＜0.001). The differences between the two groups in the main effects of interaction and time on the total score of CD-Rescan its three dimensions score were all statistically significant (Ps ＜ 0.001). Separate analyses showed that at baseline, there was no significant difference between two groups in all variables (Ps ＞0.05). After 3 months and 6 months of intervention, the IAS scores were lower in the intervention group than in the control group (Ps ＜0.001), the CD-RISC total scores and the three dimensions scores were higher in the intervention group than in the control group (Ps ＜0.05). Conclusion: It suggests that the peer support system could improve the social anxiety and resilience of new graduate nurses.

Objective To investigate the common types of fetal cardiac malformations and complicated malformations,and to assess the value of classifying on these types.Methods 3201 pregnant women were undergone with fetal echocardiography (FECG),239 fetuses of them were diagnosed to be suffered with congenital heart disease(CHD),and 8 cases were one of twins with abnormal heart confirmed by FECG.All new-births were examined by echocardiography within half year after their births.Results 155 complex CHD in 239 fetuses were diagnosed by FECG,in them the common malformations were in turn 59 cases with diagnosed univentricular heart,29 cases with double outlet right ventricle,19 with atrio ventricular septum defect,12 with tetralogy of Fallot or quinalogy of Fallot,11 with persistent truncus arteriosus,6 with right ventricular dysplasia syndrome,6 cases transposition of the great vessels.100 cases were induced labor,41 of them were comfirmed by pathology.16 fetuses were born,123 cases were being pregnanted or un-followed up.Conclusions Complex and multi-malformation were common in fetal cardiocascular abnormalities.Diagnosing rate of fetal CHD(FCHD) in our enroll fetuses was 7.47 ％,rate of complex CHD vs CHD was 64.85 ％.According different types of FCHD,able to be operated or not after birth,surgery methods,as well as prognosis evaluations,all FCHD cases were classified into three subtypes:curable type,curable palliative type and untreatable type.This newly viewpoint will help pregnant women and their family to make reasonable selection.