Objective:To evaluate the changes of the left atrial systolic function in patients with acute myocardial infarction(AMI)using quantitative tissue velocity imaging(QTVI).Methods:The systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum were measured with QTV1 in 45 patients with AMI.The left atrial volume and active atrial emptying fraction(AA-EF)were measured using single-plane Simpson method.Results:(1)Compared with the control group(30 normal subjects),the diameter and volume of the left atrium,as well as AA-EF,increased obviously in patients with AMI(P ＜ 0.01).(2)Compared with the control group,the systolic velocities of the middle of left atrial lateral wall,anterior wall,inferior wall and atrial septum,as well as the average value,increased significantly in patients with AMI (P ＜ 0.05 or P ＜ 0.01).In addition,the average value of left atrial systolic velocity was closely correlated with AA-EF(r=-0.906,tr=14.001,P ＜ 0.01).Conclusion:QTVI could be used to evaluate the left atrial systolic function accurately in patients with AMI.

Objective The Nuss procedure is a minimally invasive pectus repair.The aim of this study was to explore the changes in quality of life in patients who underwent a Nuss procedure.Methods 96 patients,who underwent a Nuss procedure in our institution,were interviewed at preoperation,1 year after operation with the bar in place,and before the planned bar removal.The Nuss Questionnaire modified by George Krasopoulos et al,which evaluates psychosocial and physical well-being,was independently used by patients.Results Most of the scoring of the individual questions and the total score of individual patients revealed a significant improvement,both in preoperation vs.1 year after operation and 1 year after operation vs.before the planned bar removal.Conclusion The Nuss procedure has been shown to improve the quality of life in patients with pectus excavatum deformity in the short term.

Objective:To investigate the clinical effect of cluster nursing on the prevention of perioperative urinary catheter associated urinary tract infection (CAUTI) in patients with spinal fracture.Methods:A retrospective case-control method was used to select 160 patients with spinal fracture admitted to the department of spinal cord injury in emergency care from January 2018 to March 2020 in the Department of Orthopaedics General Hospital of Chinese People′s Liberation Army as study subjects, 80 patients admitted to the department of spinal cord injury from January to December 2018 were set as the control group, and 80 patients admitted from January 2019 to March 2020 as the observation group. The control group was given standardized clinical nursing measures during the perioperative period, while the observation group was given cluster nursing measures. The duration of indwelling of catheters, the incidence of catheter reinsertion and the incidence of CAUTI were compared between the two groups.Results:The catheter indwelling time in the observation group was (3.37±0.64) days, lower than that in the control group (6.35±1.52) days. The incidence of catheter insertion and CAUTI was 5.00%(4/80), 3.80%(3/80) in the observation group, lower than 11.30%(9/80), 11.60%(13/80) in the control group. The differences were statistically significant ( χ2 values were -2.927, -2.654, all P<0.05). Conclusions:Cluster nursing intervention for patients with spinal fracture in the perioperative period can effectively shorten the catheter indwelling time, reduce the incidence of catheter re-insertion and the incidence of patients with CAUTI, significantly improve the quality of clinical care in the department, and have positive significance for the treatment and rehabilitation of patients.

Objective To innovate the new training model of excellent nurse talents pool, so as to improve the quality of nursing professional team. Methods We established excellent nursing talents pool and set up 3 subsidiary pool including core specific personnel pool and nursing management backup talent pool and specialist pool. For different pool, we confirmed the targets of training, strictly selected the members, regulated selection procedure, made training plan, and scientifically checked and evaluated. The selected sample and managers were provided investigation about the attitudes of awareness and training demands by questionnaire. Results The nursing staffs presented a positive attitude for the establishment of nurse specialists pool, and the selected people hoped to be utilized multiple channel, multiple forms, and enhanced, supplied, improved the construction of knowledge, advanced nursing management, professional skills, teaching research, nursing development ability, and hoped the check and evaluation carried in clinical practice. To establish nursing specialist pool promoted connotation construction, and formed systematically the training model, and protruded the training target of practical nursing talents. Conclusions To establish excellent nursing talent pool cultivates the selected objects fully promoted all kinds of talents, innovates personnel training model; and provides the system guarantee for the correct selection and appointment of nursing talents.

Objective:To explore the current status and training needs of clinical nursing teachers in Class Ⅲ Grade A hospitals in China, and provide a reference for further construction of clinical nursing teachers.Methods:From October 2017 to February 2019, by purposive sampling with a ratio of 1︰10, the clinical nursing teachers from 141 ClassⅢ Grade A hospitals in 30 provinces, autonomous regions and municipalities in China received a cross-sectional study with the Basic Information Questionnaire of Clinical Nursing Teachers in China's Class Ⅲ Grade A hospitals. A total of 11 594 questionnaires were collected, and 10 266 were valid questionnaires, with an effective rate of 88.55%.Results:Among the 10 266 clinical nursing teachers, 49.64% (5 096/10 266) were senior nurses; 51.27% (5 263/10 266) were between 30 and 39 years old; 78.42% (8 051/10 266) were those with a bachelor degree or below; 41.33% (4 243/10 266) had taught for less than 5 years; 41.84% (4 295/10 266) were selected and designated by managers; 38.78% (3 981/10 266) often or always felt the pressure of teaching; 56.31% (5 781/10 266) thought that they were competent for clinical teaching; 50.54% (5 188/10 266) occasionally participated in teaching training, and had a strong demand for training. The top three demands were teaching methods and skills, frontier knowledge of specialties, and nursing research. Clinical teachers with different teaching years, academic qualifications and professional titles are in basic theories of education, teaching methods and skills, nursing management, and nursing research. There was statistically significant difference in the training needs for the frontier knowledge of specialist subjects between clinical nursing teachers with different teaching years, educational background and job titles ( P<0.05) . Conclusions:The clinical nursing teachers in China's ClassⅢ Grade A hospitals are mainly senior nurses, and the overall initial academic qualifications are low. There are problems in the selection of clinical nursing teachers in teaching management, and the lack of teachers' participation in teaching training. It is recommended that the relevant departments establish a competency-oriented and demand-oriented selection and management system for clinical nursing teachers, thereby promoting the construction of the teaching staff.

Objective:To explore the association of peripheral blood neutrophil lymphocyte ratio(NLR) with primary osteoporosis (POP) in Chinese elderly women.Methods:From December 2015 to April 2019, a total of 788 elderly women in Chongqing Three Gorges Central Hospital were included in this study.They were divided into three groups according to bone mineral density: 242 cases of osteopenia, 206 cases of normal bone mineral density and 340 cases of osteoporosis.Their height, weight, statuses of bone of left femoral neck and results of blood tests were recorded, and the values of BMI, NLR and OSTA were calculated.The SPSS statistics software was used to analyze the differences of parameters among the three groups.Logistic regression analysis was used to get significant independent related factors for osteoporosis.The relationship of NLR and OSTA with T-score of left femoral neck was confirmed by Pearson correlation test.ROC curves were used to define the values of NLR and OSTA in diagnosis of osteoporosis.Results:There were statistically significant differences in age(median values: 66, 68 and 70, χ 2=71.596, P<0.001), BMI(median values: 23.46, 24.04 and 25.415, χ 2=64.936, P<0.001) and NLR(median values: 1.97, 2.435 and 2.84, χ 2=106.218, P<0.001) among the three groups(all P<0.01). Logistic regression analysis demonstrated that age, BMI and NLR were all independent significant related factors.There was correlation of NLR, OSTA with T-score of left femoral neck.In diagnosis of osteoporosis, the cut-off value, maximum Youden index, sensitivity and specificity were 2.395, 0.299, 70.3%, 59.6% for NLR, and -1.315, 0.174, 73.6%, 43.5% for OSTA. Conclusion:NLR has intermediate sensitivity and specificity in screening POP in Chinese elderly women, and deserves future researches.

Objective:To explore the relationship of serum exosomal miRNA-21 expression and clinical pathological parameters and prognosis in gastric cancer (GC) patients.Methods:Exosomes from serum samples of 52 GC patients and 10 healthy controls were extracted using the ExoQuick Exosome Precipitation Solution, and were further validated by immunoblotting for exosome markers and characterization of nanoparticle using NanoSight. The expression levels of exosomal miRNA-21 in exosomes was detected by RT-qPCR, and its relationship with clinicopathological features and prognosis was further analyzed.Results:The expression level of miRNA-21 in serum exosomes of patients with GC was significantly higher than that of normal subjects (2.59±0.12 vs. 1.16±0.10, t=5.168, P<0.05), and its high expression was significantly related to tumor grade, depth of invasion, lymph node metastasis, distant metastasis, vascular invasion, nerve invasion and TNM stage (all P<0.05). Patients in exosomal miRNA-21 high expression group had lower overall survival than that of exosomal miRNA-21 low expression group (χ 2=14.573, P<0.05). Multivariate analysis using the COX regression test identified that higher serum exosomal miRNA-21 was an independent predictor of mortality for GC patients ( HR=2.863, 95% CI: 1.063-7.712, P=0.038). Conclusion:The expression of miRNA-21 in serum exosomes of GC patients is up-regulated, and its high expression is associated with multiple unfavorable clinicopathological factors and poor prognosis of patients.

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

Objective:To analyze the clinical characteristics of Group A Streptococcal(GAS) toxic shock syndrome (STSS) in children. Methods:The clinical data of 10 STSS children hospitalized in Shenzhen Children′s Hospital from January 2015 to March 2022 were downloaded from the electronic medical record system.The clinical manifestations were analyzed and treatment experience was summarized respectively.Results:There were 5 males and 5 females, with an average age of (5.29±2.87) years.All the patients were healthy in the past.The diagnoses were confirmed by blood culture in 2 cases, pus culture in 5 cases, and blood metagenomics next generation sequencing in 3 cases.The rapid detection of GAS antigen was positive in 7 cases.All cases had fever, and 9 cases of them developed fever after viral infection, including pneumonia in 7 cases, skin and soft tissue infections in 6 cases, necrotizing fasciitis in 3 cases, and purulent meningitis in 1 case.All cases also presented with shock.Six cases had liver function injury, and 4 cases suffered from acute kindey injury.Four cases had infection-related encephalopathy, and 7 cases were afflicted with disseminated intravascular coagulation.Two cases had respiratory failure, and 2 cases had rhabdomyolysis.There were 3 cases with a decreased white blood cell (WBC) count and 7 cases with an increased WBC count on admission.Seven cases were found to have thrombocytopenia, but their platelet levels were all elevated after recovery.C-reactive protein and procalcitonin and the proportion of neutrophils were markedly increased in all cases.All cases suffered from hypoalbuminemia, hyponatremia and hypocalcemia.All the 10 positive strains were sensitive to Penicillin, Ceftriaxone/Cefotaxime and Vancomycin.Eight cases were treated with combined antibiotics after admission.Eight patients received intravenous immunoglobulin.All cases were cured and discharged.Conclusions:The STSS progresses rapidly in children, so pediatricians should pay great attention to the disease.Early identification, diagnosis of infection sources, infusion of antibiotics and surgical treatment are the keys to disease management.

Objective To explore the efficiency of training of professional nurses.Methods A total of 31 nurses were enrolled in a 12-week training of a comprehensive and systematic teaching practice containing theory teaching,skills training and clinical practice 3 domains between September and November in 2014.Nurses′nursing theory on specialized nursing,specialized nursing skills before and after the training were compared.Results After training,the accumulated score and item score of trainees on 50 knowledge points of burn specialized nursing theory, such as burn ward management system,monitoring skills on critically ill patients,perioperative skills,medication knowledge on specific treatment,explanation of common inspection and examination results increased compared to those before the training(P <0.05).Total and each item score of 3 skills operation assessment (body position change using turn-over bed,suspension bed application,cardiopulmonary resuscitation)of trainees after training were higher than those before training(P <0.05).Total score of self-growth evaluation and each item of 4 programs (nursing theory,basic nursing skills,intensive care level,nursing competence)of the trainees were higher than those before training(P <0.05).Conclusions Systematic and comprehensive theory teaching and clinical practice training can increase the nurses′level of professional theory and skills.Scientific and practical training content combined with training form close to clinic can effectively raise their comprehensive ability in nursing practice.