As the development of fast-tracking, the patient perception of readiness for hospital discharge is becoming more and more popular in discharge decision making. A lot of research indicates that the patient readiness of discharge can predict the satisfaction, the safety, readmission, death and compliance of the patients. This study is about to review the conception, research significances, measurements, and determinants of the discharge readiness. The primary objective was to analyze the determinants of hospital discharge, according to three aspects of patient factors, hospital factors and social support. This study is expected to offer theoretical support for the improvement of discharge readiness.

Bone morphogenetic protein (BMP) homodimers are of significant osteoinductivity. However, their clinical application is limited because of high effective dosage. Recently, BMP heterodimers are reported to address the issue. This is a review of the researches on BMP heterodimers, including existent evidences, types and synthetic methods, biological activities in comparison to BMP homodimers and possible mechanisms, further research direction and future expectations.
Animals ; Biopolymers ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Protein 7 ; Bone Morphogenetic Proteins ; genetics ; pharmacology ; Humans ; Protein Multimerization

Objective To investigate the status of the readiness for hospital discharge and pain degree in inpatients with thoracolumbar osteoporotic fractures, and the correlation between them.Methods A cross-sectional analysis of survey data from a sample of 252 patients with thoracolumbar osteoporotic fractures was conducted in a grade A tertiary hospital in Xi′an from January 1st, 2016 to June 30th, 2016. The status of the readiness for hospital discharge and pain level were investigated through the Readiness for Hospital Discharge Scale and Numerical Rating Scale (NRS) respectively. Pearson correlation coefficient method was used to detect the correlation between the two target factors. Results The average score of readiness for hospital discharge was 7.71±1.55. The mean NRS score decreased from 7.8 ± 0.8 at baseline to 2.7 ± 0.6 before discharge. The scores of each dimensions of readiness for hospital discharge from high to low were expected support, personal status, and coping capacity. There was a negative correlation between discharge readiness and pain degree in patients with thoracolumbar osteoporotic fractures (r =-0.537, P<0.05). Conclusions The status of the readiness for hospital discharge among the patients with thoracolumbar osteoporotic fractures is in a medium to high level before discharge. The pain degree is significantly decreased to a lower level. There is a negative correlation between the readiness for hospital discharge and the pain degree.

Objective To evaluate the continuation of care for colorectal cancer patients with stoma mental state and a-bility of self-care. Methods Fifty-six cases Miles patients in the observation group and 30 patients Miles patients in the control group were treated with extended care and routine care respectively, the depression, anxiety, self-care, quality of life and the incidence of complications of patients in two groups were compared after discharging for three months. Results After discharging for three months, the SDS scores and depression levels in the observation group were significantly lower than the control group(P<0.05), SAS score the of observation group were significantly lower than the control group(P<0.05), moderate and mild depression were significantly lower in the control group (P <0.05), ESCA to-tal score, skill, responsibility, self-concept and health knowledge scores of the observation group were significantly higher (P <0.05), SF-36 physical function scale, social function, emotional function, mental health, energy and overall health scores of the observation group were significantly higher (P <0.05), stoma complications in the observation group was significantly lower than the control group(P<0.05). Conclusion Extended care effectively improve colorectal cancer ostomy patients mental state, improve their self-care ability stoma, thereby improving the quality of life and reduce the incidence of stoma complications.

Objective To explore the effects of sound operation on nursing quality in nursing work at spine surgery.Methods Totally 531 cases of patients at spine surgery in our hospital from July 2015 to October 2015 were randomly divided into the control group ( n=264) and the intervention group ( n=267) . Patients in two groups were given routine nursing, and patients in the intervention group also were given sound operation. The incidence of nursing adverse events, the writing quality of nursing documents, the situation of health education, the rate of patient complaints and the satisfaction degree toward nursing were collected and analyzed. Results Nursing adverse events in the intervention group was 1 case ( 0. 4%) which were less than 11 cases (4.2%) in the control group (P<0.05). There were 2 cases (0.7%) of nonstandard nursing documents and 3 cases (1.1%) of lipography in nursing documents in the intervention group, which were less than 11 cases (4.2%) and 16 cases (6.1%) in the control group (P<0.05). There was no case of patient complaints in the intervention group which were less than 4 cases (1.5%) in the control group (P<0.05). The situation of health education in the intervention group was 1 case (0.4%) which was less than 8 cases (3.0%) in the control group (P<0.05). The satisfaction degree toward nursing in the intervention group was 97.75%(261/267)and was 92.80%(245/264) in the control group ( P<0. 05). Conclusions Sound operation in nursing work can effectively reduce nursing adverse events at spine surgery, and it also can improve the quality of nursing.

Objective To explore the effects of family involvement and online extended nursing for postoperative rehabilitation in patients with cervical spinal cord injury (CSCI). Methods Totally 60 CSCI patients who were admitted and received surgery in Honghui Hospital, Xi'an Jiaotong University from October 2013 to July 2016 and their major caregivers after being discharged from hospital were equally divided into an observation group (n=30) and a control group (n=30) according to the random number table. Patients in the control group received conventional instructions 1 day before being discharged from hospital and telephone follow-ups in Week 1, Month 1, Month 3 and Month 6 after being discharged from hospital, while patients in the observation group received extended nursing via WeChat groups on this basis. The quality of life, incidence of complications and compliance of rehabilitation exercise six months after surgery were compared between the patients in the two groups. Results The patients in the two groups showed higher scores in various dimensions indicating the quality of life six months after surgery than they did at discharge, and the patients in the observation group showed higher scores than the patients in the control group (P< 0.05). The patients in the observation group showed lower incidence of abdominal distension, constipation and pressure ulcer complications than the patients in the control group (P<0.05), and the incidence of high fever, pulmonary infection and urinary tract infection tended to decline (P>0.05). The patients in the observation group showed higher compliance of rehabilitation exercise than the patients in the control group (P< 0.05). Conclusions Family involvement and WeChat extended nursing helps to build a long-term service system for CSCI patients and accelerate their postoperative rehabilitation, thus worthy of expansion and application.

Objective:To analyze and evaluate the equity of children's health in countries along the"the Belt and Road",promote further attention to children's health in countries along the route,and promote cooperation and exchanges on children's health between China and countries along the"the Belt and Road".Methods:Using concentration index and concentration curve to measure overall equity,and using the Thiel index for intraregional and interregional euqity measurement.Results:The under-five mortality concentration index is 0.349 7,the concentration curve is below the absolute fair line.The Thiel index shows that inequality in low-income countries,lower-middle-income countries,upper-middle-income countries and high-income countries is the leading cause of child health inequities in the"the Belt and Road"countries.Conclusion:There is inequity in the health of children in countries along"the Belt and Road Initiative",countries along the"the Belt and Road"should take comprehensive measures to reduce the under-five mortality rate,at the same time strengthen international cooperation to further promote equity in children's health in"Belt and Road"countries.

Objective:To analyze the application effect of discharge planning based on enhanced recovery after surgery (ERAS) in patients with osteoporotic thoracolumbar fracture (OTLF).Methods:A retrospective cohort analysis was made on clinical information of 230 OTLF patients treated in Honghui Hospital of Xi′an Jiaotong University from January to December 2020, including 44 males and 186 females, aged 53-92 years [(72.0±9.9)years]. A total of 115 patients receiving conventional nursing intervention from January to June 2020 were enrolled in regular nursing group and 115 patients receiving discharge planning intervention based on ERAS from July to December 2020 were enrolled in discharge planning group. The length of hospital stay, readiness for hospital discharge scale (RHDS) at 4 hours before discharge, caregiver preparedness scale (CPS) on admission and at 4 hours before discharge, discharge rate before 12∶00, Chinese osteoporosis quality of life short questionnaire (COQOL) on admission and at 6 months after surgery, and re-fracture rate were compared in the two groups.Results:The patients were followed up for 6 months, except for 3 patients lost to follow up in discharge planning group and 4 patients in regular nursing group. The length of hospital stay was (2.8±0.6)days in discharge planning group and (2.6±0.7)days in regular nursing group ( P>0.05). The RHDS in discharge planning group was significantly greater at 4 hours before discharge when compared with regular nursing group [(103.0±8.3)points vs. (95.3±9.5)points] ( P<0.01). The two groups had no significant difference in CPS at admittance ( P>0.05), but a significantly greater CPS was found in discharge planning group at 4 hours before discharge when compared with regular nursing group [(28.9±3.5)points vs. (24.3±4.8)points] ( P<0.01). The discharge rate before 12∶00 in discharge planning group was significantly higher when compared with regular nursing group [27.7%(31/115) vs. 15.3%(17/115)] ( P<0.05). The COQOL was similar at admittance between the two groups ( P>0.05), but a significantly lower score was found in discharge planning group than that in regular nursing group [(21.6±6.2)points vs. (26.6±6.9)points] ( P<0.01). A significantly lower re-fracture rate was found in discharge planning group at 6 months after surgery when compared with regular nursing group [4.5%(5/112) vs. 12.6%(14/111)] ( P<0.05). Conclusion:For OTLF patients, discharge planning based on ERAS is superior to regular nursing in improving the readiness for hospital discharge, caregiver preparedness, quality of life and management of beds, and lowering re-fracture rate.

Background::Breast cancer (BC) risk-stratification tools for Asian women that are highly accurate and can provide improved interpretation ability are lacking. We aimed to develop risk-stratification models to predict long- and short-term BC risk among Chinese women and to simultaneously rank potential non-experimental risk factors.Methods::The Breast Cancer Cohort Study in Chinese Women, a large ongoing prospective dynamic cohort study, includes 122,058 women aged 25-70 years old from the eastern part of China. We developed multiple machine-learning risk prediction models using parametric models (penalized logistic regression, bootstrap, and ensemble learning), which were the short-term ensemble penalized logistic regression (EPLR) risk prediction model and the ensemble penalized long-term (EPLT) risk prediction model to estimate BC risk. The models were assessed based on calibration and discrimination, and following this assessment, they were externally validated in new study participants from 2017 to 2020.Results::The AUC values of the short-term EPLR risk prediction model were 0.800 for the internal validation and 0.751 for the external validation set. For the long-term EPLT risk prediction model, the area under the receiver operating characteristic curve was 0.692 and 0.760 in internal and external validations, respectively. The net reclassification improvement index of the EPLT relative to the Gail and the Han Chinese Breast Cancer Prediction Model (HCBCP) models for external validation was 0.193 and 0.233, respectively, indicating that the EPLT model has higher classification accuracy.Conclusions::We developed the EPLR and EPLT models to screen populations with a high risk of developing BC. These can serve as useful tools to aid in risk-stratified screening and BC prevention.

Objective:To build a health education scheme related to discharge planning for adolescent idiopathic scoliosis surgery patients, and provide systematic and standardized health education related to discharge planning for adolescent idiopathic scoliosis surgery patients.Methods:From January to June 2021, through literature review and semi-structured interviews, the first draft of health education scheme for discharge planning of adolescent idiopathic scoliosis surgery patients was formulated. The Delphi method was used to conduct 2 rounds of consultation with 15 experts, and the final version of the health education scheme for the discharge plan was determined according to the expert consultation.Results:The effective recovery rates of the 2 rounds of expert consultation questionnaires were both 100.0%, the coefficients of expert authority were 0.93 and 0.94, and the Kendall's harmony coefficients of expert opinions were 0.251 and 0.273 ( P<0.01) . Finally, the health education program was constructed according to the health needs of patients and caregivers at 7 time periods including admission day, 1 day before surgery, operation day, postoperative day 1, 1 day before discharge, discharge day and 1 week after discharge, including 7 first-level items, 24 second-level items, and 78 third-level items. Conclusions:The health education scheme related to the discharge plan for adolescent idiopathic scoliosis surgery patients constructed in this study is scientific and reasonable in design, comprehensive, reliable and clinically practical. It is of great significance for the effective implementation of the discharge plan for adolescent idiopathic scoliosis surgery patients .