Objective:To construct of evaluation index system and theory-skill-humanity (TSH) model for core competence of radiation specialist nurses, to provide reference for clinical training of radiation specialist nurses.Methods:In January 2023, the draft of the evaluation index system of core competence for radiation specialist nurses was development by literature reviews and semi-structured interviews; from February to March 2023, 20 experts were consulted with 2 rounds of Delphi consultations to determine the index system and determine indicator weights based on the importance assigned by experts to each indicator.Results:Among 20 experts, 17 were female and 3 were male, aged 35-65 (46.48 ± 8.19) years old. The effective recovery rate of the questionnaires was 100.0% (20/20) and 95.0% (19/20) in the first and second round, respectively. The authority coefficient of the experts was 0.937 in the second round, the Kendall coefficients of concordance in the first-level indexes, second-level indexes and third-level indexes were 0.448, 0.407, 0.464, respectively, the difference was statistically significant ( χ2 = 53.60, 148.81, 58.18, all P<0.001). The final evaluation index system of the core competence of radiation specialist nurses included 3 first-level indicators, 11 second-level indicators and 56 third-level indicators. Conclusions:The evaluation index system of the core competence of radiation specialist nurses constructed based on TSH model in the present study has certain feasibility and practicality, which can be used as the basis for the training and evaluation of radiation specialized nurses.

Objective:To explore the intervention effect of swallowing function training based on swallowing function assessment and aspiration risk classification in elderly patients with dysphagia.Methods:From January 2018 to December 2019, convenience sampling was used to select patients with dysphagia admitted to the Department of Geriatrics of the First Affiliated Hospital of Zhengzhou University. The patients were divided into a control group and an observation group according to the hospital stay. The patients hospitalized from January to December 2018 were in the control group, and the patients hospitalized from January to December 2019 were in the observation group. The control group carried out routine nursing for swallowing dysfunction, and the observation group implemented swallowing training based on dynamic swallowing function assessment and aspiration risk classification for 6 weeks. The Standardized Swallowing Assessment (SSA) score and aspiration risk grade, Deglutition Handicap Index (DHI) score, and the incidence of aspiration and aspiration pneumonia were compared between the two groups.Results:Among the 185 patients, 3 cases were eliminated without completing all training. There were 83 cases in the control group and 99 cases in the observation group. The SSA score and aspiration symptom scores of DHI of the control group after intervention were higher than those before intervention, and the differences were statistically significant ( P<0.05) . After the intervention, the SSA score, total score and scores of all dimensions of DHI of the observation group were lower than those before and of the control group after intervention, and the differences were statistically significant ( P<0.05) . After the intervention, the aspiration risk classification of the two groups was compared, and the difference was statistically significant ( Z=9.143, P<0.001) . The aspiration rate and the incidence of aspiration pneumonia in the observation group were 13.13% (13/99) and 7.07% (7/99) respectively, and the aspiration rate and the incidence of aspiration pneumonia in the control group were 25.30% (21/83) and 18.07% (15/83) , the differences were statistically significant ( P<0.05) . Conclusions:Swallowing function training based on dynamic swallowing function assessment and aspiration risk classification can effectively improve the swallowing function and quality of life of elderly patients with dysphagia, and reduce the incidence of aspiration and aspiration pneumonia.

Objective:To compare the influence of dronedarone and amiodarone on the bleeding risk of patients with atrial fibrillation treated with rivaroxaban anticoagulation.Methods:Clinical data of 81 patients with atrial fibrillation treated with rivaroxaban anticoagulation at Xi'an International Medical Center Hospital from January 2020 to July 2023, including 36 patients treated with dronedarone and 45 patients treated with amiodarone, were retrospectively analyzed. The effects of dronedarone and amiodarone on the anticoagulation of rivaroxaban were compared using the incidence of bleeding events, thrombosis events, and adverse reactions as outcome measures.Results:The total bleeding in the dronedarone group [22.22% (8/36)] was significantly higher than that in the amiodarone group [6.67% (3/45)] ( χ2 = 4.12, P < 0.05). The total bleeding of conventional-dose rivaroxaban in the dronedarone group was 30.00% (6/20), while the total bleeding of low-dose rivaroxaban was 12.50% (2/16), with no statistical significance ( χ2 = 1.58, P > 0.05). No thrombotic events or adverse reactions to dronedarone or amiodarone were observed in all patients. Conclusion:Compared with amiodarone, dronedarone significantly increases the bleeding risk of rivaroxaban anticoagulation in patients with non-valvular atrial fibrillation, and reducing the dose of rivaroxaban in patients using dronedarone does not reduce the bleeding risk.

Objective: To analyze the issuance of Chinese adolescents mental health promotion policies and policy objects, and to explore the use of different object policy tools and the effectiveness of the policy, so as to provide reference for the improvement of the subsequent policy. Methods: Adolescents mental health promotion policies published and policy documents that included adolescents in mental health promotion policies and regulations in China from 2014 to the present were obtained, with the search period of July to August 2024. Policy content and effectiveness were analyzed by using content cross tabulation analysis and Policy Modeling Consistency Index Model (PMC index model). It coded with Nvivo 20 software to understand the types of tools that policy depends on. Results: A total of 41 documents were included. The number of adolescent mental health promotion policy texts rose by year, most of which were issued independently, accounting for 70% of the total number of texts issued; 30% were jointly issued, with the Ministry of Education and the National Health Commission as the core subjects. Supply type policy tools accounted for 47.45 % of the total, while environment type and demand type policy tools accounted for 29.68% and 22.87% respectively; the use of policy tools by different policy targets varies, with families and social organizations using more supply type and demand type policy tools, while the education system and healthcare institutions were more inclined to supply type policy tools, and the government departments were more inclined to supply type policy tools and environment type policy tools. In terms of policy effectiveness, there was a common problem of a lack of incentives and constraints, and the PMC values of two long term planning mental health policies were high (7.76, 7.56), and both reached the excellent level. Conclusions China has paid more attention to adolescents mental health, and the basic guarantees have been established and overall policy effectiveness is good, but the use of policy tools is uneven. There is a need to improve the operational content of medium and long term policies and to strengthen synergies between implementing departments.

BACKGROUND AND OBJECTIVEExercise can improve circulation, muscular strength and happiness of cancer survivors. But more data were needed to demonstrate both the exercise ability of cancer suivivors after pulmonary lobectomy and the influences of exercise on their survivals. The aim of this study was to examine changes of exercise and its clinical effects among eldly non-small cell lung cancer survivors.

METHODSElderly non-small cell lung cancer survivors who had progression-free disease after surgery, chemotherapy, radiation therapy or tyrosine kinase inhibitors were included. Their exercises and participation rates per week before cancer diagnosis, after 3 months anticancer therapy and 1 year after diagnosis as well as their exercise motivations and prevalences were investigated retrospectively.

RESULTSForty-eight elderly non-small cell lung cancer survivors were selected. Moderate-vigorous intensity exercise had by the elderly progressin-free non-small cell lung cancer survivors after diagnosis decreased, but the participation rate of light intensity exercise was higher in 1 year after diagnosis than before diagnosis. 75.9% (14/58) patients had exercise up to the standard and the cancer recurrence rate was 20.0% (7/35). The recurrence rate of the other group was 35.7% (5/14), and the risk ratio of recurrence was 2.14 (95% CI: 0.81-5.68, P = 0.26). The most common motivations of exercise were improving health, increasing physical activity, maintaining healthy life style and improving immunity. And the main disturbances were fatigue, discomfort and lack of motivation.

CONCLUSIONThe exercise participation rate during anticancer treatment among the elderly non-small cell lung cancer survivors decreased and did not return to prediagnosis levels after treatments were completed. The relationship between exercise and recurrence of cancer was not clear and needed further work.

Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; pathology ; Female ; Humans ; Male ; Motor Activity ; physiology ; Retrospective Studies ; Survivors ; statistics & numerical data

Objective:To explore the clinical features and diagnosis of coexistence of ankylosing spondylitis (AS) and Beh?et's disease associated with antiphospholipid syndrome (APS).Methods:We analyzed a case of coexistence of ankylosing spondylitis and Beh?et's disease associated with APS in Seventh Medical Center of Chinese PLA General Hospital in 2016, and the related literature were reviewed.Results:A 26-year-old male patient suffered from inflammatory low back pain, arthralgia and iritis. A His CT imaging revealed bilateral grade Ⅱ of bilateral sacroiliac arthritis. He was diagnosed as AS. He also had recurrent oral ulceration, iritis, vascular disorders and positive acupuncture pathergy test. He was diagnosed as Beh?et's disease. He suffered from recurrentpeated venous thrombosis. Laboratory tests revealed positive antiphospholipid antibodies. He was diagnosed as secondary APS complicated with Beh?et's disease. After he was treated with of glucocorticosteroid, cyclophosphamide, adalimumab and dabigatran, his condition improved significantly.Conclusion:There are some cases reported of AS with Beh?et's disease, or Beh?et's disease with APS, or AS with APS. The relationship between them is complex. The possibility of coexistence of AS and Beh?et's disease and APS should not be ignored, in order to avoid misdiagnosis.

Objective:To investigate the utilization of peripheral intravenous catheter (PIVC) in hospitalized children in Class Ⅲ specialized children's hospitals, aiming to discover existing issues of PIVC in order to provide reference for clinical nurses and nurse administer to improve the quality on intravenous therapy and to avoid potential risk.Methods:This study uses the field survey method. From July 23rd to 31st, 2018, 25 Class Ⅲ children's specialized hospitals were first sampled in 23 provinces, municipalities, and autonomous regions of the country by the convenient sampling method. The cluster sampling method was then used to select all the pediatric patients with PIVCs admitted to the hospital on the date of investigation. A self-designed 'Cross-sectional Questionnaire for Pediatric Patients with PIVC' was used for survey, and images and data were analyzed. SPSS 17.0 software was used to statistically analyze the data.Results:In this study, 8 635 cases of PICVs were investigated, and the utilization rate of PICVs accounted for 86.9% (8 635/9 942) of all venipuncture tools. Among these cases, 4 665 (54.0%) cases' puncture sites were at the dorsal side of the hand, and 1 234 (14.3%) were at the head. Among the PIVCs, 45.8% (3 954/8 635) were safety PIVCs. And 54.6% (4 712/8 635) of the PIVCs were di (2-ethylhexyl) phthalate (DEHP) free products. The incidence rate of PICV related complications was 7.9% (682/8 635) . Univariate analysis and multivariate logistic regression analysis showed that the PIVC time, IV site, dressing fixation problems, catheter maintenance problems, and patient age were risk factors for PIVC related complications ( P<0.05) . Conclusions:PIVC is the widely used among pediatric patients. The IV site is mainly at the dorsal side of the hand, followed by head and wrist. The selection of material and type of PIVC still require further improvement to ensure the safety of pediatric intravenous therapy. Nursing measures should be taken during the use of PIVC to identify the risk factors at early stage and intervene effectively, which can reduce the occurrence of complications.

Objective:To explore the status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide, and to analyze the nursing of elderly inpatients with incontinence, so as to provide a reference for clinical intervention.Methods:On March 31, 2021, convenience sampling was used to select 14 675 elderly inpatients from 52 hospitals across the country as the research object. The self-designed Incontinence-associated Dermatitis Questionnaire for Elderly Inpatients was used to collect general demographic data, health status, incontinence, and skin nursing. Binomial Logistic regression was used to investigate the influencing factors of incontinence-associated dermatitis in elderly inpatients.Results:Among 14 675 elderly inpatients, the prevalence rates of xerosis cutis, incontinence and incontinence-associated dermatitis were 38.78% (5 691/14 675) , 11.06% (1 623/14 675) and 1.91% (280/14 675) , respectively. The prevalence of mild, moderate and severe incontinence-associated dermatitis were 1.27% (186/14 675) , 0.55% (81/14 675) , and 0.09% (13/14 675) , respectively. Among the nursing of 1 623 elderly inpatients with incontinence, the items with low implementation rate were the use neutral lotion to clean skin (14.17%, 230/1 623) , use of skin protectant after moisturizing (17.68%, 287/1 623) , moisturizing after cleansing the skin (28.90%, 469/1 623) . The results of binomial Logistic regression analysis showed that xeroderma, fecal incontinence, urinary and fecal incontinence, ≥2 kinds of combined medication, and hospital stay >30 days were risk factors for incontinence-associated dermatitis in elderly inpatients.Conclusions:The risk factors of incontinence-associated dermatitis in elderly inpatients mainly include xerosis cutis, type of incontinence, ≥2 kinds of combined medication, and hospital stay >30 days.

Objective:To analyze the association between sleep status and ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.Methods:It was a cross sentional study. Hypertensive patients who underwent 24-hour ambulatory blood pressure monitoring from May 2021 to April 2023 in Shanghai Xinzhuang Town were enrolled. The demographic information and sleep status of patients were obtained from the questionnaire. A TM-2430 blood pressure monitor was used to measure 24-hour ambulatory blood pressure, and the relevant indicators, including blood pressure level and blood pressure coefficient of variation were documented. The association between sleep status and blood pressure indicators was analyzed with multivariate linear regression model.Results:A total 1 135 patients aged (65.07±12.61) years were enrolled, and 473 (41.67%) of whom were males. The sleep time was<7 hours in 76 cases, 7- 8 hours in 219 cases and >8 hours in 840 cases; the bedtime was earlier than 22∶00 in 415 cases, between 22∶00 and 23∶00 in 474 cases and later than 23∶00 in 246 cases; the wake-up time was before 6∶00 in 230 cases, between 6∶00 and 7∶00 in 521 cases and after 7∶00 in 384 cases. Multivariate linear regression analysis showed that after controlling for gender and age, the sleep time was negatively associated with diurnal, noctumal and 24-hour diastolic blood pressure levels (all P<0.05), and positively associated with diurnal and noctumal systolic blood pressure coefficient of variation, noctumal diastolic blood pressure coefficient of variation, and 24-hour systolic blood pressure coefficient of variation (all P<0.05).The bedtime was positively associated with diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), diastolic blood pressure (all P<0.05); and negatively associated with diurnal systolic blood pressure coefficient of variation, diurnal diastolic blood pressure coefficient of variation, noctumal systolic blood pressure coefficient of variation, 24-hour systolic blood pressure coefficient of variation, and 24-hour diastolic blood pressure coefficient of variation (all P<0.05). The wake-up time was positively associated with diurnal systolic blood pressure, diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), and positively associated with diurmal systolic blood pressure and diastolic blood pressure (both P<0.05). Conclusion:Sleep status is closely associated with ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.

【Objective】 To investigate the effects of echinacoside （ECH） on mitochondrial biosynthesis and cardiomyocytes’ apoptosis in heart failure （HF） and to explore its related mechanisms. 【Methods】 The experimental animals were divided into three groups： the rat model of HF （HF） was induced by intraperitoneal injection of ISO， and pre-treated with ECH by intraperitoneal injection （ECH） and nomal control （ctrl group）. Cardiac function was detected by echocardiography after 2 weeks of treatment. The ultrastructure of myocardium was observed by transmission electron microscopy and the mitochondrial density and vacuolation rate were analyzed. The expressions of apoptosis-associated proteins were evaluated by Western blotting， and genes related to mitochondrial biosynthesis were examined by Real-time PCR. 【Results】 ECH increased 1eft ventricular ejection fraction （LVEF） and 1eft ventricular fraction shortening （LVFS）， but decreased 1eft ventricular end-systolic diameter （LVEDs） and 1eft ventrieular end-diastolic diameter （LVEDd） when compared to HF group （P<0.01） and improved cardiac function. The myocardial ultrastructure was significantly improved by ECH， the density of regular shapes of mitochondria was increased， and the percentage of vacuolated rate was reduced by ECH （P<0.01）. The expression of anti-apoptotic protein Bcl-2 was upregulated and that of pro-apoptotic protein Bax was downregulated in ECH group. The mRNA of mitochondrial biosynthesis related genes PGC-1， NFR-1， NFR-2 and TFAM was significantly upregulated in ECH group. 【Conclusion】 ECH promotes mitochondrial biosynthesis and inhibits cardiomyocytes’ apoptosis by up-regulating PGC-1/NFR signaling pathway， thus improving cardiac function.