Objective To investigate the level about illness perception in patients with coronary heart disease. Methods From July to De-cember, 2015, 198 inpatients with coronary heart disease who were admitted into hospitals twice or more were enrolled. They were assessed with Illness Perception Questionnaire-Revised (IPQ-R). Results The score of common symptoms was (4.55±1.64). The symptoms, for exam-ple, chest pains, uncomfortable feeling in chest, cold sweat, flustered and breathlessness were most frequently experienced and most often identified. For the illness perception part, the scores on subscales of treatment control and consequences were higher than 3, which was the neutral point. For the cause dimension part, the highest scores was (3.38 ± 0.90) in diet or eating habits, followed by (3.38 ± 0.89) in aging. Among these factors, immune factors had the highest mean score, followed by stress factor. Conclusion The level of illness perception in pa-tients with coronary heart disease was in the middle level, and individual differences were obvious. The awareness of the disease and the in-tervention of the patient should be strengthened.

Objective To study the clinical features and treatment of cervical spondylosis with dissociated motor loss in upper extremity. Methods Data analysis was done in 10 patients with cervical spondylosis with dissociated motor loss in upper extremity, in aspects of symptoms, sign, radiologic feature, electromyogram and treatment. Results There are 2 subtypes of cervical spondylosis with dissociated motor loss in upper extremity: Keegan and Non-Keegan types. The patients with Keegan type of cervical spondylosis manifested weakness and atrophy in the upper extremity, and no radicular pain was reported. The Non-Keegan type is in fact a combination of radicular and spinal insult in the cervical region. Our clinical practice showed that surgical operation was preferred to the conservative treatment for patients with this disease. Conclusion A well understanding of this disease is of great importance for avoiding mistakes in diagnosis and treatment of this disease.

Objective:To explore the effect of mild cognitive impairment on the subjective well-being of the elderly and the mediating role of self-efficacy in it. To provide an effective basis for health management and clinical intervention in the elderly with mild cognitive impairment.Methods:A total of 164 patients with mild cognitive impairment from December 2018 to June 2019 were surveyed by the General Self-efficacy Scale, the Montreal Cognitive Assessment Scale, and the Memorial University of Newfoundland Scale of Happiness Scale.Results:The overall score of self-efficacy was 21.41±3.98, and subjective well-being was 26.44±7.35. There was a positive correlation among cognitive function, self-efficacy and subjective well-being, except that there was no significant correlation between self-efficacy and cognitive function( r values were 0.263-0.687, P<0.01). Self-efficacy played a part in mediating between cognitive function and subjective well-being in patients with mild cognitive impairment, accounting for 37.8% of the total effect. Conclusions:Mild cognitive impairment can also have a negative impact on the subjective well-being of the elderly. Among them, self-efficacy plays a particularly important role in mediating. Interventions about self-efficacy on the elderly with mild cognitive impairment may have more significant effects.

Objective:To explore the influence of mindfulness meditation intervention on the professional identity and turnover tendency of the second victim of nurses.Methods:The convenience sampling method was used to select the second victim of 46 nurses who experienced medical adverse events within six months from January to June 2019 in Zhongnan Hospital of Wuhan University, and then an 8 weeks of mindfulness meditation intervention was carried out for them. In the entire intervention process, a self-control study was conducted, the Second Victim Experience and Support Scale (SVSET) and the Nurse Occupational Identity Scale were used to assess nurses' turnover intentions, absence and professional identity before the intervention and at 2 hours, 4 weeks, and 8 weeks after the intervention.Results:By analyzing the data, the results showed that after the mindfulness meditation intervention, the second victim of the nurse before intervention, 2h, 4 weeks, and 8 weeks of intervention were 3.28±0.87, 3.20±0.83, 2.85±0.92, 2.71±0.87, the difference was statistically significant ( F time value was 6.609, P<0.05). Before and after the intervention of the sense of grasp in professional identity were 4.91±0.83, 5.47±0.81, 5.83±0.91, 5.94±0.80, the difference was statistically significant ( F time value was 20.973, P<0.01). Consensus before and after intervention were 4.61±0.78, 5.09±0.85, 5.54±1.12, 5.76±0.85, the difference was statistically significant ( F time value was 22.237, P<0.01). The meaningful sense before and after intervention were 4.38±1.03, 5.04±0.75, 5.44±0.86, 5.59±0.76, the difference was statistically significant ( F time value was 23.656, P<0.01). The self-efficacy before and after intervention were 4.71±0.82, 5.33±0.63, 5.83±0.84, 5.90±0.77, the difference was statistically significant ( F time value was 28.866, P<0.01). The self-determination before and after intervention were 4.43±0.97, 5.06±0.81, 5.59±0.91, 5.62±0.87, the difference was statistically significant ( F time value was 25.237, P<0.01). Before and after intervention, the influence of tissue was 4.17±0.96, 4.71±0.85, 4.96±0.99, 5.30±0.88, the difference was statistically significant ( F time value was 16.487, P<0.01). Before and after intervention, the patients' feelings were 4.59±0.96, 5.08±0.84, 5.70±0.83, 5.83±0.68, the difference was statistically significant ( F time value was 25.406, P<0.01). Conclusion:This article provides an effective method to help nurses' second victims out of their predicament which confirms that mindfulness meditation intervention can effectively reduce turnover tendency of nurses 'second victims and improve their professional identity.

Objective To explore the suitable human albumin infusion speed in the liver cirrhosis patients with portal hypertension .Methods Fifty-eight portal hypertension patients need to infusion human albumin(50 ml,20%) were chosen and divided into the control group (n =30) and the experimental group ( n=28) by using the coin toss method .The control group received the infusion speed of 25 gtt/min for 45 min, and the experimental group received the infusion speed of 33 gtt/min for 30 min.The portal vein inside diameter (Dpv), mean blood flow velocity (Vpv), blood flow volume (Qpv) and the portal vein pressure measured by the color doppler ultrasound diagnostic instrument were compared at different times between two groups .Results At the end of the infusion, the Dpv,Vpv,Qpv and the portal vein pressure in the control group were (13.03 ± 2.01)mm,(9.40 ±2.06)cm/s,(782.29 ±313.02)ml/min and (2.747 ±0.348)kPa respectively, compared with the experimental group, and the differences were not statistically significant (t=-0.04,0.81,0.46,0.55, respectively;P>0.05).Conclusions It is feasible to input 10 g human albumin (50 ml,20%) during 30 min for the portal hypertension patients .

This paper reviews the literatures on the second victim at home and abroad and introduces the definition of the second victim in patient safety incidents and the controversy over the terms of the second victim. In addition, the clinical manifestations and morbidity of medical staff as second victims, the influencing factors of second victim syndrome and the adverse consequences of second victim syndrome were reviewed. The paper aims to improve the attention of medical institutions to the second victim and the attention of the society to the physical and mental health of medical personnel, so as to provide reference for the follow-up research on medical personnel as the second victim.

The update of multi-omics technology is a key means to promote the rapid development of accurate health model in the whole life cycle.It can formulate dynamic and accurate nursing measures and provide massive data information from the perspective of nursing biology of health and disease.At present,clinical nursing research faces many challenges such as insufficient application and transformation ability of multi-omics technology.This paper introduces the multi-omics technology,reviews the application status of multi-omics technology in cancer nursing,maternal and child nursing,chronic metabolic disease nursing and symptom management,and puts forward the cross integration and prospect of multi-omics technology and nursing research,so as to strengthen the information mining ability of nurses at different levels of health and disease,and provide an important basis for accelerating the clinical transformation of precision nursing.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.

Objective:To explore the psychological recovery pathway and support needs of second victims of nurses who have experienced medical adverse events through qualitative research.Methods:From June to December 2022, a purposive sampling method was used to select 20 nurses who had experienced level Ⅲ or above adverse events and voluntarily participated in this study from 3 grade A tertiary hospitals in Hubei Province and 1 grade A tertiary hospital in Sichuan Province. Semi-structured interviews were conducted with the research subjects and the data was analyze by using thematic analysis.Results:The psychological recovery path of nurses who had experienced medical adverse events included three stages, named as the plateau period, stress response period, and coping and growth period. The second victim of nurses hoped to receive support from the department′s environmental culture, organizational atmosphere, and non punitive culture, and nurses in the platform stage had a stronger need for the first two types of support; the nurses preferred emotional support from superiors, colleagues, family/friends during the stress response period, and preferred knowledge learning and training support during the coping and growth period.Conclusions:The psychological recovery of the second victim of nurses will go through a plateau period, a stress response period, and a coping and growth period. There are differences in support needs during each period, and more targeted intervention plans should be developed.

Objective:To investigate the clinical effect of laparoscopic assisted removal of greater omentum free transplantation combined with skin grafting for the repair of large area refractory wounds.Methods:From June 2013 to June 2018, 18 cases of lower extremity skin and soft tissue defects with multiple bone, joint, tendon and internal plants exposure were admitted to Hanzhong Central Hospital, including 12 males and 6 females, aged from 15 to 50 years old, with an average age of 32.6 years old. The area of skin and soft tissue defect: 30 cm×12 cm-53 cm×21 cm. The operation was divided into two stages. In the first stage, the greater omentum was acquired with the assist of laparoscope and free transplanted to cover the wound. After the greater omentum free transplantation was confirmed to survive, the split-thickness skin graft was applied for wound repair.Postoperative survival of the greater omentum and skin grafting, complications, appearance and function of lower limbs were observed and followed up.Results:The 18 operations were performed successfully, the area of omentum resection was 25 cm×10 cm-35 cm×15 cm, all the greater omentums survived after operation without complications such as intestinal adhesion, volvulus and peritonitis. The area of the skin grafting was 36 cm×8 cm-45 cm×22 cm. 16 cases skin grafting survived completely, 2 cases skin grafting were necrosis just local small area, and scar healed after dressing change. Postoperative follow-up of 6-12 months showed good appearance and function of lower limbs and satisfactory results.Conclusions:For the large area soft tissue defect wound of lower extremity, complicated with multiple deep tissues such as bone, joint and internal materials exposed, the greater omentum free transplantation under laparoscope combined with medium thick skin graft second stage has the advantages of good appearance and function after wound healing, less donor injury and fewer postoperative complications.