Objective:To explore a new training mode for nursing professionals suitable for the 1+X certificate system, and realize the training goal of "one specialty and multi-ability" compound technical nursing talents.Methods:To take the "1+ X" certificate standard as the basis for the construction of nursing specialty, to reconstruct the talent training program of integration of graduation certificate and certificate. To take the content of "1+X" certificate as the basis for the construction of professional courses, construct the core curriculum system of integration of curriculum and certificate. To build a "new double-qualified" teaching staff and constructing of new double-qualified teachers and accelerate the development of quality resources.Results:The talent training mode of integration of graduation certificate and certificate under the 1+X certificate system was constructed. The curriculum structure has been optimized. The teachers′ability of teaching, training and examination was improved.Conclusions:The new mode of training nursing professionals under the 1+X certificate system meets 1 degree education and X vocational training of nursing students and achieve a "1" and "X" seamless convergence. It provides innovative ideas for the promotion and implementation of 1+X certificate system pilot work in the field of nursing education nationwide.

Objective:To explore the talent cultivation model of nursing professional group under the 1+X certificate system, to build a talent cultivation system for nursing professional groups with "three progressions, four integrations, and five cocultivation"Methods:From 1 July 2021 to 31 December 2023, built a professional group course system of "mutual sharing of foundations, mutual generation of majors, mutual selection of positions, and progressive improvement of abilities". Aligned course content with X certificate content. Deepen the reform of the three education systems, create a "dual teacher" teaching team that combines full-time and part-time work, and build teaching resources that connect the cloud and the ground. The application effect of this model was evaluated in 2021 nursing majors in Cangzhou Medical College by cluster sampling.Results:There were 748 students majoring in nursing in class of 2021, 150 boys aged 19-22(20.00 ± 1.23), 598 girls, aged 19-21(19.00 ± 2.57). There were 118 students majoring in midwifery in class of 2021, all of them were girls, aged 18-20(18.00 ± 2.11). There were 128 students majoring in rehabilitation therapy technology in class of 2021, 66 boys aged 19-21(19.00 ± 2.11), 62 girls aged 19-21(19.00 ± 2.54). Nursing professional group completed the "Basic Nursing Technology Training Guidance", "Elderly Care" and other 5 self-compiled textbooks, 730 students had participated in the X certificate assessment, 729 students e passed the assessment, the passing rate was 99.9%.Conclusions:The talent cultivation model of "three progressions, four integrations, and five co cultivation" in the nursing professional group can cultivate students′ professional abilities, and cultivate a composite technical and skilled talent with multiple abilities and interconnections in one job.

In recent years, with the in-depth study of pemphigus, new pathogenesis has been identified based on the desmoglein antibody-mediated immune response mechanism, and new progress has been made in targeted therapy. This review summarizes recent advances in the pathogenesis and targeted therapy of pemphigus.

Objective To investigate the value of pepsinogen(PG)in diagnosing children peptic ulcer.Methods A total of 855 children patients completing gastroscopic examination in this hospital due to nausea,vomiting,abdominal pain,gastrointestinal bleeding and other gastrointestinal symptoms from July 2019 to January 2024 were selected as the study subjects.According to the gastroscopic examination results,they were divided into the healthy physical examination group(n=223),chronic gastritis group(n=418),chronic gas-tritis combined with duodenal bulbar inflammation(n=168)and gastric ulcer and duodenal bulbous ulcer group(peptic ulcer group,n=46).A total of 503 study subjects perfected the 13C breath test and divided into Helicobacter pylori(Hp)positive and Hp negative according to the test results.Serum PGⅠ,PGⅡ and PGⅠ/PGⅡ levels in all study subjects were measured by latex immunoturbidimetry.The differences of this indi-cator among different ages and different gastric diseases and its diagnostic value in peptic ulcer were analyzed.Results The proportion of female children patients in the peptic ulcer group was significantly lower than that in the other 3 group,and the difference was statistically significant(P＜0.05).The PGⅠ level of children pa-tients＜7 years old in the chronic gastritis group was lower than that of the children patients＞12 years old group,and the difference was statistically significant(P＜0.05).The PG level of the children patients＜7 years old in chronic gastritis combined with duodenal bulbar inflammation group was lower than that in the children patients＞12 years old group,the PGⅡ level in the children patients＜7 years old,7-12 years was lower than that in the children patients＞12 year old,and the difference was statistically significant(P＜0.05).Compared with the healthy physical examination group,the PGⅠ level in the chronic gastritis group was increased,the PGⅠ and PGⅡ levels in the chronic gastritis combined with duodenal bulbar inflammation group were increased,the PGⅠ/PGⅡ ratio was decreased,the PGⅠ and PGⅡ levels in the peptic ulcer group were increased and the PGⅠ/PGⅡ ratio was decreased,and the differences were statistically significant(P＜0.05).Compared with the chronic gastritis group,the PGⅠ/PGⅡ ratio in the chronic gastritis combined with duodenal bulbar inflammation group was decreased,the PGⅠ and PGⅡ levels in the peptic ulcer group were increased,the PGⅠ/PGⅡ ratio was decreased,and the differences were statistically significant(P＜0.05).Compared with chronic gastritis combined with duodenal bulbar inflammation group,the PGⅠ and PGⅡ lev-els in the peptic ulcer group were increased,the PGⅠ/PGⅡ ratio was decreased,and the differences were sta-tistically significant(P＜0.05).The area under the curve(AUC)of PGⅠ and PGⅡ for predicting peptic ul-cer was 0.689 and 0.785 respectively,the maximal Youden index served as the optimal diagnostic cutoff val-ue,when PGⅠ was 69.25 μg/L,its Youden index reached the maximal value,the sensitivity for diagnosing peptic ulcer was 67.4％,the specificity was 72.3％;when PGⅡ was 12.25 μg/L,its Youden index reached the maximal value,the sensitivity for diagnosing peptic ulcer was 71.7％,the specificity was 76.1％.Compared with the Hp negative,Hp positive PGⅠ and PGⅡ in the chronic gastritis combined with duodenal bulbar in-flammation group were increased,the PGⅠ/PGⅡ ratio was decreased,the Hp positive PGⅠ/PGⅡ ratio in the peptic ulcer group was decreased,and the differences were statistically significant(P＜0.05).Conclusion PG could be used to diagnose children peptic ulcer.

Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.