Objective To understand the nutrition status in elderly patients with hip fracture, and clarify its effects on postoperative functional recovery,complications and mortality based on literature analysis of the past 10 years. Methods PubMed,Medline,Embase Database,Wanfang Database,Chinese National Knowledge Infrastructure(CNKI)and China Biology Medicine disc(CBMdisc)were searched,and relevant researches published from 1st January,2010 to 31th May,2019 were collected. Single rate Meta-analysis was used to integrate the prevalence and mortality of malnutrition. A qualitative systematic review was used to analyze the relationship between nutritional status and prognosis after surgery. Results A total of 11 articles was included,including 21791 patients. Meta-analysis showed that the mean prevalence of malnutrition during hospitalization in elderly patients with hip fracture was 46％(95％CI:45％-47％)using serum albumin(ALB),and was 17％(95％CI:12％-22％)assessing by the Mini Nutritional Assessment (MNA),and the risk of malnutrition prevalence was 42％(95％CI:45％-47％). The results of qualitative evaluation showed that compared with the well-nutrition group(Short-form MNA 12-14 points),the malnutrition risk group(Short-form MNA 8-11 points)had lower activity ability 4 months after the operation (OR=2.03,95％CI:1.24-3.31),and the MNA score decreased by 1 point,the risk of death increased by 15％(HR=0.869,95％CI:0.757-0.998). The malnutrition group(ALB<3.5 g/dl)had a higher incidence of sepsis (P< 0.001)and pulmonary infection(P=0.019),with every 1 g/dl reduction in ALB and 0.59-fold increased risk of death(RR=0.59,95％CI:0.53-0.65). Conclusions The incidence of hip fracture malnutrition or malnutrition risk is very high in the elderly patients with hip fracture. Both malnutrition and malnutrition risk have negative effects on postoperative functional recovery,complications and death rates,and the worse the nutritional status,the worse the prognosis. So,both ALB and MNA are recommended to be included in the care plan of elderly patients with hip fracture. When ALB is failed to diagnose malnutrition,the MNA evaluation method should be adopted to find the problems of nutrition and offer nutritional intervention in advance.

Objective:The aim of the study was to develop a transcultural adaptation of Scrub Practitioners ′ List of Intraoperative Non-technical Skills to Chinese. Methods:The translation of SPLINTS was based on the Brislin ′s translation model and expert consultation were conducted for cultural adaptation before the Chinese version was accomplished. The content validity of Chinese version scale was evaluated by Delphi method. The applicability and observer reliability of the tool was tested by behavioral observation of simulate videos. Results:The positive coefficients of experts in the first and second rounds were both 100% and the authority coefficients were 0.802 and 0.906 respectively. The concordancy coefficients of expert Kendall were 0.282-0.433( P<0.05). The results of Delphi expert consultation showed that the average content validity index (S-CVI/Ave) of the scale level was 0.93, and the item level (I-CVI) content validity index was 0.87-1.00. The rater training showed that the intra-observer reliability was 0.75-0.96 and inter-observer reliability (Kendall W) was 0.502-0.557( P<0.01). Conclusion:The cross-cultural adaptation of SPLINTS-Chinese version is scientific and reliable. The content validation and observer reliability are in-line with scale evaluation criteria. Further psychometric measurement can be conducted in the group of scrub nurses in the operating room.

Objective:To analyze the application value of narrative education model in clinical teaching of nurses in operating room.Methods:A total of 90 nursing students in the Department of Operating Room, Shanghai Tenth People's Hospital from January 2018 to January 2020 were selected as the research objects and randomly divided into observation group and control group, 45 in each group. The control group was taught by traditional mentoring method, and the observation group was taught by narrative education model. The two groups of nursing students practiced for 4 weeks. After the teaching, the scores of theoretical knowledge and operation were compared between the two groups. The scores of career identity scale and caring ability evaluation scale of the two groups were compared, the scores of each dimension of Chinese registered nurse core competence scale (CIRN) were evaluated, and the feedback of the two groups of nursing students on the teaching methods was analyzed. SPSS 22.0 was used to conduct t-test and chi-square test. Results:The scores of theoretical knowledge and operation in the observation group were (94.52±5.34) points and (88.67±3.98) points, respectively, which were significantly higher than those [(85.67±5.26), (82.24±4.16)] in the control group ( t=7.92, 7.49, all P<0.001). The scores of professional identity scale and caring ability evaluation scale in the observation group were (39.12±5.12) points and (193.14±11.24) points, respectively, which were significantly higher than those [(34.21±4.23), (180.23±11.35)] in the control group ( t=4.96, 5.42, all P<0.001). The scores of various dimensions of CIRN in the observation group were significantly higher than those in the control group ( t=4.72, 7.57, 4.13, 4.66, 6.19, 4.27, 5.48, all P<0.001). The feedback of nursing students in the observation group on teaching methods was significantly better than that in the control group ( χ2=4.29, 6.48, 12.26, 4.44, 7.60, 5.03, P<0.05). Conclusion:Narrative education model can significantly improve the internship effect of operating room interns, with clinical value.

Training and improving the clinical skills of specialist nurses is an important part of nursing education in Operating Room. The objective structured clinical examination is currently recognized as an objective assessment method to evaluate the clinical practice skills of medical students. Its assessment model is still in its infancy in the field of clinical nursing education in China. This article reviews the connotation of clinical skills,the design of objective structured clinical examination and the application status of clinical skills training of specialist nurses in Operating Room.

OBJECTIVETo study the biocompatibility of the polylactic acid (PLA)-absorbable root post film prepared by solvent evaporation film.

METHODSThe PLA post film-leaching liquor was prepared by the solvent evaporation of PLA root post films, and its biocompatibility was measured. Sources of human gingival fibroblasts (HGF) were cultivated in vitro and identified initially by the immunohistochemistry method. The toxicity reaction, survival rate, and morphological change of HGF incubated in PLA post film-leaching liquor were observed and tested by morphological observation, 3-(4,5-dimethylthiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay, and flow cytometry. The HGF were implanted on the PLA post film and observed by 4',6-diamidino-2-phenylindole staining. After implanting the PLA post film, the surrounding subcutaneous tissue of SD rats and the implants were removed from the back of the rats in the 1st, 4th, 8th, and 12th weeks to observe the general condition of the incisions. The organization was given the hematoxylin-eosin (HE) stain to find the organization condition of local tissue inflammation and foreign body reaction through the infiltration degree of inflammatory fibroblasts.

RESULTSThe effects of the PLA post film-leaching liquor on the proliferation of HGF and fibroblast toxicity were insignificant. The living fibroblast rate was similar to the normal control group. The HGF were able to grow on the PLA film. The results of the organization general observation and HE staining of the rats were similar to the results for the control group, which met all the demands made by biological safety.

CONCLUSIONSThe PLA-absorbable root post film prepared by the solvent evaporation film has good biocompatibility and can be used for further clinical research.

Objective:To construct nursing quality evaluation indicator system for comprehensive stroke center, so as to provide reference for standardized nursing quality evaluation of comprehensive stroke center.Methods:From September 2018 to December 2019, based on the theory of Donabedian′s structure-process-outcome quality model, literature review, semi-structured interview, Delphi method and analytic hierarchy process were used to determine nursing quality evaluation index system and index weight for comprehensive stroke center.Results:A total of 16 experts from comprehensive stroke center were consulted for two rounds. The clinical working time was 24.63±10.08 years, and the effective recovery rates of two rounds were 100%. The authority coefficient of experts was 0.888, and the coordination coefficients W of two rounds were 0.229 and 0.283 respectively.Finally, a nursing quality evaluation indicator system for comprehensive stroke center was constructed, including 3 first-level indicators, 13 second-level indicators and 46 third-level indicators. Conclusions:The established nursing quality evaluation indicator system for comprehensive stroke center covers the whole process of stroke emergency, stroke unit, and follow-up, which is scientific and reliable, and provides an evaluation tool for daily nursing quality monitoring and continuous quality improvement in comprehensive stroke centers.

Objective From the perspective of health economics, to evaluate 23 pneumococcal polysaccharide vaccination programme among chronic obstructive pulmonary disease (COPD) patient. Methods In the pilot counties of the project of integrated care pathway for COPD patient (Hanbin district of Hanzhong city in Shanxi Province, Qianjian district of Qingqing city, Huandao district of Qindao city in Shangdong Province, Wen county of Jiaozuo city in Henan Province), information of insurance participants of New Rural Cooperative Medical System (NRCS) was collected by local NRCM information system, which included general information as well as records of medical care and medical fee. Nonprobability sampling method was applied to select a total of 860 objects, who were over 60 years old with local household registration, hospitalized within one recent year due to COPD acute exacerbation, and without vaccination of 23 voluntary pneumococcal polysaccharide vaccine within 3 years. A quasi-experimental design without control group was adopted. Objects were vaccinated with 23-valent pneumococcal polysaccharide vaccine from January to December in 2013, then were followed up from January in 2014 for one year. Data of effectiveness and medical cost was collected by self-designed questionnaire and (Chinese version). Paired rank sum test applied to test the difference of quality of life, number and direct medical cost of treatment (including outpatient treatment and hospitalization) due to COPD acute exacerbation, one year before and after intervention. The incremental cost-effectiveness ratio (ICER) and cost-benefit ratio (CBR) of the programme were calculated. Results By January 2014, eight hundred sixty objects were vaccinated. By January 2015, seven hundred eighty eight objects were followed up, with 72 cases withdrawed (8.4%). On average, COPD patients reduced 1.12±2.51 treatments due to acute exacerbation, including 0.28±2.09 outpatient treatments and 0.85±1.15 hospitalizations. Total medical cost was saved by 3 610.21 per capita yuan, including outpatient cost of 241.41 yuan and hospitalization cost of 269.82 yuan; Quality of life was gained by 0.03 QALY gain per capita. The ICER was dominant and CBR was 12.00. Conclusion COPD patients vaccinated with 23-valent pneumococcal polysaccharide vaccine within one year reduced treatments due to acute exacerbation. The vaccination was cost effective and cost saving , and we suggest the vaccine should be covered in the public health program or health insurance scheme in conditional region.

Objective From the perspective of health economics, to evaluate 23 pneumococcal polysaccharide vaccination programme among chronic obstructive pulmonary disease (COPD) patient. Methods In the pilot counties of the project of integrated care pathway for COPD patient (Hanbin district of Hanzhong city in Shanxi Province, Qianjian district of Qingqing city, Huandao district of Qindao city in Shangdong Province, Wen county of Jiaozuo city in Henan Province), information of insurance participants of New Rural Cooperative Medical System (NRCS) was collected by local NRCM information system, which included general information as well as records of medical care and medical fee. Nonprobability sampling method was applied to select a total of 860 objects, who were over 60 years old with local household registration, hospitalized within one recent year due to COPD acute exacerbation, and without vaccination of 23 voluntary pneumococcal polysaccharide vaccine within 3 years. A quasi-experimental design without control group was adopted. Objects were vaccinated with 23-valent pneumococcal polysaccharide vaccine from January to December in 2013, then were followed up from January in 2014 for one year. Data of effectiveness and medical cost was collected by self-designed questionnaire and (Chinese version). Paired rank sum test applied to test the difference of quality of life, number and direct medical cost of treatment (including outpatient treatment and hospitalization) due to COPD acute exacerbation, one year before and after intervention. The incremental cost-effectiveness ratio (ICER) and cost-benefit ratio (CBR) of the programme were calculated. Results By January 2014, eight hundred sixty objects were vaccinated. By January 2015, seven hundred eighty eight objects were followed up, with 72 cases withdrawed (8.4%). On average, COPD patients reduced 1.12±2.51 treatments due to acute exacerbation, including 0.28±2.09 outpatient treatments and 0.85±1.15 hospitalizations. Total medical cost was saved by 3 610.21 per capita yuan, including outpatient cost of 241.41 yuan and hospitalization cost of 269.82 yuan; Quality of life was gained by 0.03 QALY gain per capita. The ICER was dominant and CBR was 12.00. Conclusion COPD patients vaccinated with 23-valent pneumococcal polysaccharide vaccine within one year reduced treatments due to acute exacerbation. The vaccination was cost effective and cost saving , and we suggest the vaccine should be covered in the public health program or health insurance scheme in conditional region.

Objective? To explore the medical staff's recognition of the nursing quality evaluation of a comprehensive stroke center,so as to provide reference for constructing the nursing quality evaluation index system in the comprehensive stroke center. Methods? By descriptive qualitative method, 11 doctors and nurses from comprehensive stroke center were enrolled to have semi-structured in-depth interviews from February to April of 2019. The data were analyzed using a directed content analysis method. Results? A total of 2 subjects related to structured nursing quality evaluation were extracted: nursing staff allocation,organizational structure configuration; 6 subjects related to process nursing quality evaluation:disease condition observation and assessment,specialist nursing practice,complications management,rehabilitation nursing,health education, effective communicationand coordination; 3 subjects related to outcome nursing quality evaluation: incidence of complications,physical and mental status,patient benefits. Conclusions? The relevant topics of comprehensive stroke center nursing quality evaluation extracted based on the perspective of medical staff, can provide a reference for constructing a comprehensive, scientific and applicable index system to improve the quality of care in the comprehensive stroke center.

Objective:To explore the efficiency of a modified caries risk assessment tool(MCAT)on caries-risk prediction of children in Nanning.Methods:MCAT was designed based on caries-risk assessment tool(CAT)of American Academy of Pediatric Dentistry(AAPD)and the caries related factors of the primary school children in Guangxi,China.A cohort study was conducted in 332 children aged 3-year-old in kindergarten of Jiangnan District,Nanning,Guangxi.The data were integrated through questionnaires and oral exam-ination.The MCAT data were respectively scored by CAT and Cariogram and the caries-risk of the children was evaluated.The develop-ment of increased average caires incidece over a period of 1.5 years was compared,the predictive capacity of the methods was com-pared.Results:The ranks of caires risk assessed by CAT and Cariogram were significant different(Z=-10.34,P＜0.001),and the consistency of the 2 methods was poor(Kappa=0.234,P＜0.001).After 1.5 years,there was significant statistical difference of the caries prevalence rate between the low-high and moderate-high risk groups,and dmft increments between the moderate-high risk groups e-valuated by CAT(P＜0.05).There was significant difference of the caries prevalence rate between each risk groups and dmft increments between the low-high and moderate-high risk groups evaluated by Cariogram(P＜0.05).The AUC of CAT and Cariogram was 0.571 and 0.722 respectively(P＜0.001).In the prediction models of caries risk,the fitting of CAT was poor(P＜0.001),while that of Cariogram was better(P=1.00).Cariogram analysis showed that the chance of developing new caries lesions of the subjects with moderate and high caries risk was 2.86 and 11.65 times more than those with low caries risk.Conclusion:MCAT com-bined with Cariogram can more efficiently predict new caries de-velopment in 3-year-old children.