Objective To compare the pain management effects between painless wards with quality control circle mode and conventional pain management mode.Methods A retrospective case control study was conducted on the clinical data of 233 patients with lower limb fracture admitted from August 2015 to August 2016.There were 124 males and 109 females,aged 18-74 years [(48.3 ±3.3)years].The patients were divided into observation group (n =117) and control group (n =116) according to the pain management mode.The observation group followed the standard continuous quality improvement program and combined with professional team and patients Wechat group to implement pain management,and further measures were taken in accordance with the feedbacks.The control group adopted routine painless ward nursing model for perioperative analgesia nursing intervention.The pain score VAS,the start time of functional exercise,the compliance of rehabilitation activities,the length of hospital stay,and the healing time of fracture were compared between the two groups.Results There was no significant difference in VAS scores between the two groups at 12 hours before operation and 6 hours after operation (P ＞ 0.05).The observation group had lower VAS scores at 12 hours (3.2± 1.4),24 hours (2.8 ±0.9),48 hours (1.6 ± 0.7),and 72 hours (1.5 ± 0.8) after operation than the control group (P ＜0.05).The observation group started functional exercises earlier [(18.9 ± 0.4) hours after operation]than the control group earlier [(48.1 ± 1.7) hours after operation] (P ＜ 0.01).The observation group had a rehabilitation compliance rate of 62.6％,higher than that of the control group (17.6％) (P ＜0.05).The hospital stay [(12.18 ± 0.14) days] and fracture healing time [(97.86 ± 0.83) days] of the observation group were shorter than those of the control group (P ＜ 0.05).Conclusion The pain management model of standardized continuous quality improvement can significantly relieve pain in patients with lower limb fracture,shorten hospitalization time,bring forward the start time of functional exercise,improve the compliance of rehabilitation activities,and promote fracture healing.

Cultivating comprehensive personnel with competent professional ethics, technical skills and scientific research capabilities is the goal and task of today's laboratory medical education. How to make full use of diversified teaching materials, tools and methods to improve teaching quality is worthy of exploration and thinking in laboratory medical teaching units. In this paper, using mind map as a tool, taking the COVID-19 epidemic as an example, we intend to design a set of multidisciplinary and all-round integrated curriculum of medical laboratory education, and discuss the application status and prospect of integrated curriculum and mind map in medical laboratory education. Through doing this, we aim to optimize the training goals of laboratory medicine education, innovate the teaching methods and boost the training efficiency of laboratory medicine education to keep up with the times.

Objective:To explore the perceived stress and coping experience of spouses of elderly people with long-term disability and empty nest.Methods:Using phenomenological research methods, semi-structured interviews were conducted with 19 spouses of disabled elderly people in a community in Beijing from February to June 2023, and data analysis was conducted using Colaizzi's 7-step analysis method.Results:The perceived stress and coping experience of spouses of long-term disabled empty nest elderly people were summarized into three themes and ten sub-themes, namely, the dynamic and variable stress perception of spouses (stress changed synchronously with the state of disabled elderly people, stress changed in a "U" shape, and pressure increased in a progressive manner), the challenges for spouses in long-term care of disabled elderly people (difficult in unifying opinions and views, incomprehensible inner emotions, difficulty in ensuring their elderly care, and coexistence of multiple roles and identities) and positive coping experiences and strategies of spouses (actively seeking external support, respecting the subjective wishes of disabled elderly people, and improving dyadic coping abilities) .Conclusions:Community nursing staff should support and guide spouses who undertake care work based on changes in perceived stress characteristics of long-term disabled empty nest elderly people. At the same time, it is necessary to understand the various challenges they face in long-term care, draw on positive coping experiences of spouses, so as to provide a basis for building a friendly family support system for home-based elderly care.

Objective:To evaluate the effect of non-pharmacological interventions on benefit finding of breast cancer patients by using network Meta-analysis.Methods:Randomized controlled trials on the effect of non-pharmacological interventions on the benefit finding of breast cancer patients were retrieved by computer from CNKI, VIP, Wanfang Date, China Biology Medicine disc, PubMed, Web of Science, Cochrane Library, EBSCO, Embase, Medline, Ovid, CINAHL and other databases. The retrieval time was from establishment of the databases to October 15th, 2023. Literature screening and data extraction were carried out independently by two researchers. The Cochrane Manual 5.1.0 randomised Controlled Trial Bias Risk Assessment Scale were used to evaluate the included literature. And the Stata 14.0 were used for Network Meta-analysis.Results:A total of 10 literatures were included. The results of Network Meta-analysis showed that cognitive behavior therapy was the best intervention in improving the benefit finding of breast cancer patients. The effects of different non-pharmacological intervention methods in descending order were cognitive behavior therapy, yoga, acceptance and commitment therapy, self disclosure and muscle stretching.Conclusions:Existing evidence suggests that cognitive behavioral therapy is most effective in improving benefiting finding in breast cancer patients, but more valuable evidence support and high-quality randomized controlled trial studies are needed to further validate.

【Objective】 To investigate the anemia status of infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture, Gansu Province, and to comprehensively evaluate the differences in feeding behaviors between anaemic and normal children through the infant and child feeding index (ICFI) and feeding knowledge scores, so as to provide reference for the guidance of infants and young children feeding in ethnic minority areas and the promotion of children′s growth and development. 【Methods】 Taking infants and young children aged 6 - 24 months in Linxia Prefecture as the study subjects, a multi-stage random sampling method was used to select children who met the requirements from 5 townships and 5 villages in 7 counties in 2019 and 2020.Periphral blood samples were collected to test the level of hemoglobin, so as to determine the anemia status.Meanwhile, physical examination was performed and a questionnaire survey of guardians was conducted to analyze the association betweenanaemia and feeding patterns 【Results】 A total of 3 901 infants and children were included in this study, of whom 729 (18.70%) were anaemic, with a mean ICFI score of 12.56±2.70 and a mean feeding knowledge score of 1.97±1.01.There was no statistically significant association of low feeding knowledge score and low ICFI with anaemia after adjusting for confounders (P>0.05), Unqualified meat addition in ICFI was a risk factor for anaemia (OR=1.355, P=0.042), while non-bottle feeding in the past 24 hours (OR=0.762, P=0.021), and breastfeeding in the past 24 hours of infants and toddlers aged 12 - 24 months (OR=0.228, P=0.018) were protective factor for anemia in infants and toddlers aged 12 - 24 months. 【Conclusions】 The average prevalence of anemia in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture of Gansu Province is high, but the level of infant feeding and the level of feeding knowledge of caregivers are low.Early adherence to breastfeeding, timely addition of supplementary food, and more comsumpution of meat for children are conducive to preventing anemia.