Objective To evaluate the effects of clinical pathway combined with transitional care implemented by specialty nurses on patients with coronary heart disease after PCI (percutaneous coronary intervention) therapy. Methods Totally 124 patients after PCI were divided into the experimental group and the control group with random digit table. Patients in the control group received routine education and follow- up during hospitalization and discharge period. The experimental group received clinical pathway combined with transitional care implemented by specialty nurses based on routine education. The level of patients′knowledge, attitude, practice and risk factors were compared between the two groups 6 and 12 months after discharge. Results There were 55 patients in each group completed the research ultimately. The Coronary Heart Disease Knowledge Questionnaire in the experimental group scored (57.61 ±8.77), (81.27±6.88) and (88.47±6.10),while the control group scored (59.71±7.32),(68.61±7.12) and (76.85±7.70), after repeated measurement analysis of variance, F=74.71, 14.52, P<0.01. The scores of General Self- Efficacy Scale (GSES) and Coronary Artery Disease Self- Efficacy Scale (CSMS) between two groups at three time points showed statistical significance, F=5.40, 14.52, P<0.05 or 0.01. The risk factors of coronary heart disease such as total cholesterol, triacylglycerol, hemoglobin A1c, body mass index, systolic pressure and diastolic pressure were statistically different between two groups except for high density lipoprotein cholesterol and low density lipoprotein cholesterol, F=5.82, 20.32, 4.14, 4.15, 4.99, 7.15, P<0.05 or 0.01. Conclusions Clinical pathway combined with transitional care implemented by specialty nurses can improve the knowledge-attitude- practice level of patients, help to control the risk factors of coronary heart disease. It is an effective heart rehabilitation model for patients after PCI.

Objective To choose a best cultivar by comparing the content of total flavonoid and naringin between different cultivars of Citrus grandis 'tomentosa'.Methods The content of total flavonoids was determined by spetral photometric analysis.The content of naringin was determined by HPLC.Results The content of total flavonoid was 19.24 % and 18.06 %,and naringin content was 11.72 % and 12.38 % in the cultivars from Dachaling and Fengwei respectively,which were much higher than the other cultivars.Conclusion The contents of total flavonoid and naringin were different in different cultivars of Citrus grandis 'tomentosa'.The cultivars of Citrus grandis 'tomentosa' from Dachaling and Fengwei have the best quality.

Objective To systematically assess the efficacy and safety of non-indwelling urinary catheter during perioperative period of cesarean section.Methods The databases including Medline(PubMed),EMbase,Cochrane Library,CNKI and WanFang Data were retrieved by computer.The randomized controlled trials (RCTs) on the efficacy and safety of non-indwelling urinary catheter during perioperative period of cesarean section were comprehensively collected.Two reviewers independently screened literatures,extracted the data and assessed the quality.The Meta-analysis was conducted by using RevMan 5.3 software.Results A total of 5 RCTs involving 1 090 patients were included.The meta-analysis results showed that compared with the indwelling urinary catheter group,although the non-indwelling urinary catheter group increased the incidence rate of urinary retention[RR=11.67,95%CI(2.22,61.24),P<0.01],but significantly decreased the incidence rate of urinary tract infection(UTI) [RR=0.10,95%CI(0.04,0.26),P< 0.01] and incidence rate of initial urination discomfort [RR=0.17,95%CI (0.04,0.74),P=0.02],significantly shortened the initial time of off-bed activities [SMD=-3.68 ,95%CI(-5.25,-2.12),P<0.01]and hospitalization time [SMD=-1.03,95%CI(-1.67,-0.38),P<0.01].There were no significant differences in the operation time[SMD=-0.13,95%CI(-0.32,0.07),P=0.20] and incidence rate of postpartum hemorrhage (PPH)[RR=1.50,95%CI (0.43,5.26),P=0.53],The incidence rates of bladder injury in the two groups were similar.Conclusion According to the evidence of current clinical researches,selecting non-indwelling urinary catheter in elective cesarean section is effective and safe,prompting that indwelling urinary catheter during the perioperative period of cesarean section is selective rather than routine indwelling.

Objective? To explore the effect of video education combined with Teach-back on the compliance of patients with rheumatoid arthritis(RA) to exercise at home and the condition of disease activity. Methods? By convenience sampling, 80 patients with RA who were hospitalized in the Rheumatology and Immunology Department of Sichuan Provincial People's Hospital from March to November 2018 were included in the study. By random number table, the patients were divided into the intervention group and control group, the control group was given routine discharge instruction and the patients were taught about the functional exercise orally; on the basis of that, the intervention group was given the video education combined with Teach-back and assisted to download videos, Family Exercise Compliance Scale and Disease Activity Score in 28 Joints(DAS28) were used to evaluate the patients' compliance in functional exercise at home and disease activity condition before intervention, 1 month and 3 months after intervention. Results? Finally, 73 cases(37 cases in the control group, 36 cases in the intervention group) in two groups completed the research plan. One and 3 months after intervention, the compliance with family functional exercise of the intervention group was better than the control group from the same period with statistical significance(P＜0.05); the scores of Tender Joint Coun(t TJC28), Swollen Joint Coun(t SJC28), Patient General Health(GH) of the intervention group were all lower than the control group from the same period with statistical significance (P＜0.05), however, the scores of Erythrocyte Sedimentation Rate(ESR) and DAS28 didn't demonstrate obvious intervention effects (P＞0.05). Conclusions? Video education combined with Teach-back can effectively improve the compliance of RA patients with home functional exercise, help to cultivate healthy behavior, and hence reduce the number of tender joint, swelling joints, reduce the degree of pain, improve the prognosis of patients.

Objective To explore the mediation role of emotional labor in the relationship between workplace ostracism and emotional exhaustion, aiming to provide practical implications to manage workplace ostracism. Methods Using time-lagged survey, a total of 370 valid responses were collected at two time points from the nurses in a general hospital in Chengdu, including the data of demographics, workplace ostracism, emotional labor and emotional exhaustion. Structural equation model (SEM) was employed to test the relationships. Results The means of key variables were: workplace ostracism 1.30 (1.00, 1.73)，surface acting 1.50 (1.00,2.25), deep acting 3.00 (1.33, 4.00), and emotional exhaustion 3.53 (2.60, 4.20). There was a significant positive relationship between workplace ostracism and surface acting (P<0.01), just as well as the relationship with deep acting and emotional exhaustion (P<0.01). Surface acting led to emotional exhaustion of nurses (P<0.01) and mediated the positive relationship between workplace ostracism and emotional exhaustion. Deep acting was not significantly related to emotional exhaustion (P>0.05). SEM analysis demonstrated an acceptable and reasonable model fit. Conclusions The surveyed nurses reported a medium and low level of perceived workplace ostracism and emotional labor, but a high level of emotional exhaustion. Workplace ostracism has a positive effect on nurses' emotional exhaustion via surface acting. Hospital administration should take measure to prevent and intervene in workplace ostracism, provide organizational and supervisory supports to nurses, and particularly enhance nurse's emotional management skills and encourage use of deep acting strategy to minimize the detrimental effects of workplace ostracism.

Objective To investigate the risk factors for complications within 1 year after carotid artery stenting(CAS),construct a prediction model for these complications based on the identi-fied risk factors,and then validate the efficacy of the model.Methods A retrospective trial was conducted on 313 patients undergoing CAS in our hospital between January 2017 and December 2021.Based on the sequence of postoperative follow-up visits,these patients were categorized into a modeling group(235 cases)and a validation group(78 cases)in a ratio of 3∶1,and the patients of the modeling group was further assigned into non-complication(182 cases)and complication subgroups(53 cases).The general data were compared between the modeling and balidation groups,and univariate and multivariate logistic regression analyses were applied to identify risk factors for the risk factors for the complications,and then a prediction model was constructed using logistic scoring.ROC curve analysis was employed to evaluate the performance of the model by using AUC value.Results Multivariate logistic regression analysis revealed that non-compli-ance with antiplatelet medication(OR=65.656,95％CI:12.052-357.683,P=0.000),and abnor-mal BMI(OR=2.298,95％CI:1.023-5.163,P=0.044),cigarette history(OR=5.965,95％CI:2.527-14.079,P=0.000),and high LDL-C(OR=6.290,95％CI:1.828-21.645,P=0.004)were independent risk factors for complications occurrence within 1 year after CAS surgery.The AUC value was 0.827 for the modeling group and 0.806 for the validation group.Conclusion Non-com-pliance to antiplatelet medication,abnormal BMI,smoking history,and high LDL-C level are inde-pendent risk factors for complications occurrence within 1 year after CAS.Our developed ABCD risk prediction model demonstrates good discrimination and accuracy,and can provide valuable guid-ance for the early identification and prevention of complications following CAS surgery in clinical practice.

Objective To investigate nurses' scientific research competency and training demand in Chinese tertiary hospital.Methods It was a multi-stage large-scale survey.A total of 27 335 nurses from 22 provinces/autonomous regions/municipalities were recruited to complete the self-designed questionnaire,including demographic data(7 items),scientific research competency(objective index of 4 items,and subjective index of 6 subscales with 40 items),and training demand evaluation(6 subscales with 16 items).Results There were 1 130(4.14％) nurses who had managed or were managing the research projects as principal investigators(PIs),2 147(7.85％)nurses who had attended or were attending research programs,1 463(5.35％) nurses had published papers,and 557(2.04％) nurses obtained patents.The self-evaluated competency score was 25.00 (12.50,37.50)(rangedfrom 0 to 100)and training demand score was 53.13(37.50,75.00)(ranged from 0 to 100).Conclusion The nurses' scientific research competency should be improved and they had strong training demands.In order to improve nurses' research competency and quality,nursing administrators should pay more attention to post-graduate training focusing on research competency.

Objective:To analyze the application effect of the home care model based on the Omaha system for elderly maintenance hemodialysis patients.Methods:A total of 73 elderly patients undergoing maintenance hemodialysis in the First People's Hospital of Longquanyi District, Chengdu city from December 2018 to December 2019 were enrolled.According to the randomization and double-blind principle, they were divided into the control group receiving the clinical routine care mode(n=32)and the intervention group undergoing the home care mode based on Omaha system(n=41). The Quality of Life Score, care satisfaction and awareness rate of health knowledge of patients were compared between the two groups before and after the care intervention.Results:Compared with before intervention, the quality of life scores was increased after caring in both two groups.And the scores in all dimensions were better in the intervention group than in the control group( t=3.173, 3.833, 3.514 and 4.593, P=0.001, 0.000, 0.000 and 0.000). The awareness rates of nutrition knowledge, water-intaking knowledge, iron supplementation knowledge, potassium and phosphorus limitation and dialysis mode were better in the intervention group than in the control group( χ2=7.592, 5.423, 8.494, 6.161 and 6.962, P=0.011, 0.011, 0.000, 0.010 and 0.011). The total satisfaction rate was 97.6%(40/41)in the intervention group, which was superior to that in the control group(75.0% or 24/32)( χ2 =8.460, P=0.000). Conclusions:The extended home care model based on the Omaha system can effectively improve patients' awareness of health knowledge, improve patients' quality of life and improve the satisfaction with care in elderly maintenance hemodialysis patients with a low education level, and it is worthy of clinical promotion.

Objective To construct and validate a risk prediction model for poor inhalation in chronic obstructive pulmonary disease(COPD)patients receiving inhaler therapy,providing a decision support tool for personalized prevention of poor inhalation.Methods A cross-sectional study was conducted to collect data related to COPD patients receiving inhaler therapy,forming a dataset.The dataset was randomly divided into a training set and a test set in a ratio of 4∶1.Four different methods for missing value imputation,3 methods for variable feature selection,and 18 machine learning algorithms were employed to successfully construct 216 models on the training set.The monte carlo simulation method was used for resampling in the test set to validate the models,with the area under curve(AUC),accuracy,precision,recall,and F1 score used to evaluate model performance.The optimal model was selected to build the poor inhalation prediction platform.Results A study involving 308 patients with COPD found that 135(43.8%)were at risk of adverse inhalation.Using 33 predictor variables,216 risk prediction models were developed.Of these models,the ensemble learning algorithm yielded the highest average AUC of 0.844,with a standard deviation of 0.058[95%CI=(0.843,0.845)].The differences in predictive performance among the 216 models were statistically significant(P＜0.01).Under the ensemble learning algorithm,adherence to inhaler use(38.087 4%),inhaler satisfaction(25.680 1%),literacy(24.031 3%),number of inhalers(5.482 3%),age(4.204 5%)and number of acute exacerbations in the past year(2.184 7%)contributed most to the predictive model.The model exhibited superior performance,with an AUC of 0.869 3,an accuracy of 83.87%,a precision of 86.96%,a recall of 74.07%,and an F1 score of 0.8.Conclusion This study has developed a predictive model for poor inhalation risk in COPD inhaler therapy patients using machine learning algorithms,which exhibits strong predictive capabilities and holds potential clinical application value.