Objective To establish a scientific, systemic objective and practical competency model for head nurses. Methods Based on the PPEB model, the competency model for head nurses was formulated through literature review, theoretical analysis, specialists interview and Delphi method. Results The head nurses′competency model consisted of professional competency, psychology competency, ethic competency and behavior competency, which included 10 second- level indicators and 33 third- level items. A total of 16 questionnaires were sent out in each round of consultation, and 15 and 16 questionnaires were retrieved separately. the experts′authority coefficient was 0.88 and the coordination coefficient was 0.131. Conclusions The enthusiam, authority and harmony of the specialists were good, which meant the competency model for head nurses were scientific and reliable. And it could provide references for head nurses′selection, training and performance appraisal.

Objective To evaluated the effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI)on advanced non-small cell lung cancer (NSCLC)patients with different EGFR mutation status (exon 1 9 deletion and exon 21 mutation).Methods Seventy-two advanced NSCLC patients with EGFR mutation confirmed by histopathology were enrolled.All of the patients received first-line EGFR-TKI.The relationships between EGFR mutation status and objective response rate (ORR),disease control rate (DCR),progression free survival (PFS ) and overall survival (OS ) were analyzed.Results Of the 72 patients,37 patients expressed exon 1 9 deletion,35 patients expressed exon 21 mutation,and all of them could be evaluated.The ORR and DCR of patients with exon 1 9 deletion were higher than those of patients with exon 21 mutation (75.7%vs.51 .4%,χ2 =4.583,P=0.032;89.2%vs.68.6%,χ2 =4.636,P=0.031 ).The modified median PFS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (1 3.2 month vs.1 0.8 month,χ2 =4.700,P=0.030).The median OS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (30.2 month vs.25.6 month,χ2 =4.686,P=0.030).The side effects were similar between the two groups.The most common adverse reaction was rash,and the incidence had no significant difference between the two groups (48.7% vs.48.6%,χ2 =0.000,P=0.995 ).Conclusion EGFR mutation status is a predictor for PFS,OS and ORR of first-line EGFR-TKI in patients with advanced NSCLC.NSCLC patients with EGFR exon 1 9 deletion are associated with longer survival time and better response rate compared with those with exon 21 mutation.

Objective To establish a questionnaire to measure competence of head nurses and test its reliability and validity. Methods Based on the third-level items of the competency model built by Tanjie, the primary competency questionnaire was established combining literature review, team discussion and preliminary test. The reliability and validity of the questionnaire was tested in 236 head nurses. Results The questionnaire consisted of 4 dimensions and 33 items, and 4 common factors were extracted by principal components analysis, which contributed to 75.691%of the variance. The Cronbachα was 0.945 for the total questionnaire, and the content validity index was 0.960. Conclusions The questionnaire shows acceptable reliability and validity, and can be applied to the competence investigation of head nurses.

Objective To investigate the clinical value of acoustic radiation force impulse (ARFI) imaging in the evaluation of liver functional reserve in patients with hepatic focal lesions. Methods Eighty-six patients with hepatic focal lesions in General Hospital of the People′s Liberation Army from September 2011 to August 2012 were studied. According to Child-Pugh score, 54 of them were classified as grade A, 18 patients were classiifed as grade B, and 14 patients were classiifed as grade C. Seventy patients underwent surgery and 16 patients underwent non-surgical treatment. Shear wave velocity (SWV) values were measured using ARFI technique, and indocyanine green (ICG) clearance tests were also performed to achieve ICG clearance rate constant (ICGK) and ICG retention rate at 15 minutes (ICG15). Correlation between SWV and ICGK, SWV and ICG15 were studied using Pearson correlation, and correlation between SWV and Child-Pugh score were analyzed using Spearman rank correlation. Difference between SWV values of patients underwent surgery and those of patients underwent non-surgical treatment was compared using t-test for independent samples. Analyses of receiver operating characteristic (ROC) curve were performed to investigate the value of ARFI in the evaluation of surgical feasibility for patients with hepatic focal lesion, with the clinical decisions serving as the golden standard. Results There was correlations between SWV and ICGR15, SWV and ICGK, and SWV and Child-Pugh scores (r=0.764,P <0.001;r=-0.686,P=0.000;r=0.864,P=0.000). The SWV of patients who underwent surgery was (2.46±0.45) m/s, and the SWV of patients who underwent non-surgical treatment was (1.54±0.36) m/s, with a signiifcant difference (t=-0.80, P=0.000). The ROC curve analysis demonstrated a highest Youden′s index of 0.775 when the cut-off was 2.06m/s. The corresponding sensitivity was 87.5% and the specificity was 90.0% for ARFI in the diagnosis liver functional reserve deficiency. Conclusion ARFI can effectively evaluate the liver functional reserve in patients with hepatic focal lesions and thus could be beneifcial in the decision of clinical treatment.

Based on the conception analysis of the organizational change leadership of the upper-and mid-level nursing manager,this review described connovations of the organizational change leadership and its applications in nursing field at home and abroad,and pointed out the current research status,limitations and the inspirations we got,so as to provide references for promotion and evaluation of the upper-and midlevel nursing manager's organizational change leadership.

To design a new method to simulate the micro-motion of human body surface due to respiration and heartbeat, and to provide detection object and calibration signal for the bio-radar technology. Precision lin-ear module was used to transform rotational movement to linear displacement, with AC servo motor to precisely control the module's rotation. Ultimately, ultralow-frequency micro-motion was produced with its displacement being quantitatively controlled. A system simulating the micro-motion of human body surface was newly built. Compared with the old system, the new one produced micro-motion with better constancy, and realized quantitative control of the motion's dis-placement. The method lays technological foundation for simulating the micro-motion of human body surface due to respiration and heartbeat and may promote the development of bio-radar technology towards intensive and compre-hensive levels.

Objective To study the effect of blood glucose fluctuations on the prognosis of thrombolytic therapy in patients with acute cerebral infarction. Methods A total of 83 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,General Hospital of Beijing Military Command ( the Affiliated 81st Brain Hospital ) from January to November 2013 were enrolled retrospectively. They were divided into cerebral infarction with type 2 diabetes mellitus group (DMCI group,n=47) and cerebral infarction without type 2 diabetes mellitus group (NDMCI group,n=36) according to whether they had diabetes mellitus or not and the results of oral glucose tolerance test at day 7 after admission. Continuous glucose monitoring system ( CGMS) was used to monitor glucose for 72 hours at day 7 after admission. The mean blood glucose, standard deviation of blood glucose level, mean blood glucose fluctuation,and hemorrhagic transformation during the follow-up period,as well as vascular recanalization were observed and compared. At day 90,the modified Rankin scale (mRS) score was used to evaluate the prognosis of the patients. Results ( 1 ) Comparing the dynamic glucose parameters of the patients with acute cerebral infarction in both groups,the mean blood glucose,standard deviation of blood glucose level,mean blood glucose fluctuations at 24 hours in patients of the DMCI group were higher than those of the NDMCI group ( 8 . 3 ± 2 . 6 mmol/L vs. 5 . 8 ± 1 . 3 mmol/L,2. 1 ± 0. 4 mmol/L vs. 1. 6 ± 0. 6 mmol/L,4. 3 ± 0. 8 mmol/L vs. 3. 6 ± 0. 5 mmol/L). There were significant differences (t=31. 419, 15.537,and 15. 372,respectively;all P<0. 01). (2) Four patients (8.5%) in the DMCI group had hemorrhagic transformation during the follow-up period,17 cases (36. 2%) had good recanalization,and 15 cases (31.9%) had good prognosis (the mRS score < 2 at day 90);1 patient (2.8%) in the NDMCI group had hemorrhagic transformation,21 patients (58. 3%) had good recanalization,and 21 cases (58. 3%) had good prognosis. There was significant difference between the recanalization after thrombolysis and the prognosis in patients of both groups (P<0. 05). Conclusion The great fluctuations of blood glucose in acute cerebral infarction patients with type 2 diabetes mellitus may be an important factor of affecting its prognosis of thrombolytic therapy.

Objective To explore the therapeutic mechanism of kidney-reinforcing,blood-activating and phlegmresolving therapy for left ventricular fibrosis of spontaneously hypertensive rats (SHR).Methods Twenty SHR were randomly assigned to Chinese medicine group and model group.Additionally,ten Wistar-Kyoto(WKY) rats served as normal control group.After 12-week prevention,Masson staining method was used to measure the degree of fibrosis of left ventricular myocardial tissues,reverse transcription-polymerase chain reaction(RT-PCR) was used to detect Smad3 mRNA expression,and Western blotting method was used for the detection of Smad3 protein expression.Results The degree of left ventricular fibrosis myocardial tissue in Chinese medicine group was milder than that in the model group,and Samd3 protein and mRNA expression levels in Chinese medicine group were lower than those in the model group (P ＜ 0.05).Conclusion Kidney-reinforcing,blood-activating and phlegmresolving therapy can improve left ventricular fibrosis in SHR by inhibiting Smad3 expression.

Objective To examine the efficacy and safety of 125Iseed implantation for treating neuroblastoma (NB) in animal models.Methods A total of 45 nude mice models of neuroblastoma were constructed and divided into the 125Igroup.control group.and blank group at 15 mice per group.The long and short diameters of the tumor were measured every 3 days.and the tumor inhibition rate was calculated every 9 days.Apoptotic and proliferative protein expression levels in tumor tissue and peritumoral tissue.as well as endocrine markers and bone marrow of the nude mice.were analyzed.The independent sample t test was used to compare the mean scores.and ANOVA was used for comparison between multiple groups.Results Tumor volume inhibition rate was significantly higher in the 125Igroup than in the control group and blank group on days 9.18.and 27(all P<0.05).Caspase-3 expression in tumor tissues was significantly higher in the 125Igroup than in the control group and blank group (all P<0.05).whereas proliferating cell nuclear antigen (PCNA) expression was significantly lower in the 125Igroup than in the control group and blank group (all P<0.05).There was no significant difference in Caspase-3 and PCNA expression between the control group and blank group (all P>0.05).In addition.no significant difference in the expression of Caspase-3 and PCNA in peritumoral tissue was observed between the 125Igroup.control group.and blank group (all P>0.05).Cell apoptosis in tumor tissue was significantly lower in the blank group and control group than in the 125Igroup (all P<0.05).while there was no significant difference between the blank group and the control group (P>0.05).There was no significant difference in endocrine markers between the three groups (P>0.05).There was no significant bone marrow suppression in the 125Igroup.and this observation was similar to those in the control group and blank group (all P>0.05).Conclusions 125Iseeds have significant toxicity to NB.125Iseed implantation is safe in nude mice with NB within the therapeutic doses.

Objective:To explore the application effect of medical science competition in nursing interns whocontribute to "healthy China" , and to improve their health education awareness, ability, method and self-confidence.Methods:A total of 205 nursing interns who worked in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from 2019 to 2020 were selected as the research objects. They were divided into the control group (105 cases) and the experimental group (100 cases) according to whether they participated in the medical science competition. The control group learned the form and method of health education in clinical rotation according to the traditional practice teaching plan. The experimental group volunteered to participate in the medical science competition, which required the dissemination of health knowledge through various forms. Before and after the competition, the health education ability assessment scale was used for comparison.Results:Before the medical science competition, there was no significant difference in the total score of assessment, planning, implementation, evaluation and health education between the control group and the experimental group ( t values were 0.765 - 1.749, all P>0.05). After the medical science competition, the total scores of assessment, planning, implementation, evaluation and health education ability of nursing interns in the experimental group were (24.38 ± 4.72), (17.98 ± 3.98), (25.16 ± 5.36), (12.57 ± 2.96) and (80.09 ± 15.65) respectively, while those in the control group were (22.45 ± 6.29), (16.61 ± 4.77), (23.04 ± 6.55), (11.31 ± 3.46) and (73.41 ± 19.69).The differences between the two groups were statistically significant ( t values were 2.226 - 2.795, all P<0.05). Conclusions:The medical science competition can improve the health education ability of assessment, planning, implementation, evaluation of nursing interns and contribute to "healthy China" .