Objective To investigate the effect of early activity combined with electrical stimulation of neuromuscular system in improving intensive care unit(ICU)-acquired weakness(ICU-AW)patients with severe pneumonia.Methods A total of 150 patients with ICU-AW caused by severe pneumonia admitted to emergency intensive care unit(EICU)in a tertiary hospital in Shanghai were enrolled as the study subjects,and randomly divided into control group(75 cases)and combined group(75 cases).The control group took early exercise,and the combination group was given early exercise plus electrical stimulation of neuromuscular system.The recovery from mechanical ventilation(ICU length of stay,duration of mechanical ventilation,weaning extubation rate,ICU rollout rate),lung function[forced vital capacity(FVC),forced expiratory volume in the 1 s(FEV1)/FVC,massive inspiratory pressure(MIP)],muscle strength[Medical Research Council(MRC)score],disease severity[acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)],and complications were compared between the two groups.Results The ICU length of stay and mechanical ventilation time in the combined group were significantly lower than those in the control group(P<0.05).After intervention,FVC,FEV1/FVC,MIP and MRC scores in the two groups were significantly increased(P<0.05),and compared with the control group,the combined group was significantly increased(P<0.05).After intervention,APACHEⅡ score was significantly reduced in the two groups(P<0.05),and compared with the control group,APACHEⅡ score in combined group were significantly reduced(P<0.05).The complication rate in the combined group(9.33％)was significantly lower than that of control group(24.00％)(P<0.05).Conclusions Early exercise combined with neuromuscular electrical stimulation in patients with severe pneumonia ICU-AW can effec-tively promote recovery of patients because of improved lung function.This therapy is proved to be be safe and effective.

Objective:To analyze the expression and prognosis of B-cell lymphoma 7 protein family member A (BCL7A) in hepatocellular carcinoma, as well as the effect and mechanism of BCL7A expression on the invasion and migration of hepatocellular carcinoma cells.Methods:The cancer tissues and adjacent tissues of 40 patients with hepatocellular carcinoma who underwent radical hepatobiliary resection in the Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University from November 2017 to March 2018 were prospectively collected for protein extraction, including 29 males and 11 females, aged (58.5±10.4) years. The information of 374 cases of hepatocellular carcinoma and 50 cases of adjacent tissues were downloaded from The Cancer Genome Atlas (TCGA) database, and the hepatocellular carcinoma cell lines Hep3B and SMMC-7721 were transfected with overexpressing BCL7A plasmid and empty vector plasmid (negative control), respectively. Western blotting and immunohistochemistry were used to detect the expression of BCL7A, and Western blotting was also used to detect the expression of proteins related to epithelial-mesenchymal transition (N-cadherin, E-cadherin, snail). Transwell and cell scratch assays were used to detect cell invasion and migration.Results:Compared with adjacent tissues, the mRNA expression of BCL7A in 50 patients with hepatocellular carcinoma in TCGA was significantly increased ( t=13.38, P<0.001). According to the median mRNA expression level of BCL7A, 374 patients were divided into BCL7A high expression group ( n=187) and low expression group ( n=187), and the cumulative survival rate of BCL7A high expression patients was lower than that of low expression group, and the difference was statistically significant ( χ2=6.95, P=0.009). Western blot was used to detect the relative expression of BCL7A protein in cancer tissues, and found it was higher compared to adjacent tissues. Compared with the negative control group, the number of cells invaded by the BCL7A overexpression group of hepatoma cells Hep3B and SMMC-7721 was more than the negative control group respectively, (153.7±1.3) vs (63.7±4.7) and (307.7±25.14) vs (72.3±12.5), and the differences were statistically significant ( t=7.97, 8.38, both P=0.001) .The results of the cell scratch assay were consistent with the results of the Transwell invasion assay. The expressions of N-cadherin and snail in the BCL7A overexpression group were higher than those in the negative control group, and the E-cadherin was lower, and the difference was statistically significant (all P<0.05). Conclusions:The expression of BCL7A in cancer tissues of patients with hepatocellular carcinoma is elevated and is associated with poor prognosis. BCL7A may promote hepatocellular carcinoma cell metastasis and invasion by promoting epithelial-mesenchymal transition.

Objective:To understand the real experience and needs of early exercise rehabilitation in elderly patients with total hip arthroplasty (THA), so as to provide a preliminary basis for intervention research to meet the needs of patients.Methods:Using the purposive sampling method, a total of 12 elderly patients with THA from the First Affiliated Hospital of Naval Medical University from June to September 2021 were selected as the research objects for semi-structured in-depth interviews. Colaizzi 7-step method was used to analyze, summarize and extract the data.Results:The early exercise rehabilitation experience and needs of elderly THA patients could be summarized into four themes such as postoperative exercise being a difficult journey, the need for professional support, the need for external support and internally driven needs and 14 sub themes.Conclusions:There are various problems and needs for early exercise rehabilitation in elderly patients undergoing THA. It is necessary to strengthen communication among doctors, nurses and patients, understand their true feelings and provide personalized care and rehabilitation guidance to improve their treatment experience and enhance their satisfaction.

Atherosclerosis is the pathological basis of a variety of cardiovascular and cerebrovascular diseases. Its complicated etiology and chronic course seriously threaten human health. The prevention and treatment of atherosclerosis have been the focus of traditional Chinese and western medicine. This paper reviews the pathogenesis characteristics of atherosclerosis, and holds that deficiency of vital qi is the pathogenesis basis of atherosclerosis, which involves deficiency of heart, spleen and kidney, mutual knot of phlegm and blood stasis, and obstruction of veins. In clinical treatment, the common treatment were summarized on the principle of "replenishing deficiency and removing phlegm and blood stasis". In order to understand the relationship between deficiency and phlegm and blood stasis and atherosclerosis from the perspective of Traditional Chinese Medicine. The paper provides a theoretical basis for Traditional Chinese Medicine prevention and treatment for atherosclerosis.

Objective:To retrieve the qualitative research on real experience of multidisciplinary medical and nursing staff on early mobilization of Intensive Care Unit (ICU) patients, and conduct a Meta-synthesis.Methods:The qualitative research on the cognition and experience of multidisciplinary medical and nursing staff on the early mobilization of ICU patients was searched by computer in Web of Science, PubMed, CINAHL, Embase, the Cochrane Library, PsycINFO, Ovid, Medline, China National Knowledge Infrastructure (CNKI) , WanFang Data, VIP and China Biology Medicine disc. The search time limit was from the establishment of the database to April 2021. After evaluating the quality of the studies, the results were integrated using the collective synthesis method in the Meta-synthesis of the Joanna Briggs Institute (JBI) Evidence-based Health Care Center in Australia.Results:A total of 14 studies were included, and54 main results, 13 new categories, and 3 synthesis results were extracted. The results of the synthesis were the perception of the importance of early mobilization, the obstacles to the implementation of early mobilization, and the facilitating factors for the implementation of early mobilization.Conclusions:Multidisciplinary medical and nursing staff collaboration plays an important role in the implementation of early mobilization for ICU patients, but it is currently facing many obstacles in clinical practice. In the future, multidisciplinary collaboration strategies should be explored based on the actual situation and characteristics of domestic ICU, and the clinical development and continuous implementation of early mobilization should be actively promoted to effectively improve the prognosis of patients.

Objective:To systematically review qualitative studies on early activity experience in ICU patients.Methods:PubMed, Web of Science, Cochrane Library, Embase, Elsevier, OVID, CINAHL, CNKI, VIP, Wanfang Database and China Biomedical Literature Database were searched by computer for qualitative researches on early activity experience of ICU patients. The retrieval time was from the establishment of the database to December 31, 2021. The quality of the literature was assessed using the Australian Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Qualitative Research Quality Assessment Standard, and the results were integrated using the Meta integration method.Results:A total of 8 literatures were included, 37 results were extracted, grouped into 9 new categories, and integrated into 3 integrated results, which were the perception and benefit of early activity necessity, hindrance factors for early activity and desire for support system.Conclusions:Early activity plays an important role in the rehabilitation process of ICU patients, but patients currently face many obstacles in carrying out early activity. Medical staff should build an early activity pscheme for ICU patients with patient safety as the core based on clinical practice, provide effective social support for patients and improve their prognosis.

Objective:To analyze the real experience of male nurses in the nurse profession by Meta synthesis, so as to provide references for the effective formulation of nursing human resource management strategy of male nurses.Methods:Qualitative researches on the real experience of male nurses in the nurse profession were retrieved from Web of Science, PubMed, The Cochrane Library, EMbase, Ovid, CINAHL, China National Knowledge Infrastructure (CNKI) , WanFang Database, VIP Database and China Biology Medicine disc. And the retrieval time was from the establishment of databases to July 2020. After evaluating the quality of literatures, the results were integrated using the method of Meta synthesis.Results:A total of 12 articles were included, and 34 clear results, 9 new categories and 3 integrated results were extracted. The integrated results were positive experience, difficulty and challenge and career development.Conclusions:Male nurses will experience multiple emotional experiences in clinical nursing work. Nursing managers should pay attention to the real work experience of male nurses in the nursing profession, improve the sense of professional benefit of them, strengthen their career planning, stabilize the nursing team of them and promote the gender balance and professional development of nursing discipline.

Objective:To systematically evaluate the qualitative researches on the effective teaching behavior of clinical nursing teachers, and provide reference for the improvement of nursing teaching quality.Methods:PubMed, Web of Science, The Cochrane Library, VIP, Wanfang, China National Knowledge Infrastructure and other databases were searched, and the qualitative researches on the effective teaching behavior of clinical nursing teachers were included. The retrieval time was from the establishment of the databases to November 30, 2020. Meta-synthesis of the results was performed.Results:A total of 9 literatures were included, 27 results were extracted, 7 categories were summarized and 3 themes were integrated, namely, good teaching quality, solid professional skills and harmonious teacher-student relationship.Conclusions:The effective teaching behavior of clinical nursing teachers is the driving force for the progress and growth of nursing students. In order to improve the effectiveness of clinical nursing teaching, nursing teachers should fully realize the value of effective teaching behaviors for nursing students to master nursing theory and skills.

Total hip arthroplasty (THA) is the first choice for the treatment of end-stage hip diseases in elderly patients. Exercise therapy, as an effective intervention for the rehabilitation of elderly patients after THA, can optimize the physical conditions patients. However, there are no guidelines for exercise rehabilitation treatment in elderly adults with THA. This article reviews the concept, necessity, risk assessment, exercise plan and strategies to improve the effect of exercise therapy in elderly patients with THA after surgery and makes a prospect for the shortcomings, aiming to provide a reference for clinical nurses to choose safe and effective sports rehabilitation methods for elderly THA patients.

Objective:To construct a scientific and practical sensitive index system for emergency nursing quality of acute ST-segment elevation myocardial infarction, so as to provide a basis for the evaluation and monitoring of the nursing quality for acute ST-segment elevation myocardial infarction.Methods:From September 2019 to May 2020, based on Donabedian's "Structure-Process-Result" three-dimensional quality theoretical model, a sensitive index system for the emergency nursing quality of acute ST-segment elevation myocardial infarction was constructed through evidence-based and Delphi expert consultation.Results:In the two rounds of questionnaires, the effective recovery rates were 93.33% and 86.67% respectively, and the expert authority coefficients ( Cr) were 0.94 and 0.95, respectively, and the Kendall coordination coefficients ( W) were from 0.127 to 0.235 ( P<0.05) . The finally constructed sensitive index system for emergency nursing quality of acute ST-segment elevation myocardial infarction included 3 first-level indicators, 9 second-level indicators, and 21 third-level indicators. Conclusions:The constructed sensitive index system for emergency nursing quality in patients with acute ST-segment elevation myocardial infarction is highly scientific and practical, which can be used to standardize clinical nursing work and improve the nursing quality.