Objective:To explore the effect of applying SHOW mode of mindfulness meditation training in the psychological intervention of patients with advanced lung cancer.Methods:From June 2020 to May 2021, a total of 130 patients with advanced lung cancer who were hospitalized in Taizhou Central Hospital were selected as the research objects by the convenient sampling method. According to the random number table method, patients were divided into the study group and the control group, with 65 cases in each group. The control group was given routine mindfulness meditation intervention, while the study group was given SHOW model mindfulness meditation training on the basis of the control group. The degree of anxiety and depression, psychological resilience and self-management efficacy of patients in the two groups were observed before and after intervention.Results:After intervention, scores of Hamilton Anxiety Scale (HAMA-14) and Hamilton Depression Scale (HAMD-17) in the two groups were lower than those before intervention and scores of HAMA-14 and HAMD-17 in the study group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Connor-Davidson Resilience Scale (CD-RISC) and Strategies Used by People to Promote Health-Chinese (C-SUPPH) in two groups were higher than those before intervention and the scores of CD-RISC and C-SUPPH in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The SHOW model mindfulness meditation training has a good application effect in the psychological intervention of patients with advanced lung cancer, which can effectively improve the degree of anxiety and depression of patients and enhance their psychological resilience and self-management efficacy.

Objective:To explore the effect of applying SHOW mode of mindfulness meditation training in the psychological intervention of patients with advanced lung cancer.Methods:From June 2020 to May 2021, a total of 130 patients with advanced lung cancer who were hospitalized in Taizhou Central Hospital were selected as the research objects by the convenient sampling method. According to the random number table method, patients were divided into the study group and the control group, with 65 cases in each group. The control group was given routine mindfulness meditation intervention, while the study group was given SHOW model mindfulness meditation training on the basis of the control group. The degree of anxiety and depression, psychological resilience and self-management efficacy of patients in the two groups were observed before and after intervention.Results:After intervention, scores of Hamilton Anxiety Scale (HAMA-14) and Hamilton Depression Scale (HAMD-17) in the two groups were lower than those before intervention and scores of HAMA-14 and HAMD-17 in the study group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of Connor-Davidson Resilience Scale (CD-RISC) and Strategies Used by People to Promote Health-Chinese (C-SUPPH) in two groups were higher than those before intervention and the scores of CD-RISC and C-SUPPH in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The SHOW model mindfulness meditation training has a good application effect in the psychological intervention of patients with advanced lung cancer, which can effectively improve the degree of anxiety and depression of patients and enhance their psychological resilience and self-management efficacy.

Objective:To explore the effect of cloud follow-up system in post-hospital follow-up management of hyperuricemia gout patients.Methods:Using the convenient sampling method, a total of 120 gout patients who were discharged after treatment in Taizhou Central Hospital in June 2021 were selected as the research objects and they were randomly divided into the control group and the experimental group according to the random number table method, with 60 cases in each group. The control group carried out routine follow-up, while the experimental group carried out follow-up based on cloud follow-up system. The serum uric acid level and self-management ability of gout patients were compared between the two groups before and after 6 months of follow-up.Results:After 6 months of follow-up, the serum uric acid levels of the control group and the experimental group were lower than those before follow-up and that of the experimental group was lower than the control group, and the differences were statistically significant ( P<0.05) . After 6 months of follow-up, the self-management ability score of the experimental group was higher than that before follow-up and higher than that after follow-up of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The new follow-up model based on cloud follow-up system is helpful to improve the self-management ability of gout patients and reduce the blood uric acid level of gout patients.

Objective::Diverse antithrombotic strategies were applied to patients undergoing aortic valve replacement. However, the optimal therapeutic regimen for patients undergoing transcatheter aortic valve implantation/replacement (TAVI/TAVR) remains unclear. The purpose of this study was to compare the efficacy and safety of various antithrombotic therapies following TAVI/TAVR.Methods::Relevant clinical trials evaluating the effect of anticoagulation or antiplatelet regimens on patients after TAVI/TAVR from inception to September 2020 were identified using the PubMed, EMBASE, and the Cochrane Library databases. The inclusion criteria including (1) all patients underwent TAVI/TAVR; (2) the interventions were antithrombotic strategies that prevent the occurrence of thrombotic events in patients; (3) randomized controlled trials or prospective observational studies; and (4) investigation of at least 1 outcome with a follow-up period of ≥3 months. The exclusion criteria including (1) research content was identical or irrelevant to the purpose of the present study; (2) lack of the required outcome index or availability of fragmentary original information; and (3) the full text is not available. The major outcomes were all-cause mortality, thromboembolic complications, and bleeding events. The Cochrane Collaboration’s tool and the Newcastle-Ottawa Scale were used for assessing the risk of bias in included studies.Results::Thirteen studies (3 randomized controlled trials and 10 non-randomized studies) were identified, with a total of 23,497 patients. Four studies compared direct oral anticoagulants (DOACs) with warfarin, 1 study compared aspirin with warfarin, 6 studies compared aspirin plus clopidogrel (dual antiplatelet therapy (DAPT)) with aspirin monotherapy, and 2 studies compared DAPT and aspirin monotherapy with warfarin concurrently. There were no significant differences found between the DOAC and warfarin groups regarding all-cause mortality (risk ratio (RR): 1.03; 95% confidence interval (CI): 0.65-1.64; P = 0.909; Phet = 0.105), clinical adverse events (RR: 1.59; 95% CI: 0.99-2.58; P = 0.057; Phet = 0.738), or bleeding events (RR: 0.93; 95% CI: 0.78-1.11; P = 0.437; Phet = 0.338). The rates of all-cause mortality (RR: 0.71; 95% CI: 0.54-0.93; P = 0.012; Phet = 0.845) and bleeding events (RR: 0.43; 95% CI: 0.22-0.83; P = 0.012; Phet = 0.569) were lower in the aspirin group versus the warfarin group; however, there was no difference in the rate of clinical adverse events (RR: 0.38; 95% CI: 0.14-1.07; P = 0.068; Phet = 0.593). The DAPT group had an advantage versus the aspirin group in all-cause mortality (RR: 0.89; 95% CI: 0.82-0.98; P = 0.013; Phet = 0.299); however, the incidence of bleeding events (RR: 2.06; 95% CI: 1.39-3.07; P < 0.001; Phet = 0.001) exhibited an increasing trend. Notably, there was a slight decrease in the incidence of clinical adverse events (RR: 1.09; 95% CI: 0.94-1.26; P = 0.268; Phet = 0.554). Conclusion::The present meta-analysis integrates the latest published results on antithrombotic strategies in patients after TAVI/TAVR. Aspirin showed a favorable risk-benefit profile versus warfarin, with lower rates of all-cause mortality and bleeding events. Although DAPT was also associated with a significantly lower rate of all-cause mortality, it was linked to a higher incidence of bleeding events. The DOACs did not show significant benefits compared with warfarin. Some certain limitations should be noted, such as different types of trails produce heterogeneity and finite inclusion of TAVI/TAVR patients increased selection bias.

Objective::Diverse antithrombotic strategies were applied to patients undergoing aortic valve replacement. However, the optimal therapeutic regimen for patients undergoing transcatheter aortic valve implantation/replacement (TAVI/TAVR) remains unclear. The purpose of this study was to compare the efficacy and safety of various antithrombotic therapies following TAVI/TAVR.Methods::Relevant clinical trials evaluating the effect of anticoagulation or antiplatelet regimens on patients after TAVI/TAVR from inception to September 2020 were identified using the PubMed, EMBASE, and the Cochrane Library databases. The inclusion criteria including (1) all patients underwent TAVI/TAVR; (2) the interventions were antithrombotic strategies that prevent the occurrence of thrombotic events in patients; (3) randomized controlled trials or prospective observational studies; and (4) investigation of at least 1 outcome with a follow-up period of ≥3 months. The exclusion criteria including (1) research content was identical or irrelevant to the purpose of the present study; (2) lack of the required outcome index or availability of fragmentary original information; and (3) the full text is not available. The major outcomes were all-cause mortality, thromboembolic complications, and bleeding events. The Cochrane Collaboration’s tool and the Newcastle-Ottawa Scale were used for assessing the risk of bias in included studies.Results::Thirteen studies (3 randomized controlled trials and 10 non-randomized studies) were identified, with a total of 23,497 patients. Four studies compared direct oral anticoagulants (DOACs) with warfarin, 1 study compared aspirin with warfarin, 6 studies compared aspirin plus clopidogrel (dual antiplatelet therapy (DAPT)) with aspirin monotherapy, and 2 studies compared DAPT and aspirin monotherapy with warfarin concurrently. There were no significant differences found between the DOAC and warfarin groups regarding all-cause mortality (risk ratio (RR): 1.03; 95% confidence interval (CI): 0.65-1.64; P = 0.909; Phet = 0.105), clinical adverse events (RR: 1.59; 95% CI: 0.99-2.58; P = 0.057; Phet = 0.738), or bleeding events (RR: 0.93; 95% CI: 0.78-1.11; P = 0.437; Phet = 0.338). The rates of all-cause mortality (RR: 0.71; 95% CI: 0.54-0.93; P = 0.012; Phet = 0.845) and bleeding events (RR: 0.43; 95% CI: 0.22-0.83; P = 0.012; Phet = 0.569) were lower in the aspirin group versus the warfarin group; however, there was no difference in the rate of clinical adverse events (RR: 0.38; 95% CI: 0.14-1.07; P = 0.068; Phet = 0.593). The DAPT group had an advantage versus the aspirin group in all-cause mortality (RR: 0.89; 95% CI: 0.82-0.98; P = 0.013; Phet = 0.299); however, the incidence of bleeding events (RR: 2.06; 95% CI: 1.39-3.07; P < 0.001; Phet = 0.001) exhibited an increasing trend. Notably, there was a slight decrease in the incidence of clinical adverse events (RR: 1.09; 95% CI: 0.94-1.26; P = 0.268; Phet = 0.554). Conclusion::The present meta-analysis integrates the latest published results on antithrombotic strategies in patients after TAVI/TAVR. Aspirin showed a favorable risk-benefit profile versus warfarin, with lower rates of all-cause mortality and bleeding events. Although DAPT was also associated with a significantly lower rate of all-cause mortality, it was linked to a higher incidence of bleeding events. The DOACs did not show significant benefits compared with warfarin. Some certain limitations should be noted, such as different types of trails produce heterogeneity and finite inclusion of TAVI/TAVR patients increased selection bias.

Objective:To explore the application effect of full-process outpatient intelligent medical service mode in outpatients.Methods:By the convenient sampling method, a total of 600 inpatients in Taizhou Central Hospital from 2016 to 2017 were selected as the control group while 600 inpatients from 2018 to 2019 were selected as the experimental group. The control group adopted the traditional medical treatment mode, while the experimental group adopted the full-process outpatient intelligent medical service mode. The waiting time, visiting time, accounting rate of artificial window and one-time payment rate of patients of the two groups were compared.Results:The waiting time and visiting time of patients in the experimental group were shorter than those in the control group, and the differences were statistically significant ( P<0.01) . The one-time payment rate of patients in the experimental group was higher than that of the control group, while the accounting rate of artificial window was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Full-process outpatient intelligent medical service mode can shorten waiting time of patients, improve their medical experience and improve the service quality of the hospital.

Objective To explore the effect of application of task-based learning with experiential teaching on nursing clinical decision making ability. Methods A total of 96 nursing students were divided into experimental group and observation group with each of 48 nursing students. The experimental group used the application of task-based learning with experimental teaching, the control group used the traditional scenario simulation. At the end of the course, the final scores, skill operation scores and nursing students'evaluation of the course and clinical decision-making ability of nursing were observed in the two groups. Results The final scores, chapters related to task-based learning with experiential teaching, skill operation scores was (82.06±0.98), (12.01±0.88), (94.99±0.34) points in the experimental group, and (78.34±0.98), (9.32±0.76), (91.87±0.98) points in the control group, and the difference was significant(t=12.958, 9.872, 10.834, all P<0.01). The evaluation of teaching methods, teaching process and teaching effect was (20.06±0.98), (23.01±0.88), (35.99±0.34) points in the experimental group, and (17.34±0.98), (20.32±0.76), (30.87±0.98) points in the control group, and the difference was significant (t=5.96, 6.87, 6.99, all P<0.01).The score of clinical decision-making ability of nursing was (137.50 ± 12.61) points in the experimental group, and (123.88±9.89) points in the control group,and the difference was significant (t=5.891, P<0.01). Conclusions The effect of task-based learning with experiential teaching in teaching of nursing in vocational nursing students, enable students to transfer knowledge and experience in experience, it can improve the students' clinical decision making ability.

Objective To investigate the status quo of junior nurses' nursing work environment and clinical decision making perception,and to analyze the influence of nursing work environment on clinical decision making perception.Methods The general data questionnaire,nursing work environment scale and clinical decision making perception scale was used to investigate 633 Junior nurses in hospitals.Results The overall mean score of nursing work environment was (2.99±0.37) points,the dimensions score from high to low were:medical cooperation (3.12 ± 0.47) points,nursing management and leadership style (3.06 ± 0.47) points,nurse participation in hospital affairs (2.91 ±0.48) points,high quality nursing service (2.78 ± 0.48) points,sufficient manpower and material resources (2.75 ± 0.52) points,;clinical decision—making perception of Junior nurses was (143.36 ± 14.01) points,the dimensions score from high to low were:the decision—evaluative feedback (37.31 ± 4.53) points,determine the goal of solving the problem (36.16 ± 4.39) points,find the information again (35.04 ± 3.76) points,gather information ability (30.98 ± 3.80) points.The Total score of nursing work environment were positively correlated with the clinical decision making perception of junior nurses(r =0.08-0.28,P＜ 0.01).Conclusions Junior nurse's nursing work environment remains to be improved,nursing work environment has a good effect on clinical decision making perception,therefore,nursing managers should create a positive working atmosphere.It is beneficial to improve the awareness of nursing clinical decision-making by giving specific support to the needs of junior nurses.

Objective To explore the effect of four-element teaching design model based on comprehensive learning in teaching of basic nursing in vocational nursing students. Methods Ninety-six nursing students at Taizhou Vocational and Technical College in Zhejiang Province were selected as the study subjects. Ninety-six nursing students were divided into the experimental group and the control group with 48 nursing students in each. The experimental group used four-element teaching design model for teaching, and the control group adopted traditional teaching methods.The testing results and evaluation of nursing students for this curriculum were compared. Results The theoretical assessment and skill assessment of nursing students in the experimental group were 82.09±8.05 and 90.65±4.93 respectively, and in the control group were 76.30±10.20, 85.33±6.01. The difference was statistically significant (t =3.06,4.74, P<0.01). The scores of curriculum setting, teaching methods, assessment methods, and teaching effects in the experimental group were evaluated as 35.08±3.64, 42.06±4.75, 18.15±1.60, 40.35±6.20, in the control group were 29.63 ± 4.65, 36.02 ± 6.20, 14.04 ± 2.69, 36.35 ± 6.56. The difference was statistically significant (t=3.07-9.09, P<0.01). Conclusion The four-element teaching design model based on comprehensive learning can improve the students′ learning initiative and teaching effect of basic nursing, promote the coordinated development of nursing students'professional knowledge, skills and professional ability.

Objective To investigate the effect of extracorporeal membrane oxygenation (ECMO) combined with ultrafiltration in treatment of kidney injury induced by serious hemorrhagic shock in rabbits.Methods Models of pressure-controlled hemorrhagic shock was developed in 24 New Zealand white rabbits which were divided into unresuscitation group (n =8),ECMO combined with ultrafiltration group (combined resuscitation group,n =8),and fluid resuscitation group (n =8) according to the random number table.Heart rate was monitored via electrocardiograph and arterial pressure via fermoral artery catheter.Blood samples were collected pre-and post-shock and after resuscitation to measure levels of lactic acid,serum creatinine,IL-6,and TNF-α.Kidney samples were collected for measurement of histopathological changes via HE staining,expression of heat shock protein 70 (HSP70) via immunohistochemical staining.Results Arterial pressure was (53.1 ± 11.4) mmHg in combined resuscitation group,higher than (41.3 ± 11.1) mmHg in fluid resuscitation group and (25.9 ± 10.5) mmHg in unresuscitation group (F =41.425,P ＜ 0.05).Hemorrhagic shock induced significant up-regulation of lactic acid,serum creatinine,IL-6,and TNF-α(P ＜ 0.05),but all were lowered after resuscitation,especially in combined resuscitation group (P ＜ 0.05).HE staining showed the degree of kidney tissue necrosis and inflammatory cytokine infiltration in combined resuscitation group alleviated notably compared with fluid resuscitation group.Median and interquartile values of HSP70 were 17 828.960 0 (15 779.865 0-21 751.980 0) in unresuscitation group,2 714.270 0 (1 339.215 0-7 616.950 0) in fluid resuscitation group,and 262.930 0 (198.820 0-538.195 0) in combine resuscitation group,with statistical differences among groups(P ＜ 0.05).Conclusion ECMO combined with ultrafiltration is superior to conventional fluid resuscitation in improving hypoxia tissue injury and inflammatory reaction after hemorrhagic shock and is beneficial to attenuating kidney injury.