Objective To investigate the application of reality cross-sectional assessment ( RCA) in the ability evaluation of young nurses .Methods 32 young nurses, who had worked for 3-10 years, were enrolled in the study.Each month, we randomly selected 10 nurses to finish the RCA.The clinical ability, quality ofcare and patients ’ satisfaction were compared before and after the assessment .Results The score of clinical ability was (80.41 ±10.76) before the application of RCA .After applied the RCA for 6 and 12 month, the scores of clinical ability were (90.78 ±5.71) and (89.25 ±6.36), the difference was significant ( F=15.932,P<0.01).After applied the RCA for 6 and 12 month, the scores of quality of care were (88.03 ±6.05) and (88.22 ±5.98), the difference was significant (F=3.179,P<0.05).The patients’ satisfaction improved from 90.38%to 100.00%, which was significant different (χ2 =18.152,P<0.05).Conclusions RCA combine with practical work can reflect the state of real work of nurses and their true level , which promotes the overall quality of care and clinical practice of working ability .

Objective:To construct a Nomogram model for individualized prediction of the risk of acute exacerbation chronic obstructive pulmonary disease (AECOPD) combined with pulmonary embolism (PE) , and verify the predictive ability of the model.Methods:This study is a cross-sectional study. We retrospectively analyzed the clinical data of 292 patients admitted to the hospital for AECOPD from January 2018 to January 2020.The data was divided into training set ( n=203) and validation set ( n=89) according to the order of admission. Single factor and Logistic regression were used to analyze independent risk factors of PE. The Nomogram prediction model was established, and the Bootstrap method was used to internal verification, and the external verification was verified by the validation set. Results:Age ≥70 years, bed time ≥7 days, history of deep vein thrombosis, circumference difference of both lower limbs ≥1 cm, partial pressure of carbon dioxide in artery decreased≥5 mmHg, and D-dimer ≥500 μg/L were independent risk factors for AECOPD combined with PE ( P<0.05) . Based on the above 6 risk factors, a Nomogram model for predicting AECOPD combined with PE was established. Calibration curve verification showed that the predicted values of the training set and the validation set were basically the same as the measured values. The receiver operating characteristic (ROC) curve verification showed that the C-index of the training set and the validation set were 0.879 and 0.774 respectively. Conclusions:The Nomogram model based on the independent risk factors of AECOPD combined with PE has high prediction accuracy.

Objective To evaluate the safety and effectiveness of endoscopic ultrasonography (EUS)-guided ablation with lauromacrogol for pancreatic cystic neoplasms(PCNs). Methods A total of 38 patients with PCNs admitted to Chinese PLA General Hospital from April 2015 to March 2017 were prospectively enrolled to receive EUS-guided ablation with lauromacrogol. Adverse events, such as pancreatitis,fever,bleeding and abdominal pain, were monitored during and after the procedure. Patients were followed up with contrast-enhanced CT or MRI in 3 months,6 months,1 year and 2 year after ablation. Results Thirty-eight patients were enrolled in the study, and 8 of them underwent a second ablation;so, there were 46 treatments. There were 24 females and 14 males with mean age being 53.9±14.7 years. Mild acute pancreatitis occurred in 2 cases and moderate fever occurred in 1 case. The adverse events rate was 6.5%(3/46). Among the 29 patients with complete follow-up of 5 months(2-17 months), the medium tumor volume before operation was 7 564.40 mm3(301.38-87 082.87 mm3)while 542.84 mm3(0-18 202.58 mm3)after the operation(P=0.000). A total of 14 had complete remission(CR)and 8 had partial remission(PR)in 29 patients. The remission effective rate was 48.3%(14/29),40.0%(8/20)in the cysts of the head/uncinate and 66.7%(6/9)in the body/tail(P=0.353). The medium surface area of CR group seemed smaller than that of non-CR group(1 194.27 mm2VS 1 764.09 mm2, P=0.023). Conclusion EUS-guided ablation with lauromacrogol for PCNs is safe and effective. Cysts of smaller surface are more likely to be cured than larger ones.

Objective To investigate the clinical efficacy and safety of endoscopic resection using snares for the treatment of gastric submucosal tumors(SMTs).Methods 66 patients diagnosed with gastric SMTs and treated with endoscopic resection from August 2017 to August 2023 were retrospectively analyzed and divided into the snare group(endoscopic resection using snares,n=33)and the traditional resection group(endoscopic resection using a traditional disposable incision knife,n=33).The operation time,overall resection rate,incidence of adverse reactions,operation cost,hospitalisation cost,and the post-operative hospital days were compared between the two groups.Results The lesion diameter was 8.00(6.00,14.00)mm in the snare group and 8.00(7.50,10.00)mm in the traditional resection group,the difference between the two groups was not statistically significant(P>0.05);The operative time in the snare group was significantly shorter than that in the traditional resection group[26.00(19.00,30.50)min vs 33.00(22.50,49.50)min],the difference was statistically significant(P<0.05);The overall resection rate in both groups was 100.0%;Neither group of patients had intraoperative perforation.There were no statistically significant differences in the incidence of adverse reactions such as intraoperative bleeding,abdominal pain and fever between the two group(P>0.05);The operative cost of the snare group was significantly lower than the traditional endoscopic resection group[(8 642.18±1 078.56)yuan vs(13 266.45±2 160.80)yuan],the difference was statistically significant(P<0.05).Conclusion Compared with traditional surgical instruments,endoscopic resection of gastric SMTs using snares has a shorter operating time,lower surgical costs,safe and effective,making it worthy of promotion.