ObjectiveTo explore the application of conceive-design-implement-operate (CDIP) teaching modein the training for neurosurgical specialist nurses' core competence. MethodsA total of 76 trainees of neurosurgery specialist nurses in the Second Affiliated Hospital of Soochow University from October 2014 to August 2018 were selected as the research objects. The goal and content of core competence training were formulated by CDIO teaching mode, and the training program was designed and implemented. The results of core competence, general self-efficacy, theoretical assessment and nursing practice assessment before and after training were compared. ResultsThe total score of general self-efficacy of trainees after training was (29.54±5.02), higher than that before training (27.43±4.73), with statistical difference (P＜0.01); the core competencies of trainees after training included critical thinking and scientific research (CR), clinical care (CC), leadership (LD), interpersonal relationship (IR), law and ethics (LE), professional development (PD) and teaching consultation (TC) were (31.29±5.52), (29.11±4.73), (32.08±5.35), (25.78±4.97), (25.72±5.10), (20.13±3.25), (22.37±4.42) respectively, higher than those before training[ (27.33±6.08),(26.93±5.84), (29.32±6.51),(23.13±5.38),(22.92±5.75),(18.87±4.33),(20.72±5.19)]with statistical significance (P＜0.05). The scores of theoretical and nursing practice assessment of trainees after training were (91.96±3.58), (95.17±2.34) respectively, higher than those before training [(78.87±4.96), (83.21±3.98)] with statistical difference (P＜0.01). ConclusionsThe application of CDIO teaching model in the training of neurosurgical specialist nurses can improve students' core competence and general self-efficacy,and provide useful reference for the training of neurosurgical specialist nurses' core competence.

Objective To explore the characteristics of sleep structure in chronic insomnia disorder(CID)with disharmony between heart and kidney pattern and liver qi stagnation pattern.Methods A total of 74 patients with CID who were treated in Tongde Hospital of Zhejiang Province from June 2021 to December 2022 were selected and divided into disharmony between heart and kidney group and liver qi stagnation group according to TCM syndrome differentiation types,with 37 cases in each group.Relevant parameters of both groups were collected and analyzed using polysomnography(PSG).Results The age of patients in disharmony between heart and kidney group was significantly higher than that in liver qi stagnation group(P<0.05).There were statistically significant differences in total sleep time,sleep efficiency,rapid eye movement sleep period,N1 stage and N3 stage between two groups(P<0.05).The results indicated that patients in disharmony between heart and kidney group had light sleep,low sleep efficiency and short total sleep time.Conclusion With the increase of age,most of the syndromes of CID patients are disharmony between heart and kidney pattern,and there are obvious differences between the two types of sleep structure.Patients with disharmony between heart and kidney pattern have light sleep and low efficiency,while patients with liver qi stagnation pattern have many dreams.

Objective To explore the characteristics of polysomnography(PSG)and the types of Chinese medicine symptoms in elderly patients with chronic insomnia disorder(CID),and to provide reference for the prevention and diagnosis of CID in the elderly.Methods A total of 205 patients diagnosed as CID with parallel PSG in the outpatient clinic of the Department of Neurology of Zhejiang Provincial Tongde Hospital from May 2022 to May 2023 were selected for the study,and were divided into the geriatric group(≥ 60 years old)and the non-geriatric group(＜60 years old)based on the difference in age,and statistics were collected on the distribution of Chinese medicine syndromes in the patients of the two groups,and the PSG was used to record and compare the structure and process of sleep in the patients of the two groups.parameters,and do correlation analysis.Results Total sleep time(TST),sleep efficiency TST time in bed(TIB),total duration of rapid eyes movement(REM)period,total duration of N2 period,total duration of N3 period,and REM% were lower in elderly patients than in the non-elderly group(P＜0.05).And the time to wakefulness after sleep,N1 latency,N2 latency,and N1% were statistically higher than those of the non-elderly group(P＜0.05).The TCM diagnosis of elderly patients with CID is more commonly characterized by cardiac and renal disorders.Conclusion There were differences in polysomnographic sleep testing between the elderly and non-elderly groups of patients with CID.Compared with the non-elderly group,the elderly group had shorter sleep duration,lower sleep efficiency,longer sleep latency,reduced total REM duration,and the most common clinical Chinese medicine diagnostic typology of cardiac and renal disorders.

Objective Toinvestigatetheexpressionofsuppressorofcytokinesignaling1(SOCS1)inoverloaded ventricle papillary muscle, so as to understand its expression characteristics in structural remodeling after the overloading and the biomechanical properties of the muscle under cubic jellyfish toxin-1(CfTX-1) pretreatment that can affect cell signal transduction. Methods Abdominal aortic-venous fistula (AVF) were operated in Kunming mice (n=5), and the cardiac left ventricles were harvested after two weeks of fistulation. The mice in normal group were sham operated as a control (n=5). In vitro culture, the left ventricular papillary muscle of normal mice was used (n=20). In the stretching group, the isolated papillary muscles were double-ratio stretched and fixed on silicone plate. In the relaxation group, the muscles were not stretched. A separated subgroup that transfected with SOCS1 plasmids were set in each group of stretching and relaxation. The papillary muscle samples of each group were cultured in culture medium for 3 days at 37 ℃, and then homogenized for extracting total protein. The total protein was separated by 10％ sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The 23 ku band with SOCS1 was used as the target band, and the integrated optical density (IOD) value was measured by computer image analysis method. The expression of SOCS1 protein was detected by Western Blot and the imprinted IOD value was also measured. The papillary muscle in the stretching group was stretched by micro-positioned stretching method, and the initial load was 1 g. After stabilization, the papillary muscle was stretched by 15 mm for continuously 5 times, and the passive tension characteristic curves during the first and fifth stretching were observed and recorded. The peak passive tension (PTmax) and its deceleration velocity (DV) of the papillary muscle were calculated based on the curves. Results Comparing with the AVF group, the normal group had higher IOD values of 23 ku band and SOCS1 blot in total protein of the papillary muscle, and the differences were statistically significant (all P<0.01). The IOD value of 23 ku band in the SOCS1 transfected stretching group was significantly higher than those of the two relaxation groups, and the differences were statistically significant (all P<0.01). However, the difference of this value was not statistically significant between the two relaxation groups. The average IOD value of SOCS1 blot in the SOCS1 transfected stretching group was higher than those of the normal stretching group and the SOCS1 transfected relaxation group, and the differences were statistically significant (all P<0.01). Comparing with the normal group, the AVF group had higher PTmax and ultimate PTmax of the papillary muscles, and had a lower DV values, and the differences were statistically significant (all P<0.01). Conclusions The expression of SOCS1 is sensitive to tension load, and has a positive effect as an overload-sensitive signal in improving myocardial adaptability, protecting myocardial structure and maintaining systolic and diastolic function. CfTX-1 also has a positive effect on improving the compliance of ventricular papillary muscles.