Objective:To explore the effects of grading pulmonary rehabilitation nursing on weaning trend among patients with mechanical ventilation in ICU.Methods:A total of 68 patients with mechanical ventilation from May 2018 to May 2019 in ICU of Guangzhou Red Cross Hospital were divided into the experimental group and the control group with 34 cases in each group by random digits table method. The control group was given routine rehabilitation nursing and the experimental group was given graded pulmonary rehabilitation nursing based on routine nursing. The differences between the two groups were compared in terms of rapid shallow breathing index(RSBI), oxygenation index, mechanical ventilation time, hospitalization time, success rate of weaning and incidence of complications.Results:On the 5th day and the 7th day after the intervention, the RSBI were 80.59 ± 5.69 and 75.74 ± 8.62 in the experimental group, which were significantly lower than those in the control group (89.54 ± 8.96 and 85.15 ± 9.75), ( t=5.06 and 4.28, both P<0.05). On the 3th, 5th, 7th day after the intervention, the oxygenation index were (244.82 ± 22.77), (248.21 ± 17.49) and (263.79 ± 17.31) mmHg in the experimental group, which were significantly lower than those in the control group (137.41 ± 15.01), (192.79 ± 15.82) and (206.26 ± 17.40) mmHg, ( t=22.97, 13.70, 13.67, all P<0.05). The duration of mechanical ventilation, length of ICU stay and the incidence of ventilator-associated pneumonia, deep venous thrombosis were (11.29 ± 1.38) days, (12.47 ± 1.73) days and 0, 0 in the experimental group, which were significantly lower than those in the control group (12.18 ± 1.47) days, (13.53 ± 1.62) days and 11.8%(4/34), 14.7%(5/34). The withdrawal success rate was 94.1%(32/34) in the experimental group, significantly higher than that in the control group 76.5% (26/34), the difference was statistically significant ( χ2=4.22, P<0.05). Conclusions:Grading pulmonary rehabilitation nursing can improve the respiratory function, shorten the time of mechanical ventilation and the length of ICU hospitalization, as well as reduce the occurrence of complicaitons.

Objective To investigate the current staffing of nurses and need of hospital nursing human resources in China.Methods Data were collected from 181 secondary and tertiary hospitals and 9774 nurses in mainland China by questionnaires.Results The average doctor-nurse ratio was 1 ∶ 1.39 in tertiary hospitals and 1 ∶ 1.31 in secondary hospitals.The doctor-nurse ratios in 164 hospitals (97.6％) and the proportion of nurses in health care staff in 105 hospitals (61.8％) had not reached the standard set by the Ministry of Health of China.62.3％ nurses held secondary diploma for their initial nursing education.The constituent ratio of nurses held secondary diploma decreased,while the ratio of nurses held advanced diploma and bachelor degree increased in the last 5 years from 2003 to 2007.Sixty percent of newly employed nurses were contract nurses in 2003.The proportion increased to 78％ in 2007,and in some regions it accounted for more than 90％ of new nurses.The needs and constituent ratio of nurses with.secondary diploma and advanced diploma would decrease while nurses with bachelor degree and master degree would increase in the next 5 years (from 2009 to 2013).Conclusions The nursing shortage is still severe in China,and nursing staff mainly held secondary diploma for their initial nursing education.Most of new nurses were employed as conwact nurses.The need of hospitals for nurses has increased,especially for nurses with higher educational level such as bachelor degree and master degree,while the need for secondary diploma hold ers have decreased.The need for advanced diploma holders has increased in the last 5 years and would decrease in the next 5 years,but they would still be the majority of employed nurses.The authors suggested that the staffing of nursing manpower,the work environments and career development of contract nurses should be improved,and the initial nursing education should be upgraded to meet the needs of hospitals.

Objective To understand the correlation between health beliefs and family environment of stroke patients. Methods A questionnaire survey was carried out on 115 stroke patients with the first onset of stroke by using the special health belief simple table (SF-HBMS) and the family environment scale (Chinese version FES-CV), and the correlation was analyzed. The scores of each subscale of the family environment were compared with the domestic norm. Results The total score of health belief (75.15 ± 10.20) was at the middle level. There were significant differences in age (F=8.41), education level (F=4.44), complications (F=4.05), family history (t=2.68) and first visit time (F=3.76) among different characteristics of health belief scores (P < 0.01 or 0.05). The score of intimacy (6.23 ± 1.27) in family environment, emotional expression score (5.30 ± 1.97), success score (5.88 ±1.62), cultural score (4.54 ± 2.20) and organizational score (5.60 ±1.67) were all lower than the domestic norm and spear. The score of shield score (3.16 ± 2.00) was higher than that of domestic norm (P<0.01 or 0.05), and the total score of health belief was positively correlated with family intimacy (r=0.190), emotional expression (r=0.204), culture (r=0.206) and tissue (r=0.227) (P<0.05), and was negatively correlated with the contradiction (r=-0.186, P<0.05); regression analysis, whether there were family history (β=0.338, P<0.01), first onset time (β=0.242, P<0.01), family intimacy (β=1.614, P<0.05), emotional expression (β=1.114, P<0.05) were the factors affecting the health belief level of first stroke patients. Conclusions The level of health belief is closely related to family environment. It is suggested that the clinical medical staff should pay attention to the negative emotion and family psychological intervention, provide psychological support for the patients and their families, promote the promotion of their health beliefs, and reduce the rate of recurrence and disability.

Objective:To translate 19-Item Return-To-Work Self-Efficacy (RTWSE-19) Scale into Chinese and verify reliability and validity of its application in patients after replantation of severed fingers.Methods:Brislin translation model was used to translate and back-translate RTWSE-19 Scale, and the Chinese version of RTWSE-19 Scale was adjusted through expert evaluation, group discussion and pre-survey. Using the convenient sampling method, a total of 150 patients who were treated and were willing to return to work after replantation of severed fingers in the Fourth People's Hospital of Nanhai District in Foshan, Guangdong Province from March 2019 to February 2020 were selected, and the modified Chinese version of RTWSE-19 Scale was used to investigate. The validity of the scale was evaluated by the content validity of expert evaluation and the structure validity of exploratory factor analysis. Cronbach's α coefficient, test-retest reliability and split-half reliability were used to evaluate the reliability of the scale.Results:A total of 150 questionnaires were distributed, and 141 valid questionnaires were returned. The effective recovery rate was 94.0%. The Chinese version of RTWSE-19 Scale had the same structure as the original scale. The original 19 items were retained, which were divided into three dimensions: coping with work (items 1-7) , work adjustment (items 8-14) and request to colleagues (items 15-19) . The content validity coefficient of the scale was 0.920. Through exploratory factor analysis, 3 common factors with characteristic roots greater than 1 were extracted, and the cumulative variance contribution rate was 62.4%. The Cronbach's α coefficient of the scale was 0.903, the test-retest reliability was 0.771 and the half-reliability was 0.763.Conclusions:The Chinese version of RTWSE-19 Scale in this study has good reliability and validity, which is suitable for evaluating the return-to-work self-efficacy of patients after replantation of severed fingers.

Objective:To explores the relationship between self-efficacy and marital adjustment in infertile couples based on Actor-Partner Interdependence Model (APIM) .Methods:This study was a cross-sectional survey. A total of 310 infertile couples who underwent in vitro fertilization-embryo transfer cycle treatment in Reproductive Center of Peking University Third Hospital from January to April 2022 were selected as the research objects by the convenient sampling method. General Self-Efficacy Scale and Locke-Wallace Marital Adjustment Test were used to investigate. The relationship between self-efficacy and marital adjustment of infertile couples was analyzed by Pearson correlation analysis and APIM. A total of 310 groups of questionnaires were distributed (1 group was 1 couple) , and 293 groups of effective questionnaires were collected, with an effective recovery rate of 94.5%. Results:The self-efficacy scores of infertile couples were (25.08±5.54) for wives and (27.08±5.35) for husbands, and the self-efficacy scores of wives were lower than those of husbands ( P<0.01) . In the score of marital adjustment, the wives scored (109.39±23.13) and the husbands scored (111.99±20.87) . The APIM analysis results show that in terms of subjective effects, the self-efficacy of both infertile couples could affect their own marital adjustment (β=0.166, 0.408; P<0.01) . In terms of object effects, the husbands' self-efficacy could affect the wives' marital adjustment (β=0.117, P<0.05) . Conclusions:The self-efficacy of infertile couples undergoing in vitro fertilization-embryo transfer cycle treatment is at the middle level, and the marriage adjustment is generally good. The self-efficacy of couples is closely related to their own marital adjustment, and the self-efficacy of husbands can also positively affect the wifes' marital adjustment. In clinical work, infertile couples should be regarded as a whole, focusing on the binary interaction between both parties, and developing targeted measures to help infertile couples improve their self-efficacy, thereby improving marital adjustment, improving health outcomes, and stabilizing family relationships.

Objective:To understand the current situation of nursing undergraduate students ' mastery of core skills and analyze the impact paths of learning environment and self-efficacy on the level of nursing core ability mastery. Methods:Using the convenient sampling method, a total of 431 nursing undergraduates from 6 universities in Macao and Guangdong Province were selected as the research objects from November to December 2022. The self-made general data questionnaire, Nursing Core Skills Mastery Questionnaire and General Self-Efficacy Scale were used to investigate the patients.Results:The total score of core nursing skills for 431 undergraduate nursing students was (3.55±0.59). The learning environment had a positive direct effect on the mastery of core skills ( P<0.05), which could indirectly affect the mastery of core skills through the mediating effects of self-efficacy, personal foundation and planning ( P<0.05) . Conclusions:Application-oriented colleges, progressive practice plans and increasing the proportion of electives are conducive to the improvement of self-efficacy and the mastery of core nursing skills. It is recommended that nursing colleges clarify the direction of talent cultivation based on their own situation, increase the proportion of elective courses and add clinical practice content in the course process, in order to promote the mastery of core nursing skills for nursing undergraduate students.

Objective To investigate the anti-oxidative effects of alprostadil on contrast-induced nephropathy(CIN)after percuteous coronary intervention (PCI)in patients with chronic kidney disease(CKD).Methods A total of 200 patients with CKD were enrolled in our hospital.According to the random number table was divided into alprostadil 100 cases,100 cases of conventional treatment group.The levels of serum creatinine (Scr),creatinine clearance (eGFR),serum cystatin C (ScysC)and 8-hydroxy-deoxyguanine (8-OHdG)were observed before and after operation at 72 h and 7 d after operation.Results The incidence of CIN in the alprostadil group was significantly lower than that in the conventional treatment group (6% vs 12%,P<0.05).There was no significant difference in the level of Scr,eGFR,ScysC and 8-OHdG between the alprostadil group and the conventional treatment group (P>0.05).The level of Scr in the alprostadil group was significantly lower than that in the conventional treatment group at 72 h and 7 d after operation.The level of eGFR was significantly higher than that of the conventional treatment group (P<0.05).The levels of ScysC and 8-OHdG in the two groups were significantly higher than those before operation at 72 h and 7 d(P>0.05).The levels of ScysC and 8-OHdG in the alprostadil group were significantly lower than those in the conventional treatment group at 72 h and 7 d after PCI(P<0.05).Conclusion Alprostadil may improve the oxidative stress in patients with CKD and provide a preventive effect on CIN.

Objective To investigate the influence of WeChat + family centered health intervention on the self-efficacy of elderly hypertensive patients in General clinic. Methods A total of 102 elderly hypertensive patients aged≥60 years in General clinic from February 2017 to July 2017 were enrolled.They were divided into experimental group and control group with the table of random number, with 51 cases in each group. The experimental group used the WeChat+ family centered health intervention model,while the control group adopted the traditional health education model.The changes of blood pressure and self-efficacy were evaluated before intervention, 3 months and 6 months after intervention respectively. Results There were no statistic significant difference in blood pressure and self-efficacy total score between the two groups before intervention(P>0.05). At 3 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(144.20±4.60), (80.00±5.00)mmHg(1 mmHg=0.133 kPa)in the experimental group,those of which were(154.20±7.16), (87.00±3.81)mmHg in the control group,the differences were statistically significant (t=-2.628,-2.490,P<0.05).At 6 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(141.60±6.43),(76.00±4.85)mmHg in the experimental group,those of which were(151.60± 5.94),(85.40±4.56)mmHg in the control group,the differences were statistically significant (t=-2.555,-3.158,P<0.05).There were differences in systolic and diastolic pressure in patients with different groups at different time,and the differences were statistically significant(F=18.668,18.174,P<0.01).The total score of self-efficacy at 3 months and 6 months after intervention was(30.14±0.43),(32.56±0.23)points in the experimental group and (28.14 ± 0.15), (29.40 ± 0.19) points in the control group, the difference was statistically significant(t=9.736, 23.819, P<0.05). The differences in the total score of patients′self-efficacy in different groups at different time had statistically significance (F=2 631.551, P<0.01). Conclusions The WeChat+family centered health intervention model can significantly improve the self-efficacy of the elderly patients with high blood pressure in the General clinic.

Objective To evaluate the efficacy and safety of higenamine hydrochloride(HG) stress echocardiography for diagnosis of coronary artery disease (CAD). Methods The study was designed as prospective,randomized,open-labled,positively controlled and crossover phase II multi-center clinical research.Ninety subjects who were suspected to have CAD were enrolled.HG dosage was titrated at 0.5,1, 2,4 μg.kg -1.min-1every 3 min.Adenosine was injected 140 μg.kg -1.min-1for 6 min with total dosage 0.8 mg/kg.Visual assessment of the left ventricle wall motionand 17-segment model were used for analysis of stress echocardiography.CAD was defined as identifying >50% diameter stenosis in at least one major coronary artery by coronary angiogram.All adverse reaction were recorded. Results For HG group,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 28.9%,89.7%, 57.1%,76.5% and 47.8%,respectively;for adenosine group,they were 26.7%,94.9%,58.3%,85.7%and 47.1%,respectively. There was no significant difference between the two groups( P > 0.05). The diagnostic sensitivities of HG and adenosine echocardiography for single vessel stenosis were 11.1% and 5.6%,respectively( P >0.05).Both HG and adenosine echocardiography have the same sensitivity with 37.5% for double vessel stenosis and 44.4% for triple vessel stenosis.Advers reaction rate was 84.4% in HG group and 92.2% in adenosine group( P >0.05).Conclusions HG stress echocardiography for CAD diagnosis has high specificity,good safety and low sensitivity,which are similar to adenosine echo.

Objective To explore the echocardiographic features and pregnant outcomes in fetuses with complete closure of the ductus arteriosus ( DA) . Methods The echocardiographic data and follow-up materials were retrospectively reviewed in 28605 fetuses . Of all the fetuses ,6 fetuses had complete closure of the DA . The echocardiographic features and pregnant outcomes of the 6 fetuses with complete closure of the DA were summarized . Results Of all the 6 fetuses ,4 cases were found in the third trimester and 2 cases in the second trimester . There was no the lumen of the DA in the three vessel view on the two dimensional echocardiography ,demonstrating the line-like low echogenicity in the DA area . No DA flow signal was found on the color and spectral Doppler imaging . Four cases had dilated right heart .Six cases had thickened wall of the right ventricle ( WRV ) ,and hypokinetic motion of the WRV . Moderate to severe tricuspid regurgitation were found in 5 cases and disappeared or reversal a-wave of the ductus venosus were found in 5 cases . The mild pericardial effusion was found in 2 cases . Of all the 6 cases ,4 cases were delivered by cesarean section and the echocardiographic findings were unremarkable at the follow -up of six months . Conclusions Intrauterine complete closure of the DA can be accurately diagnosed by fetal echocardiograph in the 2-3 trimesters . If indicated ,elective delivery results in good outcome .