Objective To clarify and analyze the concept and connotation of the reflective practice in nurses.Methods CNKI,Wanfang,CBM,PubMed,Embase,Scopus,CIHNAL database were searched in relation to reflective practice in nurses.The retrieval period was from the inception to Dec.2022.Walker and Avant's concept analysis method was used to analyze the connotation.Results A total of 43 articles were retrieved.6 attributes of reflective practice in nurses were identified,including active engagement,critical thinking,openness and acceptance,making connections with previous knowledge or experiences,extemal support,dynamic and continuity.Antecedents included internal and extemal drivers.The reflective practice in nurses ultimately had a vital impact on themselves,patients and organizations.In recent years Reflective Practice Questionnaire has been one of the most commonly used data collection tools to measure the reflective practice in nurses.Conclusion The concept attributes of reflective practice in nurses were identified by concept analysis method,which provides references for nursing educators to cultivate reflective practice ability of nurses.In future research,researchers can combine the connotations of reflective practice for nurses to develop specific assessment tools for testing the level of reflective practice of nurses and construct the local reflective practice intervention scheme for nurses,so as to promote the development of reflective practice in nursing field in China.

Objective:This study aims to systematically sort out the effectiveness evaluation of the general education teaching models in epidemiology at home and abroad and provide a reference for the development and reform of epidemiology education.Methods:A systematic search of English databases such as PubMed, Embase, and Web of Science and Chinese databases such as CNKI, Sinomed, Wanfang, etc., were used to screen out the literature on different general teaching models of education in epidemiology. Each literature's teaching effect will be summarized and evaluated to conduct a systematic qualitative review in the narrative integration method, Results:A total of 45 articles (28 in Chinese and 17 in English) were included in this study, involving 14 teaching models, including mixed teaching models, PBL (problem-based learning), project designing models, and CBL (case-based learning) and other teaching models. Except for some teaching models such as project design, network platform, and flipped classroom model, the teaching effect of other innovative models is better than that of the traditional model. The distribution of teaching models was different in Chinese and foreign literature. Foreign teaching models were diverse, mainly concentrated in mixed teaching models and software/network platform learning. Domestic teaching models were relatively fixed. The mixed teaching model and PBL model were the most widely used in China, and there were fewer comparative studies between different teaching models than in foreign countries.Conclusion:General education in epidemiology is still in the early exploration stage. Compared with the traditional lecture model, the effect of various innovative teaching models has been improved. According to teaching objectives and student characteristics, we encourage extensive use of different teaching strategies, combining theoretical knowledge with practical applications and integrating epidemiological knowledge with inter-professional knowledge. Thus, students who can apply what they learn are becoming interdisciplinary talents our society needs.

Objective:To evaluate the safety and efficacy of endoscopic super-hemorrhoidal banding (SHB) in the treatment of internal hemorrhoids with prolapse.Methods:From June 2019 to June 2020, a total of 112 patients with grade Ⅱ and Ⅲ internal hemorrhoids underwent endoscopic SHB at People′s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture. The efficacy of SHB, intraoperative and postoperative complications associated with the operation and patients′ satisfaction were prospectively studied. The follow-up time was over six months.Results:A total of 112 patients received SHB for internal hemorrhoids, 74 patients (66.1%) with grade Ⅱ hemorrhoids and 38 patients (33.9%) with grade Ⅲ hemorrhoids. The operations were successfully performed in all patients. No anal pain or bleeding was reported during the operation. All patients experienced various degrees of anal bulge after the operation, which lasted for 2-24 hours before spontaneous disappearance. Five patients with grade Ⅲ internal hemorrhoids showed dysuria, which was relieved with local heat on the bladder. One patient with grade Ⅲ internal hemorrhoid had bloody stool on day 14. The bleeding was stopped with another banding at the site of bleeding ulcer. All patients completed the follow-up. No complications such as bleeding, pain, infection or stenosis occurred in one month after operation. Eighteen patients with grade Ⅲ had partial prolapse after operation without bleeding or other symptoms. Six of them received additional SHB treatment and prolapse disappeared. No postoperative complications occurred in the six months of follow-up in all patients. The satisfaction rate was 100.0% according to the survey.Conclusion:Endoscopic SHB is an effective, safe and simple technique for internal hemorrhoids with prolapse.

Objective:To select the relevant evidence of percutaneous pericardial drainage tube nursing and summarize the best evidence.Methods:Evidence-based questions were established based on PIPOST model. BMJ Best Clinical Practice, China Biology Medicine disc (CBM) , UpTodate, Cochrane Library, Joanna Briggs Institute Evidence-based Health Care Database, China Guide Network, British Guide Network, National Guide Line Clearing House (NGC) , PubMed, EMbase, Evidence-based Medicine (EBM) , Registered Nurses' Association of Ontario (RNAO) , The European Society of Cardiology (ESC) , American Heart Association (AHA) , Chinese Journal Full-text Database and Wanfang Database were conducted computer retrieval. The search time was from the establishment of the database to December 31, 2020. Two researchers respectively evaluated the quality of the included literature and extracted data and summarized and summarized the evidence that met the standards.Results:Finally, 12 articles were included, including 1 evidence summary, 2 systematic reviews, 1 systematic assesment, 2 guidelines, 1 expert consensus and 5 case series studies. Finally, 11 pieces of evidence were formed, including 6 themes such as drainage tube selection, puncture wound nursing, drainage flow control, flushing and sealing of the tube, observation and recording points, extubation indications and care.Conclusions:This study summarizes the best evidence for percutaneous pericardial drainage tube nursing, which provides evidence-based basis for improving the quality of percutaneous pericardial drainage tube care.

Objective: To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection. Methods: A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed. Results: A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%. Conclusions Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.

Objective To improve the efficiency of blood collection in hemodialysis patients by inventing and applying new blood collection needles.Methods One hundred and eighty cases of hemodialysis patients were randomly divided into control group 1(CG1),control group 2(CG2),experimental group(EG). Comparison of the three groups in time of blood collection,the number of operation that had the risk of acupuncture injury and the number of the blood samples that had been contaminated. Results There were statistically significant difference (P<0.05)in three groups.The number of times of blood collection in the number of operations that had the risk of acupuncture injury,and the number of the blood sample that had been contaminated. CG1 had the longest blood collection time(12.55 min),EG had the shortest blood collection time(5.09 min);the risk of acupuncture injury was the highest in CG2 and the lowest in the EG.The number of contamination of blood samples and the amount of inaccurate sample in CG1 were the highest,and the lowest in the EG. Conclusions The working efficiency of transfer type anti-acupuncture needle(TTAN)during blood sample collection in hemodialysis patients is signifi-cantly better than that of traditional blood collection method,and it is helpful to reduce the risk of acupuncture injury and the risk of contamination in blood samples,which is worthy of promotion.

Objective: To explore the mechanism of Yinao Jieyu Compound Formula in the treatment of post-stroke stressrats from the perspective of intestinal flora changes. Methods: A total of 48 male clean SD rats were randomly divided into4 groups: sham-operation group, post-stroke stress group, western medicine group and traditional Chinese medicinegroup, with 12 rats in each group. In the sham-operation group, only the free blood vessels were not inserted into thethread embolus. The rats in post-stroke stress group, the western medicine group and the Chinese medicine group weretreated as follows: after 1 week of middle cerebral artery occlusion, the rat model of PSD was prepared by using chronicrestraint stress and single cage feeding. The 7 th day from the beginning of the construction of the cerebral stroke model, the gavage treatment began to be done. The western medicine group was given Fluoxetine Hydrochloride Capsules2.33 mg/ (kg.d), and the Chinese medicine group was given 9.92 g/ (kg·D) . The rest of the rats were gavage with 10 mL/kgdistilled water, 1 time/day. The behavioral changes on the 14 th day after post-stroke were observed and the microbialcommunity structure and composition was analyzed by Illumina-MiSeq high throughput sequencing technique. Results:Compared with the sham operation group, the sucrose water preference, open field score and swimming struggle time ofthe post-stroke stress group were significantly decreased (P ＜ 0.01, P ＜ 0.01, P ＜ 0.01), and the proportions ofAllobaculum, Sutterella, Dorea and rc4-4 in the feces decreased significantly (P ＜ 0.01, P ＜ 0.01, P ＜ 0.01, P ＜ 0.05) .The proportion of Oscillospira increased significantly (P ＜ 0.01, P ＜ 0.05, P ＜ 0.01) . Compared with the post-strokestress group, the horizontal scores and swimming struggling time of the rats in the Chinese medicine group weresignificantly increased (P ＜ 0.05, P ＜ 0.05), and the proportions of the 6 species of Lactobacillus and Bacteroides weresignificantly increased in the feces. The difference between Lactobacillus and Bacteroides was the most obvious with27.91％ vs 5.96％ and 24.21％ vs 9.62％ (P ＜ 0.01, P ＜ 0.01) . The proportion of Oscillospira was significantly decreased (P ＜ 0.05) . Compared with the western medicine group, there was no significant difference in the behavioral scores of therats in the traditional Chinese medicine group (P＞ 0.05), and the proportion of Bacteroides and rc4-4 in the feces wassignificantly increased (P ＜ 0.01, P ＜ 0.05) . Conclusion: Yinao Jieyu Compound Formula can alleviate similar depressivesymptoms in post-stroke stress rats by increasing the content of Lactobacillus and Bacteroides in the intestine of rats.

Objective? To evaluate the effects of the "hospital-community-family" linked continuing care model dominated by nurses on the complication and self-care ability of patients receiving percutaneous transhepatic cholangiodrainage (PTCD). Methods? Totally 108 patients with malignant obstructive jaundice treated in the Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical University from May 2016 to March 2018 were selected by convenient sampling and divided into two groups according to the random number table. Patients in the treatment group (n=54) received the "hospital-community-family" linked continuing care, while patients in the control group (n=54) received conventional health education before discharge. The incidence rate of complications and patients' self-care ability 3 months post discharge were evaluated in the two groups. Results? The incidence rates of biliary tract infection, PTCD catheter obstruction or pullaway, wound infection and pipeline related hospitalization in the treatment group 3 months post discharge were 18.52%, 1.85%, 1.85% and 11.11% respectively, lower than those of the control group, 40.74%, 12.96%, 11.11% and 27.78% (χ2=8.000, 5.290, 4.182, 7.289; P＜0.05). The total score of self-care ability of the treatment group 3 months post discharge was (135.09±7.08), higher than that of the control group, which was (104.72±5.33), (t=25.174,P＜0.01). Conclusions? The "hospital-community-family" linked continuing care model dominated by nurses can reduce the incidence rate of catheter-associated complications after discharge in PTCD patients and enhance their self-care ability.

Objective To explore the clinical distribution states of human papillomavirus genotypes in tissues of 691 women with vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province and genotyping clinical significance.Methods Polymerase chain reaction(PCR)and gene-chips technology were utilized for the detection of 23 kinds of HPV genotypes in tissue specimens from 619 women of vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province.And related materials of all subjects were analyzed.Results In 691 women of vulva condyloma acuminates,597 women of HPV infecton,total infection rate of HPV was 86.40％(597/691),including single genotype infection rate of HPV was 51.38％(355/691),11、6 and 16 genotypes are the most common in single genotypes,they are successively 51.55％(183/355)、41.97％(149/355)and 3.38％(12/355).multiple genotypes infection rate of HPV was 35.02％(242/691),6+11、11+18、6+16 and 11+16 genotypes are the most common in multiple genotypes,they are successively 9.92％(24/242)、9.09％(22/242)、4.96％(12/242)and 4.13％(10/242).Conclusion The low-risk HPV types are the main factors to cause the female vulva CA,a few high-risk HPV types may cause warts as well in tissues of women with vulva condyloma acuminates in Nanjing city and Zhenjiang city in Jiangsu Province.The vulva examine of HPV types should be held to the vulva CA patients.This precaution will has extremely important meaning to the prevention and treatment of the female vulva CA and cervical lesion in our nation.

Objective:To explore the effects of KISS1 gene transfected by lentivirus on the proliferation,invasion and migration abilities of the colorectal cancer HCT116 cells,and to clarify their mechanisms.Methods:The human colorectal cancer cells with the lowest expression level of KISS1 gene were selected.The lentiviral vectors were builted and transfected the KISS1 gene,and the cells were divided into control group (treated with PBS),empty vector group (treated with empty vector) and over-expression group(treated with KISS1 gene vector).The multiplicity of infection (MOI) of the cells was detected by fluorescence microscope.Real-time PCR and Western blotting methods were used to detect the expression levels of KISS1 mRNA and protein(metastin);CCK-8 method was used to detect the proliferation ability of the cells;Transwell chambers method was used to detect the invasion and migration abilities of the cells.Results:Among LoVo,SW620,SW480,HCT-116,and HT29 cells,the expression levels of KISS1 mRNA and protein were lowest in HCT116 cells,so they were chosen as the research carrier.After transfected with lentiviral vectors,the HCT116 cells could stably express the enhanced green fluorescent protein(EGFP) gene,and the MOI was over 80%.Compared with control group and empty vector group,the expression levels of KISS1 mRNA and protein in the cells in over-expression group were significantly increased (P<0.05);the proliferation abilities of the cells in over-expression group were decreased (P<0.05);the invasion ability and migration ability of the cells in over-expression group were decreased (P<0.05).But the differences of proliferation ability,invasion ability and migration ability of the cells between control group and empty vector group were not statistically significant (P>0.05).Conclusion:The KISS1 gene transfected by lentivirus vector can over-express KISS1 protein and inhibit the proliferation,invasion and migration abilities of the colorectal cancer cells,and the mechanism may be related to the expression of KISS1 protein.