Objective To explore the objective indicators of tongue and pulse manifestations in patients with endometriosis diseases by collecting the data of tongue and pulse manifestations of patients with endometriosis diseases by digital tongue and pulse diagnostic instrument. Methods The endometriosis disease group included 72 patients with endometriosis diseases who were treated in Department of Gynecology (Professor ZHANG Tingting),Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from Jun. 1,2021 to Sep. 15,2022. The normal group included 35 healthy adult women recruited by the Physical Examination Center of Shuguang Hospital,Shanghai University of Traditional Chinese Medicine. Results In terms of age,there was no significant difference between the endometriotic disease group and normal group (P>0.05). In terms of tongue color,the values of zhiCon,zhiASM,zhiENT,zhiMEAN,zhiClrB,zhiClrI,zhiClrLa,zhiClrCb,and zhiClrLb in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of zhiClrR,zhiClrG,zhiClrS,zhiClrL,zhiClrY,or zhiClrCr between the 2 groups (all P>0.05). In terms of tongue coating color,the values of taiClrR,taiClrB,taiClrI,taiClrS,taiClrLa,taiClrLb,taiClrCr,and taiClrCb in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of taiClrG,taiClrL,or taiClrY (all P>0.05). In terms of texture and thickness of tongue coating,there were no significant differences in the values of perAll,perPart,taiCon,taiASM,taiENT,or taiMEAN between the 2 groups (all P>0.05). In terms of pulse manifestation,the values of h3,h4,h5,t4,h3/h1,and h4/h1 in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of h1,t,t1,or t5 (all P>0.05). Conclusion There are significant differences in tongue and pulse indicators between patients with endometriosis diseases and healthy individuals. It can provide objective indicators for further research on the pathogenesis changes and clinical differentiation of endometriosis diseases.

Objective: To explore the psychological experience of patients with aortic dissection facing rescue of follow patients in CCU, so as to provide evidences for proposing appropriate nursing countermeasures and responding measures. Methods: A qualitative study was used on 16 patients with aortic dissection within 24 hours when the rescue of follow patients was in CCU through semi-structured in-depth interviews and the interview data were collected and analyzed by Colaizzi content analysis. Results: The enlargement of somatic discomfort symptoms. The various emotional. The different coping strategies. The inner needs. Conclusions When rescuing patients with other aortic dissection in CCU, medical staffs should pay more attention to the distress of physical discomfort symptoms such as pain, promote their benign mood during rescue and encourage patients to adopt positive coping styles. At the same time, constructing a reasonable social and family support ways to help patients recover physically and mentally, ensure the quality of nursing services and patient safety, and improve their hospitalization comfort.

Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults,and to provide evidences for clinical management.Methods The data of clinical manifestations,laboratory examinations,chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed.The chi-square test was used for the categorical variables,and the rank sum test was used for the continuous variables of non-normal distribution.Results Compared with patients in HAdV55,those in HAdV7 group displayed more diarrhea (12.1％ [26/214] vs 2.6％ [6/235],x2 =15.583),more laryngeal lymphatic follicles (33.2％ [71/214] vs 17.9％ [42/235],x2 =23.566),more tonsil enlargement (56.5％ [121/214] vs 20.0％ [47/235],x2 =63.870) with secretions (33.2％ [71/214] vs 11.5％ [27/235],x2 =30.878),more leukocytosis (24.8％ [53/214] vs 14.0％ [33/235],x2 =8.318),more monocytosis (78.0％ [167/214] vs 52.8％ [124/235],x2 =31.364),more thrombocytosis (7.1％ [15/212] vs 3.8％ [9/235],x2 =5.835),more elevated level of C-reactive protein (80.8％ [97/120] vs 64.3％ [137/213],x2 =10.020),more abnormalities of liver function (alamne aminotransferase [ALT]:13.5％ [28/207] vs 5.6％ [13/232],x2 =8.111) and myocardial enzymes (creatine kinase [CK]:37.6％ [77/205] vs 26.4％ [61/231],x2 =6.246),creatine kinase isoenzymes ([CK-MB]:35.6％ [73/205] vs 11.1％ [24/216],x2 =35.600),and all the differences were statistically significant (all P ＜ 0.05,0.01).Compared with patients in HAdV7 group,those in HAdV55 group displayed longer duration of diseases (7 [5]days vs 6[5] days,Z=-2.632),more sore throat (72.8％ [171/235] vs 62.1％ [133/214],x2 =0.016),more headache (62.1％ [146/235] vs 16.4％ [35/214],x2 =97.527),more pharyngeal congestion (93.6％ [220/235]vs 74.8％ [160/214],x2 =30.602),more leukopenia (14.0％ [33/235] vs 24.8％ [53/214],x2 =8.318),and more elevated level of lactate dehydrogenase (12.6％ [29/230] vs 6.3％ [13/205],x2 =4.881),more pneumonia (71.5％ [168/235] vs31.8％ [68/214],x2 =70.846) (all P＜0.05,0.01).Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different.The type 55 infection is more likely to develop to pneumonia,while the type 7 infection has wider tissue tropism.

Objective To investigate the effect of nano-silver antibacterial dressing on infection control in the patients with diabetic foot. Methods 60 patients with diabetic foot who were treated in our hospital from January 2017 to January 2018 were selected as the study subjects. They were randomly divided into intervention group and control group, with 30 cases in each group. Both groups strictly controlled blood glucose levels. After debridement, the intervention group was given nano-silver antibacterial dressing. The control group was given vaseline dressing. The degree of wound pain, the severity of wound ulcer, and the area of ulcer were evaluated at the time of enrollment and 4 weeks after treatment. The ulcer healing time and the number of dressing changes were counted in both groups. Results After intervention, the Wagner grading of the two groups was significantly improved compared with that before treatment, and the difference was statistically significant (P<0.05); after treatment, the Wagner grading in the intervention group was significantly better than that in the control group, and the difference was statistically significant (P<0.05). After intervention, the ulcer area of the two groups was significantly lower than that before the intervention (P<0.05); the ulcer area in the intervention group was smaller than that in the control group after intervention (P<0.05). The VAS in the two groups after intervention was significantly lower than that before the intervention (P<0.05); the VAS in the intervention group was significantly lower than that in the control group after intervention (P<0.05). The ulcer healing time in the intervention group was significantly shorter than that in the control group, and the difference was statistically significant (P<0.05); the number of dressing changes was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion The application of nano-silver antibacterial dressing can promote the healing of ulcers, reduce the ulcer area, improve the Wagner grading and reduce the number of dressing changes.

Objective To explore and construct specialist nursing practice of safety management of sedation and analgesia in interventional surgery in China.Methods From February 2016 to November 2017, literature analysis, semi-structured interviews and cross-sectional survey were used to establish the practice scope of specialized nursing in the safety management of sedation and pain relief in interventional surgery. Delphi expert advice consultation method was used to consult and screen related items, and the weight was determined by analytic hierarchy process.Results The positive coefficient of the two rounds of expert consultation was 100％, the expert authority coefficient Cr was 0.85. The coordination coefficients of the second round from the recognition degree, correlation degree and operability were 0.204, 0.228 and 0.215 respectively (P<0.01). Finally, a total of 3 dimensions (46 items), including preoperative evaluation (8 items), intraoperative management (36 items), and postoperative evaluation and monitoring (2 items).Conclusions In order to promote the safety management of sedation and pain relief in interventional surgery, a set of specialized nursing practice areas suitable for nurses were constructed.

OBJECTIVE:To provide reference for further standardizing and perfecting the management of drug unpacking in outpatient pharmacy.METHODS:A total of 6 primary and secondary health institutions (4 community health service centers and 2 secondary hospitals) were selected from 2 districts in Shanghai to conduct a questionnaire survey on the use of their drugs and drug unpacking in outpatient pharmacy.The survey data was analyzed statistically.RESULTS:Totally 6 institution questionnaires and 6 pharmaceutical staff questionnaires were sent out,all were received with recovery of 100％.In 2015,the average number of essential medicines in community health service centers and secondary hospitals were 496.50,542.00,respectively,and the average number of varieties sold were 530.75,1 052.00.In outpatient pharmacy of surveyed community health service center,the number of unpacked drugs was 10-21 which were essential drugs and class A medical insurance drugs,and the consumption sum of unpacked drug ranged 5.56-16.70 ten thousand yuan.In outpatient pharmacy of 2 two secondary hospitals,the number of unpacked drugs were 17 and 23,respectively,most of which were essential drugs and class A medical insurance drugs,and the consumption sum of unpacked drug ranged 13.19 to 158.06 ten thousand yuan.The proportion of unpacked drugs was less than 5％ of the total number of varieties sold,and the proportion of consumption sum of unpacked drugs was less than 1％ of total consumption sum.Estazolam tablets and Alprazolam tablets took up the top 5 in the list of consumption sum of unpacking drugs in 2 types of intervi ewed instiutions.All the surveyed institutions were not equipped with drug dispensing machine in the outpatient pharmacy,still depended on manually unpacking.There were four institutions to regularly arrange the unpacking,unpacking frequency was usually 1 to 3 times a week,supplemented by the need to arrange unpacking,and another two to implement a daily unpacking.There were 5 institutions to develop a drug unpacking mechanism in the institutions,but the relevant system was not perfect.CONCLUSIONS:The enthusiasm of pharmaceutical saff in primary and secondary health institutions in Shanghai to carry out or engage in unpacking work need to be improved,the instructions for unpacked drugs are not available on request,and the way to unpack drugs still needs to explore.

Objective To introduce the super minimally invasive transintercostal device closure of ventricular septal defect (VSD) and summarize it's therapeutic effect.Methods Nine patiens with VSD from August 2014 to December 2014 in our hospital were enrolled,which performed super minimally invasive transintercostal device closure of VSD.All patients were followed up prudently post-operation.Echocardiography was scheduled according to the protocol.Results All cases were successfully occluded.There was no death case in the peri-operation period and severe complications after operation.Conclusions The super minimally invasive transintercostal device closure of VSD is safe and reliable.

Objective To investigate the clinical characteristics of patients infected with human adenovirus type 7 and to provide guidance for early diagnosis and timely control of the outbreak.Methods A total of 301 patients infected with the human adenoviruses who were quarantined in hospital from December 2012 to February 2013 were observed.Epidemiological questionnaires were used to collect data of clinical features of the disease including symptoms,signs,images and laboratory tests.To confirm infection,real time polymerase chain reaction was performed using patients' swabs to detect viral nucleotide.Results Most cases happened in December to the next February.Totally 277 cases of the 301 patients were male,and only 24 cases were female.Mean age was (19.1±1.9) years old,range 15 to 29 years old.Identifiable epidemiologic links were seen between patients.The most common symptoms were fever (100.0％),cough (70.4％),expectoration (48.2％),and sore throat (47.8％).In addition,some patients presented with headache,dizziness,chills,fatigue.The most common signs were pharyngeal congestion (62.5％),enlargement of tonsils (56.5％) and lymphatic follicular hyperplasia (26.6％).Some patients' tonsil was covered with white secretions.Lung images were abnormal in 75 cases,which were presented with mild pneumonia with or without surrounding exudative lesions and pleural effusion in lung images.Laboratory tests showed that the number of white blood cells in the peripheral blood in most of the patients (99.0 ％) was elevated or normal.The proportions of neutrophils (54.2％) and monocytes (80.7％) and the level of C-reactive protein (42.2％) increased,while the proportion of lymphocytes reduced (67.1％).The average course of disease was (6.6±2.9) d.With the treatment of intravenous ribavirin and reduning,all patients were cured.Conclusions Human adenovirus type 7 is quite contagious and may cause epidemic outbreak,especially in winter.The majority exhibits mild symptoms of upper respiratory tract infection with short duration,including fever,cough,expectoration and sore throat.Through timely and active treatment,all patients have a good prognosis.

Objective To estimate the application value of dermoscopy in the differential diagnosis of basal cell carcinoma (BCC).Methods Patients who underwent dermoscopic examination and had been definitely diagnosed by pathological examination in the Peking University First Hospital were enrolled in this study.In a blind study,dermoscopic images of 86 BCC lesions from 81 patients (case group) and 68 non-BCC hyperpigmented lesions with similar degree of hyperpigmentation and location from 61 patients (control group) were evaluated for features suggestive of BCC and melanocytic lesions.The diagnostic capability of dermoscopy in patients with BCC was evaluated by diagnostic test.Pathology served as the gold standard method for diagnosis.The frequency of features suggestive of melanocytic lesions was calculated in BCC lesions,and dermatoscopic findings were compared between heavily and lightly pigmented BCC lesions.Results The sensitivity,specificity,positive predictive value,negative predictive value of the classic dermoscopic pattern for the diagnosis of BCC were 98.84％,89.71％,92.39％,98.39％ respectively,with a Youden index of 0.88.The coincidence rate was 94.81％ between pathologic and microscopic diagnosis.Pigment network,multiple brown to black globules/dots,pigmentation around hair follicle openings were observed more frequently in melanocytic lesions compared with BCC lesions (all P ＜0.05).Blue-whitish veil-like structures were observed in 61.63％ of the BCC lesions.The presence of blue-black blotch and blue-whitish veil-like structures was significantly more frequent in heavily pigmented BCC lesions than in lightly pigmented BCC lesions (both P ＜0.01).Conclusions The classic dermoscopic pattern of BCC shows a favorable diagnostic capacity in Chinese population.Large-scale studies are needed to estimate the value of some features proposed in this study,such as peripheral pigment in palisade arrangement,peripheral hyperpigmentation and hypo-or hyperpigrnentation around hair follicle openings,in the differential diagnosis of pigmented diseases.

Objective To investigate the dermoscopic features of palmoplantar melanocytic lesions.Methods The dermoscopic images of palmoplantar melanocytic lesions that underwent examination in the Department of Dermatology in Peking University First Hospital from September 2009 to October 2011,were retrospectively analyzed.Results Totally,155 benign acral melanocytic lesions in 121 patients and 23 acral melanomas in 22 patients were analysed in this study.Among the benign acral melanocytic lesions,the parallel furrow pattern and its variations (34.2％) were the most common,followed by the fibrillar pattern (22.6％).Two benign lesions (1.3％) showed a parallel ridge pattern.Of 23 melanoma lesions,12 (52.2％) exhibited parallel ridge pattern,and 14 (60.9％) showed irregular diffuse pigmentation that was present in all of the invasive melanoma lesions.The fibrillar pattern,as a common benign acral dermoscopic pattern,was also present in 39.1％ of melanoma specimens.Conclusions Dermoscopy is valuable to some extent in the differential diagnosis of benign melanocytic nevi and malignant melanoma in palmoplantar region,and may facilitate the secreening for early melanoma.