Objective To explore the development of the research on professional thinking of clinical medicos in China with the purpose of revealing its bibliometric characteristics and rules.Methods With medico and professional thinking taken as the subject terms,relevant literature published in January 2014 was retrieved from CNKI and Wanfang database in reliance on subject retrieval strategy,and then,literature was screened after the enactment of inclusion and exclusion criteria.Finally,all pieces of the included literature were analyzed by bibliometric method.Results Finally,53 papers were included in the paper,among which there were 30 (56.6％) articles published in the year 2007-2014,and priority was given to empirical research;Besides,the research topics were scattered,involving 29 (54.7％) articles of professional attitude,26(49.1％) articles of learning attitude,13 (24.5％) articles of political thought,16 (30.2％) articles of employment and employment,4 (7.5％) articles of medical ethics,12 (22.6％) articles of the idea of professional education,4 (7.5％) articles of the idea of professional,and 21 (39.6％) other topics.Conclusions China hasn't developed a system for the research on the professional thinking of clinical medicos in terms of re-search contents,or elevated the analysis on research result to theoretical level.

Objective:To study the coronal microleakage of flared root canal teeth restored with computer aided design and computer aided manufacturing (CAD/CAM)fiber post and core.Methods:60 extracted human mandibular premolars with single canal were divided into 3 groups randomly(n =20).The roots of the teeth were restored with CAD/CAM glass fiber post and core(group A), prefabricated glass fiber post(group B)and gold alloy dowel-and-core(group C)respectively.The specimens were immersed in India ink for 4 weeks.Subsequently all teeth were demineralized,dehydrated and rendered transparent.Then coronal microleakage was ob-served with stereomicroscope.Nonparametric data were analyzed.After that,All the specimens was demineralized completely in nitric acid,Then the interface between the post,resin cement and canal wall was observed and recorded.Results:The microleakage was found in all the 3 groups,group A and C showed less microleakage than group B(P <0.05).But no difference was detected between group A and C(P >0.05).Microleakage mostly appeared at the interface between post and resin cement in group A and C,while in group B,it appeared between resin cement and the wall of root canal totally.Conclusion:CAD/CAMfiber post and core demonstrates less coronal microleakage than prefabricated glass fiber post.

Objective:To construct a knowledge, attitude and practice evaluation system of nursing humanistic care, and to provide reference for improving nursing humanistic construction.Methods:Based on literature analysis, the draft evaluation system was sorted out, and two rounds of Delphi expert consultation were conducted on 28 experts, and the items were modified according to the consultation opinions.Results:The enthusiasm coefficients of the two rounds of consultation were 100% and 96.4%, the authority coefficients were 0.888 and 0.870, and the coordination coefficients were 0.342 and 0.467, respectively, which were statistically significant ( P<0.05) . The final evaluation system of humanistic care for clinical nursing staff includes 3 first-level indicators and 63 second-level indicators. Conclusion:The humanistic care evaluation system constructed in this study is scientific and practical and can be used as a scientific evaluation tool for the humanistic care ability of clinical nurses.

Objective To explore the mental health status for new nurse during the standardization training period and provide scientific basis for managers to formulate corresponding measures.Methods Using eysenck personality questionnaire (EPQ) and symptom self-assessment scale (SCL-90),understanding social support scale (PSSS),trait coping style questionnaire (TCSQ) and other standardized psychological assessment tools and self designed general situation questionnaire,141 nurses in our hospital before rotary department and 1 year later accepted the questionnaire survey while the control group accepted the same questionnaire.Results Compared with before rotary department and the control group,the forced,anxiety and interpersonal sensitivity factor increased significantly in SCL-90 for rotary nurse and the differences were significant statistical significance (P＜0.05);Pearson correlation analysis showed rotary nurse SCL-90 forcing factor scores and EPQ-E dimension scores,TCSQ negative coping scores were positively correlated (P＜0.05;r1=0.537;r2=0.407;r3=0.701),and were negatively correlated with EPQ-E dimension scores,PSSS scores and TCSQ active responding score(P＜0.05;r1=-0.621;r2=-0.671;r3=-0.312);Anxiety was positively correlated with EPQ-N,PSSS scores and TCSQ negative responding score (P＜0.05;r1=0.607;r2=0.409;r3=0.764),was negatively correlated with EPQ-E dimension scores,PSSS scores and TCSQ positive responding score(P＜0.05;r1=-0.569;r2=-0.723;r3=-0.418);Interpersonal sensitivity factor score was positively correlated with EPQ-N,P dimension scores and TCSQ negative coping scores (P＜0.05;r1=0.611;r2=0.687;r3=0.773),was negatively correlated with EPQ-E dimension scores,PSSS scores and TCSQ active responding score(P＜0.05;r1=-0.506;r2=-0.693;r3=-0.307).Conclusion Rotary nurse mental health status was significantly lower than non-rotary nurse.lnsufficient social support,negative coping style and instability personality characteristics are the main risk factors to affect the rotation nurses mental health.

Objective To explore the mental health status for new nurse during the standardization training period and provide scientific basis for managers to formulate corresponding measures.Methods Using eysenck personality questionnaire (EPQ) and symptom self-assessment scale (SCL-90),understanding social support scale (PSSS),trait coping style questionnaire (TCSQ) and other standardized psychological assessment tools and self designed general situation questionnaire,141 nurses in our hospital before rotary department and 1 year later accepted the questionnaire survey while the control group accepted the same questionnaire.Results Compared with before rotary department and the control group,the forced,anxiety and interpersonal sensitivity factor increased significantly in SCL-90 for rotary nurse and the differences were significant statistical significance (P＜0.05);Pearson correlation analysis showed rotary nurse SCL-90 forcing factor scores and EPQ-E dimension scores,TCSQ negative coping scores were positively correlated (P＜0.05;r1=0.537;r2=0.407;r3=0.701),and were negatively correlated with EPQ-E dimension scores,PSSS scores and TCSQ active responding score(P＜0.05;r1=-0.621;r2=-0.671;r3=-0.312);Anxiety was positively correlated with EPQ-N,PSSS scores and TCSQ negative responding score (P＜0.05;r1=0.607;r2=0.409;r3=0.764),was negatively correlated with EPQ-E dimension scores,PSSS scores and TCSQ positive responding score(P＜0.05;r1=-0.569;r2=-0.723;r3=-0.418);Interpersonal sensitivity factor score was positively correlated with EPQ-N,P dimension scores and TCSQ negative coping scores (P＜0.05;r1=0.611;r2=0.687;r3=0.773),was negatively correlated with EPQ-E dimension scores,PSSS scores and TCSQ active responding score(P＜0.05;r1=-0.506;r2=-0.693;r3=-0.307).Conclusion Rotary nurse mental health status was significantly lower than non-rotary nurse.lnsufficient social support,negative coping style and instability personality characteristics are the main risk factors to affect the rotation nurses mental health.

Objective:To construct a knowledge, attitude and practice evaluation system of nursing humanistic care, and to provide reference for improving nursing humanistic construction.Methods:Based on literature analysis, the draft evaluation system was sorted out, and two rounds of Delphi expert consultation were conducted on 28 experts, and the items were modified according to the consultation opinions.Results:The enthusiasm coefficients of the two rounds of consultation were 100% and 96.4%, the authority coefficients were 0.888 and 0.870, and the coordination coefficients were 0.342 and 0.467, respectively, which were statistically significant ( P<0.05) . The final evaluation system of humanistic care for clinical nursing staff includes 3 first-level indicators and 63 second-level indicators. Conclusion:The humanistic care evaluation system constructed in this study is scientific and practical and can be used as a scientific evaluation tool for the humanistic care ability of clinical nurses.

Objective To explore a reasonable transitional care quality management model, in order to standardize the management system of transitional care. Methods Using "three-dimensionalquality structure" mode as the theoretical framework, after reviewed relevant literatures, we established the rudiment of quality evaluation index system.Twenty-two experts were enrolled,and expert consultation was conducted using Delphimethod. The experts were evaluated by authority, positivity and degree of opinion coordination. Results The experts′authority coefficient was 0.846;the coefficient of determination was 0.891;the degree of familiarity was 0.80.The positive coefficients of the two rounds of consultation were 0.958,0.957. The evaluation system for transitional care consisted of 3 level- 1 indicators,12 level-2 indicators,and 64 level-3 indicators.The Kendall coefficients of concordance of the three level Indicators were 0.519, 0.525, and 0.432(P<0.05 for all). Conclusion The quality evaluation index system with With high reliability, providing standard reference for the work of quality management and nursing quality improvement.

Objective:To evaluate the status quo of humanistic care of clinical nursing staff, and analyze its influencing factors to provide theoretical basis for improving the humanistic care ability of clinical nursing.Methods:The self-compiled questionnaire on the knowledge, attitude and practice of humanistic care of clinical nursing staff was adopted in June to July 2019 to select 2 136 nurses from five first-class tertiary general hospitals in Shandong province by random sampling method for the status survey.Results:The total score of humanistic care knowledge and practice of clinical nurses was 259.54±33.55, and the standard score was 82.39±10.65. Single factor analysis showed that the total score of humanistic care knowledge, credit and practice was statistically significant for clinical nurses with different gender, age, fertility status, relationship with parents, employment reasons, initial education background, department, working years, professional title, position, employment mode and night shift frequency ( t value was -2.604, F values were 2.667-23.692, all P < 0.01). Pearson correlation showed that in the pairwise correlation analysis of knowledge, belief/attitude and behavior dimension, there was positive correlation and the correlation coefficient ( r values were 0.638, 0.431, 0.560, all P < 0.01). Multiple stepwise regression analysis showed that: the influencing factors of knowledge, attitude and practice total score of clinical nursing staff on humanistic care were the relationship between the parents, employment way, night shift frequency, fertility status, and the employment reason, the initial degree, department, position ( β values were -0.132-0.126, all P < 0.05). Conclusions:The current situation of humanistic care knowledge and practice of clinical nursing staff is in the middle level. Relationship with parents, position, night shift frequency, fertility status, employment reasons, initial education background, department, and employment mode are the factors that affect the current situation of humanistic care, knowledge, attitude and practice of clinical nurses. Therefore, medical institutions should adopt targeted and focused training methods and intervention measures to improve the level of nursing staff′s knowledge, faith and practice from the aspects of different influencing factors of clinical nursing staff′s humanistic care.

Objective:To investigate the effect of the lactitol powder combined with piperacillin sodium and tazobactam sodium in patients with spontaneous bacterial peritonitis (SBP), and the influence on the body microenvironment.Methods:The clinical data of 135 patients with SBP from January 2017 to December 2019 in Huxi Hospital Affiliated Jining Medical College were retrospectively analyzed. Among them, 68 patients were treated with lactitol powder combined with piperacillin sodium and tazobactam sodium (observation group), 67 patients were treated with piperacillin sodium and tazobactam sodium (control group). The curative effect was compared between 2 groups. The recovery time of clinical symptoms and signs (disappearance time of abdominal pain, disappearance time of abdominal distension, disappearance time of abdominal tenderness, recovery time of body temperature and recovery time of ascites white blood cell), liver function indexes (alanine aminotransferase, ALT; total bilirubin; albumin; aspartate aminotransferase, AST), microcirculation indexes (haptoglobin; procalcitonin; interleukin-6, IL-6; neutrophil gelatinase-associated lipocalin, NGAL), intestinal mucosal permeability indexes (endotoxin, blood ammonia, diamine oxidase) and adverse reactions (diarrhea, nausea and skin itching) were recorded.Results:The total effective rate in observation group was significantly higher than that in control group: 95.59% (65/68) vs. 82.09% (55/67), and there was statistical difference ( P<0.05). The disappearance time of abdominal pain, disappearance time of abdominal distension, disappearance time of abdominal tenderness, recovery time of body temperature and recovery time of ascites white blood cell in observation group were significantly shorter than those in control group: (6.15±1.34) d vs. (8.26±1.19) d, (5.34±1.29) d vs. (7.18±1.35) d, (7.59±1.65) d vs. (9.86±1.80) d, (5.28±1.20) d vs. (6.39±1.12) d and (10.87±2.25) d vs. (12.18±1.67) d, and there were statistical differences ( P<0.01). The ALT, total bilirubin, AST, haptoglobin, procalcitonin, IL-6, NGAL, endotoxin, blood ammonia and diamine oxidase 1 and 2 weeks after treatment in observation group were significantly lower than those in control group, and there were statistical differences ( P<0.01); there was no statistical difference in albumin between 2 groups ( P>0.05). There was no statistical difference in incidence of adverse reactions between2 groups ( P>0.05). Conclusions:The lactitol powder combined with piperacillin sodium and tazobactam sodium for SBP patients can more significantly improve the liver function and intestinal mucosal permeability, and promote the body microenvironment and the recovery of symptoms.

Objective:To investigate the molecular epidemiological characteristics and antibiotic resistance of Clostridioides difficile ( Cd) in hospitalized diarrhea patients in a tertiary hospital in Shaanxi Province. Methods:This study collected 425 stool samples of hospitalized diarrhea patients from October 2018 to December 2021 for isolation and identification of Cd. Toxin genes carried by the isolates were detected. Multilocus sequence typing (MLST) was performed to analyze the phylogenetic profile. Antibiotic susceptibility was analyzed by E-test. Results:Forty-nine strains of Cd were isolated from the 425 samples, including 37 strains of toxigenic Cd (75.5%, 37/49). The detection rate of Cd was 14.0% (25/179) in diarrhea patients aged ≥65 years old and 36.4% (4/11) in Nephrology Department. In the 37 toxigenic Cd strains, A -B + CDT -Cd, A + B + CDT -Cd and A + B + CDT +Cd accounted for 18.9% (7/37), 78.4% (29/37) and 2.7% (1/37), respectively. There were 24 ST types, among which ST2, ST3 and ST54 were the predominant types, each accounting for 12.2% (6/49). All strains were sensitive to metronidazole and vancomycin, with a high resistance rate of 93.9% (46/49) to ciprofloxacin and a low resistance rate of 12.2% (6/49) and 10.2% (5/49) to rifampicin and meropenem, respectively. Conclusions:The main type of toxigenic strains was A + B + CDT -. ST2, ST3 and ST54 were the predominant types and the distribution of ST types was scattered. All isolates were sensitive to metronidazole and vancomycin and most of them were resistant to ciprofloxacin.