Objective To explore the application method and effect of mind map in practice of clinical nursing courses among nursing undergraduates. Methods In the teaching of clinical nursing courses such asAdult Nursing and Maternal and Perinatal, 70 nursing undergraduates received the teaching method by using mind map in clinical practice. A self-designed questionnaire was used and a symposium was held after clinical practice, to collect and file the feedback on the effect of using mind map teaching from 70 nursing students. Results The score of the attitude and effectiveness towards mind map was high ranged from (3.69±0.73) points to (4.29±0.57) points. Conclusions The mind map is an effective clinical teaching method, applying mind map in nursing clinical practice can improve the teaching effect. The students show positive attitudes to the teaching method.

Objective To investigate the cognition of nurse groups toward nurses' dual practice,and to analyze nurses' tendency to pursuc dual practice and its influencing factors.Methods A questionnaire survey was conducted,and 1010 registered nurses were recruited using stratified sampling method.Results Most (76.4％) nurses agreed with nurses' dual practice.The willingness about nurses' dual practice was significantly different(P=0.022,P=0.008) due to different age and length of service.The top three benefits of nurses' dual practice were to increase reasonable salary of nurses,improve quality of nursing care in community institutions for the aged and increase the utilization of health care resource.As for the disadvantages,disrupting the medical and nursing order,increasing difficulties of management and government's supervision,increasing medical risks.Nurses believed that the main obstacles for nurses' dual practice were the unclear medical risks and the unprotected nurses' interests.Conclusion The nurse groups had a positive and optimistic attitude towards nurses' dual practice.In the case that the government implements relevant laws and regulations,and the interests of nurses are well-guaranteed,nurses' dual practice is a good measure that can improve nurses' work motivation.

Objective To comprehend the students＇evaluation of PBL combined with scenario simulation teaching practice,and provide evidences for further improvement and refinement of teaching methods.Methods Twelve nursing undergraduate students participated the semi-structured interviews.Results PBL combined with scenario simulation teaching practice was superior to the traditional teaching method,because it can develop nurses＇ core competence,stimulate students＇interest in learning,enhance the independent learning ability and strengthen students＇capability in cooperation.However,there were still some problems to be solved.For example,the focal points were not prominent,the gap between students was widened.This added to students＇burden,and put forward various new request and challenges to teachers.Conclusions PBL combined with scenario simulation teaching method reflects a new teaching idea.It is helpful for developing nurses＇core competence,stimulating students＇interest in learning,enhancing team-work spirit.There are still some shortcomings in the implementation of PBL combined with scenario simulation teaching practice,it should be further developed to improve the teaching effectiveness.

Objective:To investigate the complication and compliance of different supine time and the degree of obedience in children with leukemia after intrathecal chemotherapy.Methods:A total of 553 children with leukemia after intrathecal chemotherapy from April 1, 2017 to March 28, 2019 in Beijing Children′s Hospital Affiliated to Capital Medical University were selected. Children who received intrathecal injection from April 1, 2017 to December 31, 2017 were selected as control group(274 cases), from January 1, 2018 to March 28, 2019 were selected as research group(279 cases). The children in research group were supine 2 hours but control group were supine 4 hours after intrathecal. The complications that occurred after injection and within one week after injection and compliance were observed.Results:Finally, 457 children included in this study, there were 235 cases in research group and 222 cases in control group. The number of cases of limb numbness and local pressure reddening in the research group and the control group were 18, 20 and 31, 34, respectively, with statistically significant differences between the two groups( χ2 values were 4.74, 5.07, P<0.05). After intrathecal injection, the patients' compliance with the time of supine removal was completely acceptable to the research group, relatively acceptable, acceptable, and required efforts to adhere to the number of cases were 65, 83, 42, 45, respectively, while the control group were 34, 50, 76, 62, respectively, the differences were significant ( χ2 value was 30.04, P<0.05). Conclusions:Supine for 2 hours after intrathecal injection can reduce the incidence of complications and improve compliance, which is safe and feasible. So, supine for 2 hours after intrathecal injection is recommended.

Objective:To investigate the current situation of junior medical students'cognition on the relationship between doctors and patients,and to provide reference for medical students'medical education and medical education reform,Methods:Self-made questionnaire was adopted to investigate the cognitive status of doctor-patient relationship among junior medical students from three medical universities in Guangzhou.Results:Totally 41.04％ of junior medical students had a basic understanding of doctor-patient relationship,and the degree of understanding of doctor-patient relationship is not different between junior and senior medical students (P ＞ 0.05);76.62％ of medical students got acquainted with the status of doctor-patient relationship mainly through the media;86.57％ of junior medical students thought that the doctor-patient relationship was tense.The cognition of doctor-patient relationship between male and female students was similar (P ＞ 0.05),and so wasit between freshmen and sophomores (P ＞ 0.05).Male and female students had the same opinion on the future trend of doctor-patient relationship (P ＞ 0.05).Many junior medical students were optimistic about the future doctor-patient relationship.Compared with freshmen,sophomore medical students were less optimistic about the future doctor-patient relationship (P ＜ 0.05).Medical students mostly agreed on the causes of medical disputes (P ＞ 0.05),believing that the main reason was the medical system.Conclusions:The cognition of the doctor-patient relationship profoundly affects the junior medical students as well as their choices of future employment and communication styles between patients and them,which may have important significance for avoiding medical disputes.Society,schools and the media should actively create a good atmosphere for the doctor-patient relationship.

Objective To explore the application of the automatic bone age assessment of BoneXpert software in Children and adolescent of China (Shanghai).Methods Left hand and wrist radiographs of 434 cases of children from trauma (264 boys and 170 girls) were obtained from Jan.2010 to Dec.2013.Bone age was assessed by BoneXpert software and 40 radiographs were randomly chosen and re-evaluated after a week.Results Seven images were rejected by BoneXpert,so the efficiency of the software was 98.4％ and it takes only 14.5 s for every image.Sample assessments by two times are exactly the same.As to BoneXpert software,there were statistical differences between bone age and chronological age in 8 groups:7,8,9,11 years old boys and 2,3,9,11 years old girls(P ＜ 0.05) out of 26 groups,and the average difference was about 1 s.The following modifications suggested that 0.57,0.79,0.93,-0.38 and-0.22,0.30,0.37,0.59 years could be added respectively for the groups of boys aged 7,8,9,11 and girls aged 2,3,9,11 years old according to their average differences between the bone age and the chronological age.Conclusions The BoneXpert method for automated determination of skeletal maturity which evaluates bone age objectively and quickly can be applied clinically after slight adjustment in some age groups.BoneXpert software is 100 percent automatic and could eliminate the subjective evaluation inaccuracy.

Associations between "lipid-related" candidate genes, blood lipid concentrations and coronary artery disease (CHD) risk are not clear. We aimed to investigate the effect of three newly identified lipids loci from genome-wide association studies on CHD and blood lipid levels in Chinese Han population. The genotypes of SNPs at three newly identified lipid loci and blood lipids concentrations were examined in 1360 CHD patients and 1360 age- and sex-frequency matched controls from an unrelated Chinese Han population. Allele T of rs16996148 occurred less frequently in CHD patients with the odds ratio (OR) being 0.64 (95% CI 0.50 to 0.81), after adjusting for conventional risk factors and was associated with a 33% decreased CHD risk (P<0.01) comparing with the major allele G. Individuals with GT genotype had the lowest CHD risk. No associations were found between the polymorphisms of other two loci with CHD risk and all three SNPs had no effect on lipid profile in this population. SNP rs16996148 on chromosome 19p13 is significantly associated with lower risk for CHD in Chinese Han population. However, it remains unresolved why these lipid-related loci had significantly less effects than the correspondingly expected effects on blood lipids levels in this population.

Objective To identify the risk factors of postoperative delirium after cardiac surgery . Methods Setting the inclusion and exclusion criteria and establishing the retrieval strategies for primitive literatures, several databases were searched .The RevMan 4.3 software was adopted to perform the analysis of sensitivity and heterogeneity and to calculate the cumulative effects of risk factors using either fixed or random effects model .Results Fifteen studies were included in the final analysis .The independent risk factors of delirium after cardiac surgery were older age; history of artial fibrillation , diabetes mellitus , cerebrovascular disease , abnormal serum creatinine level , anemia and depression;valve replacement or combined procedure and prolonged operation time;prolonged mechanical ventilation time , massive use of sedative and postoperative atrial fibrillation.Conclusions The patients with a history of atrial fibrillation or with a complication of postoperative atrial fibrillation are at an increased risk of developing delirium following elective cardiac surgery .And the valve replacement or combined procedure and prolonged operation time are uniquely associated with postoperative delirium.

Associations between “lipid-related” candidate genes,blood lipid concentrations and coronary artery disease (CHD) risk are not clear.We aimed to investigate the effect of three newly identified lipids loci from genome-wide association studies on CHD and blood lipid levels in Chinese Han population.The genotypes of SNPs at three newly identified lipid loci and blood lipids concentrations were examined in 1360 CHD patients and 1360 age- and sex-frequency matched controls from an unrelated Chinese Han population.Allele T of rs16996148 occurred less frequently in CHD patients with the odds ratio (OR) being 0.64 (95％ CI 0.50 to 0.81),after adjusting for conventional risk factors and was associated with a 33％ decreased CHD risk (P＜0.01) comparing with the major allele G.Individuals with GT genotype had the lowest CHD risk.No associations were found between the polymorphisms of other two loci with CHD risk and all three SNPs had no effect on lipid profile in this population.SNP rs16996148 on chromosome 19p13 is significantly associated with lower risk for CHD in Chinese Han population.However,it remains unresolved why these lipid-related loci had significantly less effects than the correspondingly expected effects on blood lipids levels in this population.

Objective To investigate the current status of knowledge-attitude-practice of cardiac rehabilitation in patients undergoing coronary artery bypass grafting(CABG)and analyze its influen-cing factors.Methods From July to November 2022,288 patients with CABG in the coronary heart disease surgery center of Beijing Anzhen Hospital Affiliated to Capital Medical University were con-veniently included,and general information questionnaire and cardiac rehabilitation knowledge and practice questionnaire were used to investigate the general situation and the level of knowledge-atti-tude-practice of cardiac rehabilitation in patients with coronary heart disease.Results A total of 290 questionnaires were sent out in this study,and 288 were effectively collected,with an effective recov-ery rate of 99.31％.The total score of the questionnaire was(106.81±13.35),and the total score rate was 62.83％,including the knowledge questionnaire scoring(39.34±9.13),belief question-naire scoring(32.86±3.39)and behavior questionnaire scoring(34.61±3.54).The scoring rates of knowledge,attitude and practice questionnaire were 46.28％,82.15％and 76.91％,respective-ly.Multiple linearregression analysis showed that patients who lived in rural areas,had education background of primary school or below,were farmers,had public health insurance,and had no previous coronary intervention,had lower levels of knowledge-attitude-practice of cardiac rehabilitation(P＜0.05).Conclusion The knowledge-attitude-practice of cardiac rehabilitation,especially the level of knowledge,in patients with CABG is needed to be improved.The factors that affect the lev-el of knowledge-attitude-practice of cardiac rehabilitation in this population are diversified,sugges-ting that individual cardiac rehabilitation guidance should be implemented according to different peo-ple and local conditions,and diversified cardiac rehabilitation models should be established to im-prove the long-term and compliance of cardiac rehabilitation.