Objective To explore the present state of clinical decision-making ability of nursing students in Sichuan Province. Methods The instrument for measuring the clinical decision-making ability of nursing students was adopted te investigate baccalaureate nursing students from four colleges and uni-versifies in Sichuan Province who had completed 10-12-month clinical practice. Results The overall mean score of clinical decision-making ability of baccalaureate nursing students in Sichuan Province was (72.86± 4.53). Among the dimensions, the scoring rate of Goal-setting Ability Dimension was the highest and that of evaluation-feedback ability dimension the lowest. In terms of the qualification rate of clinical decision-making ability, 99.52% of the students were qualified (4.82% good and 94.7% passed) and 0.48% was unqualified. Conclusions Baccalaureate nursing students in Sichuan Province have not showed a high level in clinical nursing decision-making ability and most of them are just qualified. No students have reached the level of excellence.

BACKGROUND:Oxidized low-density lipoprotein(ox-LDL) is recognized as the essential condition for atherosclerosis.As the ox-LDL-specific receptor,oxidized low-density lipoprotein receptor-1(LOX-1) involved in vascular inflammation and plaques develop-ment of the process.OBJECTIVE:To investigate the effect of fluvastatin on the expression of LOX-1 in human umbilical vein endothelial cells(HUVECs) induced by ox-LDL.DESIGN,TIME AND SETTING:The comparative observation was completed in the Medical Center of Second Xiangya Hospital,Central South University between August 2006 and May 2007.MATERIALS:Human umbilical vein endothelial cell line was purchased from the America ATCC Company.Fluvastatin original powder was supplied by Beijing Novartis Pharmaceutical Co.,Ltd.METHODS:HUVECs were incubated with:①Stimulation by ox-LDL with end concentration of 25,50,100 mg/L.②LOX-1 neutralizing antibody,and interfered with 50 mg/L ox-LDL.③Interfered with nuclear factor-?B(NF-?B) blockers pyrrolidine dithiocarbamate(PDTC),followed by 50 mg/L ox-LDL intervention.④Fluvastatin with concentration of 0.01,0.1,1 ?mol/L were used to interfere the cells,followed by 50 mg/L ox-LDL intervention.⑤There was an blank group as the control.MAIN OUTCOME MEASURES:The expression of LOX-1 mRNA level was detected by RT-PCR.RESULTS:The levels of mRNA of LOX-1 were increased after cells had beenwere incubated with different concertrations of ox-LDL,when compared with the control group.Within the dosage range of 25 to 50 mg/L,the above-mentioned indexes significantly changed in a concentration-dependent manner(P

PURPOSE: The purposes of the study were to examine psychological distress and health-related quality of life (HRQoL) in relocated and nonrelocated survivors aged 60 years and older, and to analyze predictors for psychological distress and HRQoL in older survivors 5 years after the 2008 Sichuan earthquake. METHODS: This was a cross-sectional descriptive study with 112 relocated older survivors and 156 nonrelocated older survivors. Our study used a multistage sampling method. The measurements used in the study included self-reporting questionnaire-20, medical outcomes study 36-item short form health survey, and an instrument measuring demographic and disaster-related characteristics. Descriptive and multiple linear regression analysis were performed to determine factors that contributed to psychological distress and HRQoL. RESULTS: The prevalence of psychological distress in relocated group (20.5%) was significantly higher compared to those in nonrelocated group (4.8%). Scores for HRQoL in relocated older survivors was significantly lower than those in nonrelocated older survivors. Relocation from preearthquake residence was the most significant predictor for psychological distress and HRQoL in the total sample. Other predictors were advanced age, lower educational level, the loss of family members during the earthquake, and the presence of chronic illnesses as well as the death of a spouse after the earthquake. CONCLUSIONS: Strategies can be designed in postdisaster recovery program, particularly for older survivors at high risk for psychological distress and poor HRQoL.
*Adaptation, Psychological ; Age Factors ; Aged ; Aged, 80 and over ; China/epidemiology ; Cross-Sectional Studies ; Disasters ; *Earthquakes ; Female ; *Health Status ; Humans ; Male ; Middle Aged ; Prevalence ; Quality of Life/*psychology ; *Residence Characteristics ; Socioeconomic Factors ; Stress, Psychological/*epidemiology ; Surveys and Questionnaires ; Survivors/*psychology

Permanent magnet motor has been widely used in the field of artificial heart pump due to its high power density, high stability and easy control. In this paper, the development history and research progress of permanent magnet motor for blood pump were described. Firstly, the motors were classified according to their structures and application scenarios. And then, the measures taken by different types of motors to meet the corresponding performance requirements were introduced, and the specific application cases were given. After that, commonly used control algorithms of these motors were enumerated. What's more, the advantages and disadvantages of the control algorithms and their application emphasis were carefully explained. Finally, the paper was summarized in short.
Algorithms ; Blood Substitutes ; Heart, Artificial ; Magnetics ; Magnets ; Prosthesis Design

Objective To investigate the current staffing of nurses and need of hospital nursing human resources in China.Methods Data were collected from 181 secondary and tertiary hospitals and 9774 nurses in mainland China by questionnaires.Results The average doctor-nurse ratio was 1 ∶ 1.39 in tertiary hospitals and 1 ∶ 1.31 in secondary hospitals.The doctor-nurse ratios in 164 hospitals (97.6％) and the proportion of nurses in health care staff in 105 hospitals (61.8％) had not reached the standard set by the Ministry of Health of China.62.3％ nurses held secondary diploma for their initial nursing education.The constituent ratio of nurses held secondary diploma decreased,while the ratio of nurses held advanced diploma and bachelor degree increased in the last 5 years from 2003 to 2007.Sixty percent of newly employed nurses were contract nurses in 2003.The proportion increased to 78％ in 2007,and in some regions it accounted for more than 90％ of new nurses.The needs and constituent ratio of nurses with.secondary diploma and advanced diploma would decrease while nurses with bachelor degree and master degree would increase in the next 5 years (from 2009 to 2013).Conclusions The nursing shortage is still severe in China,and nursing staff mainly held secondary diploma for their initial nursing education.Most of new nurses were employed as conwact nurses.The need of hospitals for nurses has increased,especially for nurses with higher educational level such as bachelor degree and master degree,while the need for secondary diploma hold ers have decreased.The need for advanced diploma holders has increased in the last 5 years and would decrease in the next 5 years,but they would still be the majority of employed nurses.The authors suggested that the staffing of nursing manpower,the work environments and career development of contract nurses should be improved,and the initial nursing education should be upgraded to meet the needs of hospitals.

Objective: To investigate the effects of different developmental patterns on the increases of thyroid volume in children from different genders and periods, and to explore whether there is a synergistic effect on the initiation of puberty in girls, so as to provide a theoretical basis for reducing the risk of thyroid abnormalities in adulthood. Methods: A multi-stage cluster sampling was used to select a primary school in Minhang District of Shanghai, Haimen City of Jiangsu Province and Yuhuan city of Zhejiang Province. A total of 784 children aged 8-10 years old were included in "8-10 years school-aged children cohort". At the same time, a total of 491 girls aged 11-13 years were included in the "11-13 years adolescent girls cohort". The content of survey on follow-up was consistent with the one on baseline. B-ultrasonography was used to measure thyroid volume. The physical development indexes such as height (H), weight (W) and waist circumference (WC) were measured. The morning urine samples were collected and the urinary iodine content was detected. The changes of body mass index (BMI), waist circumference (WC), and thyroid volume (V) were calculated (d BMI, d WC, and d V, respectively). According to the changes of BMI and WC, the subjects were classified into four types of developmental changes, namely "B-LW-L (low d BMI, low d WC)" "B-LW-H (low d BMI, high d WC)" "B-HW-L (high d BMI, low d WC)" and "B-HW-H (high d BMI , high d WC)". Results In partial correlation analysis, thyroid volume was significantly correlated with BMI and WC at baseline or follow-up(P<0.05). The changes of thyroid volume in 8-10 years old boys were related to the changes of BMI and WC (P<0.05), the changes of thyroid volume in 8-10 year old girls were only associated with the changes of WC (P=0.03), and no association was found in 11-13 year old girls(P>0.05). In multivariate logistic regression analysis, after adjusting for baseline age, region, and differences of urinary iodine, the risk of thyroid volume increasing in B-HW-H was 2.70 times (95%CI=1.29-5.66) higher than that of B-LW-L in boys aged 8-10 years; among girls aged 11-13 years, the risk of thyroid volume increasing in B-LW-H, B-HW-L and B-HW-H were 2.46 times (95%CI=1.31-4.61), 2.16 times (95%CI=1.15-4.03) and 1.79 times (95%CI=1.07-2.99), respectively; there was no interaction between menarche age and developmental pattern on thyroid volume change trend (P=0.49). Conclusion The thyroid volume in children and adolescents increases with the development of physical development. Different developmental patterns and estrogens have certain effects on thyroid morphological changes. To avoid obesity in childhood (especially with central obesity), timely identify and effectively intervene thyroid morphological abnormalities in childhood，and to reduce the risk of thyroid diseases in adulthood.

ObjectiveTo investigate the specific anti-SARS-CoV-2 antibody in adults and above after initial vaccination with inactivated COVID-19 vaccine， and determine the influencing factors. MethodsIn this study， residents aged 18 and above who had completed two doses of inactivated COVID-19 vaccine in Deqing County， Huzhou City， Zhejiang Province were included. Information such as gender， age， type of vaccine and vaccination time were collected， and serum specimens were sampled. Anti-SARS-CoV-2 receptor binding domain （RBD） antibody was quantitatively examined by enzyma-linked immunosorbent assay （ELISA） and influencing factors were determined. ResultsThe median concentration of anti-SARS-CoV-2 IgG antibody in the residents vaccinated with an inactivated booster vaccine was higher than that in those vaccinated with only two doses of COVID-19 vaccine or single dose （P<0.05）. The median concentration of IgG antibody in males was 9.73 （4.01‒23.70） RU‧mL^-1， lower than 17.76 （7.07‒49.23） RU‧mL^-1 in females （P<0.05）. The median concentration in the residents vaccinated with BBIBP-CorV （Sinopharm） was 6.53 （0.97‒13.69） RU‧mL^-1， which was lower than that in those vaccinated with CoronaVac （Sinovac） that was 17.29 （8.54‒43.73） RU‧mL^-1 （P<0.05）. The median concentration in those with BBIBP-CorV was also lower than 12 （5.45‒40.06） RU‧mL^-1 in those with heterologous booster vaccine （P<0.05）. The median concentration was 9.73 （3.83‒23.63） RU‧mL^-1 in the residents with an interval of more than 6 months from the second dose， which was lower than 14.66 （6.36‒35.98） RU‧mL^-1 in those with an interval of 3‒6 months （P<0.05）. Moreover， immune effect was better in females （χ²=16.464， P<0.05）， 18‒45 years（χ²=7.158， P<0.05）， and those vaccinated with CornaVac （χ²=49.637， P<0.05）， while decreased in those with an interval of more than 6 months from the second dose （χ²=8.447， P<0.05）. ConclusionGender， age， and type of vaccine may affect the effect of immunization. The COVID-19 vaccination shows an acceptable immunogenicity in adults； however， it declines in 6 months after vaccination. It warrants strengthening the booster vaccination to maintain the immune response.

Gaming addiction， as a main manifestation of internet addiction， is characterized by a pattern of persistent or recurrent gaming behaviors. Gaming behaviors are common among adolescents and can result in marked distress or significant impairment in personal， family， social or other important areas of functioning. Recent research on health hazards of gaming addiction is relatively scattered. This article reviews the harm of adolescent game addiction to physical and mental health.

ObjectiveTo determine the serum antibody level and risk factors in the adolescent population in a county in Zhejiang Province， following the immunization with inactivated COVID-19 vaccine， and to construct a prediction model for antibody concentration. MethodsWe conducted the study in a county in Zhejiang Province， employing a stratified cluster random sampling strategy in school children who had received the inactivated COVID-19 vaccine. Data on gender， age， type of vaccine， and time of vaccination was collected. Serum samples were also collected to test for anti-S and N IgG antibody against the SARS-CoV-2 by using chemiluminescent immunoassay （CLIA）. Risk factors were determined to construct a prediction model for antibody concentration. ResultsThe IgG antibody concentration was significantly higher in girls， those who received two doses， and those who had simply received the KX vaccine . It decreased with age and time interval between the sampling and last vaccination. The prediction model constructed by random forest regression in the study had a better model fit and predictive ability than that by the multivariable linear stepwise regression. ConclusionGender， age， vaccination dose， type of vaccine， and time of vaccination are associated with vaccination effectiveness of inactivated COVID-19 vaccines in adolescents. Prediction model could predict the antibody level in the vaccinated population， which can provide a new tool for better evaluation of vaccination effectiveness against emerging infectious diseases in future.

ObjectiveTo understand the usage of antibiotics in outpatients in a county of Zhejiang Province from 2015 to 2020， so as to provide a basis for further standardizing the clinical application of antibiotics in this region. MethodsOutpatient records and prescription records of 146 public medical institutions from 2015 to 2020 were extracted from the electronic medical record data sharing platform system of medical institutions in a county of Zhejiang Province. The utilization rates and the number of types of antibiotics used in outpatient patients were described. According to the drug anatomy， therapeutic and chemical classification system （ATC）， clinical application classification and dosage form， the use status of different types of antibiotics was observed. The annual percentage change （APC） was used to analyze the time trend of antibiotic use. Among the antibiotic prescriptions in each year， the proportions of prescriptions aimed for different use reasons and patients were compared to analyze the changes in the structures of antibiotic prescriptions. ResultsDuring 2015‒2020， a total of 2 861 438 prescriptions were issued in146 primary public medical institutions in this county， including 314 642 prescriptions for antibiotics， and the overall utilization rate of antibiotics was 11%. The utilization rate of antibiotics showed a decreased trend across the years （from 14.23% in 2015 to 7.59% in 2020，APC=-11.51%， 95%CI=-0.01%‒-21.7%， t=-12.05， P<0.001） and an obvious seasonal variation character （higher in winter and spring， lower in summer and autumn）. Cefoxitin sodium for injection was the most used antibiotic in 2015， and cefuroxime was the most used antibiotic from 2015 to 2020， respectively. The utilization rates of cephalosporins （APC=-11.06%， 95%CI=0‒-20.89%， t=-22.233， P<0.001）， quinolones （APC=-9.74%， 95%CI=0‒-18.53%， t=-7.652， P=0.002）， macrolides （APC=-17.52%， 95%CI=0‒-17.52%， t=-3.626， P=0.022） and lincoamides （APC=-49.01%， 95%CI=0‒-74%， t=-3.35， P=0.029） showed a decreasing trend across the years. There were differences in the distribution of drug use reasons （χ²=9 458.427， P<0.001）， as well as the age （χ²=5 421.709， P<0.001） and sex （χ²=245.322， P<0.001） of patients. During the observation period， 50.69% of antibiotic prescriptions were used to treat respiratory diseases， with the highest proportion of 57.67% in 2015 and the lowest proportion of 34.93% in 2020. 58.37% of patients were aged 50‒70 years， with a decreasing proportion of patients under 50 years （17.83% in 2015， 6.64% in 2020） and an increasing proportion of patients over 70 years （24.1% in 2015， 38.41% in 2020）. ConclusionThe utilization rate of antibiotics used in outpatients from primary public medical institutions in a county of Zhejiang Province shows a decreasing trend across the years， but higher than that of secondary and above hospitals in China， and also higher than that of primary medical institutions in economically-developed areas. The management and monitoring of the clinical use of antibiotics in the county should be actively strengthened.