ObjectiveTo explore the main mechanism of self-precipitation formed during the decoction of Sinitang（SNT）， and to provide a research basis for exploring the differences in the toxic and effective components of this compound. MethodsThe average precipitation yields of SNT， Glycyrrhizae Radix et Rhizoma（GRR）-Aconiti Lateralis Radix Praeparata（ALRP） decoction（GF）， ALRP-Zingiberis Rhizoma（ZR） decoction（FJ）， GRR-ZR decoction（GJD）， ALRP decoction（FZ）， ZR decoction（GJ） and GRR decoction（GC） were determined. The four main self-precipitation samples of SNT， GF， FZ and GC were physically characterized by particle size， scanning electron microscopy（SEM）， pH， total dissolved solids（TDS）， conductivity， and Fourier transform infrared spectroscopy（FT-IR） analysis. The chemical compositions of SNT decoction and its different phases was identified by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap-MS） for SNT， SNT self-precipitation and SNT supernatant， and the contents of its main toxic and effective components were determined by high performance liquid chromatography（HPLC）. ResultsPrecipitation yield results of the 7 samples of SNT decoction and single decoction showed that SNT had the highest self-precipitation yield. The formation of SNT self-precipitation was mainly related to the reaction between ALRP and GRR components to form complexes， and FT-IR showed that GRR had the greatest influence on the formation of self-precipitation. A total of 110 components were identified in the SNT decoction， including 100 components in the SNT self-precipitation and 106 components in the SNT supernatant. And quantitative results of the main toxic and effective components revealed that the reaction between ALRP and GRR components formed complexes， resulting in the following content hierarchy for free components：SNT decoctionsupernatantself-precipitation， these components included free liquiritin， benzoylmesaconine， benzoylaconitine， benzoylhypacoitine， liquiritigenin， aconitine， hypoaconitine， isoliquiritigenin and ammonium glycyrrhizinate. ConclusionSNT exhibits spontaneous precipitation during compound decoction， with GRR exerting the greatest influence on its formation. This suggests GRR plays a significant role in the detoxification of SNT. The differences in the self-precipitated toxic-effective components of SNT compound decoction primarily manifest as changes in component content， reflecting the characteristics of SNT "deposition in vitro and sustained release in vivo" and the importance of "administered at draught" in the clinical application of SNT.

Corona virus disease 2019 (COVID-19) patients with trauma are at high risk of venous thromboembolism (VTE), which must be taken seriously in the therapeutic processes. Hypercoagulable state is induced by 2019 novel coronavirus (2019-nCoV) in many ways, such as increasing the level of inflammatory factors and fibrinogen, and inducing endothelial cell injury. The venous wall injuries from trauma and operation directly or indirectly trigger off the exogenous coagulation pathway and the microcirculation can be damaged at the same time, which may initiate the exogenous pathway of VTE. Immobilization of limbs and forced bed rest during the treatment of traumatic patients will slow venous blood flow. Chronic non-communicable diseases such as diabetes in the elderly were independent risk factors for VTE. Furthermore, the persistent fever, severe lung disease, respiratory failure, sepsis and invasive technology application add the risk of VTE and the difficulty of treatment. In order to help effective prevention VTE of for COVID-19 patients with trauma, the authors put forward relevant technical suggestions for prevention and nursing of VTE to provide basis for nursing work during pandemic of COVID-19.

Objective To develop training program of evidence implementation(EI) based on PARIHS model and to evaluate the effectiveness on clinical nurses for evidence-based nursing knowledge,attitudes and ability,and to understand the evaluation of participants about the methodological training.Methods A quasi-experiment design was conducted.A 6-month comprehensive evidence implementation training program was developed including methodological lecture,group discussion,EI case analysis,EI project development and implementation,and was carried out among 44 clinical nurses from 11 tertiary hospitals in Shanghai.The participants' EBN knowledge,attitudes and ability were measured by EBN knowledge,attitudes and ability questionnaire at 3 months and 6 months after training.Results Participants' EBN knowledge and ability were significantly improved at 3 months and 6 months after training(P＜0.05),and participants' EBN attitude had no significant difference before and after training (P＞0.05).The level of training satisfaction among participants was higher than 80.0％,and participants had finished 22 evidence implementation programs.Conclusion Evidence implementation training based on PARIHS can enhance clinical nurses' EBN knowledge and ability.Participants' EBN attitude hasn't been significantly improved.Participants have high satisfaction towards methodological training.

Objective To investigate the correlation between lower extremity CTA and ankle brachial index (ABI) of the diabetic lower extremity arterial disease (LEAD),and to study the difference of the examination methods.Methods 80 patients of clinical diagnosed with diabetic LEAD that underwent CTA check were enrolled.The indexes of ABImax,ABImin,ABIave and lower limb atherosclerosis integral (LEAI) of the 80 patients were calculated respectively,and the relationship and correlation were analyzed between ABI and LEAI in different degree of lower extremity arterial calcification.Results ABI index of 58 (58/80) cases could be determined,with an average of 0.87.CTA results displayed that below-the-knee artery had a high incidence of atherosclerosis.According to the degree of arterial calcification,non-calcified in 4(4/58) cases,mild in 20(20/58),moderate in 10(10/58),and severe in 24(24/58).The patients with moderate and severe calcification,means the arterial calcification,had lower ABI (P =0.001),higher LEAI (P ＜ 0.001),and higher pressure of brachial artery(P =0.03).There was weak correlation between ABImax and LEAI(r =-0.48) and the best correlation between ABIave and LEAI(r=-0.59).The correlations between ABI and LEAI of non calcified cases were better than that of calcified ones.Conclusion ABI monitoring of diabetic LEAD has some limitations.Diabetic lower extremity artery CTA has important clinical value that can accurately assess the degree of arterial calcification and occlusion.

Objective To investigate the training needs of evidence implementation of clinical nurses and its influencing factors.Methods A total of 645 clinical nurses were investigated on training needs of evidence implementation by field and web survey with self-designed questionnaire about training needs of evidence implementation.Results The demand rates on training needs (17 entries) of evidence implementation in nurses were higher than 90.0%. The training methods and assessment methods of evidence implementation were diversified. There were statistically significant differences in some of the demand rates among different educational background, duties, research experiences (with or without), and attending time of evidence-based nursing training (t=26.990, 10.020, 8.719, 14.600;P<0.05).Conclusions The evidence implementation training should be carried out according to different educational background, duties, research experiences and the length of evidence-based nursing training of nurses. Besides, the training methods and assessment methods should be diversified.

Objective To Pulse oximetry saturation has been wildly used clinically.It has been reported that pulse oximetry plethysmographic waveform (POP) reflected the peripheral tissue perfusion.In this study,we parameterized POP,observed the value of POP parameters in normal adults,and established the normal reference value range.Methods A multi-center prospective descriptive study.Total of 1 019 adult volunteers with normovolemia from 7 cities were enrolled in this study.Sex,age,height,weight and pulse oximetry data in awake and spontaneous breathing under in quiet conditions in the room temperature were collected.POP parameters and perfusion index were analyzed using MATLAB 2012a software.The normal reference value ranges of POP parameters,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),were formulated.Results Statistical differences of POP parameters were detected between men and women in the normal adult.The 95％ confidence reference value of POP parameters in normal population was as follows:Amp (104.8-2298.7) PVA and AUC (3265.8-6028.5) PVPGin total,Amp (129.4-2433.6) PVA and AUC (3319.0-5862.2) PVPG in male;Amp (89.5-2138.2) PVA and AUC (3163.9-5929.9) PVPG in female.Conclusions POP,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),had normal reference value ranges in normal adults.

Objective To investigate the effects of non-nutritive sucking ( NNS) and oral support on the feeding process and expression of premature infants .Methods Totals of 110 cases of premature infants with feeding difficulty in department of neonatal from June 2014 to January 2016 were researched .They were divided randomly into observation and control group , with 55 cases in each group .The control group was given routine feeding ,and the observation group was added with oral motor function training ,and the non nutritive sucking and oral support were carried out .The feeding efficiency , the effect of feeding , the amount of milk intake , the transition time of feeding , the duration of the first feeding were observed , and the satisfaction of two groups were compared.Results In the observation group , the feeding efficiency , the effect of feeding , the amount of milk intake, the transition time of feeding , the duration of the first feeding were significantly better than the control group ( P<0.05 ) .The satisfaction of observation group was significantly higher than that of the control group (P<0.05).Conclusions Non nutritive sucking and oral support and oral motor function training can effectively improve the oral feeding of preterm infants , and promote the growth of premature infant body mass .

OBJECTIVETo investigate the frequency of different types of mature T- and NK-cell lymphomas diagnosed in a 4-year period at Sun Yat-sen University Cancer Center, and to study baseline CD30 for potential anti-CD30 targeted therapy in mature T- and NK-cell lymphoma.

METHODSAll cases of mature T- and NK-cell lymphoma diagnosed at Sun Yat-sen University Cancer Center from September 1, 2009 to August 31, 2013, were reviewed. Paraffin-blocks of available 164 consecutive cases were stained for CD30 immunohistochemistry using EnVision protocol.

RESULTSA total of 625 cases of mature T- and NK-cell lymphomas were diagnosed and the most common type was extranodal NK/T cell lymphoma (ENKTL), nasal type 319 (51.0%) cases, followed by angioimmunoblastic T-cell lymphoma (AITL) (119 cases, 19.0%), peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) (81 cases, 13.0%), and anaplastic large-cell lymphoma (ALCL), including 48 cases (7.7%) of systematic ALCL and 11 cases (1.8%) of primary cutaneous ALCL. Besides ALCL, ENKTL had the highest expression rate of CD30 among the 164 cases, with positivity observed in 41 cases (62.1%, 41/66). Only 1 case of PTCL-NOS was CD30 positive. CD30 was not expressed in all 28 cases of AITL and other rare types of mature T- and NK-cell lymphoma.

CONCLUSIONSThe frequency of different types of mature T- and NK-cell lymphoma encountered at Sun Yat-sen University Cancer Center was similar to that seen in other areas of China and other Asia countries. CD30 expression is different among several types of mature T- and NK-cell lymphoma. In addition to ALCL, ENKTL has the highest expression rate of CD30, which may be a candidate disease for anti-CD30 targeted therapy.

China ; epidemiology ; Humans ; Immunohistochemistry ; Killer Cells, Natural ; Lymphoma, Extranodal NK-T-Cell ; epidemiology ; pathology ; Lymphoma, Large-Cell, Anaplastic ; epidemiology ; pathology ; Lymphoma, Primary Cutaneous Anaplastic Large Cell ; epidemiology ; pathology ; Lymphoma, T-Cell, Peripheral ; epidemiology ; pathology ; T-Lymphocytes

Objective To develop national norms of nursing soft skills, and provide a basis for the evaluation of the nursing soft skills for new nurses.Methods With the stratified cluster sampling, 2816 new nurses were choosed from across China, and nursing soft skills evaluation scale was used to investigate.The general descriptive statistics, reliability analysis and confirmatory factor analysis of sample data were done.Results Developed the total national norms of nursing soft skills for new nurses ( the total soft skills was 150.31 ± 15.47,interpersonal skills was 28.28 ± 3.75, organizational management was 33.74 ± 4.10, self-management was 37.50 ±4.58 ,career sentiment was 28.10 ±3.52 ,cognitive kills was 22.70 ±3.11 ) and established a T-rough and percentiles-rough score conversion tables.The level of nursing soft skills of new nurses was divided into five levels: T-score ＜ 30 was poor for the soft skill, T-score at the 30 to 39 for the somewhat less, T-score at the 40 to 59 for the general level, T-score at 60 to 69 for good,T-score ≥ 70 for the best.Conclusion These norms can be used as evaluating standards of nursing soft skills for new nurses.

Objective To assess the construction quality of sanitary latrines in schistosomiasis endemic areas of China. Methods Two counties per province were sampled randomly from total 7 provinces with schistosomiasis endemic including Hunan, Hu-bei, Jiangxi, Anhui, Jiangsu, Yunnan and Sichuan, then 2 villages with schistosomiasis endemic were selected from each target county as research sites, and 30 households per village were randomly selected as respondents. Results Among the sanitary latrines being constructed and on-going used in schistosomiasis endemic areas, 64.8% of them were built indoor or inside of yards, and 52.6% of the above household latrines were constructed keeping away from water sources beyond 10 meters. In addition, the latrines with curb height of feces outlet over 100 mm accounted for 75.0% , and 96.1% of the total sanitary latrines were equipped with urinals made of pottery, plastic and cement. There were 98.2% of the latrines with an area more than 1.2 m~2, and 95.8% with structure of the whole room. Among those sanitary latrines with three-case-cesspools, merely 23.1% reached or closed to the design and implementation requirements of Technical criterion of sanitary construction in schistosomiasis endemic areas (protocol) on the part of underground. Conclusions The sanitary latrine with three-case-cesspools and three-unit methane pool is the main type of the household latrine recommended in countryside in schistosomiasis endemic areas. The construction of sanitary latrines meet the requirements of relevant standards in general, however, the design and implementation of underground parts of the latrines with three-case-cesspools need to be improved.