Objective To investigate current status in knowledge,attitude and practice(KAP)of transitional care among the nurses in Shaanxi province,identify the influencing factors that hinder the transitional care and carry out training of transitional care for the nurses in different specialties in order to provide a theoretical basis for establishing a transitional care model for discharged patients.Methods A total of 2 288 nurses were selected to participate the survey from 41 hospitals in Shaanxi province by the stratified two-stage random sampling method.A self-designed questionnaire for general information,an obstacle factor scale,and a KAP of transitional care questionnaire were used as the survey instruments.The data acquired from the survey were processed by Cluster analysis to identify potential categories and the influencing factors.Results Totally 2085 nurses finished the study.Total score of KAP of transitional care among the nurses in Shaanxi province was found at(134.96±23.75),which was at a medium level.The scores of knowledge,attitude and practice were 77.24%,80.64%and 76.98%respectively.Cluster analysis showed that all the nurses could be categorised into either a lower scored group(n=1 596,76.5%)or a higher scored group(489,23.5%),with a best potential category number of 2 for the 2 085 nurses who participated the survey.There were statistically significant differences between the groups in terms of care training,telephone follow-up,network platform,outpatient service of nursing experts,family visits,patient club and hospital categories(all P＜0.05).Logistic regression analysis on even factors above showed that care training,telephone follow-up,network platform and patient club could significantly affect the potential categorisation of KAP of the nurses in transitional care(all P＜0.05).The main factors that hindered the transitional care included insufficient human resources(93.81%),insufficient supply of community services(93.57%)and lack of a standardised flowchart for transitional care(93.09%).Conclusions Levels of KAP about the transitional care are at a medium level among the nurses of 41 hospitals in Shaanxi province,which indicates that the nurses are active in attitude,but the knowledge and practice are required to be further improved and standardised.The results of cluster analysis indicate that it is necessary for nursing managers to carry out targeted trainings in transitional care for the nurses in different categories.This study provides a theoretical basis to establish a diversified transitional care mode for discharged patients in Shaanxi province.

Objective:To construct a new thrombus risk assessment model and evaluate its predictive ability for venous thromboembolism(VTE)in the patients with malignant tumors,and to provide the basis for the early predition of the malignant tumor patients with high risk for VTE.Methods:A total of 128 untreated malignant tumor patients were included,of which 40 were diagnosed with VTE within 2 months of malignant tumor diagnosis and categorized as VTE group.A total of 88 patients who did not develop VTE were categorized as non-VTE group.The clinical risk factors and laboratory indicators of the patients in two groups were compared and analyzed;the types of thrombotic events of the patients were analyzed;the diagnostic values of thrombin-antithrombin-complex(TAT),α2-plasmin inhibitor-plasmin complex(PIC),D-dimer(D-dimer),and fibrin degradation products(FDP)in malignant tumors complicated by VTE were assessed using receiver operating characteristic(ROC)curve analysis;Multivariate Logistic regression analysis was used to analyze the correlations of the clinical risk factors and biomarkers with the malignant tumors complicated with VTE.A new thrombus risk assessment model was constructed,consisting of TAT≥0.70 μg·L-1,poor differentiation,and cardiovascular risk factors.The predictive probability of the model for malignant tumors complicated by VTE was evaluated based on the significance,goodness of fit,calibration curve,and C value of the model.The clinical application value of the new thrombus risk assessment model,COMPASS-CAT risk score(CRS),and Khorana risk score(KRS)in assessing malignant tumor patients complicated by VTE was compared using the C value and decision curve analysis(DCA).Results:The plasma levels of TAT(P＜0.001),PIC(P＜0.001),D-dimer(P＜0.05),and FDP(P＜0.01)of the patients in VTE group were higher than those in non-VTE group.Compared with the patients without cardiovascular risk factors,poor differentiation,and lymphatic metastasis,the malignant tumor patients with cardiovascular risk factors(P＜0.001),poor differentiation(P＜0.001),and lymphatic metastasis(P＜0.05)were more likely to develop VTE.Most VTE events(65％)were isolated deep vein thromboembolism(DVT).The ROC curve analysis showed that the area under the curve(AUC),sensitivity,and specificity of TAT and PIC were higher than those of D-dimer and FDP.TAT≥0.70 μg·L-1(P＜0.05),poor differentiation(P＜0.01),and cardiovascular risk factors(P＜0.01)were the independent risk factors for VTE in the malignant tumor patients.A new thrombus risk assessment model consisting of TAT≥0.70 μg·L-1,poor differentiation,and cardiovascular risk factors was constructed.The new risk assessment model had a high goodness of fit(P=0.805)and good predictive ability during internal validation(x2=75.266,P＜0.001).The ROC curve analysis results showed that the C values for the new thrombus risk prediction model,CRS,and KRS were 0.908,0.676,and 0.541,respectively.The DCA curve analysis results showed that the new thrombus risk assessment model had a higher net benefit rate compared with CRS and KRS.Conclusion:TAT and PIC have greater diagnostic efficiency than D-dimer in the early prediction of the malignant tumor patients with high-risk VTE.For the patients included in this study,the new thrombus risk assessment model,constructed from TAT≥0.70 μg·L-1,poor differentiation,and cardiovascular risk factors,has superior diagnostic efficiency and clinical predictive value compared with CRS and KRS.

Objective:The classification model of prognosis of elderly cancer patients in rural areas of Shaanxi province was constructed based on machine learning algorithm, and its effectiveness was verified, providing reference for early prognosis recognition and intervention treatment.Methods:Using a multicenter, cross-sectional survey method and convenience sampling method, 597 elderly cancer patients in rural areas hospitalized in 9 different medical institutions (Shaanxi Cancer Hospital and its member units of specialty alliance) in Shaanxi Province from July to August 2022 were selected as the research objects, and a variable database of "basic information", "self-care ability", "symptoms", "comprehensive needs" and "quality of life" of elderly cancer patients in rural areas was established. Machine learning and statistical analysis were carried out to explore the important prognostic characteristics of elderly cancer patients in rural areas, and a prognostic classification model for elderly cancer patients in rural areas was constructed and verified.Results:The 597 valid questionnaires were ultimately collected.Among the 597 elderly cancer patients in rural areas, 207 were males and 390 were females, aged (69.56 ± 8.84) years. The results of cluster exploration showed that the prognosis of elderly cancer patients in rural areas was divided into three categories: good, medium and poor. The areas under the working characteristic curves of the subjects in good, medium and poor were 0.84, 0.79 and 0.69, respectively. The results of characteristic exploration showed that 10 indicators of "whether accompanied by metastasis", "distress", "sadness", "numbness", "eating", "walking", "fatigue", "forgetfulness", "fun of life" and "relationship with others" were important characteristic indicators of prognosis evaluation of elderly cancer patients in rural areas. There were statistically significant differences among the 10 important characteristic indicators in the three categories of prognosis of rural elderly cancer patients ( χ2=21.07, H values were 18.51-144.38, all P<0.01). There were statistically significant differences in the three categories of "comprehensive needs", "quality of life", "self-care ability" and "symptoms" ( H values were 519.40, 40.80, 103.69, all P<0.01). Conclusions:The construction and verification of a prognostic classification model for elderly cancer patients in rural areas based on machine learning algorithm can effectively explore the important characteristic indicators and prognostic classification of elderly cancer patients in rural areas, and provide basis and guidance for clinical medical staff to make individualized plans.

Objective:To investigate the effect of drospirenone and ethinylestradiol in the treatment of ovulation induction in patients with premature ovarian insufficiency (POI).Methods:A randomized controlled clinical study analyzed the clinical data of 130 POI patients who underwent assisted reproductive treatment at the Department of Reproductive Medicine, Department of Obstetrics and Gynecology, the Seventh Medical Center and Department of Obstetrics and Gynecology, the Sixth Medical Center of Chinese people's Liberation Army General Hospital from December 2021 to November 2022. The subject-centered randomization method was used to conceal the allocation, and there was no blinding. The patients in experimental group was given drospirenone and ethinylestradiol as pretreatment, while control group was not treated. The main observation indicator of the follicle recovery growth rate and the secondary observation indicators of estradiol and follicle-stimulating hormone (FSH) levels before and after pretreatment, the number of eggs retrieved, the proportion of eggs retrieved, and other embryo laboratory-related indicators were compared between the two groups.Results:The recovery rate of follicular growth in the experimental group was significantly higher than that in control group, and the difference was statistically significant [50.77% (33/65) vs. 15.38% (10/65), P<0.001, rate difference =35.38%, 95% CI: 19.44%-48.98%]. The levels of FSH [17.70 (8.15, 27.00) U/L] decreased significantly and estradiol [24.00 (15.00, 90.47) ng/L] increased significantly in the experimental group after preconditioning with spironolone ethinylestradiol compared with those before preconditioning [30.30 (25.95, 48.05) U/L, P<0.001; 15.00 (15.00, 24.00) ng/L, P<0.001], the differences were statistically significant. Conclusion:The spironolone ethinylestradiol can effectively inhibit the level of FSH and increase the level of estradiol in patients with POI, and increase the probability of ovarian growth and development during ovulation induction therapy.

Objective:To investigate the effect of drospirenone and ethinylestradiol in the treatment of ovulation induction in patients with premature ovarian insufficiency (POI).Methods:A randomized controlled clinical study analyzed the clinical data of 130 POI patients who underwent assisted reproductive treatment at the Department of Reproductive Medicine, Department of Obstetrics and Gynecology, the Seventh Medical Center and Department of Obstetrics and Gynecology, the Sixth Medical Center of Chinese people's Liberation Army General Hospital from December 2021 to November 2022. The subject-centered randomization method was used to conceal the allocation, and there was no blinding. The patients in experimental group was given drospirenone and ethinylestradiol as pretreatment, while control group was not treated. The main observation indicator of the follicle recovery growth rate and the secondary observation indicators of estradiol and follicle-stimulating hormone (FSH) levels before and after pretreatment, the number of eggs retrieved, the proportion of eggs retrieved, and other embryo laboratory-related indicators were compared between the two groups.Results:The recovery rate of follicular growth in the experimental group was significantly higher than that in control group, and the difference was statistically significant [50.77% (33/65) vs. 15.38% (10/65), P<0.001, rate difference =35.38%, 95% CI: 19.44%-48.98%]. The levels of FSH [17.70 (8.15, 27.00) U/L] decreased significantly and estradiol [24.00 (15.00, 90.47) ng/L] increased significantly in the experimental group after preconditioning with spironolone ethinylestradiol compared with those before preconditioning [30.30 (25.95, 48.05) U/L, P<0.001; 15.00 (15.00, 24.00) ng/L, P<0.001], the differences were statistically significant. Conclusion:The spironolone ethinylestradiol can effectively inhibit the level of FSH and increase the level of estradiol in patients with POI, and increase the probability of ovarian growth and development during ovulation induction therapy.

Objective:To conduct a Meta-analysis on the application effect of information management on safe in-hospital transfer of patients in China.Methods:Using computers to search for randomized controlled trials and quasi experimental studies on the effect of information management on safe in-hospital transfer of patients in China from China National Knowledge Infrastructure, VIP, Wanfang Database, China Biomedical Mediline disc, PubMed, Embase, Web of Science, CINAHL and Cochrane Library. The search period was from establishment of databases to May 17, 2022. Literature screening, quality evaluation and data extraction were conducted independently by two trained researchers. Stata 15.1 software was used for Meta-analysis.Results:A total of 14 articles were included, involving a total of 130 670 patients. The results of Meta-analysis showed that the incidence of adverse event in in-hospital transfer of patients in the information management group was shorter than that in the control group ( OR=0.24, 95% CI: 0.17-0.35, P<0.01), duration of in-hospital tranfer was longer than that in the control group ( WMD=-5.76, 95% CI: -8.30-3.22, P<0.01), and patients' satisfaction ( OR=1.11, 95% CI: 1.05-1.17, P<0.01) and satisfaction of medical personnel responsible for transfer ( OR=1.37, 95% CI: 1.13-1.66, P<0.01) were higher than those of the control group. Conclusions:Information management can effectively control the incidence of adverse events in in-hospital transfer of patients in China, shorten the time required for hospital transfers and improve the satisfaction of patients and medical staff in hospital transfers.

Objective:To identify the classification characteristics and quality of life (QOL) of breast cancer (BC) patients during chemotherapy, so as to provide basis for improving the sleep and QOL of this group.Methods:A cross-sectional investigation was completed among 421 BC patients in 5 tertiary hospitals in Shanghai, Wuhan, Tangshan and Nanning in 1-12 months of 2016 using validated instruments including self-made general information questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Functional Assessment of Cancer Therapy-Breast (FACT-B).Results:Four latent class of patients were identified through latent profile analysis (LPA), named by badly worse sleep quality(SQ) (C1, n=23), medium-SQ with difficulty to fall asleep (C2, n=127), medium-SQ with worse sleeping process (C3, n=30), none sleep disorders (C4, n=241). Total points of SQ among C1-C4 had significant difference ( χ2 value was 309.28, P<0.05). Age, BMI, job status, whether had surgery and course of chemotherapy between classes had statistically significant differences ( χ2 values were 9.57-25.28, all P<0.05). It had significant difference between C2 and C3, C2 and C4, C3 and C1, C3 and C4 on QOL ( χ2 values were 5.96-52.73, all P<0.05). Conclusion:SQ of BC patients during chemotherapy has heterogeneity among population. Different features of SQ of BC patients have different performance on QOL. Health professionals should keep an eye on patients with features of older age, high BMI, in job status, already received surgery and during early-stage chemotherapy, provide personal nursing intervention to improve SQ and QOL.

Objective:To design a clinical replacement theoretic lesson based on BOPPPS on pediatric nephrotic syndrome for undergraduate nursing students and to evaluate the content and the effect of the lesson.Methods:A lesson on pediatric nephrotic syndrome for undergraduate nursing students was developed based on the BOPPPS model and the learning principles of Pediatric Nursing. The reliability of the content was assessed through expert consensus. And a group of undergraduate nursing students was invited to participate in the lesson and provide feedback on the effectiveness of the lesson.Results:An hour-long lesson was developed including a standard and real case with pediatric nephrotic syndrome and presented in a slide containing pictures. Seven experts validated the content of the lesson, ten undergraduate students and 1 professor of pediatric theory in the college commented that the lesson would improve their performance in clinical replacement.Conclusions:A clinical replacement theoretic lesson based on BOPPPS on pediatric nephrotic syndrome for undergraduate nursing students is well organized, well-accepted, and can bridge the school lessons and clinical practice for undergraduate nursing students.

Objective:To investigate the expression and significance of Nek2B and β-catenin expression in triple negative breast cancer (TNBC) at molecule levels.Methods:By using the methods of bioinformatics [GEO2R online tool, gene ontology (GO) function analysis, KEGG biological pathway enrichment analysis], the differentially expressed genes were screened from TNBC microarray data.Expression levels of Nek2B and β-catenin TNBC cell lines were detected by Western blot and qRT-PCR.From January 1, 2007 to December 31, 2012, eighty cases of TNBC were collected from the Second Hospital of Shanxi Medical University. The expression of Nek2B in TNBC tumor tissue was detected by immunohistochemistry and tissue microarray, and the relationship between Nek2B and clinical pathological characteristics of TNBC was analyzed.Results:Through bioinformatics analysis of the cDNA chip sets of 2 TNBC tumors(GSE38959,GSE27447), 998 differentially expressed genes were obtained in the initial screening, and 13 differentially expressed genes were revealed after intersection. The results of biological pathway analysis showed that the common differential expression genes were closely related to Wnt/β-catenin pathway, among which Nek2 expression showed the greatest difference and was associated with poor prognosis. Expression intensity of Nek2B and repeated β-catenin in the same TNBC cell line was consistent.The results of immunohistochemistry showed that the high expression of Nek2B was related to the high histological stage (G3;84.3% vs.37.9%, P<0.001), lymph node metastasis group (76.7% vs.54.1%, P=0.032), high Ki-67 positive index group (78.6% vs.52.6%, P=0.007) and β-catenin positive expression group (72.5% vs.27.3%, P=0.018). Conclusions:The high level of Nek2B expression is related to a poor prognosis in TNBC patients. In TNBC tissues and cells, the expression of Nek2B is correlated with β-catenin, suggesting that Nek2B may affect the occurrence and development of TNBC by regulating the Wnt/β-catenin patients signaling pathway.

Objective To retrieve,assess and summarize the best evidence on breast milk expression of premature infants' mothers in maternal separation so as to provide high-quality evidence for medical staff to carry out breast feeding guide. Methods Guidelines,systematic reviews,recommended practices and evidence summaries were retrieved in the UpToDate,WHO,Academy of Breastfeeding Medicine(ABM), Cochrane Library,Joanna Briggs Institute Library,Registered Nurses' Association of Ontario(RNAO), National Guideline Clearinghouse(NGC),PubMed,Embase,Chinese Biological Medicine,Chinese National Knowledge Infrastructure,WanFang data,VIP and the evidence-based nursing database of Fudan University from January 2008 to December 2018. Results A total of 7 literatures were included,two guidelines,one clinical decision,two systematic reviews and two evidence summaries. A total of 19 evidences were gathered in 7 aspects,such as training for medical staff,parents' education,selection of breast pump,preparation before expression,operational skills of breast expression,measures for increasing lactation and expression effects monitor. Conclusions Clinical medical staff should lay down the individualized nursing measures for maternal women to ensure breast milk collected as soon as possible,gain enough breast milk and fill the bill of growth and development of premature infants.