Objective To explore the correlations between trustworthiness leadership of head nurses and work immersion. Method A questionnaire on trustworthiness leadership of head nurse and the nurses′ work immersion scale were used to have investigation among 460 nurses. Results The total score on trustworthiness leadership was (105.04 ± 13.78), which was in the middle level and the total score on work immersion was (41.28 ± 10.08), which was at a higher level. The trustworthiness leadership was positively related to their work immersion as well as its dimensions (all P<0.05). Conclusion The administrators of the hospitals and nursing managers should pay attention to head nurse′s trustworthy leadership , for the purpose of improving the integrity of the leadership behavior of head nurses.

Objective To observe the effect of nitric oxide (NO) on exflagellation of malaria parasite. Methods The level of parasitemia and gametocytemia in DBA/2 mice infected with Plasmodium yoelii 17XL was measured by scanning Giemsa-stained blood smears, and the NO level in culture supernatant of splenocytes was checked using Griess reaction. The mice were injected with different doses of NO donor (NOC5) on day 4 post-infection, and control mice were injected with NOC5 precursor. On day 6 post-infection, mice were injected with NOS inhibitor (L-NMMA), and control mice were injected with D-NMMA and PBS, respectively. Blood samples were collected from tail vein of mice before injection, 30 and 60 min after being injected with NOC5 and NOC5 precursor, 4 and 8 h after being injected with L-NMMA, D-NMMA, and PBS respectively. Exflagellation number of gametocytes in blood culture was counted under microscope. Results The NO level in culture supernatant of splenocytes from mice on day 4 and 6 post-infection was 16.5 mmol/L and 30.4 mmol/L, and exflagellation number was 11.33 and 0.66, respectively. The number of exflagellation in parasitized erythrocytes, obtained from mice on day 4 post-infection, was 5.33 and 2.66, respectively, 30 and 60 min after injection of 1 mg NO donor (NOC5), significantly lower than that of the control (P

OBJECTIVE:To optimize the purification technology of total alkaloid from the flos of Aconitum kusnezoffii. METH-ODS:The content of total alkaloid from the flos of A. kusnezoffii was determined by acid-base titration. The purification technology of total alkaloid from the flos of A. kusnezoffii was optimized by ion resin with resin type,mass concentration of loading liquid and exchange speed as factors,maximum adsorption quantity,desorption rate and mass fraction of total alkaloid as index,and verifica-tion test was conducted. RESULTS:The optimal purification technology was as follows as type 732 cation exchange resin,mass concentration of loading liquid 0.32 g/L,exchange speed of 7 column volume(BV)/h. In validation test,the content of total alka-loid was 86.88%(RSD=0.52%,n=3),and desorption rate was 92.81%(RSD=0.40%,n=3)averagely. The extraction trans-port rate of total alkaloid from 3 batches of the flos of A. kusnezoffii was 81.76% and purification transport rate was 89.47% in av-erage. CONCLUSIONS:The established method is stable and feasible,and shows high transport rate.

Objective Hirsutella sinensis (HS) is the anmorph of Ophiocordyceps sinensis (Cordyceps sinensis). O.sinensis and Panax notoginseng are two popular Chinese herbs, commonly used in traditional Chinese prescriptions for the treatment of various diseases. A combination of HS extract with P. notoginseng saponin (PNS) extract demonstrated more prominent lung-protective activity than the two herbs individually used in our preliminary studies. This study further investigated the action of their combination (HSPNS) on anti pulmonary fibrosis using a Bleomycin (BLM)induced mouse model. Methods BLM-treated Kunming mice was given HSPNS daily for 7, 14 or 28 d via ig administration. After treatment, following parameters were monitored using proper methods, respectively. Lung index, serum and lung malondialdehyde (MDA) and hydroxyproline (HYP) contents, lung superoxide dismutase (SOD) activity, transforming growth factor β1 (TGF-β1), and expression levels of collagen Ⅰ (Col- Ⅰ) and collagen Ⅲ (Col-Ⅲ). The lung biopsies were also dissected for semiquantitative histological analysis. Results The results indicated that HSPNS significantly reduced lung index, MDA and HYP contents, and expression levels of TGF-β1,Col- Ⅰ, and Col-Ⅲ. The combination also remarkably enhanced SOD activity compared with BLM-induced group.Moreover, the severe pulmonary fibrosis histopathological changes induced by BLM could be attenuated by HSPNS treatment. Conclusion These results suggest that HSPNS could significantly inhibit the progression of pulmonary fibrosis induced by BLM and its inhibitory effect might associate with its ability to scavenge free radicals, decrease TGF-β1 level, and inhibit collagen synthesis.

Objective To investigate the current status of subjective well-being in patients with coronary heart disease (CHD) undergoing Percutaneous Coronary Interventions and its influence factors. Methods Totally 140 cases of coronary heart disease undergoing percutaneous coronary interventions were investigated with the general information questionnaire, General Well-being Scale, Self-rating Anxiety Scale and Self-rating Depression Scale, and analyzed the influence factors of subjective well-being. Results There were patients whose subjective well-being scores were lower than the average of Chinese norm among the 140 CHD patients,which took a proportion of 75.71%(106/140).The subjective well-being score in male patients was 73.33±6.43,which was lower than 75.00±15.00 of the Chinese norm (t=-2.112,P<0.05).The subjective well-being score in female patients was 65.15±8.32,which was lower than 71.00 ± 18.00 of the Chinese norm (t=-5.981, P<0.01); the self-rated health status and anxiety disorder were the main factors of subjective well-being in coronary heart disease undergoing Percutaneous Coronary Interventions patients. Conclusions The subjective well- being of patients with CHD undergoing percutaneous coronary interventions is poor; the society and family should give them much enough care and support, and effective psychological intervention measures should be taken to improve their subjective well-being.

Objective To explore the significance of long non-coding RNA (lncRNA) taurine up-regulated gene 1 (TUG1) in hepatocellular carcinoma (HCC),to predict the target gene of TUG1,and to provide a ref-erence for further study of TUG1 in HCC.Methods The differential expression of TUG1 in HCC was ana-lyzed by using the UALCAN database and the survival analysis of TUG1 was performed.The target gene of TUG1 was predicted by RegRNA 2.0 biology software,HMDD,targetscan and microT-CDS,and the regulato-ry network of lncRNA TUG1-microRNAs-mRNAs was constructed.The predicted target gene was analyzed by Gene Ontology (GO) and KEGG signal transduction pathway enrichment by using FunRich platform. Results TUG1 expression in HCC was significantly increased,and the expression level of TUG1 increased generally with the increase of tumor grade.The overall survival of patients with low expression of lncRNA TUG1 was significantly longer than that of lncRNA TUG1 high expression patients.There were four possible binding sites of HCC related microRNAs (hsa-mir-122-5p,hsa-mir-200a-3p,hsa-mir-34c-3p,hsa-mir-629-3p) on TUG1,which regulated 245 downstream target genes and formed the regulatory network of lncRNA TUG1-microRNAs-mRNAs.In the biological process,microRNA target genes were highly enriched in the processes such as the regulation of nucleobase,nucleoside,nucleotide and nucleic acid metabolism.In KEGG pathway analysis,microRNA target genes were highly enriched to the signal pathways mediated by Syndecan and TRAIL.Conclusion TUG1 expression level in HCC increased.Increased expression of TUG1 is associat-ed with poor prognosis in HCC.Bioinformatics methods can be used to explore the mechanism of tumorigene-sis from the molecular level,which can provide valuable information for subsequent experiments and clinical diagnosis and treatment.

Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.

Objective:To design and develop an unplanned extubation clinical decision support system, aiming to provide a reference for nurses' clinical decision-making.Methods:Through literature review and expert consultation, the knowledge base of the clinical decision support system for unplanned extubation was constructed, and the system function and interface were designed.Results:The authoritative coefficients of the two rounds of expert consultation were 0.853 and 0.867, respectively, and the Kendall ′s W were 0.458 and 0.492, respectively. The final built knowledge base included catheter evaluation module, unplanned extubation evaluation module, and knowledge reasoning rule module. At present, the knowledge base had sorted out 48 first-level items, 9 second-level items, 72 third-level items in the catheter evaluation module, and 5 first-level items, 12 second-level items, and 73 third-level items in the unplanned extubation evaluation module. Entry, 40 knowledge reasoning rules. Conclusions:The clinical decision-making system for unplanned extubation has changed the implementation of unplanned extubation risk early warning, optimized the management process, and realized the interaction of the hospital system. It can conduct dynamic unplanned extubation risk assessment based on individualization and assist nurses Make clinical decisions and promote the safety of nursing management.

Immune checkpoint inhibitors (ICIs) targeting CTLA-4 and PD-1 /PD-L1 are increasingly used to treat several types of cancer.Although several agents have been approved,only 10％ to 30％ of patients have benefited from them.Some studies have shown that intestinal micro-ecology can affect the outcome of ICIs through immune regulation in cancer patients.This literature review s summarized the regulation and predictive functions of intestinal micro-ecology on ICIs treatment,and introduced possible mechanisms of intestinal micro-ecology that affacted the efficacy of immunotherapy.In addition,some approaches for detecting gut microbiome were also summarized.Gut microbiota highlighted in this review may serve as novel biomarkers to predict clinical outcomes in cancer patients.

Objective To investigate the distribution of integrons in clinical isolates of carbapen-em-resistant Acinetobacter baumannii and their relationships to bacterial resistance to antimicrobial agents.Methods A total of 115 carbapenem-resistant Acinetobacter baumannii strains were isolated from clinical samples of patients from January to October, 2017. Phoenix 100 automatic microbiological analyzer was used for antimicrobial sensitivity analysis. Classes 1 and 2 integrase genes and carbapenemase-encoding genes, bla IMP , blaVIM , blaKPC , blaNDM and blaOXA-23 , were screened by PCR. The variable regions of integrons were amplified by long fragment PCR. The types of promoters and gene cassette arrays of variable regions were de-termined by sequencing and overlap PCR. Relationships between integrons and antimicrobial resistance were analyzed. Results The 115 isolates of carbapenem-resistant Acinetobacter baumannii were resistant to most commonly used antimicrobial agents, but sensitive to polymyxin E. All of the isolates carried blaOXA-23 gene and none of them were positive for blaIMP , blaVIM , blaKPC or blaNDM gene. Class 1 integrase gene intI1 was de-tected in 40 isolates (34. 8％ ), while class 2 integrase gene intI2 was not detected. Two gene cassette ar-rays of variable regions, aacA4-catB8-aadA1 (39 isolates) and aacC1-gacP-gacQ-aadA1a (23 isolates), were detected in intI1-positive isolates. Twenty-two isolates carried both aacA4-catB8-aadA1 and aacC1-gacP-gacQ-aadA1a. The upstream promoters of the variable regions were relatively strong promoters, PcH2 and PcS. The gene cassettes of the variable regions endowed bacteria with resistance to chloramphenicol and aminoglycoside antibiotics. The resistance rate of class 1 integron-positive isolates to compound sulfamethox-azole was higher than that of negative strains. However, their resistance rate to ampicillin/sulbactam was lower than that of negative strains. Conclusions Antimicrobial resistance in carbapenem-resistant Acineto-bacter baumannii was serious. Carbapenem resistance was associated with blaOXA-23 gene. The types of pro-moters of variable regions in class 1 integrons were all relatively strong promoters. Class 1 integrons were closely related to sulfonamides resistance.