Objective:To evaluate the application effect and long-term benefits of in situ simulation combined with the forgetting curve training mode in trauma nurse training, and to provide a basis for further promoting the development of trauma nurse training.Methods:From June to September 2022, a total of 78 nurses in the Trauma Center of a grade A tertiary hospital in Changsha, China were selected by the purposive sampling method as the research objects. The nurses were divided into an experimental group and a control group according to the random number table method. The control group received theoretical teaching and skill operation training by traditional teaching methods. The experimental group was trained by the teaching method of in-situ simulation combined with the forgetting curve. The scores of theoretical and operational skills of the two groups were compared by the repeated measures analysis of variance (ANOVA) before training (T1), 1 day after training (T2), 1 month after training (T3), and 6 months after training (T4). The scores of core competence of trauma nurses before and after training were compared between the two groups by the t test. Results:There was no significant difference in theoretical, operational, and core competence scores between the two groups before training ( P>0.05). The results of repeated measures ANOVA showed significant differences in the time effect, inter-group effect, and interaction effect of theoretical and operational scores between the two groups ( P<0.001). The results of one-way repeated measures ANOVA showed that the theoretical and operational scores of the two groups increased first and then decreased with time. The results of multivariate ANOVA showed no significant difference in theoretical and operational scores between the two groups at observation time point T1 ( P>0.05), but significant differences at observation time points T2, T3, and T4, at which the scores in the experimental group were higher than those in the control group ( P<0.001). The results of independent samples t test showed that the core competence score of trauma nurses in the experimental group was significantly higher than that in the control group after training ( P<0.05). Conclusions:The training mode of in situ simulation combined with the forgetting curve is more effective than traditional training mode in improving the professional skill level of trauma nurses and brings long-term training effect and benefits.

Objective To observe the effect of drinking hydrogen-rich water on preventing heat stroke(HS)of workers in special positions.Methods A total of 384 workers in special positions were selected with cluster sampling in February 2022.They were assigned to control group or observation group by a random number table,with 192 cases in each group.Double-blind experiment method was adopted.On the basis of the prevention and health education of HS,routine protection and daily drinking water in the study subjects,the observation group drank 1.5 L of hydrogen-rich water every day(200-300 ml each time,5-7 times a day,the hydrogen concentration of hydrogen-rich water was 1 800 μg/L),and the control group drank 1.5 L of pure water every day(200-300 ml each time,5-7 times a day)for 6 months.On the day after the intervention,all the workers underwent 10 km weight-bearing cross-country training.During the intervention period,the incidences of HS and its precursor,the detection rate of heat tolerance difference before and after the intervention,core temperature,serum markers of heat intolerance,and inflammatory factors were observed.Results During the intervention period,the precursor of HS appeared in 2 patients(1.04%)in the observation group and 11 patients(5.73%)in the control group,and 1 patient(0.52%)was diagnosed with HS in the control group.The incidences of HS and its precursor in the observation group were lower than those in the control group(P<0.01).After the weight-bearing training,the core body temperature was increased in both groups(P<0.01),but the core body temperature in the observation group was lower than that in the control group(P<0.01).The detection rate of heat tolerance difference,serum heat intolerance markers(alanine aminotransferase,creatine kinase,and creatinine)and inflammatory factors(interleukin-1,interleukin-6,and tumor necrosis factor-α)in the observation group were lower than those in control group after intervention(P<0.05),and those before intervention(P<0.05).Conclusion Drinking hydrogen-rich water can improve the thermal tolerance of workers in special positions,and inhibit or reduce the inflammatory response caused by high heat.It can be used to prevent HS in special positions.

Objective:To evaluate the application effect and long-term benefits of in situ simulation combined with the forgetting curve training mode in trauma nurse training, and to provide a basis for further promoting the development of trauma nurse training.Methods:From June to September 2022, a total of 78 nurses in the Trauma Center of a grade A tertiary hospital in Changsha, China were selected by the purposive sampling method as the research objects. The nurses were divided into an experimental group and a control group according to the random number table method. The control group received theoretical teaching and skill operation training by traditional teaching methods. The experimental group was trained by the teaching method of in-situ simulation combined with the forgetting curve. The scores of theoretical and operational skills of the two groups were compared by the repeated measures analysis of variance (ANOVA) before training (T1), 1 day after training (T2), 1 month after training (T3), and 6 months after training (T4). The scores of core competence of trauma nurses before and after training were compared between the two groups by the t test. Results:There was no significant difference in theoretical, operational, and core competence scores between the two groups before training ( P>0.05). The results of repeated measures ANOVA showed significant differences in the time effect, inter-group effect, and interaction effect of theoretical and operational scores between the two groups ( P<0.001). The results of one-way repeated measures ANOVA showed that the theoretical and operational scores of the two groups increased first and then decreased with time. The results of multivariate ANOVA showed no significant difference in theoretical and operational scores between the two groups at observation time point T1 ( P>0.05), but significant differences at observation time points T2, T3, and T4, at which the scores in the experimental group were higher than those in the control group ( P<0.001). The results of independent samples t test showed that the core competence score of trauma nurses in the experimental group was significantly higher than that in the control group after training ( P<0.05). Conclusions:The training mode of in situ simulation combined with the forgetting curve is more effective than traditional training mode in improving the professional skill level of trauma nurses and brings long-term training effect and benefits.

Objective? To explore the current situation of health empowerment of elderly fragility fracture patients and to analyze its influencing factors. Methods? We selected four Class Ⅲ Grade A hospitals randomly in Hengyang. From October 2017 to February 2018, a total of 176 elderly fragility fracture inpatients were investigated with the self-designed general information questionnaire, Elderly Frailty Assessment Scale, Osteoporosis Self-Efficacy Scale (OSES), Health Empowerment Scale for Elderly Patients with Chronic Disease. Multiple linear regression analysis was used to explore the influencing factors of health empowerment of patients. Results? The score of health empowerment of elderly fragility fracture patients was (89.00±14.31) and responsibility belief dimension was with the highest score (3.74±0.88). Patients' health empowerment had a negative correlation with the frailty (r=-0.576, P＜0.01) and had a positive correlation with the self-efficacy (r=0.496, P＜ 0.01). Multiple linear regression analysis showed that the main influencing factors of health empowerment of patients included ages, education levels, medical payment methods, frailty and self-efficacy (P＜0.05). Conclusions? Nurses should pay attention to patients' health empowerment ability and provide the individualized nursing to strengthen the health empowerment ability of elderly fragility fracture patients.

Objective To evaluate the effect of single injection of low dose zoledronic acid on bone resorption.Methods332 menopausal patients with bone deficiency treated in our hospital were selected.The patients were treated with zoledronic acid 1mg (1mg group), 2.5mg treatment group (2.5mg group), 5mg treatment group (5 mg group) and placebo treatment group (control group), each group of 83 patients.The patients of 1mg group, 2.5mg group and 5 mg group were treated with 1mg, 2.5mg and 5mg zoledronic acid alone.The patients in the control group were given intravenous infusion of placebo.Evaluated the lumbar spine (L1-L4) and total hip bone mineral density (BMD) and bone metabolic markers at baseline, 6, 12, 18, and 24 months in the four groups.The bone metabolic criteria included t β-Cterminal-telopeptide of type I collagen (β-CTX) and procollagen type-I N-terminal propeptide (P1NP).ResultsThe Lumbar spine BMD and the Total hip BMD were significantly higher in 1mg group than baseline value and Simultaneous valueand in the control group (P<0.05), The difference were statistically significant (all P<0.05).The values at 8 and 24 months decreased gradually.The value was significantly lower (P<0.05) compared with the control group, There were no statistically significant difference compared with the simultaneous value in control group.The lumbar BMD and the total hip BMD in 2.5mg and 5mg groups were significantly lower than the baseline values during the whole trial period (all P<0.05).The trend of β-CTX and P1NP was similar to that of BMD in each group.ConclusionIntravenous injection of 1 mg and 2.5 mg of zoledronic acid produces anti-bone resorption that can last for at least 1 year.After one year of treatment, The effect of single injection of 2.5 mg of zoledronic acid on bone is similar to that of single injection of 5 mg zoledronic acid.1 mg zoledronic acid produced by anti-bone resorption can last for 12 months, and then slowly disappear.

PURPOSE: The degradation of the extracellular matrix has been shown to play an important role in the treatment of hepatic cirrhosis. In this study, the effect of thalidomide on the degradation of extracellular matrix was evaluated in a rat model of hepatic cirrhosis. MATERIALS AND METHODS: Cirrhosis was induced in Wistar rats by intraperitoneal injection of carbon tetrachloride (CCl4) three times weekly for 8 weeks. Then CCl4 was discontinued and thalidomide (100 mg/kg) or its vehicle was administered daily by gavage for 6 weeks. Serum hyaluronic acid, laminin, procollagen type III, and collagen type IV were examined by using a radioimmunoassay. Matrix metalloproteinase-13 (MMP-13), tissue inhibitor of metalloproteinase-1 (TIMP-1), and alpha-smooth muscle actin (alpha-SMA) protein in the liver, transforming growth factor beta1 (TGF-beta1) protein in cytoplasm by using immunohistochemistry and Western blot analysis, and MMP-13, TIMP-1, and TGF-beta1 mRNA levels in the liver were studied using reverse transcriptase polymerase chain reaction. RESULTS: Liver histopathology was significantly better in rats given thalidomide than in the untreated model group. The levels of TIMP-1 and TGF-beta1 mRNA and protein expressions were decreased significantly and MMP-13 mRNA and protein in the liver were significantly elevated in the thalidomide-treated group. CONCLUSION: Thalidomide may exert its effects on the regulation of MMP-13 and TIMP-1 via inhibition of the TGF-beta1 signaling pathway, which enhances the degradation of extracellular matrix and accelerates the regression of hepatic cirrhosis in rats.
Actins ; Animals ; Carbon Tetrachloride/toxicity ; Collagen Type III/metabolism ; Down-Regulation ; Extracellular Matrix/metabolism ; Immunohistochemistry ; Immunosuppressive Agents/*pharmacology ; Liver Cirrhosis, Experimental/chemically induced/*metabolism/pathology/*prevention & control ; Male ; RNA, Messenger/analysis/metabolism ; Rats ; Rats, Wistar ; Thalidomide/*pharmacology ; Tissue Inhibitor of Metalloproteinase-1/biosynthesis/*drug effects ; Transcription Factor RelA/biosynthesis/drug effects ; Transforming Growth Factor beta1/biosynthesis/*drug effects ; Transforming Growth Factors/metabolism

OBJECTIVETo detect JAK2 V617F mutation burden and its clinical implications in patients with myeloproliferative neoplasm (MPN).

METHODSJAK2 V617F mutation burden were detected by using MGB Taqman probes and its clinical significance were retrospectively studied in 415 MPN patients.

RESULTSJAK2 V617F was found in 56.9% of all patients [83.5% in polycythemia vera (PV), 55.9% in essential thrombocythemia (ET), 41.9% in primary myelofibrosis (PMF) and 64.7% in MPN-unclassifiable)]. The majority of patients carried heterozygous JAK2 V617F mutation and homozygote was found only in 12 cases (4 in PV, 4 in MPN-U, 2 in PMF, 1 in ET, and 1 in chronic neutrophilic leukemia). Most patients (68.8%) were lower mutation burden (mutation burden<50%), but PV had the highest burden, the moderate burden in PMF and the least in ET. The patient's age and WBC count were significantly correlated with higher mutation burden in PV. WBC count was significantly related to higher mutation burden in ET. WBC count, Hb level and the platelet count were significantly related to higher mutation burden in PMF.

CONCLUSIONThe mutation burden of JAK2 V617F from high to low was PV, ET and PMF. The majority of JAK2 V617F mutation was heterozygous. JAK2 V617F mutation burden was positively correlated with age, WBC, Hb and platelet counts.

Homozygote ; Humans ; Janus Kinase 2 ; Leukocyte Count ; Mutation ; Myeloproliferative Disorders ; Platelet Count ; Polycythemia Vera ; Retrospective Studies ; Thrombocythemia, Essential

Allogeneic hematopoietic stem cell transplantation is the only measure which can cure multiple myeloma,but the high mortality rate related with it limited its use.Autologous hematopoietic stem cell transplantation(Auto-HSCT) has made a great contribution at improving the patients' quality of life and prolonging the survival.In recent years,the application of new drugs and new chemotherapy regimen consisted of traditional chemotherapy and new drugs further enhance the curative effect.

Objective To realize and analyze the current status of medical treatment for benign prostatic hyperplasia in special clinic for elderly in China.Methods The informations were gathered from 34 clinics for elderly located in 11 Chinese cities from February 2008 to September 2008.First, all male patients who visited the clinic were inquired about their history of benign prostatic hyperplasia , and then 1000 benign prostatic hyperplasia patients who were receiving medical treatment were selected to finish a detailed questionnaire and to get several examinations for benign prostatic hyperplasia.Results Among the 1000 patients, 774 completely finished the questionnaire, patients with middle or severe international prostate symptom score (IPSS) and with high volume of prostate occupied a large proportion.Medical treatments included the combined therapy of α-blockers plus 5α reductase inhibitors (45.48 %), α-blockers (36.30%), 5α reductase inhibitors (13.05 %) and other medicines (including phytotherapeutic agents and traditional medicines, 5.17%).Conclusions Nowadays in China, as to the prescription for benign prostatic hyperplasia in the clinic for elderly presents, doctors only concentrate on the improvement of symptoms, whereas ignore the progression of the disease.There is still a considerable gap between real medical treatment and international guidelines.Therefore, improvements of medical treatment are still needed in the future clinical practice.

Objective To evaluate the demands of patients with benign prostatic hyperplasia (BPH) and its influencing factors. Methods One thousand five hundred and twenty-seven patients (≥60 years old) with BPH in 26 hospitals of 9 cities were selected in the study by using stratified random sampling method. The demands of patients with BPH and its influencing factors were evaluated by rank sum test and rank correlation analysis. Results In 1527 BPH patients, most patients thought that doctors' communication with them before opening examination items (1297/ 1527,84.9%),health guidance for BPH progress(1310/1527,85.8%), BPH diagnosis(1279/1527, 83.8 %) and BPH treatment(1329/1527,87. 0%) were necessary. Doctors'communication with them before opening examination items, health guidance for BPH progress, BPH diagnosis and BPH treatment showed significant statistical difference among patients with different age, medical care, the lasting time of clinical symptoms, diagnosis time, international prostate symptom scores and quality of life scores (all P<0. 05). While in patients with different nation, retirement status, marital status, living style and average family income, there were no significant statistical difference in needing the doctors'communication with them before opening examination items, health guidance for BPH progress, BPH diagnosis and BPH treatment(all P>0.05). Conclusions Patients with BPH have a higher demand for treatment. The demand degree is related with age group, health care, the lasting time of clinical symptoms, diagnosis time, international prostate symptom scores and quality of life scores. Most patients have desire to accept health guidance.