Objective To observe the effect of Tongfu Xiere Recipe (TXP) combined with routine treatment on cytokine level in patients with acute lung injury due to surgery disease of chest. Methods Fifty eight patients with acute lung injury due to surgery disease of chest were randomized into two groups. The two groups received routine treatment subjecting to the Guideline (2006) for Diagnosis and Treatment of Acute Lung Injury/Acute Respiratory Distress Syndrome. The treatment group additionally received TXP (mainly composed of Radix et Rhizoma Rhei, Natrii Sulfas, Fructus Gardeniae, Caulis Lonicerae, Herba Taraxaci, Semen Raphani, Semen Lepidii seu Descurainiae, Rhizoma Polygoni Cuspidati, Radix Paeoniae Rubra, Fructus Aurantii Immaturus, and Cortex Magnoliae Officinalis) for 5 days or till oxygenation index recovered to the normal. The therapeutic effect was evaluated after treatment, and the changes of blood tumor necrosis factor ? (TNF-?), interleukin 6 (IL-6) and interleukin 8 (IL-8) levels were observed before and after treatment. Results The serum levels of TNF-?, IL-6 and IL-8 in the two groups after treatment were decreased (P0.05). Conclusion The therapeutic effect of traditional Chinese medicine integrated with western medicine is superior to the western medicine only for acute lung injury due to surgery disease of chest. TXP can regulate the immune function and relieve the pulmonary inflammation and injury by decreasing the blood levels of TNF-?, IL-6 and IL-8, thus enhance the therapeutic effect of western medicine.

Objective The study aimed to investigate the influence of head nurse's transformational leadership style on emotional labor and psychological empowerment of nurses.Methods Totally 851 staff nurses from four 3A hospitals were investigated with the Transformational Leadership Style Sub Scale of Multifactor Leadership Questionnaire,Psychological Empowerment Scale and Emotional Labor Scale.Results The head nurse's transformational leadership style scored (2.41±0.81).The psychological empowerment of nurses scored (3.27±0.47),its autonomy dimension scored (3.81±0.50),staying at medium level.The emotional labor of nurses scored (3.68±0.61),its deep acting dimension scored (4.67±0.76),which was above medium level.The indirect correlation coefficient between head nurse's transformational leadership style and emotional labor (r=-0.13) was far higher than direct correlation coefficient (r=-0.04).The psychological empowerment was the full mediation variable by which head nurse's transformational leadership style influence emotional labor of nurses.Conclusions Head nurse's transformational leadership style can enhance nurse's selfefficacy,cognition of work significance and work autonomy,so that nurse's deep acting and positive perception of emotional display can be increased,and nurse's emotional exhaustion and job burnout can be decreased to retain nurses.

ObjectiveTo study the clinical efficacy of Kegel on fecal incontinence in patients with anal endoscopic microsurgery.Methods Totally 60 patients with anal endoscopic microsurgery were randomly selected by purpose sampling method from October 2013 to June 2016,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group. Patients in the control group received routine care,while patients in the observation group was trained by Kegel exercises before and after surgery. Incidence of fecal incontinence,anal function excellent rate and duration of fecal incontinence were observed and compared between two groups.Results The incidence rate of fecal incontinence in the observation group was 3.3%(1/30),while that of the control group was 23.3% (7/30) (P=0.052). The postoperative duration of fecal incontinence in the observation group was (3.3±0.5) d,while that of the control group was (5.3±2.4) d (t=4.468,P<0.05). Four days after surgery,the number of patients with good anal function in evaluation in the observation was 28,while that of the control group was 22 (Z=-2.020,P<0.05). ConclusionsKegel exercises before and after anal endoscopic microsurgery can effectively improve patients' anal function and shorten the duration of fecal incontinence. This method is simple,practical and can be widely used.

OBJECTIVETo investigate the risk factors for contact dermatitis in pig farm workers.

METHODSThe cross-sectional questionnaire survey and on-site survey were conducted in pig farms raising more than 50 pigs in a county of Fujian Province, China. The study subjects were grouped based on different factors. The incidence rate was compared between groups by statistical analysis.

RESULTSOf 302 subjects, 70 (23.18%) had contact dermatitis. There was a significant difference in the prevalence of contact dermatitis between the subjects in direct contact with commercially available pannage and those in indirect contact (χ(2) = 14.552, P < 0.01). Region, season, farm scale, brand of pannage, and allergic history were not influential factors for contact dermatitis (P > 0.05 for all).

CONCLUSIONDirect contact with commercially available pannage is closely associated with contact dermatitis in pig farm workers.

Adolescent ; Adult ; Aged ; Agriculture ; China ; epidemiology ; Cross-Sectional Studies ; Dermatitis, Contact ; epidemiology ; Dermatitis, Occupational ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Young Adult

Taking the reform of payment methods based on diagnosis related groups as an opportunity, implementing performance management based on disease groups is an important lever to promote the improvement of hospital diagnosis and treatment level and high-quality development. In 2023, a tertiary comprehensive hospital introduced benchmarking management into performance management, using the average days of stay, drug costs, and consumables costs of the disease group as cost benchmark indicators. The cost benchmark values for each disease group was determined based on the big data of the disease group of the tertiary comprehensive hospital in the region and the clinical pathway management goals of the hospital. Through multidimensional and multi-level comparative analysis of the hospital′s historical values and regional big data distribution values of the benchmark indicators for each disease group, the cost benchmark values for each disease group was determined. The hospital has established a performance reward and punishment mechanism based on the benchmark value of disease group costs, and at the same time, established a performance management communication mechanism to promote relevant departments and medical groups to improve their management against the benchmark. In addition, with changes in the external environment and internal practices, the cost benchmark value of the disease group was dynamically optimized, forming a closed-loop management system that included establishing benchmarks, comparing benchmarks, achieving benchmarks, and optimizing benchmarks. Since the implementation of performance management based on disease group cost benchmarking in March 2023, the hospital′s case mix index has increased from 1.52 in March to 1.54 in September; The average days of stay decreased from 6.22 days to 5.90 days; The monthly payment weight has increased from 18 103 to 18 558; The average hospitalization cost has decreased from 16 724 yuan/person to 15 278 yuan/person, mainly due to the decrease in drug and consumables costs. The proportion of drug costs has decreased from 27.45% to 26.32%, the proportion of consumables costs has decreased from 28.75% to 26.85%, and the proportion of medical service revenue has increased from 24.64% to 26.08%; The proportion of low magnification cases decreased from 9.09% to 8.24%; The medical insurance payment rate has increased from 99.3% to 107.0%; The job satisfaction of physicians has increased from 70.00% in 2022 to 76.77% in 2023, which can provide reference for performance management practices in other hospitals.