Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Objective: Depression was common during coronavirus disease-2019 (COVID-19) pandemic, while the association of perceived stress with depression among vaccinated healthcare workers has not been investigated. This study aimed to address this issue. Methods: We included a total of 898 fully vaccinated healthcare workers during the outbreak of severe acute respiratory syndrome coronavirus 2 Delta variant in Nanjing, 2021. Depression was ascertained by Patient Health Questionnaire-9, with a cut-off score of ≥5 indicative of mild-to-severe depression. Perceived stress, resilience, and compassion fatigue were assessed by Perceived Stress Scale-10, Resilience Scale-25, and Professional Quality of Life Scale version-5, respectively. Logistic regression analyses were used to estimate the odds ratio (OR) and 95% confidence interval (CI), along with subgroup and mediation analyses. Results: The prevalence of mild-to-severe depression was 41.1% in vaccinated healthcare workers. The odd of mild-to-severe depression was increased with higher perceived stress. Compared with vaccinated healthcare workers with the lowest tertile of perceived stress, those with the highest tertile had increased odds of mild-to-severe depression by 120% (OR 2.20, 95% CI 1.46 to 3.31) after multivariable-adjustment. However, perceived stress was not associated with mild-to-severe depression in vaccinated healthcare workers with strong resilience, but was in those with weak resilience (pinteraction=0.004). Further analysis showed that compassion fatigue mediated the relationship between perceived stress and mild-to-severe depression, with a mediating effect of 49.7%. Conclusion Perceived stress was related to an increased odd of mild-to-severe depression in vaccinated healthcare workers during COVID-19 pandemic, and this relationship might be explained by compassion fatigue.

Chronic heart failure is a serious stage of various cardiovascular diseases.It has the characteristics of high morbidity, high fatality rate, and high rehospitalization rate, which leads to a decrease in the quality of life of patients.The theory of health ecology points out that the factors affecting individual health are multi-level. The theory uses systematic indicators to evaluate the prognosis of patients with chronic heart failure and scientifically analyze the complex factors behind the disease which can provide patients with professionalism, standardization and individualized high-quality medical resources and provide a reference for effectively improving the quality of life.

Objective? To establish a standardized training evaluation system for novice nurses based on Mini Clinical Evaluation Exercise(Mini-CEX)for the development of the novice nurses. Methods? The initial framework of the evaluation system based on Mini-CEX was established through literature review and topic group discussion. From March to April of 2018, by Delphi expert consultation, the weight of each indicators were determined through 2 rounds of expert consultation and Analytic Hierarchy Process. Results The effective recovery rate of questionnaires in two rounds were 100% and 98.33%. The expert authority coefficients (Cr) of the two experts were 0.86 and 0.88. A standardized training evaluation system for novice nurses based on Mini-CEX was established which includes 8 first-level dimensions and 66 subclauses. Conclusions The standardized training evaluation system for novice nurses based on Mini-CEX built through Delphi expert consultation is scientific and reliable, and can provide evidence for the evaluation method of standardized training for novice nurses in China.

Objective? To investigate the correlation between post traumatic growth, social support and resilience in patients with breast cancer, and to provide reference for intervention programme on enhancing positive psychological quality. Methods? Totally 180 patients with breast cancer from 4 ClassⅢ Grade A hospitals in Jiangsu Province were selected by convenience sampling method from June to October in 2018. They were investigated with General Information Questionnaire, Post Traumatic Growth Inventory (PTGI), Social Support Rating Scale (SSRS), and Connor-Davidson Resilience Scale (CD-RISC). Results? In breast cancer patients, the total scores of PTGI, SSRS and CD-RISC were (62.52±17.59), (35.15±9.29) and (56.51±18.33) scores. Correlation analysis showed that the total scores of PTGI and its each dimension were positively correlated with the total scores of SSRS, as well as the total scores of CD-RISC and its each dimension (P＜0.01); the total scores of SSRS and its each dimension were positively correlated with the total scores of CD-RISC and its each dimension (P＜ 0.01). Multivariate linear regression analysis showed that resilience, methods of disease detection, and treatment plans were independent influencing factors of PTG in patients with breast cancer. Both social support and resilience could positively predict PTG, whose path coefficients were 0.493 and 0.302, respectively. Resilience was a mediator of social support and PTG. The indirect effect was 0.080. Conclusions? Resilience plays an important role in mediating between social support and PTG in patients with breast cancer. The resilience training could promote patients' PTG ability .

Objective? To assess the application effects of internet-delivered cognitive-behavioral therapy(ICBT) on symptom management in cancer patients. Methods? All randomised controlled trials (RCTs) about applying ICBT in symptom management in cancer patients in the following databases were searched from the establishment date up until 20th August 2018: Web of Science, PubMed, Cochrane Library, Embase, CBMdisc, Chinese National Knowledge Infrastructure databases(CNKI) and Wanfang. After literature screening, data extraction and quality evaluation, RevMan 5.3 software was used for meta-analysis. Results? Finally, 11 RCT studies were included, totaling 2329 subjects. The results showed that ICBT was beneficial to improve mental distress [SMD=5.02, 95%CI (0.80, 9.25), P=0.02], sleep quality [SMD=0.35, 95%CI (0.02, 0.68), P=0.04]and cancer-related fatigue [SMD=0.50, 95%CI (0.01, 0.99), P=0.04]; but ICBT did not have depression relieving effects in cancer patients (P＞0.05). Conclusions? ICBT is beneficial to reduce psychological pain, improve sleep quality and alleviate cancer-related fatigue in cancer patients, but it has no obvious advantage in alleviating depression. Future studies still need to focus on specific cancer types and validate them with multi-center, large-sample and long-term intervention studies.

Objective To investigate the current status of subjective well-being in patients with coronary heart disease (CHD) undergoing Percutaneous Coronary Interventions and its influence factors. Methods Totally 140 cases of coronary heart disease undergoing percutaneous coronary interventions were investigated with the general information questionnaire, General Well-being Scale, Self-rating Anxiety Scale and Self-rating Depression Scale, and analyzed the influence factors of subjective well-being. Results There were patients whose subjective well-being scores were lower than the average of Chinese norm among the 140 CHD patients,which took a proportion of 75.71%(106/140).The subjective well-being score in male patients was 73.33±6.43,which was lower than 75.00±15.00 of the Chinese norm (t=-2.112,P<0.05).The subjective well-being score in female patients was 65.15±8.32,which was lower than 71.00 ± 18.00 of the Chinese norm (t=-5.981, P<0.01); the self-rated health status and anxiety disorder were the main factors of subjective well-being in coronary heart disease undergoing Percutaneous Coronary Interventions patients. Conclusions The subjective well- being of patients with CHD undergoing percutaneous coronary interventions is poor; the society and family should give them much enough care and support, and effective psychological intervention measures should be taken to improve their subjective well-being.

Objective To explore the implementation effect of nurses′ hierarchical training plan based on training outline and nurses′ needs. Methods Nurses′ hierarchical training outline was established in accordance with three theoretical training modules(humanistic accomplishment, professional competence, career planning/development) as well as three skill training modules(basic nursing skills, specialist nursing skills and first aid nursing skills); the training needs of nurses were investigated by adopting a self-made Training Needs Questionnaire, then the hierarchical training plan was developed based on the training outline and nurses′ training needs. Results There were some differences in the training needs of different levels of nurses in the fields of clinical knowledge and skills,nursing management, nursing education, scientific research and new nursing guidelines and progress(F=2.80-22.47,P<0.05 or 0.01). Before the implementation of nurses′ hierarchical training plan based on training outline and nurses′ needs, nurses′ satisfaction about training, theoretical examination result, clinical working ability and patients′satisfaction towards nursing were 89.06%(228/256),94.80%(1 185/1 250), 96.63%(1 060/1 097) and 95.35%(5 470/5 737), respectively. Then, after the implementation, the corresponding values got improved into 96.76%(239/247), 97.44%(1 297/1 331), 98.75%(1 106/1 120) and 99.22%(6 070/6 118),which were statistically significant(χ2=11.11-176.27,P<0.01). Conclusion Integrating nurses′hierarchical training outline with the training needs helps to provide targeted hierarchical training so as to improve the professional quality of nurses and the patients′satisfaction towards nursing.

OBJECTIVE:To investigate the effects of Astragalus injection combined with Salmeterol propionate powder inhala-tion on pulmonary function,cytokines and blood rheology indexes of Chronic obsrnctine pulmonary disease (COPD) patients. METHODS:104 COPD patients were divided into observation group and control group according to the randorn number table meth-od,with 52 cases in each group. Control group was given routine symptomatic treatment+Salmeterol propionate powder inhalation 1 dose,bid;observation group was additionally given Astragalus injection 30 ml added into 5% Glucose injection 250 ml,ivgtt, qd,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Clinical efficacy,pulmonary function indexes [forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC],CRP,cytokine [IL-6,IL-8,TNF-α] levels,blood rheology indexes (whole blood high-shear viscosity,whole blood low-shear viscosity,fibrinogen,hematokrit and plasma viscosity),and the occurrence of ADR were observed in 2 groups. RESULTS:The total effective rate of observation group (94.23%)was significantly higher than that of control group(75.00%);compared with before treatment,FEV1,FVC and FEV1/FVC of 2 groups were significantly increased after treatment,and those of observation group were significantly higher than those of control group;CRP,IL-6,IL-8 and TNF-α of 2 groups were significantly decreased,and those of observation group were signifi-cantly lower than those of control group. The whole blood high-shear viscosity,whole blood low-shear viscosity,fibrinogen,hema-tocrit and plasma viscosity of observation group were decreased significantly after treatment,and the observation group was signifi-cantly lower than the control group,with statistical significance(P<0.05). No significant ADR was found in 2 groups. CONCLU-SIONS:Astragalus injection combined with Salmeterol propionate powder inhalation is significantly effective for COPD,improves pulmonary function of patients,improves micro inflammatory state and decreases blood rheology indexes with good safety.