Objective To explore the effect of early stage of comprehensive lung rehabilitation on cervical spinal cord injury in patients with mechanical ventilation.Methods The patients with cervical spinal cord injury admitted from January to December 2015 were selected as the control group which was treated with routine nursing measures.The patients with cervical spinal cord injury admitted from January to December 2016 were selected as the treatment group,which received early stage lung rehabilitation measures.We compared two groups of patients in the using time of breathing machine,the total length of hospital stay and pulmonary infection rate.Results The duration of mechanical ventilation and hospitalization days in the control group were(13.98±11.11),(25.10±16.98)d,which were higher than those in treatment group[(7.23±4.94),(16.26±6.41)d](P<0.05).The infection rates of control group and treatment group were 76.19％and 52.38％respectively,and the difference was significant(P<0.05).Conclusion In the early stages comprehensive pulmonary rehabilitation measures for mechanical ventilation in patients with cervical spinal injury can shorten the breathing machine use time and the total hospitalization days,and reduce pulmonary infection rate.

Objective To develop a observation table with influencing factors for catheter-associated urinary tract infections in critical patients and verify its reliability and validity. Methods Literature review, brainstorming method, expert interview and group discussion were performed to identify items of the form. By convenience sampling method, totally 130 severe patients with urinary catheter were investigated by this scale. This form was evaluated by item analysis, exploratory factor analysis and reliability and validity test. Results The observation table with influencing factors for Catheter-associated Urinary Tract Infections in critical patients consisted of five dimensions and 26 items. The cumulative contribution of variance was 73.752%, the Cronbach′s alpha coefficient was 0.869 and the Spearman-Brown split-half coefficient was 0.828. Regarding to the construct validity, the correlation coefficient between the each factor and total observation table was 0.652~0.873, the correlation coefficient between the factors was 0.311~0.823. All the difference of correlation coefficients were statistically significant (P<0.01). Conclusions The observation table with influencing factors for Catheter-associated Urinary Tract Infections in critical patients has been proved to be reliable and valid. It can be used as a valid tool to assess influencing factors for Catheter-associated Urinary Tract Infections in critical patients.

Objective To enhance the management in identifying the surgical sites to comply with national standards.Methods A nurse-physician collaboration management team was set up to investigate the current identification of surgical sites in every operating room which violates regulations,with the causes analyzed and countermeasures proposed.Working hand in hand,doctors and nurses figured out the management details for preoperatively identifying the surgical sites and reengineering of the surgical process.With the responsibilities clarified and training enhanced,the surgeons,anesthesiologists,ward nurses and operating room nurses were held responsible for the process and improvements of identifying the surgical sites.The number of patients with unreasonable identification of surgical sites was calculated before and after establishment of nurse-physician collaboration management team.Results The reasonable identification rates of surgical sites were 37.94% before the reform and 80.94% after;incorrect use of all types of the surgical site identification can be minimized in the reform.Conclusion The management of nurse-physician collaboration is conducive to enhancing the reasonable identification rate of surgical sites,thus improving the quality of care and correctness of operations.

OBJECTIVETo explore the inhibitory effect of He-Ne laser irradiation on fibroblast growth of hypertrophic scars in culture.

METHODSHe-Ne laser with wavelength of 632.8 nm, power density of 50 mW/cm(2) and doses of 3 J/cm(2), 30 J/cm(2), 90 J/cm(2) and 180 J/cm(2) was used to irradiate human scar fibroblasts in culture 1, 3 and 5 times respectively, and then the cell count and cell cycle analysis were done.

RESULTSRepeated irradiation with He-Ne laser at dose of 180 J/cm(2) three and five times led to an evident decrease in total cell number compared with that of the control group and there was a significant difference (P<0.05). The cell cycle analysis showed after three and five times of irradiation with 180 J/cm(2) He-Ne laser the cell number in S-phase decreased from 51% to 20% and 14% respectively, the cell number in G(0)/G(1) phase increased from 28% to 55% and 60% respectively, and the cell percentage in Sub-G1 phase was 6.7% and 9.8% respectively.

CONCLUSIONSRepeated irradiation with 180 J/cm(2) He-Ne laser can inhibit scar fibroblasts growth in culture. It may be that He-Ne laser irradiation causes cell stagnation in G(0)/G(1) phase and apoptosis.

Cell Division ; radiation effects ; Cells, Cultured ; Cicatrix ; pathology ; Dose-Response Relationship, Radiation ; Female ; Fibroblasts ; cytology ; radiation effects ; Helium ; Humans ; Lasers ; Male ; Neon

Objective To explore the effect of stromal cell-derived factor-1 α (SDF-1 α) on inducing recruitment of bone marrow-derived cells (BMDCs) to wound area. Methods BMDCs were isolated from bone marrow, cultured with routine method and identified by CXCR4 antibody. Cells cultured with CXCR4 antibody (100 ng,/mL) for 6 hours were labeled with CM-DiI and injected into the tail vein of full-thickness incisional wound model (set as anti-CXCR4 group). BMDCs labeled with CM-DiI without antibody treatment were injected to the rats in BMDCs group, and rats were injected with DMEM/F12 serum-free medium in the control group. The quantity of labeled BMDCs at the wound site and the percentage of wound closure were measured. Results (1) All BMDCs expressed CXCR4. (2) The percentages of wound closure at days 7 and 14 in BMDCs group (7 d: 41.3% ±4.6%; 14 d:92.3% ±2. 1%) were significantly higher than those of control group (7 d: 29.3% ±2. 3%; 14 d: 77.3% ±2.5%) and anti-CXCR4 group (7 d: 30.7% ±4.6% ;14 d: 85.7% ±1.5%) (P＜0.05). The percentage of wound closure of anti-CXCR4 group was significantly higher than that of control group at day 14(P ＜ 0.05). (3) The number of CM-DiI labeled BMDCs at wound site at days 7 and 14 in BMDCs group [7 d: (535 ±84) cells/hpf; 14 d: (769 ±124) cells/hpf) were greater than those of anti-CXCR4 group [7 d: (335 ±97) cells/hpf; 14 d: (521 ± 127) cells/hpf] (P＜0.05). Conclusions BMDCs participate in the cutaneous wound healing. SDF-1α plays an important role in recruiting BMDCs to wound area.

Objective:To explore the current status and training needs of clinical nursing teachers in Class Ⅲ Grade A hospitals in China, and provide a reference for further construction of clinical nursing teachers.Methods:From October 2017 to February 2019, by purposive sampling with a ratio of 1︰10, the clinical nursing teachers from 141 ClassⅢ Grade A hospitals in 30 provinces, autonomous regions and municipalities in China received a cross-sectional study with the Basic Information Questionnaire of Clinical Nursing Teachers in China's Class Ⅲ Grade A hospitals. A total of 11 594 questionnaires were collected, and 10 266 were valid questionnaires, with an effective rate of 88.55%.Results:Among the 10 266 clinical nursing teachers, 49.64% (5 096/10 266) were senior nurses; 51.27% (5 263/10 266) were between 30 and 39 years old; 78.42% (8 051/10 266) were those with a bachelor degree or below; 41.33% (4 243/10 266) had taught for less than 5 years; 41.84% (4 295/10 266) were selected and designated by managers; 38.78% (3 981/10 266) often or always felt the pressure of teaching; 56.31% (5 781/10 266) thought that they were competent for clinical teaching; 50.54% (5 188/10 266) occasionally participated in teaching training, and had a strong demand for training. The top three demands were teaching methods and skills, frontier knowledge of specialties, and nursing research. Clinical teachers with different teaching years, academic qualifications and professional titles are in basic theories of education, teaching methods and skills, nursing management, and nursing research. There was statistically significant difference in the training needs for the frontier knowledge of specialist subjects between clinical nursing teachers with different teaching years, educational background and job titles ( P<0.05) . Conclusions:The clinical nursing teachers in China's ClassⅢ Grade A hospitals are mainly senior nurses, and the overall initial academic qualifications are low. There are problems in the selection of clinical nursing teachers in teaching management, and the lack of teachers' participation in teaching training. It is recommended that the relevant departments establish a competency-oriented and demand-oriented selection and management system for clinical nursing teachers, thereby promoting the construction of the teaching staff.

Objective:To construct a training program based on competency evaluation of clinical nursing teachers.Methods:From August 2019 to July 2020, based on Competency Evaluation Scale, through literature review and expert group discussion, the competency training program for clinical nursing teachers was constructed through expert consultation.Results:The effective recovery rates of the three rounds of expert inquiry were all 100%, the expert authority coefficient was 0.935 and the Kendall coordination coefficients of expert opinions were respectively 0.21, 0.27 and 0.35. The final training program included basic ability training module and advanced ability training module, including 3 modules, 14 projects, 25 courses and 3 modules, 8 projects and 8 courses, respectively.Conclusions:The clinical nursing teacher training program based on the competency evaluation scale is comprehensive and specific in content and it has good practicality, which provides a reference for the training of clinical nursing teachers.

Objective:To develop a questionnaire on perimenopausal cognition and behavior and verify its reliability and validity, in order to provide an effective tool for evaluating perimenopausal women's cognition, doctor-seeking and doctor-following behaviors.Methods:Baseline survey, literature analysis and brainstorming were formed in the initial items, and group discussion and expert interview were performed to identify items of the form. By convenience sampling method, A survey was conducted on perimenopausal women in the communities around Chongqing Health Center for Women and Children from July to August 2019. Project analysis, exploratory factor analysis, confirmatory factor analysis, Pearson correlation analysis and reliability test were used to evaluate the questionnaire.Results:Two rounds of questionnaires were distributed in this study. In the first round, 260 questionnaires were distributed, 249 valid questionnaires were recovered, and the effective recovery rate was 95.8% (249/260). In the second round, 249 questionnaires were distributed, and the effective recovery rate was 96.4% (240/249). The questionnaire on perimenopausal cognition and behavior included 4 dimensions and 24 items. The cumulative contribution of variance was 66.330%, the Cronbach α coefficient was 0.893 and the spearman-brown half-fold coefficient was 0.773. Regarding to the construct validity, the correlation coefficient between factors and total score of the questionnaire was 0.567-0.860 ( P < 0.01). Confirmatory factor analysis showed that the approximate error root mean square was 0.055, the normal fitting index was 0.801, and the goodness of fit index was 0.828. Conclusions:The questionnaire has been proved to be reliable and valid. It can be used to evaluate perimenopausal women′s cognition, doctor-seeking and doctor-following behaviors.

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Objective:To explore the application effect of timed, step-by-step and segmented sputum suction in airway management of patients with inhalation injury.Methods:From January 2017 to December 2019, 104 patients with inhalation injury admitted to the Department of Burns and Plastic Surgery, the Fourth Medical Center of the PLA General Hospital were selected as research objects. A non-randomized controlled study was adopted, and the patients were divided into control group ( n=49) and experimental group ( n=55) according to the single and even day of admission. The control group received the routine sputum suction, and the experimental group received the method of timed, step-by-step and segmented sputum suction. We compared the general information, incidence of lung infection and the number of daily sputum suction of patients between the two groups. Results:There was no statistically significant difference in the general information of patients between the two groups ( P>0.05) . The incidence of lung infection in the experimental group was 29.09% (16/55) , which was lower than 51.02% (25/49) in the control group with a statistically significant difference ( P<0.05) . In the experimental group, the number of daily sputum suction for patients with tracheotomy was 6 (3, 6) times, the number of daily sputum suctions for patients without tracheotomy was 1 (1, 2) times, and the number of daily sputum suctions for patients with severe inhalation injury was (6.56±2.96) times, which were less than 14 (11, 19) , 3 (3, 7) , (15.40±3.75) times respectively in the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The timed, step-by-step and segmented sputum suction can reduce the number of sputum suctions for patients with inhalation injury and the workload of nursing, and effectively decrease the rate of lung infection, which is worthy of clinical promotion.