Objective To explore the application effect of scenario simulation teaching method in the standardized training course "symptom care" for new nurses.Methods Baccalaureate nursing graduates who were enrolled in 2013 and 2014 in Xuanwu Hospital of Capital Medical University were divided into the control group (n=40) and the observation group (n=55) respectively. In the observation group,the scenario simulation teaching method was adopted,and nurses in the control group was taught by standardized patient teaching method. The scores of theoretical exam and practice skill of nurses in two groups were compared.Results The score of theoretical examination in the observation group was (82.29±7.84),while the score in the control group was (82.18±7.12) in the control group (P>0.05);the score of practice skill in the observation group was (89.43 ±2.82),and the score in the control group was (81.47±5.28) (P<0.05).Conclusions Scenario simulation teaching method can improve the learning outcomes of nurses in "symptom care",and improve nurses' clinical comprehensive practice skill.

Objective To explore the effects of problem-based learning (PBL) on the teaching of geriatric specialist nurses. Methods A total of 46 geriatric specialist nurses who were trained in Xuanwu Hospital of Capital Medical University from November 2016 to January 2018 were selected as the subjects by convenience sampling method. All the subjects were divided into control group and observation group using random number table method with 23 patients in each group. The control group adopted the routine teaching method, while the observation group adopted PBL method for 2 months. The teaching effect of the two groups was compared using the Registered Nurse Core Competence Scale (CIRN) and the Clinical Nursing Teacher's Teaching Behavior Evaluation Scale. Results After 2 months' training, the total score of CIRN of the observation group was (186.44±15.68), and the score of teaching behavior was (106.98±10.46), which were both higher than those of the control group, and the differences were statistically significant (t=3.680, 4.462; P＜0.01). Conclusions The model of PBL can improve the core competence of geriatric specialist nurses and improve the quality of teaching.

Objective To explore the application effect between ultrasound ( US)-guided central line insertion combined with modified guide wire insertion technique and the conventional US-guided peripherally inserted central catheter ( PICC) placement. Methods Totally 120 cases with PICC from January 2014 to December 2015 in Departwent of General surgery were randomly divided into the control group and the observation group. Patients in the control group received conventional US-guided PICC line placement, while patients in the observation group received US-guided central line insertion combined with modified guide wire insertion technique. The success rate and the incidence of complications related to catheter were compared in two groups.Results A statistically difference suggested that the success rate in observation group was significantly higher than the control group (χ2 =11. 582, P<0. 05 ) . Differences of the incidence of phlebophlogosis and thrombus in two groups weren′t significant(P>0.05).Conclusions US-guided central line insertion combined with modified guide wire insertion technique has a higher successful rate compared to the conventional US-guided PICC line placement.

Objective To improve the success rate of puncture among senile patients with difficulties in venipuncture by applying the near-infrared visualization puncture technology.Methods This study selected 160 elderly patients with difficulties in peripheral venipuncture of department of General Surgery and Geriatric Medicine Department by random sampling to carry out peripheral venipuncture at Xuanwu Hospital of Capital Medical University from June 2015 to December 2016. Those patients were divided into control group and observation group with the random number table, 80 patients in each group. Patients in control group received peripheral venipuncture by nurses' personal experience along with assessing vessel by routine visual method and touch method without any accessory equipment. Patients in observation group received peripheral venipuncture by the location of infrared vessel imager. The infrared vessel imager was used to evaluate the vessel shape and depth to understand vascular branches so as to locate target vessel. And then, this study compared the success rate, time and site of punctures between two groups.Results The success rate of first puncture of observation group was 91.25% significantly higher than that of control group (χ2=43.495,P<0.01). The puncture time [(3.7±1.8) min]of observation group was less than that of control group with a significant difference (t=4.629, P<0.01). In the aspect of site of punctures, there was 72.5% of patients with punctures in observation group in forearm vein higher than that in control group (χ2=46.920,P<0.01).Conclusions The near-infrared visualization puncture technology can improve the success rate of puncture in elderly patients with difficulties in peripheral venipuncture, short the puncture time and help to achieve forearm venipuncture with the first choice. This technology can also relieve the pain of elderly patients, save consumptive material cost and reduce nurses' pressure on puncture. It is worth to be used widely in clinical application.

Objective:To investigate the cognitive frailty of inpatients in Department of Geriatrics and analyze its influencing factors.Methods:This study was a cross-sectional study. Using the convenient sampling method, inpatients in Department of Geriatrics who were treated in Xuanwu Hospital of Capital Medical University were selected from June 2019 to June 2020. A total of 486 elderly patients who met the inclusion and exclusion criteria completed the questionnaire survey, physical examination and laboratory examination. The FRAIL Frailty Assessment Scale and Mini-Mental State Examination (MMSE) were used to evaluate cognitive frailty. Single factor analysis and Logistic regression were used to analyze the influencing factors of cognitive frailty in elderly inpatients.Results:The age of the survey subjects was (77.99±10.47) years old and the prevalence of cognitive impairment was 37.45% (182/486) . Logistic regression analysis showed that patients with a history of falls within 1 year, drinking, older age, anemia and ADL decline had a higher risk of cognitive impairment ( P<0.05) . Conclusions:The incidence of cognitive frailty is higher in elderly inpatients. Reducing the risk of falls, abstaining from alcohol, improving anemia and intervening to improve the ability of self-care in daily life may help to improve the cognitive frailty of the elderly.

Objective:To explore the frailty status of elderly inpatients and its influencing factors, so as to provide a basis for early identification of frailty status of elderly inpatients and scientific intervention.Methods:From January to December 2021, the convenient sampling was used to select 617 elderly patients (aged greater than or equal to 80 years old) in Department of Geriatric Medicine in Xuanwu Hospital, Capital Medical University as the research objects. The General Information Questionnaire, FRAIL Scale, Activities of Daily Living (ADL) Assessment Scale, NRS-2002 Nutritional Risk Screening Scale, John Hopkins Fall Risk Assessment Tool (JHFRAT) and Braden Scale were used to conduct cross-sectional survey. Multiple Logistic regression was used to analyze the influencing factors of frailty in elderly inpatients. A total of 617 questionnaires were distributed and 616 valid questionnaires were recovered, with an effective recovery rate of 99.8% (616/617) .Results:Among 616 elderly inpatients, the incidence of frailty was 60.9% (375/616) . The results of multiple Logistic regression analysis showed that advanced age, high fall risk, dependence on self-care ability of daily living and increased C-reactive protein were risk factors for frailty in elderly inpatients ( P<0.05) . Conclusions:Elderly inpatients have a high incidence of frailty. Advanced age, high fall risk, poor daily living ability and elevated C-reactive protein are related to the occurrence of frailty. Therefore, medical staff should do a good job of assessing the frailty of elderly patients in clinical work and formulate professional, diversified and safe intervention programs in combination with their physical conditions, so as to delay the frailty process of elderly inpatients, improve quality of life of patients and promote healthy aging.

Objective:To explore the frailty status of elderly inpatients and its influencing factors, so as to provide a basis for early identification of frailty status of elderly inpatients and scientific intervention.Methods:From January to December 2021, the convenient sampling was used to select 617 elderly patients (aged greater than or equal to 80 years old) in Department of Geriatric Medicine in Xuanwu Hospital, Capital Medical University as the research objects. The General Information Questionnaire, FRAIL Scale, Activities of Daily Living (ADL) Assessment Scale, NRS-2002 Nutritional Risk Screening Scale, John Hopkins Fall Risk Assessment Tool (JHFRAT) and Braden Scale were used to conduct cross-sectional survey. Multiple Logistic regression was used to analyze the influencing factors of frailty in elderly inpatients. A total of 617 questionnaires were distributed and 616 valid questionnaires were recovered, with an effective recovery rate of 99.8% (616/617) .Results:Among 616 elderly inpatients, the incidence of frailty was 60.9% (375/616) . The results of multiple Logistic regression analysis showed that advanced age, high fall risk, dependence on self-care ability of daily living and increased C-reactive protein were risk factors for frailty in elderly inpatients ( P<0.05) . Conclusions:Elderly inpatients have a high incidence of frailty. Advanced age, high fall risk, poor daily living ability and elevated C-reactive protein are related to the occurrence of frailty. Therefore, medical staff should do a good job of assessing the frailty of elderly patients in clinical work and formulate professional, diversified and safe intervention programs in combination with their physical conditions, so as to delay the frailty process of elderly inpatients, improve quality of life of patients and promote healthy aging.

Objective:To construct an evaluation index system for nursing teaching case base, so as to guide the construction of the nursing teaching case base, and provide a basis for evaluating the quality of the case base.Methods:From April to August 2020, the evaluation index system for nursing teaching case base was initially constructed through the integration of literature retrieval and semi-structured interview results, and based on the Donabedian model. A total of 17 experts were selected as the consultation subjects using the Delphi method. After 2 rounds of consultations, expert opinions tended to be unanimous to construct the evaluation index system for nursing teaching case base.Results:In the second round of consultation, the expert authority coefficient was 0.872, and the expert positive coefficient was 94.12% (16/17) , and the kendall's W was 0.115 with a statistical difference ( P<0.05) . Finally, the evaluation index system for nursing teaching case base included 3 first-level indicators, 8 second-level indicators, and 29 third-level indicators. Conclusions:The evaluation index system of nursing teaching case base based on the Donabedian model is scientific and credible, which can provide a basis for the evaluation of nursing teaching case base.

Objective: To understand the experience and needs of elderly specialist nurses during the period of specialist training, and to provide reference and basis for the establishment of a more perfect training plan for elderly specialist nurses. Methods: A one-to-one in-depth interview was conducted among 5 students in the third training course of the Beijing Nursing Society with the method of phenomenological research. Colaizzi undefineds seven-step data method of phenomenology was used to analyze the results. Results: Five topics were abstracted from the experience of training aged specialist nurses, including stress, safety awareness, harvest and growth, professional pride, teaching teachersundefined views and suggestions on scientific research. Conclusions The curriculum setup of elderly specialist nurses needs to be optimized. It is necessary to strengthen the training of scientific research, optimize the teachersundefined strength and perfect the training means, and the managers should formulate the specialty and standardization of the elderly nursing as soon as possible. To provide the necessary support for the training of elderly specialist nurses.

Objective:To observe the effect of high expression of polypyrimidine tract-binding protein-associated splicing factor (PSF) on low concentration of 4-hydroxynonenal (4-HNE) induced human retinal microvascular endothelial cells (HRMECs), and explore the possible mechanism.Methods:The HRMECs cultured in vitro were divided into 4-HNE treated group, PSF overexpression group combined with 4-HNE group (PSF+4-HNE group), PSF overexpression+ML385 treatment combined with 4-HNE group (PSF+ML385+4-HNE group), and 4-HNE induced PSF overexpression group with LY294002 pretreatment (LY294002+4-HNE+PSF group). Cell culture medium containing 10 μmmol/L 4-HNE was added into 4-HNE treatment group, PSF+4-HNE group, PSF+ML385+4-HNE group for 12 hours to stimulate oxidative stress. 1.0 μg of pcDNA-PSF eukaryotic expression plasmid were transfected into PSF+4-HNE group and PSF+ML385+4-HNE group to achieve the overexpression of PSF. Also cells were pretreated with ML385 (5 μmol/L) for 48 hours in the PSF+ML385+4-HNE group, meanwhile within the LY294002+4-HNE+PSF group, after pretreatment with LY294002, cells were treated with plasmid transfection and 4-HNE induction. Transwell detects the migration ability of PSF to HRMECs. The effect of PSF on the lumen formation of HRMECs was detected by using Matrigel in vitro three-dimensional molding method. Flow cytometer was used to detect the effect of PSF overexpression on reactive oxygen (ROS) level in HRMECs. Protein immunoblotting was used to detect the relative expression of PSF, nuclear factor E2 related factor 2 (Nrf2), heme oxygenase-1 (HO-1) protein, and phosphoserine threonine protein kinase (pAkt) protein. The comparison between the two groups was performed using a t-test. Results:The number of live cells, migrating cells, and intact lumen formation in the 4-HNE treatment group and the PSF+4-HNE group were 1.70±0.06, 0.80±0.13, 24.00±0.58, 10.00±0.67, and 725.00±5.77, 318.7±12.13, respectively. There were significant differences in the number of live cells, migrating cells, and intact lumen formation between the two groups ( t=12.311, 15.643, 17.346; P<0.001). The results of flow cytometry showed that the ROS levels in the 4-HNE treatment group, PSF+4-HNE group, and PSF+ML385+4-HNE group were 816.70±16.67, 416.70±15.44, and 783.30±17.41, respectively. There were statistically significant differences between the two groups ( t=16.311, 14.833, 18.442; P<0.001). Western blot analysis showed that the relative expression levels of pAkt, Nrf2, and HO-1 proteins in HRMECs in the 4-HNE treatment group, PSF+4-HNE group and LY294002+4-HNE+PSF group were 0.08±0.01, 0.57±0.04, 0.35±0.09, 0.17±0.03, 1.10±0.06, 0.08±0.11 and 0.80±0.14, 2.50±0.07, 0.50±0.05, respectively. Compared with the PSF+4-HNE group, the relative expression of pAkt, Nrf2, and HO-1 proteins in the LY294002+4-HNE+PSF group decreased significantly, with significant differences ( t=17.342, 16.813, 18.794; P<0.001). Conclusion:PSF upregulates the expression of HO-1 by activating the phosphatidylinositol 3 kinase/Akt pathway and inhibits cell proliferation, migration, and lumen formation induced by low concentrations of 4-HNE.