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 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 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 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 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 construct a quality evaluation index system of pulmonary rehabilitation for lung cancer patients in order to supply reference for evaluation of rehabilitation quality for lung cancer patients.Methods:This research adopted Delphi technique of non-experimental study. A total of 25 experts were invited to participate 2 rounds of letter enquiry from January to April in 2022. Literature retrieval, group discussion and Delphi method were used to establish the evaluation system of pulmonary rehabilitation for patients with lung cancer based on the social ecology theory.Results:The recovery rates of the two rounds of expert correspondence were 84%(21/25) and 100%(21/21), respectively, the expert authority coefficient was 0.824, and the Kendall′s W value was 0.279 and 0.186, respectively, which were statistically significant ( χ2=409.57, 218.23, both P<0.05). The finally formed quality evaluation index system of pulmonary rehabilitation for lung cancer patients based on social ecology theory included 4 first-level indicators, 11 second-level indicators, and 42 third-level indicators. Conclusions:The evaluation system of pulmonary rehabilitation for lung cancer surgery patients constructed in this study has certain scientificity and practicability, and provides a reference for the continuous improvement of the quality of care for lung cancer patients in our country.

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.

Objective:To explore the distribution of integrons in Escherichia coli isolated from community patients with urinary tract infections and their relationship with the phylogenetic groups and antimicrobial resistance. Methods:From November 2015 to December 2018, 152 isolates of E. coli that collected without repetition from the urine samples of outpatients in nephrology of Fengxian District Central Hospital in Shanghai, were studied retrospectively. Bacterial identification and antimicrobial susceptibility analysis was carried out by Phoenix 100 automatic microbiological analyzer. Class 1, 2 integron integrase genes, variable regions of integrons and the phylogenetic groups of isolated E.coli were screened by PCR. The type of promoters and gene cassette arrays of variable regions were determined by sequencing. The relationship of intergon with the phylogenetic groups and antimicrobial resistance was also analyzed. Results:The resistance rate of 152 E. coli to ampicillin was 70.39% (107/152), and the resistance rates to other antibacterial drugs were all less than 40.00%. Among the 152 E. coli isolates, class 1 integron integrase gene intI1 was detected in 65 isolates (42.76%), 8 gene cassette arrays and 14 antimicrobial resistance gene cassettes were detected in 68 class 1 integrons. The most popular gene cassette array was dfrA17-aadA5 (51.47%, 35/68), while the variable regions of class 1 integrons were failed to detected in 12 intI1-positive isolates. Five variable region promoters were detected in 68 class 1 integrons, with the relative weak promoter PcH1 to be the most popular type (77.94%, 53/68). The gene cassette array arr- 2-cmlA5-bla OXA-10-aadA1 was also detected in this study. 65 intI1-positive isolates were mainly belonged to group B2 and D. The class 2 integron integrase gene intI2 was detected in 4 isolates (2.63%,4/152), and their variable region gene cassette arrays were all dfrA1-sat2-aadA1. Conclusions:Class 1 integrons were closely related to antimicrobial resistance in E. coli isolated from community patients with urinary tract infection. Most of the variable region promoters of class 1 integrons were relatively weak promoters. The distribution of each phylogenetic group in the intI1-positive isolates was consistent with the distribution of the overall isolates. The gene cassette array arr-2-cmlA5-bla OXA-10-aadA1 was detected in E. coli.

Objective:To investigate the effect of ethyl pyruvate on proliferation activity of vascular endothelial cells after heat stress.Methods:Human umbilical vein endothelial cells (HUVECs) were placed in incubators with different temperatures (39 ℃, 41 ℃, 43 ℃) for heat shock for 4 h, or placed into the incubator with the same temperature at 43 ℃ and received heat shock for different times (2 h, 3 h, 4 h), and the control group were always placed in 37 ℃ incubator. Then the morphological changes of the cells were observed under an inverted microscope, and the cell proliferation activity was detected by the cell counting - 8 (CCK-8) kit. According to the above experimental results, the optimal intervention temperature (43 ℃) and time point (4 h) of heat stress were selected. After that, ethyl pyruvate (EP) with a concentration of 10 μmol/L was used for intervention (HS+EP group), and the cell proliferation activity was detected by CCK-8.Results:With the increasing of the heat stress temperature or the extension of exposure time, the cell morphology gradually changed under the inverted microscope, and the cells in 43 ℃ incubator for 4 h was the most obvious; and the cell proliferation activity of HUVECs decreased gradually, and the most significant decrease occurred in the group that exposure for 4 h in 43 ℃ ( F=25.79, P < 0.001 vs. control group). In addition, the cell proliferation activity of HUVECs in the HS+EP group was significantly higher than that in the HS group ( P < 0.001). Conclusions:EP can reduce significantly the effect of heat stress on the proliferation activity of HUVECs, and help to alleviate the changes of vascular endothelial cell activity caused by heat stress.

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.