The resource limitation, ineffective utilization and severe waste generated during processing restrict the sustainable development of the Chinese herbal medicine industry. The main reasons lie in insufficient utilization of medicinal components as well as few and outdated technologies. Integration and optimization of serial technologies including pretreatment, extraction, conversion and waste treatment are the keys to solve these issues. In this article, the updated research progress and technology development of biorefinery engineering for herbal medicines are reviewed. Guided by multi-products oriental fractionation refining, Chinese herbal medicine refinery technical system is constructed relied on advanced refinery technology platforms.
Bioengineering ; Chemical Fractionation ; Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; chemistry ; Medicine, Chinese Traditional ; Plants, Medicinal

Objective To construct the nurse post management questionnaire which could suit the condition of our country such as Jiangsu province. So as to know the present situation of the cities in Jiangsu province and perfect the nurse job management mechanism by small-scale empirical study,which provides the basis for further advance the quality of nursing service. Methods Firstly,through the nurse position management guidance,to construct the first draft of the questionnaire on the basis of literature review,then carrying on two rounds of 15 expert consultation by Delphi technique. Secondly,to select different nurses,nurse managements from Jiangsu province expediently,who can take part in the small-scale survey. Results Two rounds of the recovery rate was 100%,Crs were 0.887 and 0.903. The basic content of post questionnaire was determined after two rounds of expert consultation. A total of 98 personnel were investigated in the empirical study. In terms of Jiangsu province,the differences and deficiencies of nurse management station were still exist,including settings and responsibilities, performance appraisal system,the training of nurses,job satisfaction,etc. Conclusions The research provides a comprehensive and effective tool to understand the nursing job management related issues. At present there are regional differences in nurse station management,fully reflecting the urgency and importance of further understanding and perfecting our work.

This article selected several typical clinical cases, analyzed many factors affect the doctor-patient relationship of ethical issues and new technology of differentiating the ethical dilemma for clinical application, and put forward some suggestions for the reference of medical staff , hospital ethics committees and health policy makers.

In recent years , with dramatic increase of the number of clinical studies , researchers and ethical committees face with the new challenge of ethical issues about protection of subjects .Based on the experience of previous ethical review , this article summed up a few typical cases of clinical research , involving the practical ethi-cal issues, such as the goal of research , informed consent, and compensation for damage caused by research .And then it analyzed the ethical issues in these cases , and proposed some suggestions for the reference of clinical re-searchers , ethical committees and policy makers .

Objective To measure osteoporosis knowledge,belief and self-efficacy of elderly patients with vertebral fracture,and to provide the basis for reducing the incidence of refracture.Methods Totally 72 patients were recruited from an upper first-class hospital in suzhou by using the convenience sampling method.They were measured with the self-designed general information questionnaire,Osteoporosis Knowledge Tests (OKT),Osteopomsis Health Belief scale (OHBS) and Osteoporosis Self-Efficacy Scale (OSES).Results The total score of knowledge was (1 1.06±6.71),the factor scores of risk factors,exercise and calcium intake were(4.13±2.82),(2.90±2.54),(4.04±2.54).The average score of OHBS was (141.82± 13.00).The total score of self-efficacy was (79.49±35.15).Conclusions Health education for elderly patients with vertebral fractures needs to be improved,and to reduce the occurrence of refracture according to different groups of targeted education.

Objective To investigate the application value of functional MRI in the differential diagnosis between breast mucinous carcinoma and phyllodes tumor(≥ 3 cm). Methods 55 cases of breast mucinous adeno-carcinoma and phyllodes tumors(≥ 3 cm)from January 2012 to December 2017 were retrospectively analyzed. MRI features of 20 mucinous carcinomas and 35 phyllodes tumors were analyzed,compared with pathology. Re-sults There were 20 cases of breast mucinous carcinoma in current study,including 14 cases of pure mucinous carcinoma and 6 cases of mixed mucinous carcinoma. There were 35 cases of phyllodes tumors,including 9 be-nign,18 borderline and 8 malignant cases. There was no significant difference in T1WI signal and enhancement mode between breast mucinous carcinoma and phyllodes tumors. There were significant differences in age,long di-ameter,morphology,lobulation,border,ADC value,EER,T2WI signal and TIC curve pattern(P < 0.05). The area under ROC(AUC)of ADC value and EER for breast mucinous adenocarcinoma and phyllodes tumor was 0.7036 and 0.8029,respectively. Conclusions Multi-model functional MRI can effectively distinguish breast mucinous adenocarcinoma from phyllodes tumor(≥ 3 cm),and EER is more accurate than ADC value.

Objective:To investigate the effect of diabetic retinopathy (DR) on macular edema (ME) after cataract phacoemulsification in diabetic cataract patients and its risk factors.Methods:A total of 170 diabetic cataract patients (170 eyes) who underwent cataract phacoemulsification in the department of ophthalmology, BenQ Medical Center Affiliated to Nanjing Medical University from June 2017 to June 2019 were selected. All patients underwent monocular cataract phacoemulsification. They were divided into DR group (100 cases) and non diabetic retinopathy group (NDR group, 70 cases) according to whether or not DR was combined. The improvement of visual acuity and fundus lesions were compared between the two groups, the correlation between the severity of DR and the incidence of macular fovea retinal thickness and ME was analyzed, and the risk factors of DR were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of diabetes course, vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) on ME.Results:Compared with NDR group, the DR group had better postoperative best corrected visual acuity (BCVA), larger area of vascular leakage and bleeding. The retinal thickness of fovea was significantly thickened, and the incidence of ME in DR group was significantly higher than that in NDR group (all P<0.05). The severity of DR was positively correlated with the retinal thickness of fovea and the incidence of ME (all P<0.05). The duration of diabetes, VEGF and IL-6 were independent risk factors for DR (all P<0.05). The best critical values for predicting me were 4.7 years, 127.82 pg/ml and 136.45 pg/ml, respectively. The combination of the three has higher diagnostic value. Conclusions:DR can accelerate the postoperative ME of diabetic cataract patients, and is positively correlated with the severity of DR. The duration of diabetes, VEGF and IL-6 are not only independent risk factors of DR, but also have high predictive value for the occurrence of ME.

Objective:To develop the Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients suitable for China, and to test its reliability and validity.Methods:Guided by the theory of knowledge, attitude and practice, a questionnaire framework was constructed, and the first draft of the Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients was formed through literature review, group discussion, semi-structured interview, Delphi expert consultation and pre-investigation. From June to August 2020, convenience sampling was used to select 120 osteoporosis patients admitted to the First Affiliated Hospital of Soochow University as the research object to conduct a questionnaire survey to test the reliability and validity of the questionnaire. A total of 120 questionnaires were distributed, 110 valid questionnaires were recovered, and the valid recovery rate was 91.67% (110/120) .Results:Among 2 rounds of Delphi expert consultation, the expert authority coefficients were 0.880 and 0.900, respectively, and the Kendall harmony coefficients were 0.308 and 0.332, respectively, with statistically significant differences ( P<0.01) . The Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients included two sub-questionnaire of knowledge and behavior, with a total of 19 items, including 10 items in knowledge and 9 items in behavior. Exploratory factor analysis showed that 2 common factors were extracted from the exercise knowledge sub-questionnaire, and the cumulative variance contribution rate was 60.712%. A total of one common factor was extracted for the exercise behavior sub-questionnaire, and the cumulative variance contribution rate was 72.075%. The content validity index of the total questionnaire and each sub-questionnaire were 0.925, 0.921, and 0.929, respectively, and the item-level content validity index of was 0.857 to 1.000. The Cronbach's α coefficients of the total questionnaire and each sub-questionnaire t were 0.935, 0.830, and 0.953, respectively, and the split-half reliability coefficients of the total questionnaire and each sub-questionnaire were 0.979, 0.898, and 0.974, respectively, and the test-retest reliability coefficients of the total questionnaire and each sub-questionnaire were 0.878, 0.813, 0.860, respectively. Conclusions:The Exercise Knowledge and Behavior Questionnaire for Osteoporosis Patients has good reliability and validity, and can be used to evaluate exercise knowledge and behavior in patients with osteoporosis.

In recent years, the incidence and detection rate of lung cancer have gradually increased, and segmentectomy has been increasingly used to treat early non-small cell lung cancer. Some scholars believe that segmentectomy is more conducive to the preservation of postoperative lung function than lobectomy. Some studies have found that the two surgical methods have little difference in postoperative cost retention. This article deals with segmentectomy and lobectomy. A review of related studies on postoperative pulmonary function changes.
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Humans ; Lung ; physiopathology ; surgery ; Lung Neoplasms ; physiopathology ; surgery ; Pneumonectomy ; adverse effects ; methods ; Recovery of Function

Objective:To explore the psychological experience of pregnancy termination among married and parous women with unintended pregnancy, so as to provide a reference for policy formulation and health care.Methods:From May to July 2021, 18 married and parous women who underwent artificial abortion in the Family Planning Clinic of the First Affiliated Hospital of Soochow University were selected as the interview subject by objective sampling. The in-depth interview was conducted using phenomenology research methods in qualitative research, and the themes were extracted using the Colaizzi 7-step analysis.Results:A total of 5 themes were extracted, namely, non-impulsive termination of pregnancy, the influence of marriage and reproductive customs and related policies, the responsibility of parenting and financial stress, pregnancy-related health concerns and discomfort, and women's social deprivation and role conflict.Conclusions:The reasons for termination of pregnancy in married and parous women with unintended pregnancy are complex. It requires the joint efforts of society, health care, family and couples to create a healthy and friendly reproductive environment.