Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

Objective:To explore the application of 'hospital WeChat' platform combined with feedback method in improving the quality of life of patients with prostate cancer after operation, to provide suggestions for health education of patients with prostate cancer after operation.Methods:A randomized controlled trial was conducted. A total of 80 male patients who underwent radical prostatectomy in the Third People's Hospital of Yancheng City from June 2022 to July 2023 were selected by convenient sampling method. They were divided into control group and experimental group by random number method, with 40 cases in each group. The control group used routine nursing health education, the experimental group used the 'hospital WeChat' platform combined with feedback method for health education. The severity of urinary incontinence, quality of life, and satisfaction with health education after discharge were compared between the two groups.Results:Forty patients in each group completed the study. The age of the control group was (73.40 ± 4.02) years old, and the age of the experimental group was (73.25 ± 4.02) years old. The urinary incontinence scores of the experimental group at 1 week, 1 month and 3 months after discharge were (14.00 ± 1.41), (11.90 ± 1.34) and (5.13 ± 3.45) points, respectively, which were significantly different from those of the control group (16.10 ± 2.04), (15.00 ± 1.20) and (10.90 ± 3.70) points, the differences were statistically significant ( t=-5.36, -10.93, -7.23, all P<0.05). The total scores of quality of life in the experimental group at 1 and 3 months after discharge were (77.51 ± 6.11) and (79.53 ± 5.42) points, which were significantly higher than (67.70 ± 6.62) and (69.05 ± 6.92) points in the control group, the differences were statistically significant ( t=6.89, 7.62, both P<0.05). The satisfaction scores of health education mode, attitude and evaluation items in the experimental group after discharge were (5.03 ± 0.70), (4.95 ± 0.81) and (5.33 ± 0.86) points, respectively, which were higher than those in the control group (3.93 ± 1.00), (3.65 ± 1.10) and (3.80 ± 0.72) points, the differences were statistically significant ( t=5.72, 6.01, 8.59, all P<0.05). Conclusions:The 'hospital WeChat' platform combined with feedback method can effectively improve the urinary incontinence of patients after prostate cancer surgery, and improve the quality of life and satisfaction of health education for patients. This study is hopeful to provide specific measures for health education for clinical prostate cancer patients.

ObjectiveTo explore the possible mechanism of Tongdu Xingshen needling method （通督醒神针刺法） on post-stroke cognitive impairment. MethodsSD rats were randomly divided into a normal group （n=12）， a sham surgery group （n=12）， a model group （n=12）， and a electroacupuncture group （n=13）. The rats in the model group and electroacupuncture group were subjected to the wire bolus method to establish the rats model with learning memory impairment after cerebral ischaemia-reperfusion. After successful modelling， the rats in the electroacupuncture group were given electroacupuncture interventions at “Shenting （GV 24）” and “Baihui （GV 20）” once a day for 30 minutes for 14 days. The other three groups did not receive other interventions but grasp. A 5-day localisation navigation experiment was conducted on the 9th day of intervention， and a spatial exploration experiment was conducted on the 14th day of intervention to evaluate the learning and memory abilities of the rats. After the spatial exploration experiment， hippocampal tissues were taken from each group of rats， and the changes in the volume of cerebral infarction were observed by TTC staining； the changes in the morphology of pyramidal neurons and the density of dendritic spines in the CA1 area of the hippocampus were observed by Golgi staining； protein immunoblotting was used to detect the relative protein expression of the subunits of the α-amino-3-carboxy-5-methylisoxazole-4-propionic acid （AMPA） receptor including glutamate receptor 1 （GluR1）， glutamate receptor 2 （GluR2）， glutamate receptor 3 （GluR3） and auxiliary proteins TARPγ2， TARPγ8 in hippocampal tissues of rats in each group； the real-time fluorescence quantitative PCR was used to detect GluR1， GluR2， GluR3 mRNA levels in the hippocampal tissues of rats. ResultsIn the localisation navigation experiment， compared with the normal group and sham surgery group， the escape latency and total distance of rats in the model group were significantly extended （P＜0.05） at day 1， 2， 3， 4， and 5； and the escape latency and total distance of rats in the electroacupuncture group tended to be significantly shorter than those in the model group （P＜0.05）. In the spatial exploration experiment， compared with the normal group and the sham surgery group， the number of rats crossing the platform in the model group was significantly reduced （P＜0.05）， and the number of crossings of the platform in the electroacupuncture group increased significantly （P＜0.05）. The results of TTC staining showed that the volume of cerebral infarction increased clearly in the model group compared with the sham surgery group （P＜0.05）， and apparently decreased in the electroacupuncture group compared with the model group （P＜0.05）. Golgi staining showed that the number of dendritic branches of pyramidal neurons and dendritic spines in hippocampal CA1 region significantly decreased in the model group compared with the normal group and the sham surgery group （P＜0.05）. The number of dendritic branches of pyramidal neurons and the density of dendritic spines in hippocampal CA1 region significantly increased in the electroacupuncture group compared with the model group （P＜0.05）. The protein relative expression levels of GluR1， GluR2， GluR3， TARPγ2 and TARPγ8， and the mRNA levels of GluR1， GluR2 and GluR3 in hippocampus decreased in the model group compared with the normal group and the sham surgery group （P＜0.05）. The protein relative expression levels of GluR1， GluR2， GluR3， TARPγ2 and TARPγ8， and the mRNA levels of GluR1， GluR2 and GluR3 in hippocampus increased in the electroacupuncture group compared with model group （P＜0.05）. ConclusionThe Tongdu Xingshen needling method can improve learning memory impairment after cerebral ischaemia-reperfusion， which may be related to up-regulation of the expression of AMPA receptor and their auxiliary protein TARP， and promoting the synaptic plasticity of hippocampal tissues.

Objective:To explore the effect of adult growth hormone deficiency on cognitive function in adults.Methods:A total of 19 hypophyseal or craniopharyngioma patients who underwent surgical treatment and were diagnosed with adult growth hormone deficiency in Department of Endocrinolog, the Second Affiliated Hospital, School of Medicine, Zhejiang University from June 2017 to June 2018 were selected as the case group, and 19 normal people were included as the control group. All the members were assessed with the cognitive function scale and brain functional magnetic resonance examination, data between the groups were analyzed.Results:The body weight within a year of case group was significantly increased than that of the control group( P=0.017). Compared with the control group, the case group was relatively inattentive and had decreased memory(Time of stroop color words test-a, test-c, and trail-making test-A, P values were 0.009, 0.018, 0.020 respectively; Auditory word learning test N6, P=0.008). The executive function and language ability of the case group were weakened compared with the control group(Raven′s matrices score E1-E12, P=0.022; Time cost and the number of arrivals in 1 min of connection test B, P values were 0.023, 0.004; Symbol digit modalities test, P=0.037; The number of words spoken in 46-60 s and total number in 0-60 s of the case group was less than the control, P values were 0.030, 0.006). The general mental state of the case group was worse than the control group( P=0.018). The accuracy of the 2-back task of the case group was significantly lower and the activation signal of the left frontal lobe in the case group was significantly weaker( P<0.005). Conclusions:Adult growth hormone deficiency may increase obesity risk and have a detrimental influence on patients′ overall mental health, resulting in varying degrees of cognitive impairment. Working memory impairments associated with adult growth hormone deficiency may be a result of decreased frontal lobe brain activity.

From September to December 2019, the author participated in the exchange project between Soochow University and the Pflgewerk nursing home in Berlin, Germany for research and development of home care courses for the disabled elderly and intelligent elderly care. During the study and exchanges, the author was impressed by the perfect home care system in Germany, the development and application of advanced aids suitable for the aged, systematic and standardized caregiver training courses, a strong atmosphere of humanistic care and multidisciplinary team cooperation. Based on the personal experience of learning and exchange, this article considered some of the shortcomings in my country's current aging society, hoping to provide reference for establishing a complete long-term care system, so as to achieve healthy aging and active aging.

Objective:To explore the current situation and influencing factors of most prominent character strength among disabled elders.Methods:The study selected 228 disabled elders of Department of Geriatrics and Cardiovascular Department at a ClassⅡ Grade A general hospital in Shanghai as subjects by convenience sampling. The cross-sectional survey was carried out with the self-designed General Information Scale, Chinese Virtues Questionnaire-96 (CVQ-96) and Barthel Index (BI) and influencing factors were analyzed.Results:Among 228 disabled elders, there were 90 cases with character strength in affinity, 137 cases with character strength in vitality and one case with character strength in willpower. The most prominent character strength of disabled elders was vitality. Single factor analysis showed that there were statistical differences in the scores of vitality among disabled elders with different ages, education levels, use smart products or not, religious belief, relationships with spouse, social communications, overall life satisfaction, monthly income and with or without speech disorders ( t=5.562, 5.025, 10.551, -2.098, 4.047, 96.006, 11.094, 20.952, -2.196; P<0.05) . The independent influencing factors of vitality strength of character among disabled elders included the age> 85, education levels with high school or above, being able to use smart products, high frequencies of social communication as well as high level of overall life satisfaction with statistical differences ( P<0.05) . Conclusions:Those protective factors under the direction of character strength theory can provide a theoretical basis for related departments to perfect health policies of disable elders and build health assessment system of the aged.

Objective To survey the employment intention of medical students of five-year program in China.Methods A self-administered questionnaire survey on the employment intention was conducted among grade-5 medical students of 5-year program in 8 medical schools from January to June 2017,395 participants (161 males and 234 females) were selected by stratified random cluster sampling method.Results The survey showed that 57.65％ (226/392) respondents would return hometown after graduation as their first choice,20.66％ (81/392) preferred to work in large cities,only 0.76％ (3/292) chose the Western and rural areas;20.05％ (78/389) responders were willing to be a general practitioner working at the community health center,56.55％ (220/389) did not decide,while 23.40％ (91/389) did not want to be general practitioner.Students from rural areas vs.from urban areas (24.30％ vs.15.08％),whose parents with lower educational level vs.higher educational level (30.62％ vs.25.71％),from medical school in Western regions vs.in Eastern regions (28.65％ vs.11.68％) were more willing to choose general practice(P＜0.05).Students who had clerkship or rotation of general medicine vs.who had not more like the specialty of general practice (27.63％ vs.15.66％,P＜0.05),but there was no significant difference in the employment intention to be a general practitioner (19.93％ vs.20.45％,P＞0.05).Students who knew grassroots employment policies were more willing to be general practitioners (25.48％ vs.13.02％,P＜0.05).Conclusion The survey shows that the employment intention to be a general practitioner is stronger than before among medical students.But it is still need to take necessary measures to attract more medical graduates to work as general practitioners in grass-roots communities.

Objective To evaluate the effective e measures of the prevention and treatment of venous thrombosis in hospital and evaluate the effect of"antibolt work"in patients with multidisciplinary cooperation. Methods Compare the level of venous thromboembolism (VTE) incidence, average hospital day, patient satisfaction and the level of knowledge of medical staff in the high risk department of VTE. Results After intervention in high-risk departments staff VTE related knowledge level improved, 2013 high- risk departments medical staff about the basic knowledge, risk assessment, VTE prevention knowledge of three dimensional awareness were 34.7％ (26/75), 49.3％ (37/75), 32.0％ (24/75), respectively, 2016 were 56.0％(42/75), 69.3％(52/75), 90.7％(68/75), respectively, two groups compare the difference was statistically significant (χ2=6.887, 6.217, 54.423, P<0.01 or 0.05). Reduced incidence of VTE 2 groups, 2013 annual incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) were 31.7％ (38/120), 11.7％ (14/120), respectively, in 2016 the annual incidence of DVT and PE were 14.2％(17/120), 4.2％(5/120), respectively, two groups compare the difference was statistically significant (χ2 =10.402, 4.630, P<0.01 or 0.05). VTE in 2016 patients with high-risk departments the average hospitalization time significantly below 2013, 2013 was (18.3 ± 3.5) days while 2016 was (12.7 ± 2.9 )days, two groups compare the difference was statistically significant (t = 13.496, P < 0.01). In 2016, the satisfaction rate of patients with VTE was higher than that in 2013, 77.5％(93/120) in 2013, 90.8％(109/120) in 2016, and the difference between the two groups was statistically significant (χ2=8.004, P=0.005). Conclusion The prevention and control of venous thrombosis based on multi-disciplinary integration is effective in preventing the occurrence of thrombosis in hospitalized patients and is worthy of clinical promotion.

Objective To investigate the influencing factors and their weights of professional choice among medical school graduates in Shanghai.Methods Base on literature review and interviews with medicine students in a university of Shanghai,a questionnaire of"employment intention for general practice in medical graduates"was developed.A questionnaire survey on influencing factors of general practice among five year medical students was conducted in the medical college of a university in Shanghai during May to June 2016.The weights of each factor were calculated with analytic hierarchy process(AHP). Results The valid questionnaires were retrieved from 14 male and 26 female students.The results showed that 53.8%(21/40)preferred Beijing, Shanghai, Guangzhou and other economically developed cities as future working place,and 38.5%(15/40)chose to go home town; for general practice 22.5%(9/40) chose"very like",70%(28/40)chose"like"and 7.5%(3/40)chose"not like"; only 10%(4/40) were willing to be a general practitioner, 55.0%(22/40)were depended on the working conditions of community health center,and 35%(14/40)were not ready to be a GP.AHP analysis showed that the weights of influencing factors were: the salary(0.380 2), the doctor-patient relationship(0.262 3),professional interest and occupation development prospects(0.220 4),social status and family contribution (0.137 1).Weight analysis for the affecting factors on professional interest and occupation development showed that the guidance of mentors in theoretical study and clinical practice were the major factors (comprehensive weight was 0.067 3 and 0.062 1,respectively),and the attitude GPs to general practice in community learning was more important(comprehensive weight was 0.042 5 and 0.019 6).Conclusion The willingness to be a general practitioner is not strong in the medical school graduates in Shanghai.It is important to improve the status and working conditions of general practitioners, and to strengthen education and guidance of the general practice in theoretical study and clinical practice for medical students.