Objective:To explore the effect of narrative nursing on the psychological resilience, self-esteem, and medication compliance of adolescent depression patients.Methods:This study is a quasi-experimental study. From August 2021 to January 2022, 86 adolescent depression patients admitted to the Department of Mental Health at the First Hospital of Shanxi Medical University were selected as the subject by convenience sampling. According to the order of admission time, the patients were divided into a control group and an intervention group, with 43 patients in each group. The control group received routine nursing, while the intervention group received narrative nursing on the basis of routine nursing. We compared the scores of the Self-Rating Depression Scale (SDS), Hamilton Depression Scale (HAMD), Self-Esteem Scale (SES), Connor-Davidson Resilience Scale (CD-RISC), and Morisky Medication Adherence Scale (MMAS-8) before and after intervention between two groups of patients.Results:Before intervention, there was no statistically significant difference in SDS, HAMD, SES, CD-RISC, and MMAS-8 scores between the two groups ( P>0.05). After intervention, the total scores of SDS and HAMD in the intervention group were lower than those before intervention and in the control group, and the toughness, optimism, self-improvement scores and the CD-RISC total score, SES scores and MMAS-8 scores were higher than those before intervention and in the control group, with statistically significant differences ( P<0.05) . Conclusions:Narrative nursing can improve the depressive mood of adolescent depression patients, enhance their psychological resilience, self-esteem, and medication compliance, and can be promoted and applied in clinical practice.

To compare changes in platelet related parameters in obese patients before and after sleeve gastrectomy (SG), we retrospectively analyzed the clinical data of 31 obese patients who underwent SG in Peking Union Medical College Hospital from December 2012 to September 2020. Results showed that compared with those before surgery, platelet count (PLT) decreased significantly at 2-12 weeks of follow-up ( P=0.009), while platelet distribution width (PDW), mean platelet volume (MPV), and large platelet ratio (P-LCR) increased significantly at the same periods of follow-up after operation ( P<0.001). However, the levels of PDW, MPV, and P-LCR began to decrease at 16-55 weeks when compared with those at 2-12 weeks of follow-up ( P<0.01). PLT was positively correlated with white blood cells and neutrophils at 2-12 weeks of follow-up and positively correlated with high sensitivity C-reactive protein at 16-55 weeks of follow-up after operation ( P<0.05).

Objective:To explore the effect of the glycemic load food exchange method based on the information-motivation-behavioral skills (IMB) model in the diet intervention of obese patients with type 2 diabetes.Methods:From March to November 2019, convenience sampling was used to select 70 obese patients with type 2 diabetes in the Outpatient Department of Endocrinology of a Class Ⅲ Grade A hospital as the research object. According to the random number table method, patients were divided into control group and experimental group, with 35 cases in each group. Control group implemented the diet intervention of traditional food exchange, and experimental group carried out the diet intervention of the glycemic load food exchange method based on the IMB model. We compared the fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, triglycerides, total cholesterol, body mass index (BMI) , waist circumference, and the Summary of Diabetes Self-Care Activities (SDSCA) score of patients between two groups before and after intervention.Results:The number of patients who completed the intervention in control group and experimental group were 32 and 34 respectively. The fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, triglycerides, total cholesterol, BMI, and waist circumference of experimental group after intervention were lower than those of control group, and the SDSCA scale score was higher than that of control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of the glycemic load food exchange method based on the IMB model in diet intervention in obese patients with type 2 diabetes can improve the patients' self-management behavior, blood glucose, blood lipids, and anthropometric indicators, and can increase the diet intervention effect of obese patients with type 2 diabetes.

Objective:To conduct a longitudinal study on different social support needs of patients with acute myocardial infarction (AMI) at different stages undergoing emergency PCI based on timing it right framework combined with multidimensional model of social support, so as to provide reference for the implementation of accurate nursing.Methods:Using the interpretative phenomenological research method, a total of 21 emergency PCI patients from Department of Cardiology in two ClassⅢ Grade A hospitals in Taiyuan were selected from December 2019 to July 2020 by the purposive sampling method. According to the course of the disease, 4 semi-structured interviews were conducted on the patients, combined with participatory observation. The interpretive phenomenological analysis method was used to analyze the data, and the social support multi-dimensional model was used to classify the results.Results:A total of 23 themes were extracted. The information support requirements of each phase were in order of diagnosis and risk, AMI and PCI related knowledge, medical notification rights, individualized paper discharge guidance, causes of discomfort and first aid knowledge (the latter two phases were the same) . The tool support requirements for each phase were emergency medical services, advanced stents and emergency PCI technology, green channels, economic support and mobile health care resources (the latter two phases were the same) . The emotional support needs of each stage included companionship and sense of security, acceptance and encouragement, psychological adjustment and construction (the same in the next phase) and strengthening independence. The social network support needs of each stage included the assistance of strangers to send to the hospital, the virtue and skill of medical staff, peer support, and reintegration into society (the latter three stages were the same) . The need for self-esteem support in each period was believing that they can survive, taking care of themselves as much as possible, keeping their illness confidential, receiving recognition for their recovery and giving back to others.Conclusions:The social support needs of emergency PCI patients change with the course of the disease. It is recommended that medical staff adopt a dynamic and continuous care concept, establish and improve a framework of social support needs that meets the local humanities, so as to facilitate education, evaluation and intervention.

Objective To explore the effect of nursing intervention based on the transtheoretical model and stages of change on breastfeeding knowledge, self-efficacy, and duration of breastfeeding in newly born pregnant women, aimed to provide reference for breastfeeding behavior health education model for pregnant women. Methods The 130 primiparas who came to the hospital graded a class- three of Shanxi Province for perinatal examination were selected as the research subjects from May to June in 2017 , they were divided into test group and control group by random digits table method. In the control group, the normal breastfeeding health guidance was carried out in the three stages of prenatal, hospitalized and after discharge. The test group divided the primipara from the beginning of pregnancy to 6th months postpartum period into 5 stages according to transtheoretical model and stages of change. The new strategy of breastfeeding should be formulated and implemented according to different stages and behavior changing processes. Results The total score of breastfeeding knowledge of primipara were (8.76±1.14), (8.92±1.21), (9.90±1.27), (9.94±1.29) points in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, and they were (9.11 ± 1.42), (12.02 ± 1.64), (13.04 ± 1.67), (15.00±1.83) points respectively in test group, the differences were statistically significant(Ftime= 51.823, Fgroup=10.406, Finteractive=56.641, all P < 0.05). The total scores of breastfeeding self-efficacy of primipara were (84.62 ± 1.14), (88.96 ± 1.41), (86.65 ± 1.47), (84.31 ± 1.57) points respectively in control group before intervention, the 3rd day, the 42nd day and the 6th month after delivery, while in test group they were (84.98 ± 1.20), (104.02 ± 1.42), (111.00 ± 1.45), (120.04 ± 1.40) points, the differences were statistically significan (Ftime=12.592, Fgroup=229.674, Finteractive=79.955, all P<0.05). The pure breastfeeding rates of primipara were 60.0％(33/55) , 41.8％(23/55), 21.8％(12/55) in control group on the 3rd day, the 42nd day and the 6th month after delivery, they were 84.7％(50/59), 76.3％(45/59) , 49.2％(29/59) in the test group. The differences was statistically significant (χ2=8.804, 14.038, 9.235, all P <0.01). Conclusion Breastfeeding intervention based on the theory of behavioral staged transition can help primipara to improve breastfeeding knowledge and self-efficacy, and improve breastfeeding status.

Objective? To design a Seminar curriculum model for graduate nursing students based on the discussion of SCI papers and evaluate its effect on students' scientific research ability. Methods? Using the cluster sampling method, 57 graduate nursing students from a medical university were selected as the control group, and 58 graduate nursing students were selected as the experimental group. Using SCI nursing papers as the subject of discussion, the control group implemented the empirical Seminar curriculum model. The experimental group constructed and implemented the curriculum model based on the research capability structure model and the Seminar learning objectives. The effects of the intervention were evaluated using the Research Motivation Scale (RMS), the Nursing Research Self-Efficacy Scale (NURSES), the Nursing Staff Scientific Research Self-Assessment Scale (SRASES), and the Seminar Survey Questionnaire. Results? After the course, the scores of RMS total score, intrinsic motivation and extrinsic motivation of the nursing students in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05). At the end of the course, the scores of the NURSES total scores, scientific knowledge resources of the nursing students and "effect of collective research" in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05). At the end of the course, the scores of the total scores and dimensions of the SRASES in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05). Conclusions? The Seminar curriculum model based on SCI papers can improve the motivation, scientific research efficacy and scientific research ability of graduate nursing students to a certain extent. However, it is still necessary to further explore the curriculum model to help students avoid the motivation of scientific research failure and the understanding and application of theory.

Objective? To investigate the correlation between self-efficacy, discharge readiness and self-management in readmitted patients with myocardial infarction, to explore the influencing factors to self-management and to provide a basis for intervention strategies in clinical practice. Methods? Totally 198 readmitted patients with myocardial infarction from First Hospital of Shanxi Medical University were selected using convenient sampling from December 2017 to May 2018 and investigated with the general informational questionnaire, Coronary Heart Disease Self-Efficacy Questionnaire (CHDSEQ), Discharge Readiness Scale (DRS), and Coronary Heart Disease Self-Management Scale (CHDSMS). Pearson correlation analysis and multivariate linear multilayer regression analysis were used to explore the influencing factors to self-management behavior. Results? The CHDSMS score of the 198 patients was (75.21±9.31), with a 63.12% scoring metrics;the CHDSEQ score was (50.91±10.43); the DRS score was (161.53±26.76). Correlation analysis showed that self-efficacy was positively correlated with self-management (r=0.537, P＜0.01), and that discharge readiness was positively correlated with self-management (r=0.416, P＜ 0.01). Multilayer correlation analysis revealed that the two factors could account for 14.1% of the variance of self-management. Conclusions? Medical and nursing workers should evaluate the discharge readiness of readmitted patients with myocardial infarction accurately, improve patients' self-efficacy, and provide effective discharge guidance for different groups according to relevant influencing factors, thus improving patients' self-management.

Objective Henoch-Sch?nlein purpura(HSP)is a common multisystemic vasculitis in children ,but the exact pathogenesis remains unknown. Pentraxin 3(PTX3),a new kind of inflammatory cytokines,has a strong inflammatory effect,and is involved in occurrence and develop-ment of a variety of autoimmune diseases. The objective of this study is to evaluate the expression of PTX3,interleukin-8(IL-8),tumor necrosis fac-tor-α(TNF-α)and high sensitivity C-reactive protein(hs-CRP)in children with HSP,and explore the clinical significance of PTX3 in HSP devel-opment. Methods Thirty-six children(HSP group)and 17 healthy children(control group)were enrolled in the study. Serum levels of PTX3,IL-8 and TNF-α were detected by enzyme-linked immunosorbent assay. Serum hs-CRP levels were measured by automatic biochemical analyzer. Re-sults The serum levels of PTX3,IL-8,TNF-α,and hs-CRP were up-regulated in HSP group compared with the control group(P<0.05). The levels of PTX3,IL-8,TNF-α,and hs-CRP in patients with joint symptoms,or/and gastrointestinal symptoms,or/and kidney injury were significant-ly higher than those patients without joint symptoms,or/and gastrointestinal symptoms,or/and kidney injury(P<0.05). The expression of PTX3 was positively correlated with the expression of IL-8 and TNF-α(r=0.514,0.833,all P<0.05),but there was no correlation between PTX3 and hs-CRP(r=0.292,P>0.05). The expression of PTX3,IL-8,TNF-α and hs-CRP in HSP patients had no gender difference(all P>0.05). Con-clusion The high expression of PTX3 is related to the degree of inflammation in children with HSP. The up-regulated expression of PTX3 may play an important role in pathogenesis of HSP in children.

Objective To evaluate and analyze the clinical practical competence level of nursing graduates before and after internship and to screen its deficiency under current clinical practical ability training model and provide references for developing nursing graduates education of clinical practice ability and for improving clinical practical competence training pattern in clinical setting .Methods To implement the clinical practice guide tutor system to 160 graduate students in Shanxi Medical University from 2008 to 2011 , the students were asked to complete the clinical practical manual , which were designed to evaluate their clinical practical competence level using “OPSN” ( self-evaluation scale of oriented problem solving behavior in nursing practice) and “NPGA” (nursing practice goal attainment ).Results In the dimension of “OPSN” scale, the scores of “to discover problems by organizing and applying information ” “to offer psychological support for patients problem solution” “to provide personalized care for patients” and “to evaluate for solved problems”were (20.28 ±2.78), (17.23 ±1.92), (26.81 ±2.59), (20.76 ±2.59) after the internship, which were (17.82 ±3.47), (14.53 ±3.03), (24.82 ±3.44), (18.31 ±4.40), respectively, before the internship, and the differences were statistically significant (t=3.98, 5.40, 3.32, 3.43, respectively;P<0.05).The scores of “coordination of behavior between nurses and patients” were (16.76 ±2.72) and (17.51 ±1.96) before and after the internship, which had no significant difference (t=1.61, P>0.05).Each dimension of“NPGA” scale was not statistically significant before and after the internship (P>0.05).Conclusions There is still a gap between standard requirements and acquisition of practice ability under current clinical teaching environment .The project training for graduate students should be added according to the weak points in clinical practice ability training .

Objective To investigate the relationship between phosphatidylinositol 3-kinase catalytic subunit α(PIK3CA) expression and the incidence and different pathological grade of gastric cancer, and the mechanism thereof. Meth-ods The expressions of PIK3CA, serine/threonine protein kinase (pAkt) and cell proliferation associated nuclear antigen (ki-67) in gastric carcinoma and adjacent tissues and normal gastric mucosa were detected by immunohistochemical method. The relationship between expressions of PIK3CA, pAkt and ki-67 and tumorigenesis was analyzed. The expressions of PIK3CA, pAkt and ki-67 in different pathological conditions of gastric tissues were analyzed. The relationship between tu-mor pathologic classification and differentiation were analyzed too. Results There were significantly higher expressions of PIK3CA, pAkt and ki-67 in gastric cancer (P＜0.05), which were the highest in the poorly differentiated gastric adenocarci-noma (P＜0.05). There were a positive correlation between expressions of PIK3CA, pAkt and ki-67 and different pathologi-cal levels of gastric carcinoma and adjacent tissues and normal gastric tissues (P＜0.05). Conclusion PIK3CA may be the initiating factor of PI3K/Akt signaling pathway, which induced phosphorylation of Akt and activation PI3K/Akt signaling pathway, promoting the proliferation, invasion and metastasis of gastric adenocarcinoma.