Objective To explore the correlation between the characteristics of left atrial(LA)strain and exercise endurance in patients with chronic heart failure(CHF).Methods A total of 212 CHF patients admitted to our hospital from November 2021 to January 2023 were prospec-tively subjected in this study.According to their maximal oxygen uptake(VO2max),they were di-vided into high endurance group[≥16 ml/(kg·min),125 cases]and low endurance group[＜16 ml/(kg·min),125 cases].The general data and results of laboratory test were analyzed and com-pared between the two groups.Logistic regression analysis was used to analyze the related factors affecting the exercise endurance.Results Significant differences were observed between the two groups in level of NT-proBNP,ratio of early diastolic peak velocity of mitral valve(E)to early di-astolic peak velocity of mitral annulus(e'),E,LVEDVI,LVESVI,LVSVI,LVEF,LVGLS,LA maximum volume index(LAVImax),LA minimum volume index(LAVImin),LA reservoir strain(LASr),LA conduit strain duct strain(LAScd),and LA contractile strain(LASct)(P＜0.05).Multivariate logistic regression analysis showed that LASr(OR=0.987,95％CI:1.003-1.029),LAScd(OR=1.177,95％CI:0.688-0.955),LASct(OR=1.341,95％CI:0.507-0.884).NT-proBNP(OR=1.002,95％CI:0.995-1.000),E/e'(OR=1.086,95％CI:1.000-1.183),LVEDVI(OR=1.127,95％CI:0.805-0.936)and LVEF(OR=0.909,95％CI:0.824-1.000)were related factors influencing exercise endurance in CHF patients(P＜0.05).Restricted cube chart revealed that there was a significant nonlinear relationship between LASr,LAScd and LASct and exercise endurance in the patients(x2=9.830,16.820,9.080,P＜0.05).Conclusion The char-acteristic indicators of LA strain are related to exercise endurance of CHF patients.

Through the theoretical analysis of teaching reform and quality management in tradi-tional Chinese medicine col-leges, this paper puts forward the necessity of improving the quality management and optimizing the reform of education and teaching. Meanwhile, this paper further expounds the comprehen-sive, guiding, operable, qualitative and quantitative principles of teaching reform and quality management in traditional Chinese medicine colleges. Based on the above analysis, the paper puts forward and prac-tices the reform countermeasures to improve the interactive mechanism between the quality of graduates and the reform of teaching in traditional Chinese medicine colleges. The countermeasures include establishing an effective quality tracking feedback mechanism for graduates, actively carrying out the monitoring and evalu-ation of teaching quality, and constructing the measurement and evaluation system of teaching quality of traditional Chinese medicine education. This paper combines the needs of the current society for the culti-vation of talents of traditional Chinese medicine and the training quality standards, so as to promote the development of traditional Chinese medicine.

Objective To study the association, clinical presentation, and diagnosis and treatment of bile duct cancer as a late complication of biliary-enteric anastomoses for benign diseases. Methods A retrospective study was carried out on 5 patients and the medical literature was reviewed. Results They were 3 males and 2 females. The average age was ( 66. 0 ± 0. 7 ) years. The average time period was ( 14. 0 ± 6. 1 ) years after biliary-enteric anastomosis. The clinical presentations included right upper quadrant pain, fever, chills and jaundice. CA19-9, CT and MRI were valuable in diagnosis. There were two patients with distal and three patients with perihilar cholangiocarcinomas (type IIIa, n=2, and type IV, n=1). Local resection with lymphadenectomy was carried out in one patient. Another patient underwent pancreaticoduodenectomy. The remaining three patients only underwent percutaneous transhepatic cholangial drainage ( PTCD). The 2 patients who underwent surgery died of progressive tumor disease at 8 and 13 months postoperatively. The other three patients who underwent palliative biliary drainage died within 6 months of PTCD. There was no significant difference between the two types of treatment ( P ＞0. 05). Conclusions Chronic cholangitis caused by reflux and bacterial infection was properly a predisposing factor leading to late development of bile duct cancer after biliary-enteric anastomosis for benign diseases. Patients treated with biliary-enteric anastomosis should be closely monitored for late development of cholangiocarcinoma. Some procedures such as choledochoduodenostomy and jejunum interposition choledochoduodenostomy should be abandoned because of their poor outcomes and severe complications. Proper indications of biliary-enteric anastomosis should strictly be followed and the Oddi's sphincter should be protected if possible to prevent late development of bile duct cancer.

Objective:To analyze the research in nursing informatization in Operating Room in China, summarize the current research characteristics and hotspots, and provide reference for further research in nursing informatization in Operating Room.Methods:Studies on nursing informatization in Operating Room were systematically retrieved from CNKI, Wanfang, SinoMed, and VIP databases. The search time limit was up to March 20, 2021, and the type of studies was set as experimental research or quasi-experimental research in quantitative studies. EndNote 22.0 was used for literature deduplication, and Excel 2016 was employed to draw tables and research trend graphs. The publication year, literature source, number of citations, published journals, funding source, research institutions, and research content of the articles were extracted to explore research hotspots.Results:A total of 140 articles were included, and the number of articles was on the rise. The articles were mainly distributed in Central, East, and North China; the funding rate was 15.71% (22/140) ; the research institution with the most articles was Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (9 articles) ; the journal with the most articles was the Journal of Nursing Science (15 articles) ; the total number of citations was the highest in the articles published in the Chinese Journal of Nursing in 2015 (64 times) ; the research content mainly concerned "the construction and application of Operating Room information system", of which "information technology applied to nursing quality management in Operating Room" was most studied (95 articles) . Conclusions:The development of nursing informatization in Operating Room has received general attention, and more and more hospitals have realized the use of information technology to optimize the nursing process and improve the management model. It is expected that the maintenance of information network security, the training of information-based nursing talents, the standardized management and application of medical big data, and the interconnection at all levels will become the hotspots and difficulties in the development of nursing informatization in Operating Room.

Objective:To understand the context, frontiers and hotspots of researches on informatics nurses, in order to provide a basis for the training of informatics nurses in China.Methods:Relevant literature on informatics nurses included in Web of Science Core Collection Database was searched from the establishment of the database to November 1, 2021. HistCite Pro 2.1 software was used to analyze the publication time, countries, institutions, journals, authors, keywords and highly cited papers.Results:A total of 1 246 papers were included, and research institutions in the United States, Brazil, and Canada were in the leading position in the field of information nurses. The exploration of the information ability of nursing managers and the management of patient diagnosis and treatment data were the research frontiers in the past 5 years. Participating in designing software based on clinical needs and improving nursing quality based on information and data were research hotspots in this field.Conclusions:The foreign researches on informatics nurses started early and developed more maturely. China should learn from the training experience of foreign informatics nurses, pay attention to the teaching quality of information nursing courses in schools and encourage clinical nursing information skills training. In addition, it should be based on the fact that information nurses can skillfully apply clinical information systems, support nurses to participate in the development of nursing information systems, improve the data analysis capabilities of information nurses and give full play to the clinical value of information nurses, so as to accelerate the realization of clinical nursing informatization.

Objective:To understand the status quo of first aid ability and critical thinking of Operating Room nurses and to explore the correlation of critical thinking and first aid ability of Operating Room nurses.Methods:Using the convenient sampling method, a total of 158 nurses in Operating Room of First Maternity and Infant Hospital Affiliated to Tongji University were selected as the research objects from September 1 to 5, 2021. Nursing staff were surveyed using general information questionnaire, Operating Room Nurses ' First Aid Ability Assessment Questionnaire and Critical Thinking Ability Questionnaire. Pearson correlation was used to analyze the correlation between first aid ability and critical thinking of Operating Room nurses. A total of 158 questionnaires were distributed in this study and 152 valid questionnaires were recovered, with an effective recovery rate of 96.20%. Results:The total score of first aid ability of 152 Operating Room nurses was (109.25±6.39) , and the total score of critical thinking ability was (312.36±12.94) . Pearson correlation analysis showed that the total score of first aid ability of Operating Room nurses was positively correlated with the total score of critical thinking ability ( P<0.01) . Conclusions:First aid ability is related to critical thinking ability. For Operating Room nurses, the higher the critical thinking ability, the higher the first aid level.