Objective To observe the clinical effect of Salmeterol xinafoate and fluticasone propionate powder for inhalation in patients with chronic obstructive pulmonary disease.Methods 70 patients diagnosed with chronic obstructive pulmonary disease from March 2014 to March 2015, were randomly divided into two groups ( n =35 ) .Control group were given basic treatment, observation group was given Salmeterol xinafoate and fluticasone propionate powder for inhalation on the basis of control group , patients were followed up and changes of related indicators wererecorded. Results After treatment one month, serum airway remodeling index b-FGF, TIMP-1 values were (93.86 ±17.36 μg/L, 38.06 ±4.28ng/mL) respectively, more than control group(135.03 ±16.06μg/L, 53.95 ±4.15ng/mL)(P<0.05).After treatment one month, inflammatory markers IL-8, TNF-αwere(7.26 ±1.57 pg/mL, 4.29 ±1.02 ng/L)respectively, were more than the control group (14.27 ±1.71 pg/mL, 8.90 ±1.21 ng/L) (P<0.05).After treatment, the observation group, the total effective rate was 91.43%, higher than 77.14%(P <0.05).Conclusion Salmeterol xinafoate and fluticasone propionate powder for inhalation has good effect in treatment of chronic obstructive pulmonary disease , better than the use of basic treatment alone.

Objective:To investigate the relationship between ciaH, eno, pykF genes and fluoride resistance through determining the differential expressions of ciaH, eno and pykF genes of fluoride-resistant Streptococcus mutans cultivated in fluoride environment. Methods:The cultured Streptococcus mutans and their fluoride-resistant strains were divided into UA (Streptococcus mutans subcultured in BHI without NaF), FR (fluoride-resistant Streptococcus mutans subcultured in BHI without NaF) and FFR (fluoride-resistant Streptococcus mutans subcultured in BHI containing 1 g·L-1 NaF) groups.After 11 h (logarithmic phase) and 20 h (platform stage) cultivation, the expression levels of ciaH, eno and pykF mRNA were detected by RT-PCR method.Results:Compared with FR group, the expression levels of ciaH, eno and pykF mRNA in FFR group were increased both in the logarithmic phase and the platform stage(P<0.05 or P<0.01).Compared with UA group, the expression levels of eno and pykF mRNA in FR group were decreased both in the logarithmic phase and the platform stage(P<0.01), whereas the expression level of ciaH mRNA had no significant difference in the logarithmic phase (P>0.05), but it was increased in the platform stage (P<0.01).Conclusion:Fluoride can increase the expression levels of ciaH, eno and pykF genes in fluoride-resistant Streptococcus mutans, indicating that these genes are related to the production of fluoride resistance.

Professionalism is the core quality necessary for outstanding physicians in the new era. As an important content of medical students’ ideological and political education， the medical professionalism with the scientific connotation of “respecting and protecting life， healing the wounded and rescuing the dying， being willing to contribute， and boundless love” radiates new vitality in the new era. The medical professionalism in the new era embodies the unity of science and humanity， regularity and purposefulness， timeliness and development， and theoreticality and practicality. In the ideological and political education of medical students based on the cultivation of professionalism in the new era， only by insisting on the combination of “ideological and political education in the curriculum” and “ideological and political courses”， “supply” and “demand”， “on-campus” and “off-campus”， and “virtual” and “reality”， as well as strengthening internal cohesion and external connection and making targeted efforts， the medical professionalism can better be cultivated， providing spiritual support for training a new force for the construction of a healthy China.

Objective:To investigate the current status of knowledge expectation satisfaction of orthopedic patients during hospitalization, and to analyze the main influencing factors.Methods:From March 2021 to July 2021, a total of 320 orthopedic inpatients from Affiliated Hospital of Qingdao University were selected by convenient sampling method, who were investigated by the general information, Patient Participation Ability Questionnaire, Excepted Knowledge of Hospital Patients and a self-designed questionnaire of actual accepted knowledge on the basis of this scale.Results:The highest level of knowledge expectation satisfaction in the functional dimension (-0.40 ± 0.32), and the lowest level in the economic dimension (-1.27 ± 0.38) ( t=22.45, 59.64, both P<0.01). Knowledge expectation difference was positively correlated with information acquisition ability ( r=0.802, P<0.01) and emotion management ability( r=0.671, P<0.01). Multiple linear regression analysis showed that education level, hospitalization experience, information acquisition ability and ability to manage emotions were the main influencing factors for this difference ( t values were -6.40-13.17, all P<0.05). Conclusions:The level of knowledge expectation satisfaction of orthopedic patients′ needs to be further improved. According to the level of education, hospitalization experience, information acquisition ability and emotion management ability of patients, nurses should formulate measures to improve the level of knowledge expectation satisfaction.

Objective To explore the correlation between self-management behavior and activation among elderly patients with chronic heart failure,so as to provide a basis for improving patients' self-management skills.Methods From 1st May 2016 to 30th September 2017,we selected 230 elderly patients with chronic heart failure at the Second Affiliated Hospital of Harbin Medical University by convenience sampling.The Self-Management Scale of Heart Failure Patients and Patient Activation Measure (PAM) were used to investigate the scores of self-management behavior and activation among chronic heart failure patients.Pearson correlation analysis was used to analyze the correlation between them.Results A total of 245 questionnaires were sent out with 230 valid questionnaires and 93.8% for the effective recovery rate.The total scores of self-management behavior and activation were (72.3±12.4) and (56.3±10.3) among chronic heart failure patients.The influencing factors of self-management behavior of chronic heart failure patients included cardiac functional grading,course of disease and patient activation (P＜ 0.05).The total self-management behavior and its four dimensions had positive correlations with patient activation (P＜0.05).Conclusions Elderly patients with chronic heart failure are with a poor level of self-management behavior and patient activation needs to be improved.Medical staff should formulate individual intervention based on patient activation,so as to improve patients' self-management skills.

Objective:To understand the current status of follow-up care needs of patients undergoing total knee arthroplasty after discharge, and analyze the influencing factors of follow-up care needs.Methods:A total of 270 patients who underwent total knee arthroplasty in the Department of Joint Surgery of a ClassⅢ Grade A hospital in Qingdao from April to August 2019 were selected by convenience sampling method. All the patients were investigated for nursing demands by a self-designed follow-up nursing demand questionnaire, Hospital for Special Surgery Scale (HSS) and General Self-Efficacy Scale (GSES) . The influencing factors were analyzed by multiple linear regression.Results:Finally, 268 valid questionnaires were collected. The score for follow-up nursing needs of 268 patients undergoing total knee arthroplasty was (56.18±8.35) , and the dimension with the highest score was functional exercise requirement, with a score of (3.85±0.75) . The most desirable form of follow-up care was network follow-up (52.6%, 141/268) . Multiple linear regression analysis showed that education, living conditions, rehabilitation knowledge, knee function and self-efficacy were the independent influencing factors of follow-up nursing needs of patients with total knee arthroplasty ( P<0.05) . Conclusions:Patients with total knee arthroplasty have a strong demand for follow-up care after discharge. It is recommended that medical staff shall carry out various and personalized follow-up care for knee arthroplasty patients through the application of Internet technology.

Objective:To translate and revise the Expected Knowledge of Hospital Patients Scale (EKhp) , and evaluate its reliability and validity in orthopedic patients.Methods:The Brislin translation method was used to translate, back translate and cross-culturally adapt to form the Chinese version of the EKhp. From May to August 2020, convenience sampling was used to select 744 orthopedic patients hospitalized in a Class Ⅲ Grade A in Qingdao, and the Chinese version of the Ekhp was used for investigation. The reliability and validity were evaluated through exploratory factor analysis, confirmatory factor analysis, internal consistency test and other methods.Results:The Chinese version of the EKhp had 40 items, and a total of 6 common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 62.584%. The confirmatory factor analysis results showed that the model fitted well. The Cronbach's α coefficient of the scale was 0.960, and the Guttman's half-reliability coefficient was 0.912. The Cronbach's α coefficient of each dimension was from 0.847 to 0.927, and the Guttman's half-reliability coefficient was from 0.732 to 0.923. The item-level content validity index of the scale ranged from 0.875 to 1.000, and the average scale-level content validity index of was 0.938.Conclusions:The Chinese version of the EKhp has good reliability and validity through preliminary tests in domestic orthopedic patients, which can effectively assess the knowledge needs of orthopedic inpatients in our country.

The diagnosis of chronic pain requires a true and reliable pain assessment, which relies on timely self-reporting. Ecological momentary assessment (EMA) is a method of repeated dynamic sampling through patient self-report to minimize recall bias. This review introduces and analyzes the concept and application of EMA, and expounds the feasibility and limitations of EMA in chronic pain management, aiming to provide reference for medical and nursing staff to evaluate chronic pain management efficiently.

Objective To explore the trajectory and influencing factors of joint awareness after total knee arthroplasty.Methods With the method for convenience sampling,patients who met the standards for total knee arthroplasty from July 2021 to March 2022 were selected.General information,severity of osteoarthritis,anxiety and depression,and self-efficacy were investigated before surgery(T0).Joint awareness was investigated at 1 month(T1),3 months(T2),and 6 months(T3)after surgery,respectively.Latent growth curve model was used to describe the overall trend of joint awareness;latent class growth model was used to analyze latent subgroups;logistic regression analysis was used to determine the impact of related variables on the trajectory of joint awareness.Results The scores of joint awareness were(32.70±5.80),(47.67±4.67)and(61.53±7.81)respectively at T1 to T3,and joint awareness showed an increasing trend(P＜0.001).The trajectory of joint awareness was divided into 2 potential subgroups:the rapid growth group(61.83％)and the slow growth group(38.17％).Age,BMI,other chronic diseases or not,years of osteoarthritis,severity of osteoarthritis,anxiety,depression,and self-efficacy affected the trend of joint awareness(all P＜0.05).Conclusion Joint awareness showed a linear growth trend with the postoperative time,and there were 2 potential subgroups in the trajectory.Medical workers could develop corresponding interventions based on the influencing factors to improve patients'postoperative awareness of artificial joints.

Objective To construct a high-quality practical teaching system of rehabilitation majors for undergraduate based on World Health Organization rehabilitation competence framework(RCF). Methods Using the principles and methods of RCF,the competency requirements for rehabilitation therapy were ana-lyzed and a practical teaching system suitable for undergraduate education in rehabilitation therapy was construct-ed. Results The rehabilitation practice education were constructed as practice courses,clinical practice and social service practice,and the practice education modules and objectives were discussed based on RCF. Conclusion A competency-oriented rehabilitation practice education system has been constructed based on RCF,includ-ing practice courses,clinical practice and social service practice.