In order to improve the utilization efficiency of nursing human resources, stable nursing troop and enhance the quality of care, at present, the post management experiences for nurses of domestic and international are adopted by many hospitals and certain results are achieved. Study about nurses stratified management is reviewed, the approach, basis, effects, features and the advantages and disadvantages of hierarchical management experiences for nurses in different countries and regions is summarized and some thinking and prospect in studying is proposed in this article, as well as the follow-up research, to explore a constructive policy of further promoting the development of the level management for nurses.

Objective To investigate the correlation between methylation status and death-associated protein kinase 1 (DAPK1) in SiHa and Hela cell line of cervical carcinoma and intervention of DNA methyltransferase inhibitor 5-azacytidine on the expression of DAPK1 and the proliferation of the cells. Methods DAPK1 methylation status was analyzed using methylation-specific PCR methods. The expression of mRNA and protein of DAPK1 were analyzed by RT-PCR and SABC methods after the treatment with 5-azacytidine. MTT assay was used to observe the changes of proliferation activity of the cells after 5-azacytidine treatment. Results DAPK1 genes were methylated and did not express in SiHa cells in the cervical carcinoma. Its expression could be restored by 5-azacytidine. MTT assay showed 5-azacytidine could weaken the proliferation of cancerous cells. Conclusion DAPK1 methylation plays an important role in the carcinogenesis of cervical cells and can reexpress after the treatment with 5-azacytidine which also restored its inhibitory function on carcinoma.

Objective To investigate the actuality and risk factors of mild cognitive impairment among the elderly in Xi'an. Methods The elderly from 10 urban communities in Xi'an were selected using random cluster sample method. Mini-Mental Status Examination and cognitive function questionnaire self-designed were assessed. Results and Conclusion There were 396 (25.02%) elder people with cognitive impairment in 1583 cases. The morbidity of mild cognitive impairment was inverse to the educational level, and was related to age, gender, job category, marriage and social support (P<0.05).

: The recovery of spinal cord injury(SCI) is a difficult problem in neuroscience research field, one of the reasons is that the ability of injured spinal cord regeneration is limited. Recent years many experiments prove that neurotrophin-3 is very important in SCI regeneration recovery, the gene transplantation is effective. This article makes a summary of SCI treatment research advancement.

Objective To investigate the effects of electrical stimulation on the expression of nerve growth factor (NGF) in adult rats with spinal cord injury. Methods 72 adult SD rats were randomly divided into 3 groups: damage control group, electrical stimulation group and normal group. The spinal cord incomplete injury model on T9 was made with Allen's method. The electrical stimulation group received electrical stimulation for 7 d. They were assessed with the Basso, Beattie & Bresnahan locomotor rating scale (BBB scale), and the expression of NGF were tested with immunohistochemistry and Western blot l d, 3 d, 5 d, 7 d after injury. Results The BBB score improved after spinal cord injury, and electrical stimulation group improved more than control group since the 5th day after injury (P<0.05). The expression of NGF increased in electrical stimulation and injury control group after injury (P<0.05). Conclusion Electrical stimulation after spinal cord injury induces expression of NGF that creates a favorable microenvironment for nerve regeneration.

Objective:To explore the application effect of multidimensional intervention strategies based on sensitive risk indicators in patients with uterine fibroids complicated with climacteric syndrome.Methods:From October 2020 to October 2021, the convenient sampling method was used to select 120 patients with uterine fibroids complicated with climacteric syndrome from Affiliated Hospital of Jining Medical University as the research subjects. They were divided into the observation group and the control group using the random number table method, with 60 cases in each group. The control group received routine care, while the observation group implemented multidimensional intervention strategies based on sensitive risk indicators. The treatment coping style, psychological resilience, quality of life and sleep quality of the two groups were compared.Results:After intervention, the face dimension score of the observation group was higher than that of the control group, and the avoidance and yield dimension scores were lower than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of resilience, strength and optimism of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of interpersonal tension, depression, anxiety and fear of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05). After intervention, the total score of sleep quality and scores of all dimensions of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Multidimensional intervention strategies based on sensitive risk indicators can improve the treatment enthusiasm and psychological resilience of patients with uterine fibroids complicated with climacteric syndrome, reduce their negative emotion and improve their sleep quality.

Objective:To explore the application effect of rehabilitation nursing based on gratitude extension-construction theory in postoperative patients with endometrial cancer.Methods:Using the convenient sampling method, a total of 80 patients with endometrial cancer who were admitted to the Affiliated Hospital of Jining Medical University from January 2019 to December 2021 were selected as the research objects. The patients were divided into the observation group (42 cases) and the control group (38 cases) using the random number table method. The control group received routine nursing interventions, while the observation group received rehabilitation nursing interventions based on gratitude extension-construction theory. Psychological distress, gratitude, fear of cancer recurrence, quality of life and pelvic floor function were compared between the two groups before and after intervention.Results:After intervention, the scores of psychological distress, cancer recurrence and Pelvic Floor Distress Inventory score in the observation group were lower than those in the control group, and the scores of gratitude and quality of life in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Rehabilitation nursing based on gratitude extension-construction theory can increase the gratitude level of patients undergoing endometrial cancer surgery, promote the recovery of pelvic floor function, reduce psychological pain and cancer recurrence concerns and improve their quality of life.

Objective:To explore the role of continuous renal replacement therapy (CRRT) combined with extracorporeal carbon dioxide removal (ECCO 2R) in the treatment of children with respiratory failure. Methods:The clinical data of 12 children with respiratory failure who were treated with CRRT+ECCO 2R in PICU of Jinan Children's Hospital from July 2020 to August 2022 were collected and analyzed retrospectively. The outcomes and the external pipeline usage of the patients were observed, and the blood gas analysis and ventilator parameters before 1 h and after 1, 6, 12 and 24 h of the treatment were compared by one-way ANOVA with LSD post hoc correction. Results:Six patients successfully withdrew from CRRT+ECCO 2R and mechanical ventilation, three patients were transferred to ECMO treatment. Three cases died after voluntary withdrawal of treatment, and two cases died due to treatment failure. The mortality rate was 41.7%. After continuous treatment of CRRT+ECCO 2R for 15 to 112 h, two cases experienced extracorporeal circuit obstruction. After 1 h of treatment, PaCO 2 decreased from (64.67±24.4) mmHg to (49.42±15.54) mmHg, pH increased from (7.28±0.20) to (7.38±0.11), FiO 2 decreased from (0.85±0.13) to (0.78±0.15), PC decreased from (19.42±4.34) cmH 2O to (17.75±4.00) cmH 2O. After 24 h of treatment, PaCO 2 decreased to (39.2±5.55) mmHg, pH increased to (7.41±0.04), FiO 2 decreased to (0.46±0.11), and PC decreased to (13.8±3.36) cmH 2O, and the differences were statistically significant compared with before treatment ( P < 0.05). Conclusions:The combination of CRRT and ECCO 2R therapy can safely substitute for partial lung ventilation/perfusion function, and play a role in protecting right heart function and improving lung-kidney interaction. It can be considered as an option for extracorporeal respiratory, circulatory, and renal support, and consequently has broad prospects.

Objective:This study aimed to observe whether the treatment-free remission (TFR) of second-generation tyrosine kinase inhibitors (TKI) in chronic myeloid leukemia (CML) is better than imatinib (IM) .Methods:The clinical data of 274 CML patients who discontinued treatment and with complete clinical data were retrospectively studied from June 2013 to March 2021. Using both univariate and multivariate Cox proportional hazards regression models, risk factors influencing TFR outcomes after drug withdrawal in CML patients were assessed.Results:A total of 274 patients were enrolled, 140 patients were women (51.1%) , with a median age of 48 (9-84) years at the time of TKI discontinuation. Prior to TKI discontinuation, 172 (62.8%) patients were treated with IM, and 102 (37.2%) had received second-generation TKI treatment, including 73 patients who had shifted from IM to a second-generation TKI and 29 patients who used second-generation TKI as the first-line treatment. The rationale for converting to a second-generation TKI are as follows: 37 patients aimed deep molecular response (DMR) to achieve TFR, seven patients changed due to IM intolerance, and 29 patients changed because of failure to achieve the optimal treatment response. The use of the last type of TKI included 96 patients (94.1%) with nilotinib, three patients (2.9%) with dasatinib, and two patients (2%) with flumatinib, including one patient who changed to IM due to second-generation TKI intolerance. No statistical differences were found in the median age at diagnosis and TKI discontinuation, sex, Sokal score, IFN treatment before TKI, median time of TKI treatment to achieve DMR, and the reasons for TKI discontinuation between the second TKI and IM ( P>0.05) .The median cumulative treatment time of TKI (71.5 months vs 88 months, P<0.001) , the last TKI median treatment time (60 months vs 88 months, P<0.001) , and the median duration of DMR (58 months vs 66 months, P=0.002) were significantly shorter in the second-generation TKI compared with IM. In the median follow-up of 22 (6-118) months after TKI discontinuation, 88 patients (32.1%) had lost their MMR at a median of 6 (1-91) months; of the 53 patients (60.2%) who lost MMR within 6 months, the overall TFR rate was 67.9%, and the cumulative TFR rates at 12 and 24 months were 70.5% and 67.5%, respectively. Withdrawal syndrome occurred in 26 patients (9.5%) . For patients who restarted TKI treatment, 72 patients (83.7%) achieved DMR again at a median treatment of 4 (1 to 18) months. The univariate analysis showed that the TFR rate of patients treated with second-generation TKI was significantly higher than those who were treated with IM (77.5% vs 62.2%, P=0.041) . A further subgroup analysis found that the TFR rate of the second-generation TKI patients was significantly higher than those treated with IM (80.8% vs 62.2%, P=0.026) . No significant difference was found in the second-generation TKI used as the first line treatment compared with those who were treated with IM (69.0% vs 62.2%, P=0.599) . The multivariate analysis results showed that second-generation TKI treatment was an independent prognostic factor affecting TFR in patients who discontinued TKI ( RR=1.827, 95% CI 1.015-3.288, P=0.044) . Conclusion:In the clinical setting, more CML patients rapidly achieved TFR using second-generation TKI than IM treatment.