Inquiry is the main method of history taking. The training should not be limited to the medical inpatients inquiry. Different training scenes should be taken. The outpatient history inquiry needs a similar clinic room and set time limit, and focuses on key point history inquiry as well as document writing. Some principles in emergency inquiry are introduced, such as SAMPLE principle. The key points of inquiry of different patients including elderly patients, child patients, traumatic patients and drug addiction patients are also introduced. Through the combination of theory and practice mode, the group discussion and role-play, different scenes design and standardized patients application, reasonable design of teaching hours and content distribution, as well as feedback in time, optimal teaching effect can be finally achieved.

Objective:To construct the nursing quality evaluation index system for the disabled elderly in medical-nursing combined institutions, so as to provide a basis for nursing managers to evaluate nursing quality of the disabled elderly in medical-nursing combined institutions.Methods:A total of 20 experts were selected by the convenient sampling method. From May 2020 to January 2021, the research team used literature analysis to construct the evaluation index framework of nursing quality for the disabled elderly in medical-nursing combined institutions and conducted two rounds of expert consultation among 20 experts through Delphi expert consultation method to determine the evaluation index system and weight of nursing quality for disabled elderly people in medical-nursing combined institutions.Results:The recovery rate of the two rounds of expert consultation questionnaire was 100.00% (20/20) , and the expert authority coefficient was 0.880. The Kendall's concordance coefficients of the first and second rounds were 0.138 and 0.128, respectively ( P<0.01) . Finally, the evaluation index system of nursing quality for the disabled elderly in medical-nursing combined institutions was constructed, including 3 first-level indicators, 8 second-level indicators and 43 third-level indicators. Conclusions:The nursing quality evaluation index system for the disabled elderly in medical-nursing combined institutions established in this study is scientific and reliable, which can provide a basis for nursing managers to quantitatively evaluate the nursing quality of the disabled elderly.

Objective: To explore the association between dietary behaviors and sleep duration among middle school students in Shanghai, so as to provide reference for interventions targeting insufficient sleep. Methods: From May to June 2021, a stratified cluster random sampling method was employed to select a sample of 10-17yearold middle school students for monitoring their healthrisk behaviors. A total of 5 538 valid questionnaires were collected. The survey included items such as daily sleep duration, weekly consumption of sugary beverages, freshly squeezed fruit juice, fresh fruits, fresh vegetables, fried foods, milk and yogurt, breakfast habits, and frequency of eating outside. Statistical analysis was conducted using Chisquare test, Wilcoxon ranksum test, and multivariable Logistic regression model. Results: About 73.7% of middle school students reported insufficient sleep in Shanghai. There was a positive correlation between the average daily consumption of fresh fruits and breakfast consumption with sleep duration. In other words, a higher frequency of consuming fresh fruits (OR=1.29) and eating breakfast (OR=1.07) were associated with a higher likelihood of sufficient sleep. Conversely, there was a negative correlation between the frequency of consuming desserts (OR=0.78) and fried foods (OR=0.88) and sleep duration (P<0.05). Conclusions Increasing the consumption of fresh fruits and maintaining regular breakfast habits while reducing the intake of fried foods can contribute to achieving sufficient sleep among middle school students. When implementing interventions to improve sleep among middle school students, promoting healthy and balanced diets can be considered as one of the intervention strategies.

Objective: To understand the relationship between stress and Internet addiction among middle school students in Shanghai, so as to provide a scientific basis for promoting students mental health and preventing Internet addiction. Methods: From May to June 2021, a stratified random cluster sampling method was used to select 6 123 middle and high school students in Shanghai for health risk behavior monitoring. Daily Stressors Evaluation Scale for Urban Secondary School Students was used to evaluate students' stress, and the Internet Addiction Test compiled by Young was used to evaluate students Internet addiction. The correlation between student stress and Internet addiction was analyzed by Kruskal-Wallis H test , Chi square test and multiple Logistic regression. Results: Total stress score of middle school students in Shanghai was 24 (12, 39), academic stress score was 8 (5, 13), physical and psychological stress score was 6 (2, 10), interpersonal stress score was 5 (1, 9), and family stress score was 4 (1, 8). The detection rate of Internet addiction was 4.7%. Multivariate Logistic regression analysis showed that the risk of Internet addiction among middle school students with high levels of stress was 8.05 times(95% CI =4.59-14.12) that of students with low levels of stress( P <0.05). The risk of Internet addiction among middle school students with high levels of academic stress, physical and psychological stress, interpersonal stress and family stress was 5.98(95% CI =3.69-9.70), 6.92(95% CI =4.03-11.88), 4.85(95% CI =3.11-7.55), and 4.18(95% CI =2.73-6.40) times that of students with low levels of stress, respectively( P <0.05). Conclusion The academic stress, physical and psychological stress, interpersonal stress, and family stress among middle school students can all lead to an increased risk of Internet addiction.

Objective To investigate the expression of differential genes in testicular tissue of patients with obstructive and non-ob-structive azoospermia by bioinformatics,and provide new markers for the diagnosis of non-obstructive azoospermia(NOA).Methods The microarray data of azoospermia related genes(GSE45885 and GSE9210)were downloaded from the gene expression comprehensive database(GEO)and analyzed online by GEO2R,and the NOA related differentially expressed genes(DEGs)were obtained.The common DEGs were determined by using Wayne's intersection.GO annotation and KEGG enrichment analysis of DEGs were carried out by using R software.The DEGs-related protein interaction network(PPI)was constructed with STRING.Then,the most significant Hub gene of NOA was screened out by Cytoscape software and visualization was performed.The diagnostic value of Hub gene for NOA was estimated by the receiver operating characteristics(ROC)curve and verified in GSE145467 data set.Results A total of 83 DEGs were obtained,of which 78 were down-regulated and 5 were up-regulated.GO enrichment analysis showed that DEGs was involved in biological processes(BP),including the development and differentiation of sperm cells,development of germ cells,assembly of motor cilia,etc.Cell composition(CC)mainly included sperm flagella,motor cilia,acrosome vesicles,spermatogenic nuclei,etc.Molecular function(MF)mainly included structural components,protein binding,heat shock protein binding and so on,which endowed com-pressive strength for extracellular matrix.KEGG-related pathways were involved in longevity regulation pathways,cell cycle and apopto-sis,and meiosis of oocytes in multiple species.The five Hub genes closely related to NOA,including SPAG5,CCNB2,AURKC,NCAPH and PTTG1,were screened by PPI network.The ROC curve showed that all the five Hub genes were potential genetic markers of NOA.Conclusion SPAG5,CCNB2,AURKC,NCAPH and PTTG1 genes may play the key role in the development of NOA and may be used as the new biomarkers for NOA.

Objective To investigate and analyze the cognition , attitude to disease in outpatient with atrial fibrillation ( AF) to provide the basis for clinical nursing .Methods One hundred and sixty outpatient with AF from March 2013 to April 2013 were chosen and were surveyed by the self-made questionnaire about the cognition, attitude to disease in AF patients .The related factors which can affect the cognition , attitude to disease in AF patients including age , gender , occupation , education , economic income monthly , payment of medical expenses , type of AF were analyzed .Results The score of the cognition in AF patients was (14.91 ± 4.92), and was in a bad level .The score of the attitude to disease was (18.59 ±4.16), and was in a good level.The differences were found in the cognition in AF patiens with different age , occupation, education, the type of AF (F=1.00, 2.61, 2.20, 4.21, respectively;P<0.05).The differences were found in the attitude to disease in AF patients with different occupation , education, payment of medical expenses (F=0.28, 0.95, 0.92, respectively;P<0.05).Conclusions The nurses should carry out health education according to the different clinical characteristics in AF patients , and improve the patient compliance , and actively cooperate with medical treatment .

Humans ; Animals ; Mice ; NF-kappa B/metabolism* ; Crohn Disease/drug therapy* ; Dextran Sulfate ; Colitis/metabolism* ; Macrophages/metabolism* ; Adenosine Triphosphate/metabolism* ; Mice, Inbred C57BL ; Disease Models, Animal ; Colon/metabolism*

Objective To culture and identify corneal fibroblasts from human keratoconus patients (HKCs).Methods HKCs and corneal fibroblasts from human healthy controls (HCFs) were cultured by tissue block adherence method.Cellular morphology and ultrastructure were observed by inverted phase contrast microscope and electron microscopy respectively.Cell viability was detected by cell counting kit-8 (CCK-8) assay.α-Smooth muscle actin (αt-SMA),collagen type 1 alpha 1 (COL1A1) and collagen type 3 alpha 1 (COL3A1) protein expression levels were detected by Western blot.This study protocol was approved by Ethic Committee of Xi'an No.1 Hospital (No.1504).Results Compared with HCFs,HKCs showed several distinguishing properties.First of all,its growth speed was faster,with collagen fibers decreased and attenuated.At the same time,mitochondrion swelled and mitochondrial cristae disappeared.Additionally,Golgi apparatus presented significant expansion and endoplasmic reticulum displayed severe swelling.There were statistically significant differences in A values between the two kinds of corneal fibroblasts at different time points after culture (Fgroup =5 023.13,P＜0.01;Ftime =38 518.16,P＜0.01),the A value of HKCs was significantly higher than that of HCFs at the same time point,and the difference was statistically significant (all at P＜0.01).The relative expression of α-SMA,COL3A1 and COL1 A1 was 120.00±5.77,158.33 ±4.41 and 88.33± 1.67,respectively in HKCs,the relative expression of α-SMA,COL3A1 and COL1 A1 was 100.00±0.00,100.00±0.00 and 100.00±0.00,respectively in HCFs,the relative expressions of α-SMA and COL3A1 were significantly increased in HKCs than those in HCFs,the relative expression of COL1 A1 was significantly decreased in HKCs than that in HCFs,with significant differences between them (t =-3.46,P ＜ 0.05;t =-13.23,P ＜ 0.01;t =7.00,P＜0.05).Conclusions HKCs are cultured and identied,which is suitable for establishing in vitro cell model of keratoconus.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.