Objective To describe the structure and the level of the stress of nursing students in clinic practice,and supply reference for reform of clinical teaching method.Methods Totally 100 undergraduate nursing students in clinic practice,who would graduate from nursing school and begin to work in 2013,were interviewed and investigated.Results The main stress sources were divided into five aspects:recognition,clinical nursing ability,career development,field response and exhaustion of body and mind.Conclusions The structure and level of the stress of nursing students changed a lot.Some new appropriate reform should be introduced into clinic education,in order to help nursing students to complete psychological change and role adaptation.

OBJECTIVE To analyze the epidemiological characteristics,the efficiency of the surveillance system for nosocomial infections in our hospital,the sensitivity,specificity and timeliness of case reporting and to evaluate the efficiencies of the monitoring and reporting system.METHODS We reviewed the nosocomial infection reporting data in the year of 2005 and identified all the reported cases,confirmed cases and under-reported cases.Sensitivity and specificity of the reporting system were calculated based on these data.RESULTS The incidence of nosocomial infection was 3.04% in 2005.A majority(72.07%) of the cases were reported within 7 days of occurrence.Respiratory tract infection accounted for 57.75% of all nosocomial infections and was by far the most common site of concern.The rates of false positive reporting ranged from 14-37% and were statistically significantly associated with the sites of the infection(P

Objective To explore the associations of anxiety with optimism ,resilience and related demographic factors in lung cancer patients , and to provide a scientific basis for reducing the level of anxiety and improving the psychosomatic health. Methods A total of 130 lung cancer pa-tients from the department internal medicine of respiratory tumors in Liaoning Cancer Hospital&Institute were investigated by convenience sam-pling method from February 2013 to January 2014. The survey was anonymous. Finally,107 questionnaires were effective,and the effective rate was 82.307%. Results Among lung cancer patients,optimism and resilience were positively and significantly associated with anxiety. Physical ex-ercise had an effect on the anxiety symptoms. Conclusion Optimism and resilience have significant predictive value on the anxiety among lung cancer patients. It is important to encourage lung cancer patients to improve their psychological health ,so as to reduce their anxiety symptoms effec-tively.

In hospital performance evaluation, significant differences in the work objects, work content and economic operation of various departments result in the lack of indicators comparability between different departments. This has become a prominent problem that hospitals have been unable to effectively solve for a long time, and has also affected the fairness of performance distribution to a certain extent. Starting from the dilemma of cost-benefit evaluation, the authors put forward the basic concepts of the sequence advance and retreat method, and comprehensively elaborated the implementation steps and operating points of the performance assessment using the sequence advance and retreat method. It is pointed out that the sequence advance and retreat method has four characteristics: weakening the differences between departments by vertical and horizontal combination, avoiding the deviation of guidance by scientific comparison, highlighting the incentive effect by grade differentiation, and reflecting the advantages and disadvantages by end adjustment. The value of this method in the hospital performance appraisal system is discussed from three aspects: promoting the de-profitization process of hospitals, achieving fair distribution of hospital performance, and strengthening the guidance of hospital performance management. Based on such studies, this article provides new methods and ideas for building a more scientific and fair performance evaluation system.

Objective The aim of this study was to explore the role and mechanism of ferroptosis in SiO2-induced cardiac injury using a mouse model. Methods Male C57BL/6 mice were intratracheally instilled with SiO2 to create a silicosis model.Ferrostatin-1(Fer-1)and deferoxamine(DFO)were used to suppress ferroptosis.Serum biomarkers,oxidative stress markers,histopathology,iron content,and the expression of ferroptosis-related proteins were assessed. Results SiO2 altered serum cardiac injury biomarkers,oxidative stress,iron accumulation,and ferroptosis markers in myocardial tissue.Fer-1 and DFO reduced lipid peroxidation and iron overload,and alleviated SiO2-induced mitochondrial damage and myocardial injury.SiO2 inhibited Nuclear factor erythroid 2-related factor 2(Nrf2)and its downstream antioxidant genes,while Fer-1 more potently reactivated Nrf2 compared to DFO. Conclusion Iron overload-induced ferroptosis contributes to SiO2-induced cardiac injury.Targeting ferroptosis by reducing iron accumulation or inhibiting lipid peroxidation protects against SiO2 cardiotoxicity,potentially via modulation of the Nrf2 pathway.

Objective:To investigate the clinical characteristics of first-episode and recurrent acute hypertriglyceridemic pancreatitis (HTGP).Methods:The retrospective cohort study was con-ducted. The clinical data of 313 patients with HTGP admitted to 26 medical centers in China in the Chinese Acute Pancreatitis Clinical Research Group (CAPCTG)-PERFORM database from November 2020 to December 2021 were collected. There were 219 males and 94 females, aged 38(32,44)years. Of the 313 patients, 193 patients with first-episode HTGP were allocated into the first-episode group and 120 patients with recurrent HTGP were allocated into the recurrent group. Observation indica-tors: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) comparison of severity and prognosis in the course of disease within 14 days between the two groups; (3) the association between recurrent HTGP and the risk of persistent organ failure (POF); (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. The Kaplan-Meier method was used to plot the cumulative recurrence rate curve and Log-Rank test was used for survival analysis. The Logistic regression model was used for multivariate analysis, and continuous variables were converted into categorical variables according to the mean value or common criteria. Propensity score matching was performed by 1∶1 nearest neighbor matching method, with caliper value of 0.02. Paired t test or Wilcoxon rank sum test and McNemar′s test were used for comparison between matched groups. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 313 patients,208 cases were successfully matched, including 104 cases in the first-episode group and 104 cases in the recurrent group. After propensity score matching, there was no significant difference in demographic characteristics, severity of illness scores and laboratory test between the two groups ( P>0.05). The elimination of gender, acute physiology and chornic health evaluation (APACHE) Ⅱ score, computed tomography severity index score, systemic inflammatory response syndrome score, sequential organ failure assessment score, apolipoprotein E, C-reactive protein, creatinine, lactic acid dehydrogenase, procal-citonin confounding bias ensured comparability between the two groups. (2) Comparison of severity and prognosis in the course of disease within 14 days between the two groups. There were signifi-cant differences in POF and local complications between the first-episode group and the recurrent group ( P<0.05). (3) The association between recurrent HTGP and the risk of POF. Results of uncor-rected univariate analysis showed that there was no association between recurrent HTGP and the risk of POF ( odds ratio=0.78, 95% confidence interval as 0.46-1.30, P>0.05). Results of multivariate analysis after adjusting for covariates such as gender, age, APACHE Ⅱ score, C-reactive protein, triglyceride and total cholesterol showed that compared with first-episode HTGP, recurrent HTGP was associated with a higher risk of POF ( odds ratio=2.22, 95% confidence interval as 1.05-4.71, P<0.05). Results of subgroup analysis showed that age<40 years was associated with an increased risk of POF ( odds ratio=3.31, 95% confidence interval as 1.09-10.08, P<0.05). (4) Follow-up. Twelve of the 313 patients died during hospitalization, including 9 cases in the first-episode group and 3 cases in the recurrent group. The rest of 301 surviving patients, including 184 cases in the first-episode group and 117 cases in the recurrent group, were followed up for 19.2(15.5, 21.9)months. Results of follow-up showed that for 184 survived patients of the first-episode group, 164 cases were followed up and 24 cases experienced recurrence, for 117 survived patients of the recurrent group,29 cases experienced recurrence, showing a significant difference between the two groups ( χ2=4.67, P<0.05). Conclusion:Compared with first-episode HTGP, patients with recurrent HTGP are more prone to POF and local complications, and are more prone to recurrence after discharge. The risk of POF in recurrent HTGP patients is 2.22 times that of those with first-episode, and the risk is higher in patients with age <40 years.