The status quo and influencing factors of the overall clinical performance in nursing students / 中国实用护理杂志

Objective:To investigate the overall clinical performance of nursing students and analyze its influencing factors to provide evidence for the improvement.Methods:A questionnaire survey was carried out among 288 nursing students from Qilu Hospital of Shandong University in March to May 2020. The survey included a general data questionnaire, Holistic Clinical Assessment Tool, Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Medical Student Safety Attitudes and Professionalism Survey of nursing students. The factors associated with overall clinical performance of nursing students were analyzed by t test, analysis of variance, Pearson correlation analysis and multiple linear regression. Results:The total score of Holistic Clinical Assessment Tool was 114.95 ± 22.91. The total score of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was 156.70 ± 26.98. The total score of Medical Student Safety Attitudes and Professionalism Survey was 123.65 ± 31.00. The influencing factors included social practice experience and clinical learning environment, which accounted for 28.0% of the total variation of overall clinical performance of nursing students.Conclusions:Educators and managers of nursing students' schools and internship hospitals should actively explore the educational reform practice to promote the improvement of clinical ability, so as to promote the improvement of the overall clinical ability of nursing students.

The effects of Mediterranean diet on cardiovascular risk factors in patients with type 2 diabetes: a Meta-analysis / 中国实用护理杂志

Objective:To investigate the effect of Mediterranean diet on blood glucose control and cardiovascular risk factors in patients with type 2 diabetes.Methods:As to December 2021, the PubMed, Cochrance Central Register of Controlled Trials and Cochrance Database, Cochranc Library, Embase, China National Knowledge Infrastructure and Wanfang Medical Network system were searched for clinical randomized controlled trials(RCTs) of Mediterranean diet in patients with type 2 diabetes to conduct Meta-analysis The main observation index were cardiovascular risk factors, and the mean difference and its 95% confidence interval were used to estimate the effect size.Results:There were six RCTs, and 1181 patients met the inclusion criteria and entered the Meta-analysis. Compared with the control group, the intervention group can significantly reduce the level of systolic blood pressure ( MD=-1.20, 95% CI-2.21 to -0.19) and diastolic blood pressure ( MD=-4.17, 95% CI-7.12 to -1.22) in patients with type 2 diabetes mellitus, but there were no significant difference in the level of TC ( MD=2.92, 95% CI-0.84 to-6.67), HDL ( MD=2.33, 95% CI-0.27 to -4.92) and LDL ( MD=-2.34, 95% CI-5.67 to -0.99) between the two groups (all P>0.05). Conclusions:The meta-analysis provided evidence the Mediterranean diet showed the beneficial improvements in blood pressure glycemic control, but the effect of Mediterranean diet on lipid profile was not significant, which needed further verification.

Dermatomyositis with malignancy: an update / 中华皮肤科杂志

Dermatomyositis with malignancy is a subtype of dermatomyositis, and the concurrence of malignancy is a major factor for poor prognosis of dermatomyositis. Malignancy usually occurs within 1 year before or after the diagnosis of dermatomyositis. Compared with classic dermatomyositis, dermatomyositis with malignancy mostly occurs in patients aged>50 years, and is typically characterized by the heliotrope sign, skin necrosis and presence of myositis-specific antibodies such as anti-transcriptional intermediary factor-1γ and anti-nuclear matrix protein-2 antibodies, etc. Thorough screening for malignancy or close monitoring and follow-up are necessary in patients with dermatomyositis.

Clinical and imaging characteristics of 107 patients with linear morphea: a retrospective analysis / 中华皮肤科杂志

Objective:To analyze clinical, laboratory and imaging characteristics of different subtypes of linear morphea (LM) , and to propose an appropriate approach to the diagnosis and severity assessment of LM.Methods:Clinical data were collected from patients with clinically and/or pathologically confirmed LM in Department of Dermatology, West China Hospital, Sichuan University from January 2018 to December 2019, and retrospectively analyzed.Results:A total of 107 patients with LM were enrolled into this study, including 63 with LM of the limbs/trunk, 22 with morphea en coup de sabre, 11 with progressive hemifacial atrophy and 11 with eosinophilic fasciitis. Disease severity was evaluated by using the modified localized scleroderma skin severity index (mLoSSI) and localized scleroderma skin damage index (LoSDI) scores in 88 patients, with the mLoSSI scores ranging from 0 to 51 points, and the LoSDI scores ranging from 0 to 40 points. Routine blood examination of 10 patients with eosinophilic fasciitis showed increased eosinophil counts in 4 patients. Thirteen (14.8%) of 88 patients with LM were positive for antinuclear antibody, with titers of ≥ 1∶320. Magnetic resonance imaging (MRI) examination showed ipsilateral cerebral hemisphere atrophy and contralateral white matter hyperintensity on T2-weighted images in 2 out of 4 patients with progressive hemifacial atrophy, myofascial thickening in 26 out of 28 patients with LM of the limbs/trunk (92.9%) , subcutaneous septal and myofascial thickening in all 11 patients with eosinophilic fasciitis.Conclusions:The preliminary assessment of disease activity, severity and prognosis of LM can be made by mLoSSI and LoSDI. MRI examination is recommended for patients with clinical signs of involvement of subcutaneous structures.

A systematic evaluation of the postfall psychological experience of inpatients and the cognitive quality of fall prevention / 中国实用护理杂志

Objective@#To systematic evaluate the real experience of patients after falling during hospitalization and qualitative research on the cognition and demand for fall prevention will provide theoretical basis for patients, their families, medical staff and medical institutions to better carry out fall prevention.@*Methods@#English databases such as PsycINFO, Medline, Embase, CINAHL, Cochrane, PubMed, and Chinese databases such as Chinese biomedical literature database, CNKI, Wanang database were retrieved by computer. Included qualitative studies on the emotional experience of fall of inpatients and their cognition and needs for fall prevention. The retrieval time limit was until November 1, 2018.The literature was evaluated using the quality evaluation criteria for qualitative research (2016) of the JBI evidence-based health care center, and the results were integrated using a pooled integration method.@*Results@#A total of 8 studies were included, and 33 clear research results were extracted. Similar results were summarized and combined to form 7 new categories, which were integrated into 4 results. Results 1: psychological experience of hospitalized patients after falling down. Integration results 2: the causes of falls from the perspective of inpatients. Integration results 3: hospital fall prevention measures and evaluation from the perspective of inpatients. Integration result 4: inpatients expected to receive care from their families and help from medical staff.@*Conclusion@#Fall events seriously affect the mental health of patients; Patients′ cognition of falling is affected and changed by many factors. Fall prevention should shift from clinical focus to patient-centered and attach importance to the participation of family members.

Qualitative approach on the cognition and experience of fall prevention among the geriatric ward staff / 中国实用护理杂志

Objective To understand the cognition and experience of fall prevention amongthe geriatric ward staff. Methods The methods of qualitativeresearch conducted focus groups interviews of the geriatric ward staff. The interview data of focus groups were collated and analyzed using Colaizzi's seven-step analysis method. Results A total of 5 themes had been raised: the recognition of the uniqueness of elderly patients; the overestimation of self-competence; the lack of family support; the significance of environment facilities;the problem of cooperation and communication. Conclusions In the prevention of falls in elderly patients, We should identify related promote and hinder factors. And the special needs of elderly patients should be taken into consideration. The prevention strategy of falls prevention is formulated to reduce the incidence of falls.

Exploration on the Origin of Qilu Modern Nursing and Some Thoughts / 中国医学伦理学

In the early 20th century,the term Nursing was introduced into China.In 1884,with the arrival of the first batch of missionary nurse,modern nursing initiated by Nightingale was introduced into China and greatly changed the way of care.The missionary nurses were full of enthusiasm for the spreading Gospel of Christ,the love for nursing care and the empathy for Chinese people;and encountered the lack of staff and material,the mis-understanding and resistance from the local people and other multiple tests.With the untiring effort of them and the trained local nurses,China had led the international care in nursing education and practice standard.Based on this,nursing in Shandong gradually rose and had an unprecedented development as a new medical subject.By clearing up and consulting Chinese and English historical materials,this paper reviewed the 60 years of the mission-ary nurses in China,saw the early development of nursing in our country from the budding and development of Shandong nursing and provided more insights for understanding and solving the complex problems contemporary Chinese nursing faces.

Azathioprine-induced myelosuppression in a pemphigus patient with a heterozygous mutation in the NUDT15 gene / 中华皮肤科杂志

A 49-year-old male patient presented with repeated oral erosions for 1 year,as well as cutaneous erythema and blisters for 1 month.According to histopathological examination and detection of specific antibodies of pemphigus,the patient was diagnosed with pemphigus vulgaris.After the treatment with oral prednisone and azathioprine for 1 month,the white blood cell count and segmented neutrophilic granulocyte count both decreased.After withdrawal of azathioprine,the patient was subcutaneously injected with 150 μg recombinant human granulocyte colony-stimulating factor for 1 session.Then,the white blood cell count became normal.Genotyping test revealed that the patient carried a heterozygous mutation in the NUDT15 gene (JZ274),and was homozygous for wild-type TPMT*2,TPMT*3C and ITPA genes.The patient was diagnosed with azathioprine-induced myelosuppression.

In vitro study of TGF-β1-induced epithelial-mesenchymal transition of keloid epithelial cells / 中华整形外科杂志

<p><b>OBJECTIVE</b>To construct and characterize the TGF-β1, induced epithelial-mesenchymal transition (EMT) model of keloid epithelial cells in vitro, and to investigate the expression of epithelial stem cells related surface markers in keloid epithelial cells during EMT induction.</p><p><b>METHODS</b>The epithelial cells from 3 keloid samples of ears were cultured in vitro and induced by transforming growth factor betal (TGF-β1, 1 ng/ml) for 5 days, which was the experimental group, the same cells untreated were considered as the negative control group. The expressions of EMT-associated markers and regulative genes were detected using immunofluorescence staining, real-time PCR and western blot analysis. Then the surface markers of epithelial stem cells were detected using real-time PCR. Statistical significance was determined using Independent-Samples t Test, a p value less than 0. 05 was considered statistically significant.</p><p><b>RESULTS</b>The mRNA expression of transcription factor snail2 and mesenchymal-specific marker vimentin increased significantly in TGF-β1, induced keloid epithelial cells (P < 0. 05), in which snail2 increasing from 0. 91 ± 0. 23 to 1. 69 ± 0. 10, and vimentin from 5. 86 ± 2. 07 to 24. 29 ± 5. 39. Whereas the mRNA expression of epithelial-specific marker E-cadherin decreased from 1. 06 ± 0. 19 to 0. 65 ± 0. 09. The mRNA expression of CD29 and Lgr6, two surface markers of epithelial stem cells, significantly increased after induction of the TGF-β1, (P < 0. 05), from 0. 55 ± 0. 14 and 1. 61 ± 0. 31 to 1. 19 ± 0. 12 and 3. 84 t 0. 62 respectively. In induced cells, the immunofluorescence results showed staining of E- cadherin became faint, but the number of positive staining cells of vimentin increased. Western blot confirmed the protein expression of E-cadherin weakened, and the vimentin and p-Smad3 enhanced (P < 0. 05).</p><p><b>CONCLUSIONS</b>TGF-β1, initiated EMT in keloid epithelial cells by inducing the up-regulation of snail2, and TGF-β1,/Smad3 signaling pathway was involved in EMT. EMT could change the phenotype of epithelial stem cells in keloid.</p>

Cross-section survey on smoking behavior and cognition in Chongqing, 2014 / 中华流行病学杂志

Objective To investigate the prevalence of smoking, smoking cessation, passive smoking and awareness of the dangers of tobacco in population in Chongqing and provide evidence for developing prevention and control measures.Methods A total of 5 400 residents aged ≥ 18 years were selected from 9 districts/counties in Chongqing through stratified multi-stage cluster sampling and face-to-face interviews were conducted among them.Indicators as current smoking rates, smoking cessation rates and passive smoking rates were calculated by the weight of age proportions from 2010 population census.The analytical method was based on complex sampling design.Results The current smoking rate of the residents aged ≥ 18 years was 27.4％ (male: 53.5％ and female: 1.1％), which was highest in age group 40-50 years (58.4％) for males.The current smoking rate among rural residents was higher than that in urban residents.The prevalence of daily cigarette smoking was 27.5％, which was significantly higher in southeastern Chongqing.The rate of passive smoking was 52.4％.Among daily smokers, the mean number of cigarettes smoked was 17.5 per day (men: 17.6 per day;women: 13.5 per day).The daily smoked cigarette number in males was higher in age group 40-50 years (20.1 per day) and those with junior middle school education level (18.9 per day).The proportion of the current smokers who smoked more than 20 cigarettes per day (the rate of heavy smoker) was higher in males than in females and in rural residents than in urban residents.The proportion of heavy smokers was 59.3％, which was highest in age group 40-50 years (66.8％),followed by those with junior middle school educational level (65.2％).The average age of smokers when they stared to smoke was 20.8 years old, which was low in males and rural residents.About 80.2％ of the smokers stared to smoke under 25 years old, and 70.3％ of the smokers stared to smoke between 15 and 25 years old.The overall rate of smoking cessation was 20.1％ and the successful smoking cessation rate was 13.7％.The two rates increased with age, the successful smoking cessation rate was lowest in age group 18-40 years (4.8％).The awareness of the tobacco risk related knowledge seemed poor among the residents, only 19.6％ of the residents were aware that smoking could cause serious diseases (stoke, heart disease and lung cancer).21.9％ of the residents were aware that passive smoking could cause serious diseases (heart disease, lung disease and lung cancer).Conclusion Current prevalence of smoking in males in Chongqing remains at a high level,indicating that the publicity programs on the tobacco risk related knowledge needs to be strengthened and the tobacco control needs more efforts.The tobacco control in Chongqing is still facing serious challenge.