Objective Although graded nursing has been implemented in nursing homes since 2001 in China, it is not popu-lar.This research aimed to investigate factors of graded nursing implementation in nursing homes by subject analysis in order to provide a reference for the construction of graded nursing system in nursing homes . Methods We performed an analysis of data retrievals for grading nursing system in nursing homes from 2005 to 2015 based on five large databases: CNKI, Wanfang, VIP, CBM, and PubMed.Subject analysis was applied in the conclusion of retrieved literature . Results There were 993 related documents by pre-liminary selection and 21 documents were concluded for subject analysis .By document acquisition , code design , subject code search , integrated subject search and subject definition , five factors including policy , professional quality , institutional management , resource supply and individual were summarized . Conclusion These five factors give a correct and overall view of the facilitators and barriers to the implementation of graded nursing in nursing homes in China , which will contribute to its improvement .

Prion diseases are infectious and fatal neurodegenerative diseases. The pathogenic agent is an abnormal prion protein aggregate. Microglial activation in the centre nervous system is a characteristic feature of prion disease. In this study, we examined the effect of PrP 106-126 on PrP mRNA gene expression in Mouse microglia cells BV-2 by real-time quantitative PCR. PrP mRNA expression level was found to be significantly increased after 18 h exposure of BV-2 cells to PrP 106-126, with 3-fold increase after 18 h and 4.5-fold increase after 24 h and BV-2 cells proliferating occurred correspondingly. Our results provide the first in vitro evidence of the increase of PrP mRNA levels in microglial cells exposed to PrP 106-126, and indicate that microglial cells might play a critical role in prion pathogenesis.

Objective To investigate the diagnostic value of MR fast scanning techniques in fetal congenital diaphragmatic hernia. Methods 12 cases diagnosed or suspected fetal congenital diaphragmatic hernia by ultrasound with gestational age (>20 weeks) were underwent MR examination.The fast scan sequences were as follows:Half-Fourier acquisition single-shot fast spinecho se-quence(HASTE)、True fast imaging steady-state precession sequence (True FISP)、Turbo FLASH T1 WI sequence.The axial,co-ronal and sagittal scanning were focused on fetal head and body.The results of prenatal MR examination was compared with neonatal surgical findings or autopsy results after inducing labor.Results All of 12 cases,9 cases were left diaphragmatic hernia,2 cases were right diaphragmatic hernia and 1 case was hiatal hernia.2 cases of them were complicated with other congenital malformations. The features of MRI were as follows:Some portions of bowels and stomach crossed into the thorax were visible in the HASTE and TRUE FISP sequence.The herniated stomach and bowels showed high or scattered high signals.The intestinal types were visible as well.The lung tissue intruded at the apex of the lung and the heart deviated to the opposite side were demonstrated.T1 weighted im-ages obtained from ultra-fast FLASH (Turbo FLASH)T1WI sequence showed characteristic high signals in the meconium,which delineated clearly the shape of the colon and small intestine.The prenatal MRI results of all cases were consistent with surgical (10 cases)and autopsy (2 cases)findings.Conclusion MR fast scanning techniques can clearly show fetal congenital diaphragmatic her-nia.Multiple sequences scanning can comprehensively map the organizational structure and anatomical relationship of fetal congenital diaphragmatic hernia with the surrounding tissues.MR fast scanning techniques play an important role in the diagnosis of fetal con-genital diaphragmatic hernia.

Objective To investigate the expressions of intermedin /adrenomeduliin 2 (IMD/AM2) and its receptor calcitonin receptor-like receptor (CRLR) in the kidney of rats after renal ischemia reperfusion injury(IRI). Methods Male Wistar rats were divided randomly into two groups: sham group and operation group. Renal IRI model was induced by clamping both renal arteries. Blood and kidney were harversted at 0 h, 6 h, 12 h, 24 h, 48 h, 72 h after reperfusion, respectively. Renal histological changes were semi-quantitated. Expressions of IMD and CRLR in the kidney were detected by Western blot, and the content of IMD in serum was measured by radioimmunity at 12 h, 48 h, 72 h after repeffusion. Results Kidneys of renal IRI model rats displayed significant pathologic changes, and the changes were much severer at 48 h after reperfusion. The expressions of IMD and CRLR in kidney were significantly up-regnlated at 12 h, 48 h, 72 h after renal IRI (P<0.01). The level of IMD in serum increased at 12 h, 48 h, 72 h after renal IRI (P<0.05). Conclusion The expressions of IMD and its receptor are up-regulated in the kidney after renal IRI, which may participate in the pathophysiological changes induced by renal IRI.

Objective:To explore the effect of case-based learning (CBL) guided by ICF (International Classification of Functioning, Disability and Health) in rehabilitation practice teaching.Methods:Fifty-eight rehabilitation undergraduates who had practiced in the Department of Rehabilitation Medicine in The First Affiliated Hospital of Chongqing Medical University from February 2019 to December 2019 were randomized into observation group and control group. The observation group adopted ICF-guided CBL method for practice teaching, while the control group adopted traditional teaching methods. At the end of the internship, all the students were assessed in terms of their theoretical knowledge, case analysis and clinical practice ability. At the same time, questionnaires were used to conduct a satisfaction survey on the teaching method, and the results of the two groups were compared and analyzed by ttest and rank-sum test through SPSS 25.0. Results:The scores of the observation group were higher than those of the control group, with statistical significance ( P<0.05) . In the satisfaction survey, the observation group was superior to the traditional teaching method in terms of self-thinking ability and learning initiative, with statistical significance ( P<0.05). Conclusion:ICF-guided CBL method can strengthen students' independent thinking ability and learning initiative, and improve the students' clinical comprehensive ability of rehabilitation treatment.

Based on the development trends of nursing care in the ongoing healthcare reform, the PEST model was called into play to analyze the macro-environment of nursing development in terms of such aspects as political, economic, social-cultural, and science and technology factors. Based on such, policy suggestions are raised to tackle the following challenges, namely incomplete political and legal environment for nursing, relative shortage of nursing resources, low social recognition, and poor capability of nursing technique innovation. These suggestions aim to further improve the political and legal system for nursing, explore highly efficient nursing resource allocation, enhance nursing service capability, and nurture nursing technique innovation talents.

Objective To construct a grading nursing care system at public hospitals based on the severity of illness and activities of daily living ( ADL). Methods Multi-center stratified random sampling was used to investigate the general adult patients hospitalized in 12 wards of six tertiary-level hospitals in the eastern, central and western parts of China from January to December of 2016. The Barthel index and simple clinical score ( SCS) were used to evaluate their ADL and severity of illness, while a customized direct nursing hour scale was applied to record the direct nursing time needed by patients in 24 hours. Nursing grades were defined according to different conditions and ADL and to the difference of patient needs of 24 h direct nursing hours. Results 7 200 patients were investigated in total, and 7 073 effective questionnaires were collected (98. 24% ). Seven new grades of nursing care were defined based on patients′ severity of illness, ADL and different 24 h direct nursing time. These grades match the existing four grading nursing care levels to become refined sub-levels. Conclusions Patients can be graded according to their conditions, ADL and the 24 h direct nursing time needed. Such a new method is more objective, specific and quantitative than before, conducive to upgrading fine management level of nursing.

Objective To explore the execution and effect of family-focused psychoeducational therapy for patients with anovulatory infertility .Methods We used the convenient sampling method to choose 110 out-patients with ovulatory infertility that came from the Reproduction Unit of hospital during January to October 2013 .Patients were randomly divided into intervention group and control group on average .On the basis of normal treatment and care , patients in the intervention group underwent family-focused psychoeducational therapy.Six month later, we compared the scores of symptom checklist 90 ( SCL-90 ), family function ( APGAR ) and social support rating scale ( SSRS ) .Results Before intervention , there was no statistical difference between two groups in SCL-90, APGAR and SSRS (P>0.05).After intervention, the scores of SCL-90, somatization, obsessive symptom, interpersonal relationship, depression, anxiety, hostile, terror, crankiness and psychoticism acquired (35.23 ±9.82), (0.15 ±0.14), (0.27 ±0.14), (0.35 ±0.18), (0.25 ±0.15), (0.23 ±0.11), (0.29 ±0.27), (0.17 ±0.13), (0.21 ±0.25) and (0.19 ±0.22) respectively in the intervention group that all were lower than those ( 129.65 ±20.53, 1.24 ±0.41, 1.38 ±0.59, 1.51 ±0.44, 1.73 ±0.39, 1.78 ±0.28, 1.32 ±0.74, 0.89 ±0.39, 1.39 ±0.46, 1.22 ± 0.39, respectively)in the control group (t=-26.748, -10.140, -13.973, -14.215, -16.623, -16.374, -11.351, -8.963, -8.966, -13.867, respectively;P<0.01).In the intervention group, the satisfactory rate of APGAR obtained 87.3%(48/55) after intervention which was higher than 27.3%(15/55) in the control group (χ2 =42.225,P<0.01).The score of SSRS acquired (36.19 ±8.77) in the intervention group better than (28.21 ±7.06) in the control group after intervention (t=12.408, P<0.01).Conclusions Based on routine treatment and care , family-focused psychoeducational therapy can improve the psychological status and pregnancy rate for patients with ovulation disorder , and improve family function and social support .Therefore, it can be used as auxiliary means in clinical treatment , and be worth of spreading .

Traditional Chinese medicine (TCM) nursing is an important part in the nursing discipline which plays an important role in prevention, health care and nursing rehabilitation. It is imperative to strengthen the cultivation of health service ability of TCM for nurses. However, the expert consensus on the training standard of core knowledge and practical ability of TCM nursing has not been formed so far. On the basis of establishing a research group, a questionnaire was formed based on literature research, university research, brain storm and expert interviews. A total of 76 TCM nursing experts from universities and hospitals at home and abroad of TCM were investigated with the questionnaire to form an expert consensus. Finally, the training standard of core knowledge and practical ability of TCM nursing was established, including three course modules of basic courses of TCM, basic courses of TCM nursing, and specialized courses of TCM nursing, and 9 courses of basic theory of TCM, diagnosis of TCM, science of Chinese materia medica, pharmacology of TCM, fundamental of TCM nursing, TCM diet therapy, acupuncture and moxibustion and nursing, TCM nursing skill operation, TCM nursing clinical practice so as to provide a reference for the training of nursing talents of TCM at home and abroad.

Objective:To explore the current status of clinical teaching staff for the graduate program of master of nursing specialist (abbreviated to nursing masters) in traditional Chinese medicine (TCM) universities and compare it with the role expectations of students, aiming to provide a reference for the subsequent construction and improvement of clinical teaching staff.Methods:Totally 172 nursing masters from Jiangsu, Zhejiang, Henan provinces and Tianjin and 86 clinical teaching staff from the hospitals where they practiced were selected using convenient samping and investigated with the self-made questionnaire from October to December 2018. The differences between clinical teaching staff's resources, abilities and students' expectations were compared. A total of 258 questionnaires were distributed among 86 clinical teachers and 172 nursing masters, and 258 valid questionnaires were recovered, with an effective rate of 100%. SPSS 22.0 software was used for statistical analysis of data.Results:There was a certain gap between the clinical teaching staff and students' expectations, especially in terms of the graduate school and academic qualifications of the clinical teachers. Totally 34.88% (30/86) of the clinical teachers graduated from TCM universities, while 71.51% (123/172) of the students expected to be taught by teachers graduating from TCM universities. Among the clinical teachers, 60.47% (52/86) were undergraduates, and fewer were masters or graduates with higher education. There was a certain difference between the teaching teachers' abilities and students' expectations. There were statistically significant differences in 17 secondary indicators (χ 2 were 12.027-130.149, P<0.05) , except for the professional attitude in clinical nursing abilities, decision-making abilities in clinical management abilities, communication abilities in interpersonal abilities, and collaboration abilities ( P>0.05) . There were statistically significant differences between students' current status and their learning needs for TCM nursing (χ 2 were 14.722-165.339, P<0.01) . TCM nursing skills and practical application of TCM nursing research were the contents that most students wanted to learn, accounting for 83.72% (144/172) and 70.35% (151/172) , respectively. Conclusions:There were differences between the current status of the teaching staff for nursing masters at TCM universities and the expectations of the students. The universities should fully consider the graduates' own expectations and needs based on the training objectives for graduates, actively explore the admission system for clinical teachers, improve the training system for teachers, and standardize the teaching evaluation mechanism based on the status quo of nursing talents in China.