Chronic heart failure （CHF） is a complex clinical syndrome that the cardiac output is not enough to meet the metabolic needs of the body， or depends on the increase of filling pressure to compensate. Its high morbidity and mortality pose a serious threat to human health， necessitating attention and active intervention. At present， western medicine treatment of CHF is mainly based on diuretics， intravenous vasodilators， intravenous positive inotropic drugs， etc.， which， however， have problems such as long medication cycles， serious side effects， and limited applicable population. Recent studies have shown that traditional Chinese medicine can act in a multi-pathway， multi-component， and multi-target manner， showing unique advantages in the prevention and treatment of CHF. Buyang Huanwutang has the effects of tonifying Qi， activating blood， and dredging collaterals. Clinical and mechanism studies have confirmed that this prescription is effective in treating CHF and its syndromes. The clinical studies can be classified into two categories. Studies of the first category use simple modern medical diagnostic criteria as the inclusion criteria for CHF patients， which can improve the scientificity and objectivity. Studies of the second category uses modern medicine combined with traditional Chinese medicine disease diagnostic criteria for the screening of CHF patients， which helps to improve the accuracy of efficacy evaluation. However， there are problems such as the lack of unified research standards and the insufficiency of mechanism research. In addition， the available studies remain to be classified or summarized. This study systematically sorted out the clinical and mechanism studies of Buyang Huanwutang in the treatment of CHF in recent years to review the research status. In clinical treatment， Buyang Huanwutang can be used alone， or modified， or combined with other prescriptions or Western medicine. The mechanism studies predict that Buyang Huanwutang can ameliorate CHF by regulating the calcium balance， protecting the mitochondrial structure and function， and regulating intestinal flora. This review aims to provide a theoretical basis and practical guidance for the clinical application and optimization and subsequent in-depth study of Buyang Huanwutang in the treatment of CHF.

Objective:To explore the association between the G71R polymorphism of the UGT1A1 gene and neonatal hyperbilirubinemia. Methods:DNA was extracted from blood samples of 61 neonates with severe neonatal hyperbilirubinemia(severe neonatal hyperbilirubinemia group), 60 neonates with hyperbilirubinemia(hyperbilirubinemia group) and 62 healthy neonates(control group), the G71R mutation of UGT1A1 gene was analyzed by direct sequencing. Results:In severe neonatal hyperbilirubinemia group, there were 17 cases of homozygous mutation(A/A), 23 cases of heterozygous mutation(A/G) , and 21 cases of wild type(G/G) , with 28.87% homozygous mutation rate and 37.70% heterozygous mutation rate.In neonatal hyperbilirubinemia group, there were ten cases of homozygous mutation(A/A), 28 cases of heterozygous mutation(A/G) and 22 cases of wild type(G/G), with 16.67% homozygous mutation rate and 46.67% heterozygous mutation rate.In the control group, there were nine cases of homozygous mutation (A/A), 28 cases of heterozygous mutation(A/G) and 25 cases of wild type(G/G), among which the homozygous mutation rate was 14.52% and the heterozygous mutation rate was 45.16%.The genotype frequency( χ2=4.14, P=0.38)and allele frequency( χ2=2.47, P=0.29)of G71R in severe neonatal hyperbilirubinemia group, neonatal hyperbilirubinemia group and control group were not statistically significant. Conclusion:The G71R polymorphism of the UGT1A1 gene may not be significantly correlated with the prevalence of neonatal hyperbilirubinemia.

OBJECTIVE To understan d the c urrent situation and feasibility of payment reform for TCM dominant diseases from the perspective of clinicians ，so as to provide reference for optimizing and improving the reform scheme. METHODS A questionnaire was designed by ourselves ，and a simple random sampling method was used to select clinicians from the pilot hospitals of payment reform for TCM dominant diseases in Guizhou province to conduct a face-to-face questionnaire survey. SPSS 20.0 software was used for statistical analysis. The single-factor analysis and ordered Logistic regression analysis of multi-factor were used to analyze the influential factors of reform feasibility. RESULTS A total of 420 questionnaires were distributed in this survey，and 413 valid questionnaires were recovered ，with an effective rate of 98.3％. Totally 86.0％ of the clinicians thought that it was feasible for the reform to be carried out in their hospitals ，and 81.8％ thought that the selected TCM dominant diseases in the pilot hospitals were reasonable. After the reform was carried out ，61.0％ and 58.8％ of clinicians indicated that the daily number of patients treated in their departments and their willingness to communicate with patients increased ，respectively；60.3％ indicated that the difficulties and obstacles encountered in the reform were the complexity and diversity of TCM diseases ，for the treatment of patients with integrated traditional Chinese and Western medicine ，which was difficult to use a unified disease and surgery code to correctly code ；76.3％ indicated that the greatest advantage of the reform implementation was the improvement of medical quality ，while 54.2％ indicated that the greatest disadvantage was the excessive restriction of doctors ’autonomy. The results of multi-factor ordered Logistic regression analysis showed that changes in treatment services （changes in readmission rate of patient），the reasonableness of the selection of TCM dominant diseases ，and whether to reduce medical costs ，improve doctor-patient relationship ， and promote hierarchical treatment were the influential factors of reform feasibility after the implementation of reform （P＜0.05）. CONCLUSIONS It is feasible to carry out payment reform for TCM dominant diseases in Guizhou province ，but it is still in the exploratery stage ，and there are many factors affecting the feasibility of the reform. It is suggested that in the future ，when promoting in the whole pr ovince and even the whole c ountry，we should pay attention to selecting more and more reasonable dominant diseases for payment reform ， further standardize the diagnosis and treatment behavior of clinicians ， control the unreasonablegrowth of medical expenses ， strengthen communication between clinicians and patients， improve the accurate diagnosis rate of traditional Chinese medicine diseases ，implement hierarchical calculation of dominant diseases ，and promote hierarchical diagnosis and treatment of medical institutions.

Objective To explore a multi-dimensional nursing post performance management system based on hospital development as the objective and workload account as the foundation. Methods A total of 1 321 nursing staff in the nursing post of Changzhou Second People's Hospital Affiliated to Nanjing Medical University was selected as the study object, to observe the effect of the nursing performance appraisal team formally established in our hospital since November 2015 on nursing performane, the nursing department, the management office, etc departments jointly developed the nursing performance allocation principle, program and allocation method, the hospital resource planning (HRP) system, hospital information system (HIS) and self-made questionnaire were used to collect data, and the changes of various indexes before implementation of performance reform (from December 2014 to November 2015) and after implementation of performance reform (from December 2015 to November 2016) were compared and analyzed; the indexes were as follows: average monthly business income, average monthly nursing income, annual clinical non-receivable consumables expenditure, nursing human resources flexible allocation rate, nurses' degree of satisfaction with performance (remuneration and paying score, performance assessment system score) and qualified rate of nursing care quality. Results After the implementation of performance reform, average monthly business income, the average monthly nursing income, nursing human resources flexible allocation rate, compensation, paying scores and performance appraisal system scores were significantly higher than those before the implementation of performance reform [average monthly business income (ten thousand yuan): 13 653.24±1 309.49 vs. 11 869.26±991.16, average monthly nursing income (ten thousand yuan): 264.2 (252.1, 269.7) vs. 88.5 (80.8, 95.2), the ratio of nursing human resources flexible allocation rate: (1.74±0.52)% vs. (0.43±0.23)%, compensation and payment score: 4.76 (4.62, 4.85) vs. 3.47 (3.12, 3.60), performance appraisal system score: 4.88 (4.78, 4.95) vs. 2.80 (2.70, 3.14)], the difference was statistically significant (all P < 0.05), the annual clinical non-receivable consumables expenditure was decreased significantly compared with those before implementation performance reform (million yuan: 1.88±0.21 vs. 2.62±0.14, P < 0.05), and the qualified rate of nursing quality after performance appraisal were significantly improved compared with those before performance appraisal [nursing grading: (97.83±1.90)% vs. (91.11±1.61)%, ward management: (96.64±2.90)% vs. (90.06±2.40)%, nursing writing: (97.30±2.51)% vs. (91.33±1.96)%, nursing safety: (97.40±2.67)% vs. (90.13±1.96)%, first aid items: (97.44±2.64)% vs. (92.27±2.56)%, perioperative period: (96.86±2.50)% vs. (90.83±3.06)%, blood transfusion quality: (97.51±2.21)% vs. (92.13±2.37)%, disinfection and isolation: (97.43±2.70) % vs. (88.50±2.57)%, basic operation: (93.48±2.22)% vs. (87.51±2.03)%, practical ability: (93.38±1.97)% vs. (85.85±2.58)%, all P < 0.05]. Conclusion The establishment and application of the new performance management system mobilizes the enthusiasm of the department to actively control costs and decrease the expenditure of non-chargeable consumables, the nursing management staff can more flexibly arrange human resources and exert the management potential of middle-level cadres, and the nurses' degree of satisfaction and the nursing quality are significantly higher than those before nursing performance reform.

Objective To study the effects of pravastatin sodium on the release and activity of neutrophil elastase ( NE) in human neutrophile granulocyte induced by lipopolysaccharide( LPS) . Methods Human neutrophile gran-ulocyte were isolated by Ficoll density gradient centrifugation, neutrophils and intracellular azurophilic granules were identified by myeloperoxidase( MPO) staining, LPS stimulated degranulation of neutrophils. The MPO activity in the supernatant was measured by colorimetric assay to determine the appropriate stimulus time and concentration, and neutrophil was treated with pravastatin sodium after LPS stimulation. ELISA mothed was used to detect the cell culture supernatant of NE content and NE activity was detected by colorimetric method. Results The content and activity of NE in the supernatant were significantly increased after LPS stimulation. The NE in the supernatant of the cells treated with pravastatin was significantly lower( P＜0.05) . Conclusion Pravastatin sodium can reduce neutrophil degranulation induced by LPS stimulation and decrease the release and activity of NE.

Objective: To investigate the reproductive health status of female workers in petrochemical industry, and to provide a reference for improving reproductive health status and developing preventive and control measures for female workers in petrochemical industry. Methods: A face-to-face questionnaire survey was performed from January to October, 2016. The Questionnaire on Women's Reproductive Health was used to investigate the reproductive health of female workers in petrochemical industry. The multivariate logistic regression model was used to identify the influencing factors for reproductive health of female workers in petrochemical industry. Results: Among the 7485 female workers, 1 268 (40.9%) had abnormal menstrual period, 1 437 (46.4%) had abnormal menstrual volume, 177 (28.5%) had hyperplasia of mammary glands, and 1 807 (24.6%) had gynecological inflammation. The reproductive system diseases in female workers in petrochemical industry were associated with the factors including age, marital status, education level, unhealthy living habits, abortion, overtime work, work shift, workload, video operation, occupational exposure, positive events, and negative events, and among these factors, negative events (odds ratio[OR]= 1.856) , unhealthy living habits (OR=1.542) , and positive events (OR=1.516) had greater impact on reproductive system diseases. Conclusion Many chemical substances in the occupational environment of petrochemical industry can cause damage to the reproductive system, which not only affects the health of the female workers, but also poses potential threats to the health of their offspring. Occupational exposure, unhealthy living habits, overtime work, and work shift have great influence on reproductive system diseases in female workers.

Objective To study influence of hospital-community-family integrated nursing model for patients with coronary heart disease based on Omaha system under the " Nightingale + " era.Methods A total of 90 coronary heart disease patients were selected as research objects,and were divided into observation group and control group according to digital table method,with 45 cases per group.The control group implemented traditional nursing,while observation group implemented hospital-community-family integrated nursing model based on Omaha system under the " Nightingale +" era.Results The observation group had higher compliance,quality of life after discharge than the control group (P ＜ 0.05).The incidence rates of primary and secondary cardiovascular adverse events were lower than that in the control group (P ＜ 0.05).Conclusion Hospital-community-family integrated nursing model for patients with coronary heart disease based on Omaha system is feasible,and can enhance compliance after discharge coronary heart disease patients,improve the quality of life,reduce the incidence rate of cardiovascular adverse events.

Objective To study influence of hospital-community-family integrated nursing model for patients with coronary heart disease based on Omaha system under the " Nightingale + " era.Methods A total of 90 coronary heart disease patients were selected as research objects,and were divided into observation group and control group according to digital table method,with 45 cases per group.The control group implemented traditional nursing,while observation group implemented hospital-community-family integrated nursing model based on Omaha system under the " Nightingale +" era.Results The observation group had higher compliance,quality of life after discharge than the control group (P ＜ 0.05).The incidence rates of primary and secondary cardiovascular adverse events were lower than that in the control group (P ＜ 0.05).Conclusion Hospital-community-family integrated nursing model for patients with coronary heart disease based on Omaha system is feasible,and can enhance compliance after discharge coronary heart disease patients,improve the quality of life,reduce the incidence rate of cardiovascular adverse events.

Objective To investigate the effect of inhaled pravastatin on the acute inflammation of lung in smoked rats.Methods 32 male SD rats were randomly divided into four groups(n=8 per group),as the controls,cigarette-smoking exposure group,saline or pravastatin treatment groups.The rats in the control group were treated routinely,the other groups were exposed to cigarette smoking for one week.Rats in saline or pravastatin group were treated with saline or pravastatin inhalation respectively.During smoking exposure period rats were weighted before and after the treatment,executed at day eight,blood,bronchoalveolar lavage fluid(BALF),and lung tissue were collected.The morphological alternations of lung tissue were observed.Total cell numbers in BALF were counted.Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of serum IL-10 and IL-17 content.Results The increase of body weight of smoke-exposed rats were less than that of the controls.In smoking-exposed rats,acute inflammatory changes were remarkable in the lung.The total cell numbers in BALF and levels of IL-10 were increased significantly(P<0.05).These changes were mitigated in pravastatin treated rats and an IL-10/IL-17 rebalance was observed.Conclusion Inhalation of pravastatin sodium has a certain inhibitory effect on cigarette smoke-induced acute lung inflammation in rats.

Objective To study the postpartum pelvic floor rehabilitation on the improvement of pelvic floor electrical physiological indexes and the prevention of female pelvic floor dysfunction in China. Methods A multicenter prospective randomized controlled study was carried out. From October 2011, postpartum women in five provinces were randomly assigned into treatment group and control group. The women in treatment group received electrical stimulation and biofeedback treatment. The women in control group performed pelvic floor muscle exercise at home. When 6 months and 12 months after delivery, comparing two groups of patients with pelvic floor electrical physiological indexes and pelvic organ prolapse quantitation measurements (POP-Q), to evaluate the effect of postpartum pelvic floor rehabilitation on the prevention of pelvic floor dysfunction. Pelvic floor impact questionnaire short form (PFIQ-7) and pelvic organ prolapse/incontinence sexual questionnaire-12 (PISQ-12) were used to evaluate the influence on quality of life and sexual life. Results Until June 2013, 324 women were participated, 124 in control group, 200 in treatment group. According to the baseline results, there was statistical significance in the results of pelvic floor electrical physiological indexes between the treatment and control groups in postpartum 6 months and 12 months; the proportion above level Ⅲ of type Ⅰ and type Ⅱ muscle fibers strength in the treatment group, it was from 41.5% (83/200) and 40.5% (81/200) to 76.3% (145/190) and 79.5% (151/190) in postpartum 6 weeks and postpartum 6 months, increased to 80.6%(58/72) and 80.6%(58/72) in postpartum 12 months, improved significantly comparing with the control group (P<0.01). According to Point Aa, treatment group and control group in the postpartum 6 weeks was (-2.2 ± 0.7) versus (-2.4 ± 0.6) cm, in postpartum 12 months (-2.5 ± 1.1) versus (-2.7 ± 0.6) cm, the improvement in treatment group was statistically significant (P<0.01). And the other points were not significantly different (P>0.05). There was no significant difference in the questionnaires in quality of life and quality of sexual life (P>0.05). Conclusion Neuromuscular electrical stimulation and biofeedback therapy in the early postpartum period could obviously improve pelvic floor electrical physiological indexes, and is beneficial to prevent the pelvic floor dysfunction.