Objective:To understand the psychological load status of nurses in psychological nursing work and to explore its correlation with stress perception and mental health.Methods:Using the convenient sampling method, a total of 260 nurses who participated in vocational education and training in Naval Medical University were selected as the research objects from November to December 2021. A questionnaire survey was conducted using National Aeronautics and Space Administration-Task Load Index, Perceived Stress Scale and World Health Organization Five-Item Well-Being Index. Using the Process plugin to analyze the relationship between psychological load in nurses' psychological nursing work, stress perception, and mental health.Results:A total of 260 questionnaires were distributed in this study and 248 valid questionnaires were collected, with a questionnaire effective rate of 95.38%. The total score of psychological load and the score of load perception dimension in nurses' psychological nursing work were lower than those in their daily nursing work. The results of the mediating effect model showed that there was a mediating effect between the self-evaluation dimension of psychological load in nurses' psychological nursing work and mental health . The total effect of self-evaluation dimension on mental health was -0.150 7.Conclusions:The level of psychological load in nurses' psychological nursing work is lower than that in daily nursing work. The self-evaluation of psychological load in psychological nursing work can not only directly affect the mental health of nurses, but also indirectly affect their mental health through stress perception. Relevant departments should strengthen the cultivation of nurses' psychological nursing abilities and promote their professional mental health.

Objective:To explore the effect and mechanism of Wenbu Gushen Recipe on renal fibrosis and pyroptosis in diabetic nephropathy (DN) rats.Methods:Sixty SD rats were randomly divided into control group, model group, low, medium and high dose groups of Wenbu Gushen Decoction, irbesartan group with 10 rats each. Except for control group, other groups were given intraperitoneal injection of streptozotocin (60 mg/kg) to construct model the DN. The low-dose, middle-dose, and high-dose groups were given different doses of Wenbu Gushen(0.92, 1.84, and 3.68 g·kg -1·d -1) respectively, irbesarta group was gavaged with 13.5 mg·kg -1·d -1 of . The rats were given the same amount of normal saline in the control group and the model group. After 12 weeks of treatment, 24 hour urine protein, urea nitrogen, creatinine and blood glucose of each group of rats were measured; the pathological changes of rat kidneys were observed; The expression of collagen Ⅲ, transforming growth factor(TGF)-β1, pro-casapse-1, cleaved-caspase-1, GSDMD, GSDMD-N, interleukin(IL)-1β, IL-18, and C1q/tumor necrosis factor-related protein 6 (CTRP6) were detected in kidney tissues; ELISA to detect IL-1β, IL-18 concentration in serum. Results:Compared with control group, the 24 hour urine protein, urea nitrogen, creatinine and blood glucose were significantly increased in the model group; The kidney tissue showed obvious pathological changes, and the expression of TGF-β1, collagen Ⅲ, cleaved-caspase-1, GSDMD-N, IL-1β, IL-18 and CTRP6 were increased in renal tissues, accompanied with IL-1β and IL-18 concentration were increased in serum. Compared with the model group, Wenbu Gushen Decoction inhibited the above indicators and improve kidney injury.Conclusion:Wenbu Gushen Recipe has a protective effect on DN renal injury, and it may inhibit renal fibrosis and pyrpoptosis via down-regulation of CTRP6.

Objective:To investigate the serum level of insulin-like growth factor binding protein 7 (IGFBP7) in patients with gastric cancer and its diagnostic significance.Methods:A total of 100 gastric cancer patients (gastric cancer group) including 49 patients with early gastric cancer (early gastric cancer group) , who were hospitalized in Sun Yat-sen University Cancer Center from May to December 2019 were selected as the research subjects, and 94 physical examination subjects during the same period were selected as the normal control group. The levels of serum IGFBP7 were detected by enzyme-linked immunosorbent assay. At the same time, the laboratory carcinoembryonic antigen (CEA) test results were collected. The relationships between the level of serum IGFBP7 and the clinicopathological features of gastric cancer patients were analyzed. The diagnostic value was evaluated by receiver operating characteristic (ROC) curve.Results:The level of serum IGFBP7 in the gastric cancer group was (1.595±0.159) ng/ml, and that in the normal control group was (1.850±0.328) ng/ml, with a statistically significant difference ( t=-0.26, P<0.001) , and among them, the level of serum IGFBP7 in the early gastric cancer group was (1.601±0.153) ng/ml, and there was a statistically significant difference compared with the normal control group ( t=-0.26, P<0.001) . The level of serum CEA in the gastric cancer group was 2.230 (2.043) ng/ml, and that in the normal control group was 1.805 (1.020) ng/ml, with a statistically significant difference ( U=0.45, P=0.004) , and among them, the level of serum CEA in the early gastric cancer group was 2.220 (1.780) ng/ml, and there was a statistically significant difference compared with the normal control group ( U=0.53, P=0.002) . There were no significant correlations between IGFBP7 and CEA level ( χ2=0.36, P=0.547) , age ( χ2=0.16, P=0.688) , gender ( χ2=0.97, P=0.326) , depth of invasion ( χ2=0.30, P=0.585) , lymph node metastasis ( χ2=0.17, P=0.684) , distant metastasis ( χ2=0.09, P=0.767) and TNM stage ( χ2=0.38, P=0.537) . ROC curve analysis showed that the area under the curve (AUC) of IGFBP7 for gastric cancer diagnosis was 0.84 (95% CI: 0.78-0.89) , the AUC of CEA for gastric cancer diagnosis was 0.62 (95% CI: 0.54-0.70) , and there was a statistically significant difference ( Z=4.33, P<0.001) . The AUC of IGFBP7 combined with CEA for gastric cancer diagnosis was 0.85 (95% CI: 0.79-0.90) . Compared with CEA alone, there was a statistically significant difference ( Z=4.97, P<0.001) . Compared with IGFBP7 alone, there was no statistically significant difference ( Z=1.41, P=0.159) . The AUC of IGFBP7 in the diagnosis of early gastric cancer was 0.84 (95% CI: 0.78-0.91) , the AUC of CEA in the diagnosis of early gastric cancer was 0.66 (95% CI: 0.56-0.75) , and there was a statistically significant difference ( Z=3.11, P=0.002) . The AUC of IGFBP7 combined with CEA in the diagnosis of early gastric cancer was 0.85 (95% CI: 0.78-0.91) . Compared with CEA alone, there was a statistically significant difference ( Z=3.54, P<0.001) . Compared with IGFBP7 alone, there was no statistically significant difference ( Z=1.19, P=0.232) . Conclusion:The serum IGFBP7 level of gastric cancer patients is lower than that of normal controls. Compared with CEA, serum IGFBP7 has better diagnostic value for gastric cancer.

Objective:To construct a humanistic care intervention program for stroke patients after discharge and evaluate the implementation effect.Methods:Through preliminary research, literature review and expert consultation, the humanistic care program for stroke patients after discharge based on Watson's humanistic care theory was constructed and integrated into clinical practice intervention program and implemented. By convenience sampling method, stroke patients discharged from the Neurology Department of Shanghai Pudong New Area People's Hospital in June 2019 were selected as the control group, and patients discharged in July 2019 were selected as the intervention group. The control group received routine follow-up, and the intervention group received humanistic care intervention program after discharge. The scores of the WHO Quality of Life-BREF (WHOQOL-BREF) , limb function improvement, and the General Well-Being Schedule were compared between the two groups before and after the intervention.Results:After the intervention, the WHOQOL-BREF total score of the intervention group was (55.74±4.88) , and the total score of the General Well-Being Schedule was (72.06±8.02) , which was higher than (48.49±5.77) , (65.09±3.45) of the control group. The differences were statistically significant ( P<0.05) . After the intervention, the limb function improvement score of the intervention group was (3.52±0.71) , which was not significantly different from that in the control group (3.20±0.63) . Conclusions:Through the construction and application of humanistic care program for stroke patients after discharge, it can effectively improve the quality of life, and happiness of COPD patients.

[Objective]To study the clinical features and expressions of IL-17A,IFN-γ,and IL-10 in serum and intestinal mucosa of patients with post-infectious irritable bowel syndrome and non post-infectious irritable bowel syndrome.[Methods]44 diar?rhea-predominate IBS patients(21 with PI-IBS,23 with NPI-IBS)and 10 healthy controls were recruited in this study. Investigation questionnaires of GSRS,SAS,SDS were carried out to evaluate the gastrointestinal function,anxiety status and depression status of IBS patients. The expressions of IL-17A,IFN-γ,and IL-10 in intestinal mucosa and serum were measured by immunohistochemis?try(IHC)and enzyme-linked immunosorbent assay(ELISA).[Results]The SDS scores of NPI-IBS patients were higher than those of controls(P<0.05),and the SAS and SDS scores of PI-IBS patients were higher than those of controls(P<0.05). The GSRS, SAS and SDS scores of PI-IBS group were higher than those of NPI-IBS group(P<0.05). Compared with healthy controls,PI-IBS and NPI-IBS group showed significant rise of IL-17A,IFN-γlevels and decrease of IL-10 level in intestinal mucosa(P<0.05);In serum,the IL-17A levels were up-regulated and the IL-10 levels were decreased in PI-IBS group but not in NPI-IBS group when compared with controls(P<0.05). In intestinal mucosa and serum,IL-17A and IFN-γlevels in PI-IBS group were slightly higher than those in NPI-IBS group(P > 0.05).[Conclusion]PI-IBS and NPI-IBS patients existed various anxiety and depression. The levels of IL-17A and IFN-γ increased and level of IL-10 decreased in PI-IBS and NPI-IBS group. But the clinical symptoms and changes of cytokines of PI-IBS patients were more significant. There may exist other pathogenesis in PI-IBS but not in NPI-IBS.

Objective To investigate the status of inhabitant ’ s self-medicine in Shanghai countryside , and to explore its risks and influencing factors .Methods We utilized self-designed normal information questionnaire and self-medicine risks survey questionnaire , and a total of 750 questionnaires had been distributed to survey Shanghai countryside inhabitants ’ demographic data and self-medicine risks survey . Results We gave out 750 questionnaires and retrieved 712 , so percent retrieve was 94 .9%.A total of 656 of them were effective (effective rate 92.1%).Inhabitants in Shanghai countryside acquired 2.10 ±0.55 scores for risks of self-medicine.Inhabitants with different gender , occupation, degree of education, family income, medical insurance and daily routine had different level of self-medicine risks ( P <0.05 ).According to multivariate analysis , the main influencing factors of self-medicine included the type of medical insurance , daily routine, the degree of education and occupation (P<0.01).Conclusions The behavior of inhabitant’s self-medicine should be brought into standardized management under professional instruction to minimize personal health risks and social medical resources waste .

Objeetive To develop decision-making training system in fundamentals of nursing for nursing students and evaluate its application effect.Methods The training contents and level requirements were determined first.Then based on the five steps of clinical decision-making theory (put forward questions,determine goals,make decisions,implement and evaluate),the simulated training cases were designed and integrated into software of the training system.And 28 nursing students used the training system.Results Most of the nursing students liked this learning method.They thought it was very interesting,challenging,and useful.It could help increase the enthusiasm learning and the participation of students.Using it the students could integrate the theoretical knowledge into the practice.So it was helpful to train the capacity of solving clinical problems and clinical decision-making of students.The results of the open-ended question showed that the comprehensive training system could help students grasp the knowledge,test and consolidate the knowledge.It contributed to the combination of theory and practice,the cultivation the capacities of basic nursing skills,teamwork,self-learning,and solving clinical problems.Conclusions The comprehensive training system could help nursing students develop the ability to solve clinical problems and improve the clinical decision-making ability.It can be applied in the related fields.

Objective To isolate,purify and identify pancreatic duct derived stem cells (PDSCs) from the pancreatic duct of rats,and culture in the three-dimension cell culture system.Methods Adult male Wistar rats underwent perfusion with collagenase V via the pancreatic duct,then the pancreas was surgically procured,digested,followed by discontinued density gradient centrifuge to isolate ductal tissue from islets.The acinar and ductal tissue was cultivated in serumcontaining medium in the three-dimension cell culture to obtain adherent cells,as PDSCs,which were expanded by consecutive passages.The morphology and characterization of PDSCs on phenotype were examined.Results PDSCs could be obtained through in situ collagenase V digestion,discontinued density gradient centrifuge,and culture in the three dimension cell culture system.Morphologically,PDSCs had remarkable size,most with one nucleus.PDSCs grew in many layers in three-dimension cell culture system.PDSCs was revealed to express CD29,CD73,CD90,CD105,but not CD14,CD19,CD34,CD45 by FACS,in agreement with MSCs.Conclusion PDSCs of rats could be obtained through in situ collagenase V digestion,discontinued density gradient centrifuge,and culture in the three-dimension cell culture system.PDSCs lines were successfully established.

Objective To evaluate the effect of islet transplantation for patients with type 2diabetes mellitus (DM). Methods Since December 2007, 4 cases of islet transplantations were performed on 3 patients with type 2 DM and end-stage renal disease (ESRD). Two patients received simultaneous islet-kidney transplant from single-donor (SIK), and one received 2 consecutive islet transplants 5 months following kidney transplantion (IAK). All recipients given insulin with a dose of percutaneous transhepatic portal catheterization. Anti-CD25 monoclonal antibody was used as induction. For SIK, low-doses of Tacrolimus and sirolimus were used as maintenance immunosuppression protocol. For IAK, the maintenance protocol included cyclosporine and MMF.Insulin dose, the level of blood glucose, C-peptide and the value of HbA1 were observed. Results The first patient of SIKhad normal glucose level 3 days after surgery and became insulin independent within the first month, but insulin was administered gradually and the dose reduced to 1/3. The second patient of SIK died of bleeding and secondary infection of liver puncture site 5 days following operation, the blood glucose level recovered to normal 24 h after operation. The insulin dose of the patient of IAK was reduced to 1/2 after the first transplant. The patient became insulin free after the second operation. The level of fasting and postprandial C-peptide of the surviving recipients increased by 600 pmol/L. The value of HbA1 of the SIK was 6.7 %～7.3 %, while that of the IAK was 5. 5 %～ 5. 9 %. Conclusion Islet transplantation is an effective treatment for patients with type 2 DM.

Objective To summarize the clinical experience of harvesting and using the kidneys from donation after cardiac death (DCD) donors.Methods Fourteen kidney transplantations were successfully performed on 14 patients with end-stage renal diseases.The kidneys were harvested from 7 volunteer donors (age 30～53 years) diagnosed with cardiac death,who were scored 19～23according to the University of Wisconsin donation after cardiac death evaluation.Primary diseases of the donors were cerebral hemorrhage,brain injury,ischemic cerebral vascular disease and brain tumor.Warm ischemia time ranged from 5 to 45 min,and cold ischemia time was 4.5 ～ 12.5 h.Results After transplantation,three patients had delayed graft function (DGF),one had primary non-function (PNF),and two patients developed acute rejection.In the patient with PNF,the transplanted kidney was removed one day after operation and the patient went back to hemodialysis.One patient with DGF was still in recovery with serum creatine 149 μmnol/L (within 3 months after operation).The above two cases both utilized the kidneys with 45 min of warm ischemia time.The rest 12 patients were discharged with normal renal function.Conclusion Under the condition of our country,kidneys strictly harvested from DCD donors can be used as one of the main sources of kidney grafts for kidney transplantation.