Objective To investigate the correlation between professional commitment and academic self-efficiency of nursing undergraduates.Method A total of 258 students were investigated by nursing professional commitment questionnaire and academic self-efficiency scale.Results The score of professional commitment was (89.05±14.92) and the academic self-efficiency was scored (73.78±10.38).The professional commitment was positively correlated with academic self-efficiency (P＜0.01).Conclusions There are close relationships between professional commitment and academic self-efficiency for nursing undergraduates.The nursing educator should take effective measures to improve nursing students' professional commitment and academic self-efficiency.

Objective To explore the effect of unsupported arm exercise (UAE) on dyspnea, exercise endurance of upper limbs and qual-ity of life in patients with chronic obstructive pulmonary disease (COPD). Methods From May to October, 2014, totally 70 patients with COPD were recruited and were randomly assigned to control group and intervention group. Both groups received routine care, and the inter-vention group performed UAE for six weeks additionally. The COPD Assessment Test (CAT), baseline dyspnoea index (BDI) and six-min-ute Pegbord and Ring Test (6PBRT) were recorded. Results The scores of CAT and BDI, and the number of turns in six minutes were better in the intervention group than in the control group (P<0.05). Conclusion UAE can increase the exercise endurance of upper limbs, relieve the dyspnea, and improve the quality of life in patients with COPD.

Breast cancer is the most common cancer among females. During the time of treatment and rehabilitation, the patients and their relatives need to help them to prevent, control or relieve all sorts of complications and adverse events that beyond their medical, surgi-cal or radiation interventions, called Supportive Care Need. There are many tools to evaluate these needs, such as Supportive Care Need Sur-vey, Cancer Patients Needs Questionnaire, etc., and mainly involved the needs of health system, information, patient support, psychology, physical and daily living, and sexuality, varied with the factors of social demography, disease and treatment, and psychology;and the inter-ventions contain cognitive behavior and psychology.

Objective To do a longitudinal study of nursing undergraduates′ humanistic care ability in different period of clinical practice, and analyze its trend, aiming to provide reference about how to intervene to enhance the nursing undergraduates' humanistic care ability. Methods A total of 67 nursing undergraduates were investigated about their humanistic care ability with the Care Ability Inventory (Caring Ability Inventory, CAI) at the beginning, middle and end of the internship. Results The scores of seniors′ humanistic care ability at the beginning, middle and end of the internship were 194.97±22.93, 192.18±26.87, 187.24±22.15, and there was a statistically significant difference among the three time points (F=3.234, P<0.05), there was significant difference of the dimension of courage in different periods (F=7.511, P<0.01). Conclusions There is a downtrend of nursing undergraduates′humanistic care ability in different stages of clinical practice, and we suggest that nursing educators and administrators should consider the characteristics of different periods in the clinical practice, and then do a targeted training to foster nursing students′humanistic care ability.

Objective To evaluate the effect of the collaboration care model on posttraumatic growth and resilience in patients with breast cancer.Methods 70 patients who were diagnosed with breast cancer in department of Breast Surgery of the First Affiliated Hospital of Dalian Medical University were assigned into two groups by random number table.32 patients who completed the research in the experimental group received collaboration care while 31 patients who completed the research in the control group received routine care both for there months.The patients were investigated with the Posttraumatic Growth Inventory (PTGI) and Connor-Davidson Resilience Scale (CD-RISC) before and after intervention.Results After the intervention,there were significant differences in scores of posttraumatic growth [(63.83±11.87) scores vs.(60.33±10.09) scores,t=2.384] and resilience [(66.52±15.23) scores vs.(61.33±10.09) scores,t=2.472] between the two groups (P＜0.05).And also there were significant differences of posttraumatic growth scores before and after intervention in the experimental group [(56.24±10.01) scores vs.(63.83±11.87) scores,t=-3.988,P＜ 0.01] and the control group [(56.68±10.32) scores vs.(60.33±10.09) scores,t=-2.426,P＜0.05].Differences of resilience also existed in the experimental group [(61.28±14.40) scores vs.(66.52±15.25) scores,t=-3.225,P＜0.01] and the control group [(63.97±17.66) scores vs.(61.33±10.09) scores,t=-2.370,P＜0.05].Conclusions Collaboration care model can significantly improve the level of patients' posttraumatic growth and resilience.

Objective To observe the level of supportive care need and quality of life in patients postoperation for breast cancer and ac-cepting chemotherapy, and the relationship between them. Methods From September, 2015 to June, 2016, 235 patients with breast cancer af-ter surgery were conveniently sampled, and investigated with the general situation questionnaire, Supportive Care Need Survey Short-form (SCNS-SF34) and Functional Assessment of Cancer Therapy-Breast (FACT-B). Results A total of 230 patients were analyzed. Patients self-reported to need supportive care in all dimensions of SCNS-SF34, and the most frequency was in the health information (31.30％). The score of FACT-B was (93.25±23.53), that needed further improvement. The needs of supportive care in each dimension negatively correlat-ed with the scores of FACT-B in the dimensions (|r|>0.168, P<0.05) except society/family and function. Conclusion The patients with breast cancer need variety of supportive care, which may impact their quality of life.

Objective:To investigate the effect of external dissection and internal ligation (MMH) in the treatment of grade Ⅲ to Ⅳ mixed hemorrhoids with anorectal resting hypertension and its prognostic risk factors.Methods:The clinical data of 48 patients with grade Ⅲ-Ⅳ mixed hemorrhoids complicated with rectal and anal resting hypertension treated by MMH in Nanjing Jiangbei people′s Hospital Affiliated to Nantong University from February 2018 to February 2020 were analyzed retrospectively (observation group), including 24 males and 24 females; The age ranged from 22 to 55 (41.87±7.52) years. Another 48 patients with grade Ⅲ-Ⅳ mixed hemorrhoids complicated with anorectal resting hypertension treated by PPH were selected as the control group, including 20 males and 28 females; The average age was (42.68±7.14) years. The clinical effective rates , pain score at 6, 24 and 72 h after operation, postoperative complications were compared between the two groups. Multiple logistic regression was used to analyze the related risk factors affecting the prognosis.Results:There was no significant difference in VAS score between the two groups at 6 h after operation ( t=0.25, P=0.807); the VAS score of the observation group at 24 h and 72 h after operation was lower than that of the control group ( t=7.044, P<0.001; t=5.307, P<0.001); the total effective rate of the observation group was higher than that of the control group (93.75% vs 77.08%, χ2=5.35, P=0.021); the total incidence of postoperative anal edema, defecation difficulty, bloody stool, anal pain and fecal incontinence in the observation group was lower than that in the control group, the difference was statistically significant (12.50% vs 33.33%, χ2=5.879, P=0.015). Age, course of disease, grading of internal hemorrhoids and treatment methods were related to the prognosis of patients ( P<0.05); logistic regression analysis showed that age (> 45 years), course of disease (>10 years), grade of internal hemorrhoids (grade Ⅳ) and treatment (PPH) were independent risk factors for prognosis of patients ( P<0.05). Conclusions:MMH has less complications, less postoperative pain and satisfactory curative effect in the treatment of Ⅲ to Ⅳ mixed hemorrhoids and anorectal resting hypertension. The older the patients, the longer the course of disease, the higher the degree of internal hemorrhoids and the choice of treatment methods were the risk factors for the prognosis. Early diagnosis and reasonable treatment are helpful to improve the prognosis of patients.

Objective: To investigate the current status and influencing factors of basis of the replacement of short peripheral intravenous catheters for clinical nurses and explore the obstruction of the latest guide promoted in practice. Methods: The qualitative research method was adopted, and semistructured interviews were used to interview 11 clinical nurses. Data were analyzed by the method of category analysis. Results: Although the clinical nurses mainly used the national standards to do practical operation, they preferred to carry out catheter replacement according to clinical indications. The difference between the latest guide and the national standards was the main obstruction in the practical promotion of the latest guide. Conclusions The removal of short peripheral intravenous catheters according to clinical indications is more suitable for clinical practice. Further improving the standards of intravenous therapy in China has become a fundamental measure to solve the contradictions of work of clinical nurses, improve patients′ medical experience and save medical resources.

Objective: To explore the application effect of mixed reality technology in the teaching of hepatobiliary surgery. Methods: A total of 120 professional postgraduates majored in surgery who had received the four-month standardized training of residents in hepatobiliary surgery department of the First Affiliated Hospital of Army Military Medical University and the First Affiliated Hospital of Chongqing Medical University during 2016-2018 were selected and were equally allocated into the control group and the research group via random number table method. Students in the control group were trained with traditional surgical teaching mode and in the research group were trained with three-dimensional visualization model which was constructed by mixed reality. Students in both groups received assessment and questionnaires at the end of training. Results: Scores of theoretical examination and surgical operation assessment of students in the research group were higher than those in the control group (P<0.05). The error rate for separating gallbladder artery and bile duct in the laparoscopic simulated system of students in the research group was significantly lower than that in the control group (P<0.05). Students-teacher satisfaction degree in the research group was higher than that in the control group (P<0.05). Conclusion Using mixed reality technology to construct a three-dimensional visualization model and to implement hepatobiliary surgery teaching enables the trainees to better master anatomical key points in the hepatobiliary system and the hepatobiliary surgical approach, with good feedback.

BACKGROUND: Current practice uses the latest measure of glycated hemoglobin (HbAlc) to facilitate clinical decision-making. Studies have demonstrated that HbAlc variability links the risk of death and complications of diabetes. However, the role of HbAlc variability is unclear in clinical practice. This systematic review summarized the evidence of visit-to-visit HbAlc variability regarding different metrics in micro- and macro-vascular complications and death in people with type 2 diabetes. METHODS: We searched PubMed, EMBASE (via OVID), and Cochrane Central Register (CENTRAL, via OVID) for studies investigating the association between HbAlc variability and adverse outcomes in patients with type 2 diabetes and performed random-effects meta-analysis stratified by HbAlc variability metrics in terms of standard deviation (SD), coefficient of variation (CV), and HbAlc variability score (HVS). RESULTS: In people with type 2 diabetes, the highest quantile of all three HbAlc variability metrics (HbAlc-standard deviation [HbAlc-SD], HbAlc-coefficient of variance [HbAlc-CV], and HVS) is associated with increased risks of all-cause mortality, cardiovascular events, progression to chronic kidney disease, amputation, and peripheral neuropathy. For example, the hazard ratio of HbAlc-SD on all-cause mortality was l.89 with 95% confidence interval (95% CI) l.46-2.45 (HbAlc-CV l.47, 95% CI l.26-l.72; HVS l.67, 95% CI l.34-2.09). CONCLUSIONS High HbAlc variability leads to micro- and macro-vascular complications of type 2 diabetes and related death. People with type 2 diabetes and high HbAlc variability need additional attention and care for the potential adverse outcomes.
Humans ; Adult ; Diabetes Mellitus, Type 2/complications* ; Glycated Hemoglobin ; Cardiovascular Diseases/etiology* ; Risk Factors ; Blood Glucose