ObjectiveTo improve the response capabilities to disasters and prevent major epidemics， it is of practical use to study the capability evaluation system of the national emergency medical rescue team that combines theoretical training and practical exercises， to enhance the overall quality of the teams. MethodsFirst， a capability assessment system for the national emergency medical rescue team was constructed based on the INSARAG External Classification （IEC） standards of the national emergency medical rescue team. Then， based on the outcome based education （OBE） concept， we conducted innovative research on the curriculum design and exercise programs for team building and member training. Finally， an empirical analysis was conducted on the effectiveness of the evaluation system and training exercises based on the statistical analysis of the comprehensive quality evaluation of the Shanghai national emergency medical rescue team from 2020 to 2023， as well as the empirical analysis of the rescue exercise on the Cruise of spectrum. ResultsBased on the linear regression analysis of each core competency indicators， the five core competencies in the evaluation system， including rescue skills， medical and health knowledge， disaster coping ability， team cooperation ability， and mental resilience training， were positively correlated with the cumulative number of trainings （r=0.71， r=0.76， r=0.81， r=0.84， r=0.96，all P<0.05）， indicating that the training was effective and the course design was reasonable. Empirical cases showed that the three-dimensional rescue drill model had remarkable results in the actual combat application and ability improvement of team members. ConclusionThe training courses and drills designed based on the three-level assessment system are effective in improving the comprehensive capabilities of the national emergency medical rescue team.

Objective:To explore the effect of hospital-community-family trinity linkage home visiting on quality of life of convalescent patients with traumatic brain injury.Methods:A total of 100 convalescence patients with traumatic brain injury admitted to Shanghai Yangzhi Rehabilitation Hospital from January 2019 to January 2020 were selected as the research objects, and randomly divided into the intervention group ( n=51) and the control group ( n=49) by random number table method. The control group received routine rehabilitation nursing guidance. Patients in the intervention group were treated with hospital-community-family triple linkage family visit for nursing intervention for 10 months. The Medical Outcomes Study 36-Item Short-Form (SF-36), General Self-Efficacy Scale (GSES) and Exercise of Self Care Agency Scale (ESCA) were used to compare the quality of life of 2 groups before intervention, 1, 4, 6, 8 and 10 months after intervention. Results:After 6 months of the intervention, eight dimensions of SF-36 such as physiological function, role-physical, body pain, general health, vitality, social function, role-emotional, and mental health scored 29.61 ± 9.21, 38.73 ± 14.42, 41.96 ± 8.25, 38.63 ± 8.43, 50.10 ± 8.03, 42.40 ± 18.28, 43.14 ± 15.34, 38.31 ± 8.88 in the intervention group, and 35.92 ± 8.02, 52.04 ± 14.29, 50.00 ± 11.90, 47.76 ± 9.08, 56.12 ± 7.66, 56.99 ± 19.40, 55.10 ± 16.03, 44.96 ± 7.73 in the control group. The difference between two groups showed significant difference ( t values were -5.21--3.81, all P<0.05). The GSES scores and ESCA scores after 1,4,6,8,10 months of the intervention showed an distinct advantage in the intervention group than the control group ( t values were -20.99-11.55, all P<0.05). Conclusions:The hospital-community-family trinity linkage home visiting could improve the quality of life, self-efficacy, and self-care ability of patients with traumatic brain injury, and promote their rehabilitation effect when they returned to family and society.

Objective:To investigate the effect of hospital-community-family transitional rehabilitation care model on patients with brain trauma and explore an economic, effective, all-sided rehabilitation approach.Methods:A total of 82 in-patients with brain trauma were recruited from January 2018 to June 2019 in Shanghai Yang Zhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center). The participants were allocated into 2 groups based on randomized digital tables. Forty patients in the observation group received the hospital-community-family transitional rehabilitation care, and forty-two patients in the control group received routine rehabilitation care. All the participants completed assessments with the Fugl-Meyer Assessment Scale (FMA), the Barthel Index for the Activities of Daily Living (BI) and the Hamilton Anxiety Scale (HAMA) before the intervention, at discharge, 1 month, 4 months, 6 months and 10 months after discharge, respectively.Results:Before the intervention, no statistical significance was identified in the total scores of FMA, BI and HAMA between the two groups ( P>0.05). Compared to the control group, the total scores of FMA, BI and HAMA in the observation group were significantly improved at the discharge, 1 month, 4 months, 6 months and 10 months after discharge, respectively ( t values were -13.82 - 10.28, all P<0.05). Significant differences were observed in the level of FMA, BI and HAMA between the two groups across 6 time points ( Ftime×group=20.34, 18.34, 19.55, Ftime=183.24, 184.30, 179.09, Fgroup=28.86, 32.19, 26.63, all P<0.05). Conclusions:The hospital-community-family transitional rehabilitation care model which is based on medical consortium effectively improved traumatic brain-injured patients′motor function, the level of activities of daily living, and patients′anxiety. In addition, the model also improved the quality of medical services.

Objective:To explore the application effects of the Doctor-nurse-therapist integrated Model on the patients with brain injury in the rehabilitation period.Methods:A total of 60 patients with brain injury from January 2016 to October 2017 were selected as the control group underwent interventions based on traditional treatment model involving medical treatment, nursing and rehabilitation, and then 56 patients with brain injury from January 2018 to October 2019 were aselected as the experimental group followed Doctor-Nurse-Therapist integrated model for rehabilitation treatment. All subjects were recruited from inpatients hospitalized in the Forth Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center). The differences of motor function, activities of daily life (ADLs), anxiety and depression scores between the two groups were compared.Results:After 6 weeks of interventions, the scores of motor function were 80.27±18.20 and 67.32±19.71, and ADLs scores were 73.14±19.18 and 64.59±20.33 for the experimental group and the control group, respectively. The differences of the motor function and ADLs scores showed statistical significance between the experimental group and the control group ( t values were 3.491, 2.105, P<0.05). The anxiety and depression scores were 44.68±12.29 and 42.61±17.95 in the experimental group, while 52.25±12.95 and 50.84±18.14 in the control group, respectively. Statistical significance was found according to differences of anxiety and depression scores between the experimental group and the control group ( t values were 2.965,-2.236, P<0.05). Conclusions:Under the integrated model, doctors, nurses and therapists can evaluate, discuss, formulate and implement the flow scheme of the model, which can significantly improve the motor function and daily life ability of patients with brain injury in the rehabilitation period as well as anxiety, depression and the quality of medical services, and reduce the burden of family and society.

Objective:To explore the clinical application effect of the integrated health education model of medical care and treatment in the rehabilitation of hospitalized patients with brain injury.Methods:A total of 90 patients with brain injury who were admitted to Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) from May 2018 to October 2019 were selected as the research objects by the convenient sampling method. The patients were divided into the observation group ( n=46) and the control group ( n=44) by random number table method. The control group adopted traditional methods for health education, while the observation group adopted integrated health education model of medical care and treatment. Standardized assessments were performed before the intervention and the first, third and sixth weeks of the intervention. The responsible nurses used Fugl-Meyer Assessment Scale (FMA) , Self-care Ability Assessment Scale (Barthel index) and Exercise of Self-Care Agency scale (ESCA) to evaluate the motor function, daily life self-care ability and self-care ability of the observation group and the control group. And self-made questionnaire was used to assist patients to complete the nursing quality satisfaction score. Results:After 6 weeks, the score of limb motor function score of the observation group was (89.57±11.28) and score of the daily self-care ability was (89.46±11.75) . Those of the control group were respectively (69.82±10.04) and (56.70±10.67) . The differences were all statistically significant ( P<0.05) . After intervention, the scores of self-care ability of patients in the observation group were (23.26±2.87) , (34.17±4.23) , (17.57±2.52) and (48.40±6.03) , and the satisfaction rate of nursing quality was 87.0% (40/46) . The scores of self-care ability of patients in the control group were (16.50±1.86) , (24.21±3.01) , (12.66±1.78) and (34.18±3.96) and 63.6% (28/44) . The differences were all statistically significant ( P<0.01) . Conclusions:The integrated health education model of medical care and treatment can improve the limb motor function of patients with brain injury and the self-care ability of daily life, improve the self-care ability of patients in rehabilitation treatment, improve the satisfaction of nursing quality and improve the quality of medical service.

ObjectiveTo explore the effects of empathic nursing on psychological state and quality of life in patients with hand trauma under rehabilitation. MethodsTotally 92 patients with hand trauma admitted from January to October 2016 were selected as control group, where the routine rehabilitation nursing mode was adopted. A total of 104 patients with hand trauma under rehabilitation admitted from January to October 2017 were selected as observation group, where empathy nursing service on the basis of routine rehabilitation nursing was given. The two groups were compared in terms of anxiety, depression, quality of life, compliance of rehabilitation treatment and nursing satisfaction before and after intervention. ResultsAfter the nursing intervention, the observation group achieved (33.14±5.20)points in the Self-Rating Anxiety Scale (SAS) and (35.81±6.11)points in the Self-Rating Depression Scale (SDS), both lower than the control group with statistical differences (P＜0.05); the observation group achieved higher score in all dimensions of the The Chinese version of the SF-36 Health Survey Scale(SF-36) than the control group with statistical differences (P＜0.05); The observation group achieved (1.72±0.45)points in compliance of rehabilitation treatment, (98.60±0.72)points from nursing satisfaction, both higher than the control group with statistical differences (P＜ 0.05). ConclusionsEmpathic care can significantly improve the anxiety, depression, quality of life, compliance with rehabilitation treatment and nursing satisfaction of hand trauma patients, and to a certain extent improve the nurse's sense of responsibility, communication skills and problem-solving ability, which is worth popularizing and applying to other clinical fields.

Objective To explore the effects of swallow-feeding management in patients with dysphagia after traumatic brain injury (TBI). Methods By convenient sampling, 53 TBI patients from the Forth Department of Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) from January 2016 to December received a conventional rehabilitation program as the control group. 52 TBI patients from January 2017 to December were recruited into the observation group, while they received the swallow-feeding training and rehabilitation nursing intervention in comparison with the conventional rehabilitation program received in the above control group. The therapeutic effects were evaluated in the two groups through comparing swallowing function pre and post the 30-days interventions, respectively. Results Before intervention the swallowing function of the observation group was graded as grade I (0 example), grade Ⅱ (16 examples), grade Ⅲ (14 examples), grade Ⅳ (14 examples) and grade Ⅴ (8 examples) respectively, while the swallowing function of the control group was graded as gradeⅠ(0 example), gradeⅡ(11 examples), grade Ⅲ(13 examples), gradeⅣ (18 examples) and grade Ⅴ (11 examples) respectively before intervention. The difference in the degrees of the swallowing function had no statistical significance between the control group and the observation group before interventions (Z=-1.268, P=0.205). After intervention the swallowing function of the observation group was graded as grade Ⅰ (20 example), grade Ⅱ (19 examples), grade Ⅲ (10 examples), grade Ⅳ (2 examples) and grade Ⅴ (8 examples) respectively. Meanwhile the swallowing function of the control group was graded as grade Ⅰ (8 example), grade Ⅱ (19 examples), grade Ⅲ (13 examples), grade Ⅳ(10 examples) and grade Ⅴ(3 examples) respectively after intervention. Hence, The difference in the degrees of the swallowing function had statistical significance between the observation group (Z=-6.222, P＜0.01) and control group (Z=-5.892, P＜0.01) pre and post interventions. Moreover, the improvement of swallowing function in the observation group was larger than that of the control group and the difference in the degree of the swallowing function have statistics significance between the two groups (Z=-3.265, P＜0.01). The food intake of the two groups were observed for 30 days, and the results revealed that there were 1 502 cases and 808 cases in respiratory aspiration in the control group and observation group respectively. It can be seen that the incident rate of respiratory aspiration was significantly lower in the observation group than that of the control group (χ2=52.567, P=0.047). Conclusion The Swallow-feeding management can improve the swallowing function, effectively reduce the incidence of respiratory aspiration and also enhance the quality of life in TBI patients.

Objective To study the changes of gonadotropin releasing hormone agonist (GnRH-a) in pinopodes during luteal phase and to explore the possible mechanism of GnRH-a in luteal phase support of assisted reproductive technology (ART).Methods Totally 40 primary infertility women who were treated with ART due to male factors were enrolled,according to the order of the group they were randomly divided into experimental group and control group.On the 7th day after ovulation,the experimental group received a subcutaneous injection of 0.1 mg of GnRH-a,while the control group received a subcutaneous injection of placebo only (0.9％ salinc 2 ml),3 days later they came to the clinic again.Serum estradiol and progesterone levels were measured before and after treatment in each group.Pinopodes were collected for electron microscopic examination.Levels of ER and PR were detected by western blot.Results (1) There was no significant difference between the experimental group and the control group in the estrogen level before and after the treatment (all P＞0.05).The level of progesterone in the experimental group after treatment [(66.8± 14.9) nmol/L] was significantly higher than that before treatment(P＜0.05);also significantly higher than the same period of the control group (P＜0.05).(2) There was no significant difference in the expression of ER protein in the experimental group before and after treatment (P＞0.05).The expression of PR in the experimental group after treatment was significantly lower than that before treatment (P＜0.05);also lower than the same period of the control group (P＜0.05).(3) Expression amount of pinopodes in the experimental group after treatment was significantly higher than that before treatment [65％ (13/20) versus 25％ (5/20),P＜ 0.05],and the development trend was more mature [the percentage of maturation:75％ (15/20) versus 35％ (7/ 20),P＜0.05].Expression amount of pinopodes after treatment and the percentage of maturation in the experimental group were significantly higher than those in the same period of control group (P＜0.05).Conclusion GnRH-a in luteal phase support may play a role through the corpus luteum,which may promote the secretion of progesterone,downregulation of PR expression,promote the growth of pinopodes,and improve the endometrial receptivity.

Objective To explore the influences of the network medical health management on the coping styles , hope level and quality of life in patients with primary kidney cancer surgery .Methods The patients of control group received normal health management and the participants included 77 kidney cancer patients who were laboratory diagnosed during March 2011 and September 2012 .The patients of intervention group received the network medical health management based on the normal health management and the participants included 79 kidney cancer patients who were laboratory diagnosed during March 2013 and September 2014 .The coping styles , hope level and quality of life before and after the intervention were compared between the two groups .Results Before the intervention , the coping styles and the hope level had no statistical differences between the two groups (P>0.05).After the intervention for the coping styles , the intervention group had higher scores of the positive coping style (25.44 ±2.61) and lower scores of the negative coping style (9.76 ±1.89) and presented statistical differences compared with that of the control group ( t=-10.468, 7.572;P <0.01).For the hope level, there was no statistical significance between two groups before intervention (P >0.05); however, after intervention, the intervention group had higher scores of positive attitudes (14.5 ±2.6), positive behaviors (15.1 ±2.4) and close contact with people (15.6 ±2.1), and presented statistical differences with that of the control group (t=4.965, 5.569, 4.965; P<0.05).For the quality of life, there were no statistical differences for the dimensions of PF , RF and DY (P>0.05) but the intervention group performed better on other 12 dimensions′scores ( P <0.05 ); the quality of life in the intervention group was better than that of control group .Conclusions The network medical health management should be further applied to the clinical practice , because it can significantly improve the coping styles , hope level and quality of life among the patient with primary kidney cancer surgery .

Objective To investigate the effects of application of problem-based learning (PBL) education in primary renal cell carcinoma surgical patients.Methods A total of 1 00 renal cell carcinoma patients who received surgical treatments from July 201 3 to January 201 5 in Cancer Hospital Affiliated to Zhengzhou University were randomly divided into control group (50 cases)and observation group (50 cases). The patients in control group received routine health education and the patients in observation group received PBL health education.The psychological status,satisfaction with nursing and occurrence of postoperative complications were compared in two groups when admitted and discharged from hospital.Results The difference of psychological status in two groups was not significant when admitted hospital (P >0.05),while it is better in observation group when discharged from hospital (P <0.05).In addition,the degree of satisfaction was higher in observation group (P <0.05).Furthermore,the occurrence of complications was lower in observation group (P <0.05).Conclusions Health education based on PBL can arouse patients′enthusiasm in actively learning disease-related knowledge, improve their psychological status, decrease the occurrence of postoperative complications and increase patients′satisfaction.