Objective:To explore the clinical effect of the integrated model of doctors, nurses and patients in postoperative pain nursing of patients with osteosarcoma.Methods:A total of 20 patients with osteosarcoma who underwent surgical treatment in the Department of Orthopedics of Henan Provincial People's Hospital from June 2018 to June 2019 were selected as control group, and 20 patients with osteosarcoma surgery from July 2019 to July 2020 were selected as observation group. Control group was given routine nursing, and observation group carried out the integrated nursing of doctors, nurses and patients. One day before discharge, the Satisfaction Questionnaire on Postoperative Pain Management by the Patient and the limb salvage surgery efficacy scoring system (Musculoskeletal Tumor Society, MSTS) were distributed to patients to compare patients' satisfaction with postoperative pain management, pain status and limb function between two groups.Results:The hospital stay of control group was (45.63±8.56) d, and that of observation group was (36.78±7.69) d, the difference was statistically significant ( t=7.868, P<0.01) . The most severe postoperative pain score of observation group was (3.94±1.29) , which was lower than that of control group, and the difference was statistically significant ( t=4.458, P<0.01) . The satisfaction score of observation group for the pain effect was (4.11±0.64) , which was higher than that of control group, and the difference was statistically significant ( t=4.921, P<0.05) . The total score of MSTS in observation group was (25.98±2.15) , and that of control group was (20.54±2.08) , and the difference was statistically significant ( t=8.132, P<0.01) . Conclusions:The integrated model of doctors, nurses and patients can improve the satisfaction of perioperative pain management of patients with osteosarcoma, reduce the level of pain, and improve the level of limb function of patients.

Objective:To examined the effects of the evidence-based nursing teaching mode for undergraduate nursing students on evidence-based practice ability, critical thinking and creativity.Methods:From July 2019 to November 2021, 79 undergraduate nursing students from 14 groups who practiced in Department of Colorectal Surgery/Thyroid Surgery of Qilu Hospital of Shandong University were randomly assigned to evidence-based nursing teaching group (33 cases) and traditional teaching group (46 cases) by random number method. The traditional teaching group conducts one-to-one teaching according to the general clinical practice plan, the teaching plan of the department, and the list of training items; the evidence-based nursing teaching group, on the basis of traditional teaching, implements three courses and corresponding practice guidance of evidence-based nursing teaching for 4 weeks. The evidence-based practice ability, critical thinking and creativity tendency of undergraduate nursing students were evaluated by the Evidence-Based Practice Competence Questionnaire, Critical Thinking Disposition Inventory-Chinese Version, and Williams Creativity Tendency Scale before and immediately after the intervention. Generalized linear models (repeated measures) were used in the analyses.Results:After the intervention, the scores of evidence-based practical knowledge, truth seeking (the dimension of critical thinking) and creative tendency in evidence-based nursing teaching group were 22.09 ± 3.15, 39.61 ± 5.26, and 109.88 ± 11.76, respectively, the traditional teaching group was 20.56 ± 3.00, 37.93 ± 4.38, and 109.37 ± 10.78, respectively. Before the intervention, the scores of evidence-based practical knowledge, truth seeking (the dimension of critical thinking) and creative tendency in evidence-based nursing teaching group were 19.54 ± 3.54, 39.24 ± 3.54 and 104.88 ± 10.97, respectively, the traditional teaching group were 19.89 ± 3.15, 40.48 ± 4.12, and 108.72 ± 10.72, respectively. The increased scores of evidence-based practical knowledge, truth-seeking (dimension of critical thinking), and creativity tendency after the intervention in the evidence-based nursing teaching group were significantly higher than those of the traditional teaching group ( F=4.51, 10.03, 4.21, all P<0.05). Conclusions:The evidence-based nursing teaching mode is conducive to the increase of evidence-based practical knowledge, improvement of the critical thinking ability and creativity of undergraduate nursing students.

The purpose of this research was to explore the differences of the components of Radix Polygalae in herbal pair of Radix Polygalae and Rhizoma Acori Tatarinowii. An HPLC-Q-TOF-MS/MS method and an HPLC-UV method were established for the identification and determination of the components of Radix Polygalae, respectively. HPLC separation was carried out on a C18 column(250 mm×4. 6 mm, 5 μm)with linear gradient elution using a mobile phase consisting of acetonitrile and 0. 1% formic acid aqueous solution. Mass spectrometry with ESI source was performed in the positive ion mode to scan MS data including total ion chromatograms and ion peaks of Radix Polygalae. Eight components including 3, 4, 5-trimethoxycinnamic acid, p-methoxycinnamic acid, tenuifolin, sibiricose A5, polygalaxanthone III, tenuifoliside B, 3, 6′-disinapoly sucrose, and tenuifoliside A were identified according to the reference substance retention time, MS data and literatures. There was no significant variation found in the contents of eight chemical constituents of Radix Polygalae. The qualification and quantitation study of the components in herbal pair of Radix Polygalae and Rhizoma Acori Tatarinowii provide the methodological basis for compatibility mechanism exploration in vivo.

Objective:To investigate the differential expression of cyclooxygenase (COX) gene between familial aggregated atherosclerotic large-artery atherosclerosis(LAA) cerebral infarction patients and sporadic LAA cerebral infarction patients.Methods:Twenty-five patients with familial aggregation LAA cerebral infarction (familial aggregation LAA group) and 25 sporadic LAA cerebral infarction patients (sporadic LAA group) were collected.Another 25 patients with non-cardiovascular and cerebrovascular diseases were selected as control group.Real-time quantitative PCR and ELISA were used to detect COX-1 and COX-2 protein in the supernatant of samples.Results:The expression level of COX-1 gene was 0.5436±0.2737, 0.2400±0.1656 and 0.8340±0.3799 in the familial aggregation, sporadic LAA cerebral infarction and control groups.Compared with control group, COX-1 gene expression in sporadic LAA cerebral infarction group and familial aggregation LAA cerebral infarction group was significantly down-regulated, the differences were significant( P<0.05). The expression level of COX-2 gene was 1.3672±0.8249, 1.3932±0.7158 and 0.7212±0.9623 in the familial aggregation, sporadic LAA cerebral infarction and control groups.Compared with the normal control group, the expression of COX-2 gene in familial aggregation LAA cerebral infarction group and sporadic LAA cerebral infarction group increased significantly( P<0.05). The expression of COX-1 protein was 2.9956±0.5672, 2.5572±1.0289 and 2.6721±0.7944 in the familial aggregation, sporadic cerebral infarction and control groups.The expression of COX-2 protein was 16.63±4.06, 16.86±7.93 and 15.94±5.94 in the familial aggregation, sporadic cerebral infarction and control groups.There was no significant difference in the relative expression of COX-1 and COX-2 proteins among familial aggregation LAA cerebral infarction group, sporadic LAA cerebral infarction group and control group(all P>0.05). Conclusion:There is significant difference in COX-1 gene expression between patients with familial LAA and sporadic LAA cerebral infarction.

Objective:To explore the feasibility, accuracy and reproducibility of a novel, fully automated three-dimensional echocardiography right ventricular(RV) quantification software(3D Anto RV) to evaluate the RV volume and RV ejection fraction (RVEF) using artificial intelligence in patients after heart transplantation (HT) comparing with the gold reference-cardiac magnetic resonance (CMR).Methods:Forty-six patients after HT who were scheduled for echocardiogram at their routine follow-up examinations and also agreed to undergo CMR examination within the following 24 hours in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2018 to June 2019 were prospectively included. The right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV) and RVEF of HT patients were measured by CMR 3D Auto RV and conventional semi-automated three-dimensional echocardiography RV quantification software (Tomtec 4D RV function 2.0). The results of the 3D Auto RV and conventional semi-automated Tomtec were respectively compared with CMR using paired two-tailed student′s t-tests, Pearson correlation coefficients and Bland-Altman analyses. Results:The feasibility of the 3D Auto RV was 87%.The fully automated analysis realized in 27 (59%) patients by 3D Auto RV and the analysis time required only (12±1)s. The results of the remaining 19 (41%) patients needed manual adjustment and the mean analysis time in manual adjustment was also <2 min that was shorter than the conventional semi-automated three-dimensional echocardiography RV quantification software[(108±15)s vs (160±34)s, P<0.001]. For the results of RV volumes: There were good correlations between the 3D Auto RV and CMR, conventional semi-automated Tomtec and CMR for the measurements of RVEDV, RVESV and RVSV ( r=0.77-0.84, all P<0.001). In addition, compared with CMR, although there were significantly underestimated RV volumes by the 3D Auto RV and conventional semi-automated Tomtec, the negative bias was smaller in the 3D Auto RV than the conventional semi-automated Tomtec. For the results of RVEF: the corresponding RVEF derived from 3D Auto RV and CMR showed an excellent correlation and consistency ( r=0.84, P<0.001; bias=-1.1%, Limit of agreement=-8.1%-6.0%). In addition, the correlations between the manual adjustment by 3D Auto RV and the CMR ( r=0.63-0.72, all P<0.001) was lower than the correlations between the 3D Auto RV and the CMR ( r=0.76-0.82, all P<0.001) for RV volumes and RVEF.Finally, 3D Auto RV had a good reproducibility. Conclusions:The new fully 3D Auto RV quantification software underestimate RV volumes that less than the conventional semi-automated Tomtec. And the 3D Auto RV quantification software can accurately evaluate the RVEF in patients after HT with rapid analysis and higher reproducibility, which may also support the routine adoption of this method during follow-ups of HT patients in the daily clinical workflow.

【Objective】 To understand factors associated with children′s attendance at nursery care institutions (NCIs) and the basic characteristics of the NCIs children were enrolled in, so as to provide scientific evidence for policymakers. 【Methods】 During November 2020 and January 2021, parents who visited the Department of Child Health Care in six selected maternal and children′s hospitals, as well as nearby NCIs in Zhejiang were invited to finish an online questionnaire. Information such as children′s sociodemographic characteristics, parents′ knowledge, attitude and practice regarding nursery and feeding, etc. were collected. A total of 1 756 questionnaires were collected. 【Results】 Compared to children who were not in NCIs, children enrolled in NCIs were older (94.4% of children ≥24 months vs. 30.1%, χ²=835.27), more likely to be from the local area (87.2% vs. 81.4%,χ²=12.25), more likely to have parents with a college degree (mother: 83.6% vs. 74.2%, χ²=35.29; father: 79.9% vs. 70.0%, χ²=27.01), had a higher prevalence of family annual income >200 000 CNY (49.5% vs. 28.2%, χ²=110.49), and were less likely to have their grandparents available to take care of them (16.7% vs. 26.8%, χ²=31.4) The difference all have great significant.(P<0.05). In a multivariate Logistic regression model, the older the child, the more likely they were to attend an NCI (for children aged 6 - 23 months, OR=6.70; for children aged 24 - 35 months, OR=134.03; and for children aged 36 - 42 months, OR=699.33; P<0.05). Family annual income was positively associated with children′s attendance at NCIs (for those earning 100 000 - 200 000 CNY/year, OR=1.63; for those earning 200 000 - 500 000 CNY/year, OR=2.96; and for those earning >500 000 CNY/year, OR=4.62, P<0.05). Conversely, the higher the level of grandparent involvement in daily care, the lower the attendance at NCIs (for children cared for by both parents and grandparents, OR=0.57; for those primarily cared for by grandparents, OR=0.26, P<0.05). For children who used to stay at NCIs, 82.8% stayed at institutions that only recruited children aged 0 - 3 years, 97.4% spent their whole day in NCIs, and 71.4% spent less than 3 000 CNY per month for NCI services. Additionally, over 95% of parents were satisfied with the food and care services in NCIs, as well as their children′s physical development in NCIs. However, 32.1% of NCIs were reported by parents as having no room for breastfeeding. 【Conclusions】 Children′s age, grandparent involvement in routine care, and family annual income are the main factors associated with children′s attendance at NCIs. There is a greater need for more affordable and community-based NCIs, particularly for children under 2 years old. Additionally, more attention should be paid to the quality surveillance, assessment and management of NCIs.