BackgroundSevere mental disorders are characterized by high recurrence rate， high disability rate， high rates of harmful incidents， and low treatment-seeking rate， with affected patients demonstrating increased frequencies of dangerous behaviors. Ningxia Hui Autonomous Region has implemented community management for patients with severe mental disorders across the region since 2004， while the current status and regional characteristics of the managed patients remain unclear. ObjectiveTo analyze the current status of management and treatment of patients with severe mental disorders in Ningxia Hui Autonomous Region， and to explore their regional distribution characteristics， so as to provide references for optimizing regional prevention and control strategies. MethodsPatients with severe mental disorders diagnosed and registered in the Severe Mental Disorder Management Information Platform of Ningxia Hui Autonomous Region from August 1， 2011 to December 31， 2021 were selected. Patients' basic information， management indicators， and treatment metrics were extracted from the platform， followed by descriptive statistical analysis of the corresponding data. ResultsAs of December 31， 2021， the permanent resident population of Ningxia Hui Autonomous Region was 6 946 540， with 29 787 registered patients with severe mental disorders. The majority of the patients were female （50.25%）， aged 18-59 years （79.01%）， with educational level of junior high school or below （84.63%）， married （52.87%）， farmers （56.01%）， and diagnosed with schizophrenia （55.91%）， while ethnic minority patients accounted for a relatively high proportion （31.35%）. In 2021， the reported prevalence rate of severe mental disorders in Ningxia Hui Autonomous Region was 0.43%， with standardized management and regular medication adherence rates at 90.39% and 66.34%， respectively. The standardized management rate in 8 counties/districts （36.36%） was lower than the average level of Ningxia Hui Autonomous Region， while 10 counties/districts （45.45%） showed below-average medication adherence rates， of which 6 counties/districts（60.00%） were located in the south-central region. ConclusionPatients with severe mental disorders in Ningxia Hui Autonomous Region are predominantly young and middle-aged adults with low level of education， and those in the central-southern region demonstrate lower medication adherence. ［Funded by Key Research and Development Program Project of Ningxia Hui Autonomous Region （number， 2023BEG02029）］

Purpose/Significance To establish an informatization platform for nursing quality control in tertiary hospitals of Qinghai province,and to analyze its influence on nursing quality.Method/Process According to the needs of nursing quality management in Qing-hai province,based on the nursing quality data platform,a nursing quality index monitoring module is established.A tertiary hospital is selected as a pilot hospital,and the nursing quality data of this hospital from January to June 2021 is selected as the control group by u-sing the historical comparative study method,and the nursing quality data collected by the informatization platform from January to June 2022 is selected as the observation group.The changes of nursing quality before and after the application of informatization platform are compared.Result/Conclusion After the application of the informatization platform for nursing quality control,the rate of physical restraint and unplanned extubation of endotracheal intubation of hospitalized patients decreases significantly,and the score of patients'satisfaction with nursing work increases significantly.The informatization platform has strong operability and clinical application value.

Objective:To investigate effect of acacetin on alveolar epithelial cell damage caused by Streptococcus pneumoniae(SP)infection by regulating sirtuin 1(Sirt1)-mediated 5'-AMP activated protein kinase(AMPK)/nuclear factor erythroid-2 related factor 2(Nrf2)signaling pathway.Methods:Alveolar epithelial cells A549 cultured in vitro were infected with SP to establish a cell damage model.After treatment with acacetin at final concentrations of 0,5,25,50,100,150,200 μmol/L,CCK-8 was performed to detect cell viability of each treatment group and optimal concentration of acacetin was screened.A549 cells cultured in vitro were ran-domly separated into five groups:control group,model group,acacetin(150 μmol/L)group,EX527(Sirt1 inhibitor,40 μmol/L)group,acacetin(150 μmol/L)+EX527(40 μmol/L)group,control group was not treated,other groups were infected with SP to establish a cell damage model,and then treated with 150 μmol/L acacetin and 40 μmol/L EX527,CCK-8 and flow cytometry were performed to measure cell viability and apoptosis rate in each group;kits were performed to measure levels of reactive oxygen species(ROS),superoxide dismutase(SOD),malondialdehyde(MDA),lactate dehydrogenase(LDH)and IL-10,IL-1β,TNF-α levels of cells in each group;Western blot was performed to measure proliferation-related proteins Ki-67,proliferating cell nuclear antigen(PCNA),apoptosis-related proteins caspase-9,Bax,Sirt1 and AMPK/Nrf2 signaling pathway proteins p-AMPK/AMPK,Nrf2 expres-sions of cells in each group.Results:Model group had decreased A549 cell viability,SOD and IL-10 levels,p-AMPK/AMPK,Sirt1,Nrf2,Ki-67 and PCNA protein expressions(P<0.05),and increased apoptosis rate,MDA,LDH,ROS,IL-1β and TNF-α levels than control group(P<0.05).Compared with model group and acacetin+EX527 group,acacetin group had increased A549 cell viability,SOD and IL-10 levels,p-AMPK/AMPK,Sirt1,Nrf2,Ki-67 and PCNA protein expressions(P<0.05),and decreased apoptosis rate,MDA,LDH,ROS,IL-1β and TNF-α levels(P<0.05);EX527 group had decreased A549 cell viability,SOD and IL-10 levels,p-AMPK/AMPK,Sirt1,Nrf2,Ki-67 and PCNA protein expressions(P<0.05),and increased apoptosis rate,MDA,LDH,ROS,IL-1β and TNF-α levels(P<0.05).Conclusion:Acnestin can activate AMPK/Nrf2 signaling by up-regulating Sirt1 expression,thereby promoting secretion of anti-inflammatory factors,reducing production of ROS and pro-inflammatory factors,reducing inflammation and oxidative stress,and finally alleviating neuronal damage.

Objective To search,evaluate and integrate the best evidence of wound procedural pain management in patients with chronic wounds,and to provide evidence-based references for clinical practice.Methods Following the"6S"evidence model,we systematically searched relevant literature of wound procedural pain management in patients with chronic wounds,including clinical practice guidelines,clinical decisions,expert consensuses,evidence summaries,recommended practice and systematic reviews,with the search period from the datebase establishment to December 2022.The quality evaluation,extraction and integration for evidence were conducted independently by 2 researchers,respectively.Results A total of 17 articles were involved,including 2 guidelines,1 expert consensus,3 clinical decisions,6 evidence summaries,2 recommended practice,3 systematic reviews.34 pieces of best evidence were synthesized into 9 categories,including general principles,pain assessment and documentation,replacement and selection of the wound dressing,wound cleaning,wound debridement,negative pressure wound therapy,drug intervention strategies,non-drug intervention strategies,education and training.Conclusion The best evidence of wound procedural pain management in patients with chronic wounds in this study is scientific and practical.Medical staff can select and apply the best evidence based on clinical situation and patient willingness to reduce wound procedural pain.

Humans ; East Asian People ; Surveys and Questionnaires ; Vitiligo/epidemiology*

Purpose: Screening for hepatocellular carcinoma (HCC) as an effective instrument to reduce the burden of late diagnoses remains underutilized in China, much of the Asian countries, and in a sense all over the world. Modifiable psychosocial factors should be identified to improve screening utilization and reduce the burden of late diagnoses. However, valid psychosocial measures are unavailable. This study aimed to translate, culturally adapt, and validate the preventive health model (PHM) instrument for measuring psychosocial factors of HCC screening among patients with hepatitis B. Methods: This study was conducted from June 2020 to April 2021 in three rigorous phases: (1) committee-based translation from English to Chinese; (2) cognitive interviews (n = 33) and Delphi expert consultations (n = 7) for cultural adaptation; and (3) a cross-sectional study (n = 305) for validation. Results: In phase I, two items were reworded, and two retranslated for semantic equivalence. In phase II, issues related to comprehension, sensitive wording, wording clarity, question relevance, and cultural sensitivity were addressed by including pictures, rewording five items, and developing seven items. In phase III, exploratory and confirmatory factor analyses suggested a five-factor 20-item solution: it explained 76.9% of the variance; had adequate factor loading (.60–.91), convergent and discriminant validity; satisfactory model fit indices; and reliability (Cronbach's α, .86−.91). Known-group analysis showed that patients with optimal HCC screening behavior had significantly higher scores on each subscale than those not having such. Conclusion The Chinese PHM instrument is culturally sensitive, reliable, and valid to measure the psychosocial factors of HCC screening. It can help nurses and researchers to tailor strategies to improve clinical HCC screening practices in high-risk HCC regions.

Objective:To investigate the current status and influencing factors of stroke patients.Methods:Using stratified sampling method, 458 stroke patients was investigated for the health behavior from October to December, 2015. Based on PROCEDE-PROCEED model, logistic regression analysis was conducted with the health behavior level of the subjects as the dependent variable, and the characteristic factors in the chi-square test as the independent variables to analyze the factors which influence the health behavior level of stroke patients from predisposing factors, enabling factors and reinforcing factors.Results:The health behavior score of stroke patients was (14.5±3.9), which was at medium level. The score of each dimension was nutrition (0.80±0.25), disease management (0.60±0.26), interpersonal relationship (0.57±0.33), and medication compliance (0.49±0.41). The multiple logistic regression analysis showed that the predisposition factors including age ( OR=2.03, 95% CI=1.08-3.80) and history of hypertension( OR=2.35, 95%=1.16-4.76), the enabling factors including the allocation of social resources ( OR=1.73, 95% CI=0.89-3.36), and the reinforcing factors including family support ( OR=2.03, 95% CI=0.99-4.17) were important factors which affect the health behavior of stroke patients. Conclusion:The health behavior level of stroke patients need to be improved. The relevant community resource allocation system continuously, and focus on the impact of family environment and particularly the elderly and patients with a history of hypertension should be attentioned when improving the health behavior of patients.

Guided by the development of new medical science proposed by Ministry of Education and the "Education and Training Plan for Excellent Doctors 2.0", shifted from treatment-oriented to whole life-health cycle, we have explored curriculum ideological and political education in metabolic-related curriculum chain. Firstly, we constructed a core teaching team and had the training of curriculum ideological and political education. The top-level design was made with the integration of moral education into medical education. Secondly, the syllabus was comprehensively revised, containing the connotation of "morality education". The elements relevant to curriculum ideological and political education hidden behind professional courses were excavated. Finally, the mixed teaching mode of online combining with offline was carried out. Metabolism-related curriculum chain, focused on "metabolism, diabetes, obesity and patient education", formed a progressive link from basic medical science to practice to clinical, strengthening the "prevention, treatment and health care" based "one health" philosophy and giving full play to the implicit curriculum ideological and political education hidden behind professional courses. Our practice shows that the implementation of curriculum ideological and political education in metabolism-related curriculum has been accepted by students, and curriculum ideological and political education has been become part of professional courses. The "gene chimera" mode for curriculum ideological and political education incorporation into professional courses needs to be infiltrated imperceptibly, and the effect will be visualized in the future.

Objective:To explore the application of web problem-based learning (WPBL) + case-based learning (CBL) combined with clinical pathways in dermatological nursing teaching.Methods:A total of 120 nurses who practiced in the dermatology department of The First Affiliated Hospital of Air Force Medical University from July 2018 to June 2020 were selected as the research objects. According to the nurse practice period, they were divided into a control group and a study group, with 60 people in each group. The control group used traditional teaching, and the study group used WPBL+CBL combined with clinical pathways for teaching. After the teaching, the two groups of practical nurses were assessed for their theoretical and clinical operational abilities, and the comprehensive abilities of the two groups of practical nurses and their satisfaction with teaching were assessed through questionnaire surveys. SPSS 22.0 was used for t test and χ2 test. Results:The theoretical and clinical performance assessment results of the study group were better than those of the control group, and the difference was statistically significant ( P<0.001). The research group was better than the control group in assessment of improving clinical operation ability, independent problem-solving ability, cultivating teamwork ability, improving self-learning ability, improving ability of presenting and analyzing problems, improving comprehensive analysis ability, cultivating clinical thinking ability and comprehensive ability, with statistical significance ( P<0.001). The satisfaction rate of the trainee nurses in the study group was 93.33%, and the satisfaction rate of the trainee nurses in the control group was 31.67%, with statistically significant differences. Conclusion:WPBL+CBL combined with clinical pathways teaching can significantly improve the theoretical and clinical operation ability of dermatology practice nurses, and improve their comprehensive ability and clinical teaching satisfaction rate, which is worthy of application and promotion in clinical nursing teaching.

OBJECTIVE: To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis. METHODS: Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients. RESULTS: Female patients are more likely to have anxiety (=3.206, 95%: 1.073-9.583, <0.05) and depression (=9.111, 95%: 2.143-38.729, <0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (=3.267, 95%: 1.082-9.597, <0.05). CONCLUSIONS During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.
Anxiety ; diagnosis ; etiology ; therapy ; Betacoronavirus ; isolation & purification ; Coronavirus Infections ; complications ; diagnosis ; psychology ; Depression ; diagnosis ; etiology ; Female ; Humans ; Logistic Models ; Male ; Pandemics ; Pneumonia, Viral ; complications ; diagnosis ; psychology ; Risk Factors