Objective:To explore the status quo of the independent work readiness of newly recruited pediatric nurses and analyze its influencing factors, so as to provide a reference for improving the independent work readiness of newly recruited pediatric nurses.Methods:This study was a cross-sectional study. From July to December 2021, 600 newly recruited pediatric nurses from 18 ClassⅢ children's hospitals in China were selected as the subject by convenience sampling. The nurses were investigated by using the General Information Questionnaire, Self-assessment New Nurses' Independent Competence Questionnaire, Chinese version of Utrecht Work Engagement Scale (UWES) , and Chinese version of Psychological Capital Questionnaire (PCQ) . Hierarchical regression analysis was used to explore the influencing factors of the independent work readiness of newly recruited pediatric nurses. A total of 600 questionnaires were distributed, and 587 valid questionnaires were recovered, with a valid recovery rate of 97.8%.Results:Among 587 newly recruited pediatric nurses, the total score of the Self-assessment New Nurses' Independent Competence Questionnaire was (141.61±13.28) , and the average score of the items was (2.83±0.39) . Pearson correlation showed that the total score and each dimension score of the self-assessment New Nurses' Independent Competence Questionnaire were positively correlated with the total score and each dimension score of the UWES and the PCQ, and the difference was statistically significant ( P<0.05) . Hierarchical regression analysis showed that work engagement and psychological capital were the influencing factors of the independent work readiness of newly recruited pediatric nurses with a statistical difference ( P<0.05) , among which work engagement and psychological capital could independently explain 29.9% of the variation of the independent work readiness of newly recruited pediatric nurses. Conclusions:The readiness for independent work of newly recruited pediatric nurses is at a medium low level. Work engagement and psychological capital are the influencing factors of independent work readiness of newly recruited pediatric nurses. The work engagement and psychological capital of newly recruited pediatric nurses can be improved to increase their independent work readiness.

BACKGROUND: The epidermal growth factor receptor (EFGR) mutation was closely related to the invasion and metastasis of lung adenocarcinoma and the biological axis of CXCR4/CXCL12 (chemokine receptor 4/chemokine ligand 12) played an important role in the organ-specific metastasis of the tumor. It was a question surrounding whether there is interaction between them in the process of lung adenocarcinoma metastasis. To investigate the potential molecular mechanisms of EGFR over-expression and EFGR-mutations effects on cell proliferation, migration and invasion, we constructed EGFR over-expression and three EFGR-mutant human lung adenocarcinoma H1299 cell sublines. METHODS: EGFR over-expression and three EFGR-mutant (EGFR-E746-A750del, EGFR-T790M and EGFR-L858R) plasmid were designed and transfected H1299 cells with Lipofectamine 2000. H1299 cells transfected with empty vector were negative control (NC), and H1299 cells without transfection were set as blank control (BC). The effects of EGFR over-expression and mutations on the proliferation, migration and invasion of H1299 cells were detected by cell cloning assay, wound healing assay and Transwell assay. The mRNA and protein expression levels of MMP-2, MMP-9, CXCR4 and CXCL12 were detected by RT-PCR and Western blot. RESULTS: Compared with negative control group and blank control group, EGFR over-expression and EGFR-E746-A750 deletion have significantly higher colony formation (28±2, 28.33±4.16; respectively) (P<0.05) and the cell migration and invasion ability were significantly increased (P<0.05). RT-PCR and Western blot assay showed that the mRNA and protein expression of MMP-2, MMP-9, CXCR4 and CXCL12 in EGFR over-expression and EGFR-E746-A750 deletion group were remarkably higher than that in negative control and blank control group (P<0.05). CONCLUSIONS EGFR over-expression and 19 exon deletion can promote the expression of MMP-2 and MMP-9 by up-regulating CXCR4/CXCL12 signaling pathway, leading to the change of tumor biological characteristics such as higher proliferation, migration and invasion ability.
Adenocarcinoma ; pathology ; Adenocarcinoma of Lung ; Cell Line, Tumor ; Cell Movement ; genetics ; Chemokine CXCL12 ; metabolism ; ErbB Receptors ; genetics ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms ; pathology ; Mutation ; Neoplasm Invasiveness ; Receptors, CXCR4 ; metabolism ; Signal Transduction ; genetics

OBJECTIVE To establish management index system for rational drug use of key monitoring drugs， and provide reference for the management of key monitoring drugs in the hospitals. METHODS First， the management index system for rational drug use of key monitoring drugs was drafted by collecting the evidence from related medical literature. Next， using a modified Delphi method， twenty experienced experts from the fields of pharmacy， medical practice， healthcare insurance， and finance were selected to participate in two rounds of questionnaire consultations. Based on the expert enthusiasm coefficient， authority coefficient， degree of opinion concentration， and degree of coordination， the final indicators were determined to establish a management index system for rational drug use of key monitored drugs in medical institutions. RESULTS The expert enthusiasm coefficients reached 100% in both rounds of consultation. In first-level， second-level and third-level indicators， the authority coefficients of experts were 0.89， 0.86 and 0.87， and coordination coefficients of the experts in importance score were 0.300 （P＜ 0.05）， 0.125 （P＜0.05） and 0.139 （P＜0.05）， respectively. The average score for the importance of all indicators reached over 3.5， in which the full score ratio ranged from 35% to 100%. Except that the variation coefficient of a third-level indicator “number of specifications purchased for key monitored drugs” was 0.26， the variation coefficients of rest indicators were less than or equal to 0.25. Based on the results of expert consultation， final version of the management index system established in this study， including two first-level indicators （drug procurement and use， and rational drug use）， five second-level indicators （such as the accessibility， cost-effectiveness） and twenty third-level indicators （such as the number of specifications purchased for key monitored drugs， the increase in the cost of key monitored drugs）. CONCLUSIONS The management index system established in this study possesses high reliability and strong operability， and may provide a reference for the management of key monitoring drugs in the hospitals.