Objective To explore the effects of self-management strategy on cancer-related fatigue patients though meta-analysis. Methods Randomized controlled trials(RCTs) of self-management strategy on cancer-related fatigue were searched in databases including Cochrane Library, Web of Science, PubMed, Elsevier, CBM, CNKI, WanFang. After two researchers evaluated the literature quality, ReviewManager 5.3 was used to analyze. Results Twelve RCTs were retrieved and considered as eligible, using The Brief Fatigue Inventory (BFI),Cancer Fatigue Scale (CFS), Function Assessment of Cancer Therapy-Fatigue (FACT-F), Checklist Individual Strength (CIS), Multidimensional Fatigue Inventory (MFI). According to the Meta-analysis, cancer-related fatigue could be effectively improved though self-management strategy. Two classification data-the results of BFI measurement RR=0.75 (95％CI: 0.70-0.81, P<0.01), continuous data-SMD=-0.96 (95％CI:-1.81--0.11, P=0.03), CFS measurement results, WMD=-10.69 (95％CI:-12.37--9.01, P<0.01), FACT-F,CIS,MFI measurement results, SMD=-0.22 (95％CI:-0.40--0.04,P=0.01). Conclusions Using self-management strategy can significantly relieve cancer-related fatigue, and more high quality researches were needed to support the findings.

Objective:To investigate the status of clinical nurses′ professional identity, structural empowerment and psychological empowerment, analyze the correlation between professional identity and structural empowerment and psychological empowerment, and establish a multiple stepwise regression model to discuss the dependence between professional identity and structural empowerment and psychological empowerment in clinical nurses.Methods:A total of 1 008 clinical nurses from Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University were selected as the subject by using the convenience sampling method. The General Information Questionnaire, Professional Identity Scale, Conditions of Work Effectiveness Scale, and Psychological Empowerment Scale were used to questionnaire.Results:The professional identity of nurses was at medium level (104.49±19.54), the total scores of structural and psychological empowerment of nurses were 60.09±13.49 and 42.59±7.31. Correlation analysis showed that the total score of professional identity of clinical nurses was positively correlated with the total score of structural empowerment, psychological empowerment and theirs dimensions ( r values were 0.436-0.715, P<0.01). Multivariate stepwise regression results showed that the nurse working years, health status self-assessment, formal empowerment, informal empowerment, work meaning, self-efficacy, work influence was the main influencing factors of nurses professional identity, which explained 60.5% of the total variation. Conclusions:Nursing managers should focus on the professional identity of clinical nurses, by optimizing the management organizational structure and pay attention to the perception of empowerment behavior to improve the comprehensive empowerment level, so as to enhance the professional identity of nurses.

Objective:To explore the incidence and degree of compassion fatigue in clinical nurses, and the effects of psychological empowerment on nurses' compassion fatigue level.Methods:A total of 1 005 clinical nurses were investigated with the general information, Chinese version of Professional Quality of Life Scale, Psychological Empowerment Scale. And the relationship between different degrees of compassion fatigue and psychological empowerment were analyzed by ordinal regression analysis.Results:The incidence of sympathetic fatigue was 93.0%,(935/1 005), mild was 53.8%(541/1 005), medium was 22.7%(228/1 005), severe was 16.5%(166/1 005). The score of Chinese version of Professional Quality of Life Scale three dimensions: compassion satisfaction, burnout, and secondary traumatic stress of clinical nurses were 34.15±5.53, 23.96±5.10, 23.73±5.92. The degree of compassion fatigue was negatively correlated with psychological empowerment score and score of each dimension( r values were 0.094-0.468, all P<0.05). The ordinal regression analysis indicated that job impact(odds ratio(OR) value was 1.095, 95% credible interval( CI) 0.094-0.236, P<0.01), self-efficacy( OR value was 0.920, 95% CI 0.250-0.054 , P<0.01) and job meaning( OR value was 0.820, 95% CI 0.431-0.240, P<0.01) were the independent risk factor of compassion fatigue level. Conclusions:The nurses mainly showed mild compassion fatigue, and main manifestation is secondary traumatic stress. The nurses who had more higher job impact scores were more likely to report higher levels of empathy fatigue, while nurses who had higher job meaning and self-efficacy scores were more likely to have low levels of empathy fatigue. Therefore, it is suggested that nursing managers should carry out timely intervention and management in accordance with the different level of compassion fatigue:improve nurses' perception of work meaning and self-efficacy, and avoid increasing workload while paying attention to the influence of work on perception level.

Objective:To investigate the predictive value of 3-hour post-endoscopic retrograde cholangiopancreatography (ERCP) serum amylase and lipase levels for postoperative pancreatitis (PEP).Methods:Clinical data of patients who underwent ERCP from June 2017 to December 2018 in our hospital were retrospectively analyzed. Risk factors of PEP were examined with univariate and multivariate analysis. Receiver operator characteristic (ROC) curve for 3-h postoperative serum amylase and lipase was generated and the optimal cut-off levels for PEP prediction were calculated.Results:A total of 491 patients were enrolled in this study, and 29 patients developed PEP. Compared with the uncomplicated group, female gender [75.9% (22/29) vs. 49.1% (227/462)], pancreatogram [65.5% (19/29) vs. 32.0% (148/462)], pancreatic duct cannulation [27.6% (8/29) vs. 11.7% (54/462)] and coronary heart disease [17.2% (5/29) vs. 4.5% (21/462)] accounted for a significant higher proportion in PEP group (χ 2=7.79, 13.63, 6.25, 6.42, all P<0.05), while logistic regression analysis revealed that only pancreatic duct cannulation was an independent risk factor ( OR=3.574, 95 %CI: 1.315-9.713, P<0.05). Areas under the ROC curve of serum amylase and lipase at 3 h were 0.897 (95 %CI: 0.842-0.951, P<0.01) and 0.915 (95 %CI: 0.881-0.948, P<0.01), respectively ( Z=0.550, P>0.05). For amylase, ideal sensitivity(93.1%) and specificity(93.3%) could be obtained as cut-off levels>1.0 and 3.0 times the upper limit reference (ULR), respectively. Correspondingly, as cut-off levels for lipase>2.5 and 6.0 times the ULR, the sensitivity was 93.1% and specificity was 91.3%, respectively. Conclusion:Three-hour postoperative serum amylase and lipase are both ideal indicators for predicting PEP with similar clinical value.

Hyperandrogenism is a common endocrine pathological state in women, and polycystic ovary syndrome is the main cause. Studies have shown that in addition to affecting reproductive function, hyperandrogenism in women can also interfere with vascular endothelial function, and directly or indirectly increases the risk of atherosclerotic disease by affecting risk factors such as blood pressure, lipids, and glucose. This article reviews the impact of hyperandrogenism on the cardiovascular system of women, aiming at a deeper understanding of the role of androgens in women′s health.

Objective? To analyze the current situation of clinical research on cardiac rehabilitation in China from 2008 to 2018, so as to provide references for clinical research and practice in this field. Methods? CNKI and Wanfang database were used as retrieval tools to retrieve published clinical research literature on cardiac rehabilitation. Bibliometric methods were used to analyze the annual distribution, regional distribution, authors, journals and fund support of the published literature. Results? A total of 603 articles were included in this study and the numbers of articles and funds showed a rapid growth trend. Both of them were widely distributed but not balanced in different regions. Among the 582 first authors, 563 authors were with one article, accounting for 96.74%. 40 articles published by 19 core authors who have published over 2 articles were accounting for 6.63%. The co-authorship rate was 65.51% and the degree of cooperation was 2.50. There were 218 journals involved and only 5 of the 15 core journals belonged to the core journals of science and technology of China in 2018. Conclusions? From 2008 to 2018, the clinical research of cardiac rehabilitation in China was in a rapid development stage. Researchers in this field were highly collaborative but dispersive and lack of sustainability. The quality of core journals was unsatisfactory. It is suggested that more attention should be paid, more technology and talents should be input and balanced, fund supports should be provided to produce high quality researches and high level results.

Objective To explore the multiple mediating role of positive psychological capital and adaptive emotion expression between individual social capital and humanistic care ability in nursing students. Methods From December 2018 to August 2019,the study selected 238 undergraduate nursing students of Grade 2015 to 2018 by cluster stratified sampling as subjects in a medical university. All of students were investigated with the Caring Ability Inventory, Individual Social Capital Questionnaire, Positive Psychological Capital Scale and Emotional Expression Questionnaire in college students of China. Structure equation model was used to analyze the correlations among the variables. Results Among 238 nursing students, the scores of humanistic care ability, individual social capital, positive psychological capital, inhibitory emotion expression, adaptive emotion expression and excessive emotion expression were (185.79±17.52), (20.26±2.38), (125.24±17.71), (17.23±3.86), (20.85±3.91) and (9.70±3.97) respectively. Individual social capital, positive psychological capital, adaptive emotion expression and humanistic care ability had positive correlations with each other (r=0.223-0.627,P<0.01). Multiple mediating effect model analysis showed that the positive psychological capital and adaptive emotion expression had multiple mediating roles between individual social capital and humanistic care ability in nursing students(P<0.05). The relative mediating effects of positive psychological capital, adaptive emotion expression and chain mediation were 83.37％, 11.64 ％ and 4.77％ respectively. Conclusions Nursing students have a low level of humanistic care ability with the adaptive emotion expression. Nursing educators can improve nursing students' individual social capital, enrich their positive psychological capital and strengthen their adaptive emotion expression so as to cultivate the humanistic care ability.

?? [Abstract]? Objective? To explore the effect of physical cooling method by the use of external cooling ice-packs for treatment of the in-patients with fever. Methods? In accordance with the model of Australian JBI evidence-based health care, the evidence was applied to the clinical practice after evidence generation, and synthesis. Admitted from November 2017 to June 2018 into the hematology department in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, the hyperpyretic patients with blood disease were divided into two groups-observation group and control group randomly. 68 patients were included in each group. The patients in observation group were given by 0.5 g acetaminophen orally along with ice-packs while the patients in control group were just given by 0.5 g oral acetaminophen. The temperature lowering effect in both groups was compared and studied. Results? In the observation group, patients' temperature was (38.90±0.37)℃ before intervention, (38.85±0.36)℃ in 30 minutes after intervention, (38.63±0.52)℃ in 1 hour and (38.07±0.76)℃ in 2 hours. And those for control group were (38.89±0.39),(38.82±0.40),(38.58± 0.59),(37.90±0.67)℃,respectively. Repeated measurement analysis of variance indicated that patients' temperature showed significant differences at each point of time during the study in both group (Ftime=77.862,P＜ 0.01). The intervention methods in the two groups did not interact with different point of time (Finteraction=0.728, P＞0.05). The effect of intervention in different groups at different point of time was not significant (Fgroups=0.909, P＞ 0.05). Conclusions? The use of physical cooling method along with medication is proved to be not significant in the patients' temperature control. Health workers should or not select the physical cooling method based on patients' condition and willingness in order to ensure their vital signs' stability and their comfort.

Objectives To explore the establishment and effects of a multilevel and inter-disciplinary management scheme for specialist nurses.Methods The multilevel and inter-disciplinary management scheme included establishing the pyramid hierarchical training model,exploring superimposed training mechanism for specialist nurses with horizontal expansion,vertical extension,and deep development,and constructing stereoscopic clinical evaluation and quantitative assessment system.Four hundred-forty two specialized nurses have been recruited to join the multilevel and inter-disciplinary management scheme from July 2021 to August 2023.The core competencies of specialized nurses were compared before and after the implementation of management scheme.Results The quality development of specialized nursing have been improved,and the total scores and the scores of 3 dimensions(research innovation,management,and professional development)in core competencies of specialized nurses after the intervention of multilevel and inter-disciplinary management scheme were higher than those before(P＜0.05).Conclusion The multilevel and inter-disciplinary management scheme can effectively improve the core competencies of specialized nurses,and promote the high-quality development of specialized nursing.

Objective: To understand the status quo and correlation between problem solving ability and positive mental capital of nursing undergraduates. Methods: A total of 238 nursing undergraduate were investigated with the Problem Solving Scale and the Positive Mental Capital Scale. Results: In terms of each dimension in Problem Solving Ability Inventory, the scores from high to low respectively were rational problem solving, positive problem orientation, avoidance style, negative problem orientation, impulsivity/carelessness style, the total score of positive mental capital was 125.24±17.71. Multivariate stepwise regression analysis showed that self-efficacy, hope explained for 29.4% of positive problem orientation variation and 15.4% of explaining rational problem solving variation. Resiliency, self-efficacy explain for 35.8% of the negative problem orientation variation. Hoped, resiliency explained for 9% of impulsive/carelessness style variation and 21.8% of avoidance style variation. Conclusions The problem solving ability of nursing undergraduates was weak, which was closely related to positive psychological capital, and can improve the overall problem solving ability of nursing students by improving their self-efficacy, hope and resiliency.