Objective To construct an objective,comprehensive core competence evaluation index system for nursing postgraduates,and to provide evidence for postgraduates nursing education.Methods According to literature review,expert interviews,focus group discussions,Delphi and other research methods,we conducted two rounds of 32 experts consultation in 18 cities from 10 provinces to establish the final core competence evaluation index system.Results The two experts consultation derived core competence evaluation index system including 7 level-1 indexes,20 level-2 indexes and 53 entries.Level-1 indexes:theoretical knowledge and skills,critical thinking ability,research ability,clinical care ability,teaching skills,interpersonal communication skills,professional development skills.Conclusions This program is rigorous and reliable,with some theoretical and practical significance of its results,which provide a reference for the training program,evaluation of the quality,assessment of postgraduate nursing education.

Objective To explore the influence of different feeding methods on feeding tolerance and nutritional status of preterm infants.Methods Forty-eight cases of preterm infants were randomly divided into experiment group and control group,24 cases in each group.The experiment group adopt 24 hours continuous feeding by infusion pump,and the control group with syringe injection,with injection time of 3~5mins every 2 hours.The two groups were compared in terms of feeding tolerance,body weight and nutritional status.Results The feeding intolerance of experiment group was lower than that in the control group,weight and prealbumin were higher than those in the control group(P<0.05 or P<0.01).Conclusion The continuous feeding is the ideal feeding method,which can improve growth,feeding tolerance and nutritional status of preterm infants.

ObjectiveTo explore the effect of sustained spinal cord compression on spinal cord injury (SCI).MethodsTwenty four dogs underwent sustained spinal cord compression for 30 minutes (group A), 90 minutes (group B) and 180 min (group C) with a device designed by the authors for weight loading spinal compression, and anthor four dogs as the control group (group D) only underwent surgical operation without SCI. Cortex somatosensory evoked potentials (CSEP) were monitored during all the procedure of making model. The changes of pathologic histology, imaging and behavior examination of all animals were observed.ResultsThe lesion degrees gradually increased from group A to group C (P<0.01), and there was similar outcome in MRI imaging. The behavior improvement in group A was more significantly than that in groups B and C (P<0.05).ConclusionSustained spinal cord compression aggravates the extent of SCI process, and the decompression must be taken as soon as possible.

Objectives To evaluate the application of preoperative endoscopic ultrasonography ( EUS) in assessment of invasive risk and selection of therapeutic modalities for gastric stromal tumors ( GST).Methods The clinical data of 135 patients with GST admitted in our hospital from January 2011 to January 2012 were retrospectively analyzed.The invasion extent of GST was assessed by image of EUS before surgery, and compared with pathological results after surgery; the Fletcher 4-tier system was used for predicting the aggressiveness of GST.The selection of therapeutic modalities in 38 patients, who underwent surgical treatment was analyzed.Results No specific clinical manifestations were noticed , but some patients with enormous GST had symptoms of ulcer , hematemesis , and melena.Among 135 patients 97 cases received conservative treatment and followed up;in remaining 38 cases, according to invasion risk assessed by EUS, there were 9 cases in low risk, 18 in intermediate risk and 11 in high risk.The surgical modalities were selected based on the risk assessment:endoscopic therapy was performed in 15 cases, laparoscopic with gastroscopic surgery in 17 cases and laparotomy in 6 cases.The coincidence rate of diagnosis between preoperative EUS and postoperative pathological examination was 79.0%.Conclusions Preoperative endoscopic ultrasonography is of value in assessment of invasion risk and selection of appropriate therapeutic modalities for gastric stromal tumors.

Objective To investigate the current status about the knowledge,attitude and practice of medical staff for fast-track surgery (FTS) in third-grade class-A general hospital in Xuzhou,and provide reference for the popularization of the FTS concept.Methods The self-administered questionnaires were employed to survey 130 medical staff in the general surgical department of one third-grade class-A general hospital in Xuzhou.Results The FTS knowledge score was (20±8).The differences of knowledge scores were statistically significant because of different age,degree of education and positional title.The FTS attitude score was (66±20).And the differences of attitude scores were statistically significant because of different age and degree of education.The FTS practice score was (64.50±13.25).There was no statistical significance on the practice scores between the medical staff with different characteristics.Attitude was correlated with knowledge and practice while knowledge was not correlated with practice.Conclusions The FTS knowledge of medical staff was not rich.The FTS attitude was not so positive,and there were also few clinical practice.Medical staff should study the FTS concept and its contents actively.They also should apply FTS in clinic scientifically in order to better control the iatrogenic injury and promote the rehabilitation of patients effectively.

The education of postgraduate nursing is the highest level in nursing education system.Innovative capability cultivation is the core of postgraduate nursing education,as well as an important measurement index of education quality.How to reform and innovate teaching methods and foster highly specialized clinical talents based on their characteristics has been the focus of attention and exploration.This article aims to explore the methods of innovative talent cultivation of postgraduate nursing from the following several aspects about constructing innovative curriculum system,creating first-class tutor team,promoting scientific research ability,forming innovative postgraduate cultivation pattern and intensifying the scholarly communication.

Objective To investigate the expressions of c-Fos,5-HT and spontaneous activities in single prolonged stress (SPS) stress rats,and to study the possible mechanism of posttraumatic stress disorder(PTSD).Methods forty-eight male SD rats were randomly divided into 6 groups:Individual living + SPS group (IS group),Individual living+control group (IC group),Enriched environment+SPS group (ES group),Enriched environment+control group (EC group),control+SPS group(CS group),control group(C group),8 rats in each group,spontaneous activities were measured before the experiment and post experiment at week 1,2.And the expressions of c-Fos,5-HT in the hippocampus were examined by immunohistochemical staining.Results (1) Spontaneous activity:there were no differences of crossing number and distance among 6 groups before experiment (P＞0.05).On SPS 14 days the crossing number and distance of IS group (12.12±9.64,(2.71 ± 1.99)m) decreased compared with the CS group(45.25±8.37,(6.37± 1.18) m,P＜0.05),and ES group (69.75± 10.05,(10.69± 1.50) m)showed significant increase compared with CS group (P＜0.05).(2)5-HT:the expression of 5-HT in the hippocampus of IS group(0.1125±0.0095) was significantly higher than that in CS group(0.6138±0.0059,P＜0.05),menwhile lower in ES group(0.0495±0.0074,P＜0.05).(3)c-Fos:compared with CS group(0.3108±0.0074),the expression of c-Fos in the hippocampus of IS group(0.3585±0.0150,P＜0.05) significantly increased,but decreased in ES group (0.2613±0.0063,P＜ 0.05).Conclusion Enriched environmental can improve the level of activities in PTSD rats,and to reduce the the expression of c-Fos and 5-HT in the hippocampal neurons.

Objective To give an empirical study on the interests claims of patients in public hospitals. Methods By questionnaire investigation, to sum up data using factor analysis and pairedsamples T test, and to compare difference between different kinds of patients using ANOVA. Results The interests claims of patients can be summed up to six factors and there is no significant difference between different kinds of patients. Conclusion At current stage, public hospitals need improve medical technique and cut down medical expenses.

In recent years, the contradiction between the construction of backward first aid system and the demand for emergency services in rural areas in China is increasingly serious. In order to further improve the quality and efficiency of first aid, the state has vigorously promoted the construction of the " Five Centers" , namely chest pain centers, stroke centers, trauma centers, critical maternal treatment centers, and critically ill children and neonatal treatment centers in rural areas, in an effort to develop an efficient rural emergency service network. The authors collected relevant policy documents and summarized practices of the " Five Centers" construction. On such basis, they referred to experiences of overseas emergency systems and medical rescue centers, and made focused analysis for on the functionality and mechanism of the " Five Centers" in building an innovative first-aid system, in terms of internal and external environment, institutional function positioning, resource integration, and operation mechanism. In view of the integration among " Five Centers" , pre-hospital emergency and in-hospital first aid in rural areas, information construction, personnel first aid capacity building and interest allocation, policy recommendations are proposed.

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.