Objective:To analyze the research hotspots and trends of the consolidated framework for implementation research (CFIR) in nursing through bibliometrics, so as to provide reference for implementation research in nursing in China.Methods:The article on the application of CFIR in nursing was searched in the Web of Science core collection, with a search period from database establishment to August 8, 2023. CiteSpace 6.2.R4 software was used for analysis.Results:A total of 165 articles were included. The overall number of articles on the application of CFIR in nursing was on the rise. The top five countries with the highest number of publications were the United States, Canada, Australia, the United Kingdom, and the Netherlands. The top five institutions in terms of publication volume were the United States Department of Veterans Affairs, the Veterans Health Administration, the University of North Carolina, the University of Pennsylvania, and the Feinberg School of Medicine. Research hotspots included implementation science, implementation research, qualitative research, acceptability, barriers, systematic review, health disparities, symptom management, quality improvement, primary health care, and so on.Conclusions:The research on CFIR in the domestic nursing field is still in its early stages. We should draw on the experience of foreign study, verify the applicability of the Chinese version of CFIR and the connotation of its various elements, and promote the development of high-quality nursing implementation research.

Objective To investigate the training needs and suggestions of advanced practice nurses in medical institutions in China,and to provide references for the formulation of training programs for advanced practice nurses.Methods By a convenient sampling method,from May to July in 2023,the heads of nursing nurses in medical institutions in 29 provinces,autonomous regions and municipalities directly under the Central Government were investigated,and the self-designed questionnaires were distributed in the form of electronic questionnaire.Results 1 287 medical institutions participated in the survey,with tertiary hospitals accounting for 65.50％.93.16％of medical institutions had the use needs of advanced practice nurses,and the top 3 professional fields hoping to prioritize in the APN training were in the order of critical illness,emergency treatment and intravenous treatment.Among the APN core competence,the most important one was direct clinical practice(92.77％),followed by professional development(89.43％)and scientific research and evidence-based practice(86.40％).71.72％of medical institutions suggested that the theoretical training time is 4 weeks,combining online and offline training(50.35％),and the clinical practice time should not be less than 12 weeks(97.66％).Theoretical learning course assignment(92.93％),case report(90.83％)and clinical practice reflection diary(88.19％)were the main process evaluation methods,while 1 case study with the completion of the report and defense(87.65％)and 1 evidence-based nursing practice research plan with the completion of a report and defense(77.93％)were the main final evaluation methods.Conclusion Advanced practice nurses are important roles in the process of nursing professional development,and medical institutions in our country have a high demand for the training of advanced practice nurses.It is imperative to carry out the training of advanced practice nurses.The suggestions of medical institutions on the training content and methods focus more on the training of core competence.On this basis,the admission conditions should be clarified,and the training program of advanced practice nurses for China's national conditions should be explored.

Objective:To review the imaging characteristics and evaluate the diagnostic value of Doppler echocardiography for congenital pseudoaneurysm of the mitral-aortic intervalvular fibrosa (PMAIVF).Methods:Between June 2008 and January 2020, 4 patients with PMAIVF were diagnosed by CTA, MRI and operative findings in Shanghai Children′s Medical Center and Children′s Hospital of Soochow University. The echocardiographic characteristics were analyzed retrospectively in these children.Results:PMAIVF was characterized by a pulsatile echo-free sac that expanded in systole and collapsed in diastole with to-and-fro blood flow on color and pulsed-wave Doppler echocardiography between the mitral leaflet and the aortic annulus. Three cases were diagnosed correctly, and 1 case was misdiagnosed as left atrial mass.Conclusions:PMAIVF can be diagnosed accurately by Doppler echocardiography, but it is prone to be misdiagnosed and must be distinguished from aortic root abscess, atrial mass and coronary artery fistula.

Objective: To observe the survival and side effects of stereotactic body radiotherapy (SBRT) in large hepatocellular carcinoma (HCC) patients. Methods: Twenty-eight large HCC patients undergoing SBRT in 302 Military Hospital from November 1, 2011 to January 31, 2014 were observed. The prescribed dose was 39-61 Gy/3-9f. Among them, 20 patients simultaneously received transcatheter arterial embolization. The overall survival (OS), progression-free survival (PFS) and local control (LC) rates were calculated by using Kaplan-Meier method. The influencing factors of OS were analyzed by Cox regression model. The influencing factors of radiation-induced liver disease (RILD) were identified by using Logistic regression analysis. Results: The 1-, 2-, 3-and 5-year OS rates were 75%, 57%, 54% and 22%, respectively. The 1-, 2-, 3-and 5-year PFS rates were 59%, 47%, 36% and 18%, respectively. The 1-, 2-, 3-and 5-year LC rates were 92%, 86%, 86% and 86%, respectively. Four patients suffered from RILD and none died from RILD. Child-Pugh classification was the influencing factor of OS and RILD. Conclusion It is preliminarily believed that SBRT is an alternative and safe treatment for patients with large HCC.

By searching recent related researches about ultrasound pulmonary assessment in intensive care unit (ICU) patients and chest physiotherapy domestically and abroad, it reviewed the nursing progress of chest physiotherapy effect evaluation, the overview of lung ultrasound, the application of critical ultrasound in chest physiotherapy, ultrasound guided target chest physiotherapy and the feasibility of nurses' applying ultrasound, in order to provide reference for critical medical staff.

Objective To observe the effect of costimulatory molecule B7-1 on cytoskeleton rearrangement in mouse podocytes induced by angiotensin Ⅱ (Ang Ⅱ),and to study the underlying molecular mechanism of B7-1 in the pathological changes of podocytes.Methods All cultivation of conditionally immortalized mouse podocytes (MPC) in vitro were divided into the following groups:normal control group,CTLA-4 group,Ang Ⅱ group (10-6 mmol/L 12 h,24 h;10-8 mmol/L 12 h,24 h) and CTLA-4 with Ang Ⅱ group.Transfect B7-1 RNA interference fragment (siRNA) to the mature podocytes,and then restimulated by Ang Ⅱ (10-6 mmol/L 12 h),the change of podocyte cytoskeleton after Ang Ⅱ stimulation were observed.The expression of B7-1 in each group was assayed by flow cytometry and Western blotting.The nephrin and p-nephrin protein levels in the four groups were also analyzed by Western blotting.At the same time,the podocyte cytoskeleton distribution as indicated by F-actin was observed by fluorescence microscopy.Results Flow cytometry and Western blotting showed that B7-1 was not expressed in the normal control group.Ang Ⅱ showed a concentration and time dependent induction of B7-1 expression in mouse podocytes (P ＜ 0.05).Western blotting indicated that Ang Ⅱ induced B7-1 protein expression (P ＜ 0.05).Expression of nephrin and p-nephrin was significantly down-regulated by Ang Ⅱ (P ＜ 0.05).Compared with the normal control group,the expression of podocyte protein nephrin and p-nephrin in Ang Ⅱ stimulation group was significantly reduced (P ＜ 0.05).Using FITC phalloidin fluorescence staining showed that CTLA-4+Ang Ⅱ stimulation group cytoskeleton rearrangement was improved significantly and F-actin recombinant score (mCFS) decreased compared with Ang Ⅱ group (P ＜ 0.05),suggesting that Ang Ⅱ led to the disorder of the podocytes cytoskeleton and the destruction of the cytoskeleton of podocytes by Ang Ⅱ could be improved after B7-1 blocking.Compared with the Ang Ⅱ stimulation,transfection of B7-1 siRNA + Ang Ⅱ stimulation group improved F-actin cytoskeletal rearrangement,and mCFS also decreased significantly (P ＜ 0.05),suggesting that transfection of B7-1 siRNA might improve the damage of Ang Ⅱ on podocytes cytoskeleton.Conclusions B7-1 participates in the process of cytoskeleton reconstruction and plays an important role in the pathological changes of podocytes.

Objective To analyze the clinical value of gastric bacterial cultivation in the early diagnosis of bacterial infection in preterm infants.Methods 174 preterm with risk perinatal factors of infection in NICU of Chang’an Hospital from January 2013 to December 2014 were collected,they were given the gastric juice cultivation checking in 1 hour after birth before eat-ing,watering and giving medicine.According to the clinical symptoms and laboratory test results,they were divided into the infected group and non-infected group.Their Gastric cultivation inspection was compared and analyzed in two groups.Results The positive rate of bacterial culture of gastric fluid was 40.8% (71/174),and located in the top four is Escherichia coli 30.99% (22/71),coagulase-negative staphylococci 21.13%(15/71),Staphylococcus aureus 14.08%(10/71)and group B streptococcus 8.45% (6/71).There was relation between premature infants with bacterial culture positive and meconium stained amniotic fluid,maternal infection during pregnancy,premature rupture of membranes,but not with gestational hyper-tension,fever unrelated to the mother giving birth.Conclusion There was high positive rate of gastric juice bacterial culture with a significant correlation of early onset infection.

Objective To understand the distribution and drug resistance of pathogens isolated from blood culture samples Chang’an Hospital from 2012 to 2014 to provide basis for rational use of antibacterial drugs.Methods The clinical date of distribution,changes and drug resistance of main pathogens in blood culture samples during 2012 and 2014 in chang anhospi-tal were retrospectively analyzed.Results 512 pathogenic bacterial strains were isolated from 4 792 blood culture samples in 2012~2014.Among them,gram-negative bacteria accounted for 62.50% (320/512),Escherichia coli ,Klebsiella pneumoni-ae and Pseudomonas aeruginosa accounted for 25.20% (129/512),14.26% (73/512)and 8.20% (42/512)respectively;Gram-positive bacteria accounted for 29.30% (150/512),Staphylococcus aureus and Coagulase-negative Staphylococcus ac-counted for 11.52% (59/512)and 10.16% (52/512)respectively.The rate of fungi was 7.62% (39/512).Susceptibility re-sults showed that Escherichia coli and Klebsiella pneumoniae had highly sensitive to carbapenems,but had a varying degrees of resistance to other antibacterial drugs.The rate of drug resistant of Gram-positive cocci to Penicillin,Erythromycin and Clindamycin had been a high level,but no strains being resistant to van comycin and linezolid had been detected.Conclusion The pathogens causing bloodstream infection widely distribute,and have highly drug-resistant.It is necessary to under-stand the distribution of pathogens isolated from blood culture as well as the changes of drug resistance in a timely manner so as to guide the reasonable clinical medication.

This article introduces a new model of the communication between doctors and nurses, with the aid of the electronic medical advice platform. This model has achieved good results in improving doctor and nurse's co-working efficiency, treating patients safely, preventing medical accidents, reducing medical errors and so on.
Communication ; Electronics, Medical ; instrumentation ; methods ; Humans ; Nurse's Role ; Physician-Nurse Relations

Objective To explore the value of phase-contrast magnetic resonance imaging (PC-MR) in diagnosis of secundum atrial septal defect (ASD) in pediatric patients. Methods Totally 42 patients (aged from 9 months to 15 years) with secundum ASD proved with tansthoric echocardiographic (TTE) were evaluated with PC-MRI. Images of the flow through ASD were obtained with PC-MRI. The distances of ASD rim to superior vena cava (SVC), inferior vena cava (IVC), atrioventricular valves (AVV) and right upper pulmonary vein (RUPV), as well as the entrances of the vena cava and right upper pulmonary vein (RUPV) were assessed. Results The sizes of ASD and distances of ASD rim to the adjacent structures (SVC, RVC, AVV and RUPV) at PC-MRI were well consistent with those of TTE in 42 patients (P<0.001). PC-MRI results in 26 patients correlated well with surgical results (P<0.001). With different velocity encoding, compared with surgical results, measurements of ASD's sizes were more accurate when setting velocity from 50 to 70 cm/s than 90 cm/s. Conclusion The shape of ASD can be virtually depicted with PC-MRI. PC-MRI can accurately assess the defect size, number, rim distances to adjacent structures, therefore providing a new method for depiction of congenital heart anomaly.