Objective:To explore the efforts of applying mindfulness stress reduction therapy in alleviating stress reactions and burnout among head nurses in the context of the Coronavirus disease 2019 (COVID-19).Methods:This was a quasi experimental study. In June 2021, 109 head nurses with mild or above burnout measured by Maslach Burnout Inventory (MBI) from 12 hospitals in Zhangjiagang City were selected as the research objects to implement mindfulness-based stress reduction therapy for 8 weeks, and the scores of the Five Facet Mindfulness Question-naire (FFMQ), Stress Response Questionnaire (SRQ) and MBI of the head nurses were compared before and after the intervention.Results:The five dimensions of observation, description, perceived action, non-judgment, and non-response and the total scores of the FFMQ were (26.28 ± 1.32), (26.94 ± 1.29), (25.49 ± 0.99), (25.45 ± 1.05), (23.48 ± 1.01), and (127.63 ± 3.78) of the post-intervention, which were higher than the pre-intervention scores of (25.04 ± 1.37), (25.04 ± 1.37), (25.37 ± 1.18), (24.15 ± 1.00), (24.09 ± 0.98), (22.26 ± 1.04), and (120.90 ± 4.06), with statistically significant differences ( t values were -39.21- -15.36, all P<0.01). The three dimensions of emotional, somatic, and behavioral responses and total scores of the post-intervention SRQ were (27.70 ± 6.12), (20.75 ± 4.20), (15.19 ± 3.11), and (65.99 ± 12.43), respectively, lower than the pre-intervention scores of (29.19 ± 6.91), (21.86 ± 5.20), (16.48 ± 4.16), and (70.12 ± 15.97), with statistically significant differences ( t values were 5.70-9.33, all P<0.01); the scores of dimensions of emotional exhaustion and depersonalization in post-intervention MBI were (26.24 ± 4.60) and (5.96 ± 1.25), lower than the pre-intervention scores of (29.66 ± 6.02) and (6.90 ± 1.59). The post-intervention scores of personal fulfillment (32.37 ± 5.02), higher than the pre-intervention scores of (28.60 ± 6.04), all with statistically significant differences ( t=15.36, 13.50, -9.65, all P<0.01). Conclusions:The implementation of mindfulness stress reduction therapy for the head nurses can relieve their work pressure due to the prevention and control of the COVID-19 epidemic, reshape their healthy psychology, and reduce job burnout.

Objectives:To explore the prognostic factors of primary central nervous system lymphoma(PCNSL) and to analyze the efficacy of different treatment methods.Methods:Clinical data of 4 812 patients with PCNSL in SEER database from January 1975 to December 2016 were retrospectively analyzed.Among them, 2 831 were male and 1 981 were female, the ratio of male to female was 1.4∶1.0.There were 2 236 cases(46.47%) under 60 years old, 1 718 cases(35.70%) aged 60 to 74 years old, and 858 cases(17.83%) aged 75 years old or above. Two thousand four hundred and seventeen cases(50.23%) had supratentorial tumors, 299 cases (6.21%) had infratentorial tumors, and 554 cases(11.51%) had multiple brain tumors, 1 542 cases (32.04%) were other or unspecified location.Three thousand five hundred and thirteen cases(73.00%) had diffuse large B-cell lymphoma (DLBCL), 234 cases(4.86%) had non DLBCL, 1 065 cases (22.13%) had other or unspecified types of tumor.The treatment included 2 011 cases (41.77%) of biopsy, 61 cases (1.27%) of subtotal resection(STR), 54 cases (1.12%) of gross total resection(GTR), 2 384 cases (49.54%) of biopsy and chemotherapy, 159 cases (3.30%) of STR and chemotherapy, 144 cases (3.00%) of GTR and chemotherapy.Univariate and multivariate Cox regression models were used to analyze the prognostic factors affecting the overall survival of the patients.Fine-Gray test and competitive risk model were used to analyze the prognostic factors affecting cancer-specific survival.Kaplan-Meier method and Log-rank test was used for survival analysis.Results:Univariate and multivariate Cox regression analyses showed that age, race, marital status, tumor site, pathological subtype, surgery, chemotherapy, combined with other malignant tumors, and HIV infection were the independent prognostic factors affecting the overall survival of PCNSL patients.The results of Fine-Gray test and competitive risk model analyses showed that age, race, marital status, tumor location, pathological subtype, surgical method, chemotherapy, combined with other malignant tumors, and HIV infection were independent prognostic factors affecting cancer-specific survival, while gender and radiotherapy had no significant correlation with cancer-specific survival.Compared with biopsy, PCNSL patients may benefit from surgical resection (STR: HR=0.805, 95% CI:0.656?0.989, P=0.04; GTR: HR=0.521, 95% CI:0.414?0.656, P<0.01).Kaplan-Meier survival analysis showed that the median survival time of biopsy+chemotherapy group was 28 months (95% CI:24.497?31.503), 2 months (95% CI:1.756?2.244) in the biopsy group, 2 months (95% CI:1.410-2.590) in the STR group, 19 months ( 95%CI:0?39.311) in the biopsy+chemotherapy group, 67 months (95% CI:46.187-87.813) in the STR+chemotherapy group, 84 months (95% CI:57.448?110.552) in the GTR+chemotherapy group.The median survival time of patients with different treatment methods was statistically significant ( P<0.01). Conclusions:Surgical resection may improve the prognosis of some PCNSL patients.Patients who have access to receive GTR or STR combined with chemotherapy may have prolonged Cancer-specific survival.

Objectives:To explore the prognostic factors of primary central nervous system lymphoma(PCNSL) and to analyze the efficacy of different treatment methods.Methods:Clinical data of 4 812 patients with PCNSL in SEER database from January 1975 to December 2016 were retrospectively analyzed.Among them, 2 831 were male and 1 981 were female, the ratio of male to female was 1.4∶1.0.There were 2 236 cases(46.47%) under 60 years old, 1 718 cases(35.70%) aged 60 to 74 years old, and 858 cases(17.83%) aged 75 years old or above. Two thousand four hundred and seventeen cases(50.23%) had supratentorial tumors, 299 cases (6.21%) had infratentorial tumors, and 554 cases(11.51%) had multiple brain tumors, 1 542 cases (32.04%) were other or unspecified location.Three thousand five hundred and thirteen cases(73.00%) had diffuse large B-cell lymphoma (DLBCL), 234 cases(4.86%) had non DLBCL, 1 065 cases (22.13%) had other or unspecified types of tumor.The treatment included 2 011 cases (41.77%) of biopsy, 61 cases (1.27%) of subtotal resection(STR), 54 cases (1.12%) of gross total resection(GTR), 2 384 cases (49.54%) of biopsy and chemotherapy, 159 cases (3.30%) of STR and chemotherapy, 144 cases (3.00%) of GTR and chemotherapy.Univariate and multivariate Cox regression models were used to analyze the prognostic factors affecting the overall survival of the patients.Fine-Gray test and competitive risk model were used to analyze the prognostic factors affecting cancer-specific survival.Kaplan-Meier method and Log-rank test was used for survival analysis.Results:Univariate and multivariate Cox regression analyses showed that age, race, marital status, tumor site, pathological subtype, surgery, chemotherapy, combined with other malignant tumors, and HIV infection were the independent prognostic factors affecting the overall survival of PCNSL patients.The results of Fine-Gray test and competitive risk model analyses showed that age, race, marital status, tumor location, pathological subtype, surgical method, chemotherapy, combined with other malignant tumors, and HIV infection were independent prognostic factors affecting cancer-specific survival, while gender and radiotherapy had no significant correlation with cancer-specific survival.Compared with biopsy, PCNSL patients may benefit from surgical resection (STR: HR=0.805, 95% CI:0.656?0.989, P=0.04; GTR: HR=0.521, 95% CI:0.414?0.656, P<0.01).Kaplan-Meier survival analysis showed that the median survival time of biopsy+chemotherapy group was 28 months (95% CI:24.497?31.503), 2 months (95% CI:1.756?2.244) in the biopsy group, 2 months (95% CI:1.410-2.590) in the STR group, 19 months ( 95%CI:0?39.311) in the biopsy+chemotherapy group, 67 months (95% CI:46.187-87.813) in the STR+chemotherapy group, 84 months (95% CI:57.448?110.552) in the GTR+chemotherapy group.The median survival time of patients with different treatment methods was statistically significant ( P<0.01). Conclusions:Surgical resection may improve the prognosis of some PCNSL patients.Patients who have access to receive GTR or STR combined with chemotherapy may have prolonged Cancer-specific survival.

Objective: To evaluate the effects of the classical prescriptions Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine on the lipid metabolism disorder and changes of intestinal microflora in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 120 patients who met the inclusion criteria were divided into the two group according to the treatment order, with 60 patients in each group. Both groups were given conventional hypoglycemic therapy, the control group was given bifidobacteria lactobacillus triple viable tablets, and the treatment group was given Dahuang-Huanglian-Xiexin decoction on the basis of the control group. Both groups were treated with 14 days for one course and 4 courses in total. The number of gram-positive coccus (G+c), gram-negative coccus (G-c), gram-positive bacillus (G+b) and gram-negative bacillus (G-b) in each 500 bacteria were observed under oil microscope, and the cocci/bacillus ratio were calculated. The TC and TG were detected by oxidase method, and HDL and LDL were detected by automatic biochemical analyzer. The FPG, 2 hPG and HbA1c were detected by automatic biochemical analyzer. TCM symptom scores were calculated. Results: After treatment, the abdominal distension, congestion discomfort, and constipation score were significantly lower than the control group (t values were 3.685, 3.551 and 3.708, respectively, all Ps<0.05); Serum TG, TC and LDL-c levels were significantly lower than the control group (t values were 3.602, 3.581 and 3.421, respectively, all Ps<0.05); HDL-c level was significantly higher than that of the control group (t=3.358, P=0.046); Serum FPG, 2 hPG and HbA1c levels were significantly lower than the control group (t values were 3.502, 3.271 and 3.708, respectively, all Ps<0.05). After treatment, the G-c (271.47/500 ± 22.63/500 vs. 266.81/500 ± 22.36/500, t=3.792), G+b (81.26/500 ± 6.52/500 vs. 73.19/500 ± 6.94/500, t=3.511), G-b (183.76/500 ± 16.19/500 vs. 164.37/500 ± 15.83/500, t=3.306) levels in the treatment group significantly higher than those in the control group (P<0.05). After treatment, both c/b levels was (0.65 ± 0.13 vs. 0.87 ± 0.21, t=3.325) decreased significantly (P<0.05). Conclusions Dahuang-Huanglian-Xiexin decoction combined with conventional western medicine can improve the clinical symptoms of T2DM patients, reduce blood glucose and lipid levels, and inhibit the body mass and improve insulin resistance by adjusting the structure of intestinal flora, increasing probiotics and reducing pathogenic bacteria.

[Objective]To investigate the mechanism of Qingre Yiqi Tongluo(QRYQTL) fang in treating the diabetic nephropathy. [Methods]60 Sprague-Dawleg rats were divided into normal control group(N), Diabetic nephropathy model group(M) (model rats were prepared by intraperitoneal injection with STZ after unilateral nephrectomy), then the model rats were assigned into model control group, QRYQTL fang treatment group(Q) and Irbesartan treatment group(I). After 12 weeks of the treatment, the contents of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px) and malondialdehyde (MDA) in renal tissue were examined by enzyme linked immunoassay(ELISA); the glomerular area(GA), mesangium area(MA),MA/GA, mean width of the podocyte foot processes(FPW) ,foot process fusion rate(FPFR) and average thickness of glomerular basement membrane(GBMT) were measured. [Results]Compared with N group, the contents of MDA in kidney homogenate and the GA,MA, FPW,FPFR,GBMT were markedly increased (P<0.01or P<0.05),the contents of SOD,CAT, GSH-Px and MA/GA were significantly decreased( P<0.01or P<0.05). QRYQTL fang reduced the level of MDA and decreased the GA, FPW, FPFR and GBMT(P<0.01or P<0.05). Compared with I group ,the QRYQTL fang was superior to Irbesartan in reducing the MDA, FPFR as wel as increasing the SOD,CAT(P<0.05).[ Conclusions]QRYQTL fang has a protective effect on the experimental diabec-tic nephropathy rats. The mechanism may be related to inhibiting oxidative stress, improving the body ’s antioxidant ability and al eviating the glomerular morphologic injury.

Objective To determine the in vitro antibacterial activity of levornidazole against 375 anaerobic isolates.Methods Agar dilution method was used to determine the minimum inhibitory concentrations (MICs)of levornidazole,3 comparators (metronidazole,ornidazole and dextrornidazole)against 375 anaerobic isolates.Results For anaerobic gram-negative and gram-positive bacilli,and anaerobic gram-positive cocci,levornidazole displayed activity similar to or slightly higher than that of met-ronidazole,ornidazole and dextrornidazole.Levornidazole showed good activity against B.fragilis,Bacteroides thetaiotaomi-cron ,Clostridium difficile ,Clostridium perfringens ,and Peptostreptococcus magnus .The MIC90 value of levornidazole a-gainst the above-mentioned anaerobes was 0.5,1,0.25,2 and 1 mg/L,respectively.However,levornidazole and the compa-rators had poor antibacterial activity against Veillonella spp.among anaerobic gram-negative cocci.Conclusions The in vitro anti-anaerobic activity of levornidazole is similar to or slightly higher than that of metronidazole, ornidazole and dex-trornidazole.Levornidazole has good activity against both gram-negative and gram-positive anaerobic bacilli,and gram-positive anaerobic cocci,suggesting its promising clinical use.

[Objective]To study the effect of Qingre Yiqi Tongluo(QRYQTL) preseription on proteinria in diabetic nephropathy(DN) rats by means of ob-servation on the expressions of fibroblast-specific protein 1(FSP1) and P-cadherin in in glomerulus in rats.[Methods]60 Sprague-Dawleg rats were divided into normal control group(N), Diabetic nephropathy model group(M), QRYQTL preseription treatment group(Q) and Irbesartan treatment group(I). DN model rats were prepared by intraperitoneal injection with STZ after unilateral nephrectomy. The rats were sacrificed after 12 weeks of the treatment. The creatinine clearance(Ccr),blood urea nitrogen(BUN) and 24h urinary protein(UPro) were tested. Immunohistochemical staining was performed to explore the expressions of P-cadherin and fsp1 in glomerulus.[Results] ①Compared with M group, the levels of 24-hour upro in Q group were significantly de-creased(P<0.01).The levels of Ccr and BUN in Q group were both lower than those of M group( P<0.05). ② Compared with M group, the expressions of P-cadherin in glomerulus in Q group were increased( P<0.01) and the expressions of FSP1 were obviously decreased( P<0.01). The expressions of FSP1 in Q group were decreased compared with that of I groups(P<0.05).[Conclusions]QRYQTL preseription weakened the epithelial-mesenchymal transition (EMT) of podocyte by means of increasing the expression of P-cadherin and reducing the expression of FSP1, thereby decreased the Upro and protect the renal function.

Objective To investigate the expression levels of phospholipase C(PLC)-γ1 and PLC-γ2 in the peripheral blood mononuclear cells (PBMCs) of patients with systemic lupus erythematosus (SLE),and explore the relations between these genes expression levels and disease activity of SLE.Methods Reverse transcription polymerase chain reaction (RT-PCR) method was used to detect the expression levels of PLC-γ1 and PLC-γ2 in 30 patients with SLE and 25 controls.The associations between the expression levels of PLC- γ1 and PLC-γ2,complement C3,C4,antidouble stranded DNA antibody and SLEDAI scores in patients with SLE were analyzed by Pearson correlation analysis.Results ①The expression levels of PLC-γ1 and PLC-γ2 in the SLE patients were significantly higher than those of the normal controls (P＜0.01).) The expression levels of PLC-γ1 and PLC-γ2 showed positive correlations with each other (r=0.726,P＜0.01 ).③ The expression levels of PLC-γ2 were negatively correlated with serum complement C3,C4 (P＜0.05),but positively correlated with anti-double stranded DNA antibody,at the same time,they were not correlated with SLEDAI scores (P＞0.05).There was no correlation between complement C3,C4,anti-double stranded DNA antibody and the expression levels of PLC-γ1 (r=0.220,0.256,0.116,P＞0.05),but the expression levels of PLC-γ1 were positively correlated with SLEDAI scores.Conclusion We have shown that the expression levels of PLC-γ1 and PLC-γ2 is positively correlated and the PLC-γ1 and PLC-γ2 in patients with SLE are significantly higher than those of the normal controls.PLC-γ2 is negatively associated with complement C3,C4,PLC-γ1 is positively correlated with SLEDAI scores.Both PLC-γ1 and PLC-γ2 are be helpful in evaluating SLE disease activity and severity.

Objective Allograft vasculopathy (AV), feature of chronic rejection, is a major serious long-term post-operation complication in organ transplantation. The accurate mechanisms for AV have not been definitively established, but extensive basic and clinical studies demonstrate AV is triggered by immune reaction and nonimmunologic factors, and also possibly attributed to the metabolism of branched-chain amino acids (BCAA). Methods The transplanted hearts from Lewis to Sprague-Dawely rats served as allografts and those from Lewis to Lewis rats as isografts based on Ono 's model. The differential proteins in transplanted hearts were separated by comparative proteomic technique, and some enzymes which regulated the metabolism of BCAA were identified and validated.Results All transplanted hearts at second week postoperation were characterized by lumen loss (total area-luminal area/total area) in coronary artery, but more predominant at 8th week. All samples from the left ventricles were analyzed by proteomic techniques and the subunits E1 a, E1β and E3 of branched-chain α-ketoacid dehydrogenase (BCKDH) complex were decreased in the heart allografts.Immunohistological detection also showed the expression of BCKDH was reduced not only in the cardiac muscle but also more significantly in blool vessels with cardiac allograft vasculopathy (CAV).BCAA concentrations were increased in the cardiac allografts, but there was no difference in the serum. Conclusion These findings suggest that the catabolic pathways of the BCAA may be inhibited owing to the reduced expression of BCKDH complex, and elevated intracellular concentrations of leucine. The vascular smooth muscle cell and cardiac muscle cell proliferation is stimulated via mTOR-dependent and mTOR-independent pathways, which is associated with the formation of myocardial hypertrophy and AV in the heart allografts.

Objective To investigate the epidemiological characteristics and factors of hemorrhagic fever with renal syndrome (HFRS) during 1958 to 2007 in Fuyang.Methods Descriptive study method was used to analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome.The incidence peak of hemorrhagic fever with renal syndrome was computed by using rotundity distribution.The correlation was analyzed between incidence and virus index by Pearson correlation.Results 40 002 HFRS cases was reported during 1958 to 2007 in Fuyang and 2381 cases were dead.The average incidence and fatality rate of HFRS were 11.99 per 100 thousand and 5.95 percent respectively.Eight counties all had cases.Yingshang county had the highest cases and Jieshou city had the highest fatality rate.Since 1958,there're 4 incidence peak in Fuyang.The period of high incidence was during November to January of next year and the peak of incidence rate was on December 13.Indoor density and field density of mouse were 9.84 percent and 7.91 percent respectively.Virus rate of indoor and field of mouse were 9.21 percent and 6.99 percent respectively.During 1984 to 2007,the correlation coefficient between virus index and incidence was 0.58.In room brown mouse was the most before 2000,but then house mouse become the most.In open country heavy line Japanese fieldmouse is the most mouse all the time.Conclusions In Fuyang,the focus of HFRS is exist widely.Density and virus rate of mouse will directly affect the incidence.So surveillance among mouse should be strengthened.