Objective:To explore the potential categories of transformation shock levels among newly employed nurses and their influencing factors, in order to provide references for implementing targeted interventions.Methods:In March and April 2024, a convenience sampling method was used to select 208 nurses undergoing standardized training at Beijing Tiantan Hospital, Capital Medical University, as the study subjects. The Transformation Shock Evaluation Scale, the Chinese Registered Nurse Core Competency Scale, and the Work Confidence and Ability Scale were used for data collection. Latent profile analysis was employed to identify the potential categories of transformation shock levels among newly employed nurses, and multinomial Logistic regression was used to analyze the influencing factors for different categories.Results:A total of 208 questionnaires were distributed, with 195 valid ones returned, yielding an effective response rate of 93.75%. The overall transformation shock score of the 195 newly employed nurses was (2.10±0.84), the career core competency score was (179.30±35.32), and the work confidence and ability score was (80.01±10.64). The transformation shock levels of the newly employed nurses were divided into four categories: high transformation shock-negative coping group (22.56%, 44/195), moderate transformation shock-psychological barrier group (29.23%, 57/195), lower transformation shock-high communication effectiveness group (36.41%, 71/195), and low transformation shock-high coping ability group (11.79%, 23/195). Logistic regression analysis showed that education level, clinical nursing ability, leadership, communication, critical thinking and research ability were influencing factors for the different categories of transformation shock levels among newly employed nurses ( P<0.05) . Conclusions:The transformation shock levels among newly employed nurses exhibit distinct categorical characteristics. Nursing education and management personnel should provide targeted training based on the influencing factors of different categories to reduce the level of transformation shock.

Objective:To explore the current status and influencing factors of the core competencies of nursing interns based on a mixed-methods approach, with the goal of providing a reference for the reform of high-quality teaching models and the enhancement of nursing students' core competencies.Methods:An explanatory sequential research design of mixed-methods research was adopted. Using convenience sampling, 105 nursing interns who were on clinical practice at Beijing Tiantan Hospital, Capital Medical University, from July to August 2022, were selected as participants. A general information questionnaire and a core competency scale for nursing students were used for data collection, and multiple linear regression analysis was conducted to identify the factors influencing the core competencies. From September to October 2022, purposive sampling was used to select six nursing interns for semi-structured interviews. Thematic framework analysis was used to extract opinions, categorize inferences, and summarize themes.Results:The overall average score of the core competencies of the 105 nursing interns was (6.11±0.74). The highest mean score was for the "moral and responsibility" dimension, which was (6.36±0.93), while the lowest was for the "clinical biomedical science" dimension, with a mean score of (5.21±1.04). Parental recognition of the nursing profession was identified as a factor influencing the core competencies ( P<0.05). The qualitative interviews yielded three themes: the teaching ability of instructors directly impacts the enhancement of interns' core competencies; professional identity influences nursing interns' motivation to improve core competencies; clinical practice is an effective way to enhance the core competencies of nursing interns. Conclusions:In this study, the core competencies of nursing interns were found to be at a moderately high level, influenced by various factors. Insufficient teaching resources and clinical practice opportunities are objective factors affecting the development of core competencies. The ability of interns to gain recognition of the nursing profession through external or self-practice and gradually build professional confidence is an intrinsic motivation for the development of core competencies.

Objective:To investigate the application value of combined detection of urine genes Twist1,Onecut2,VIM methyl-ation and folate metabolism related genes MTHFR(C677T/A1298C),MTRR(A66G)polymorphisms in the screening and diagnosis of bladder cancer.Methods:A total of 134 patients with primary bladder cancer admitted to the Department of Urology of Qingyang Peo-ple's Hospital and the Second Hospital of Lanzhou University from January 2023 to January 2024 were selected(bladder cancer group),and a total of 130 patients with common benign urinary system diseases and other malignant tumors of urinary system treated with cystoscopy were admitted during the same period(control group).Methylation-specific polymerase chain reaction was used to de-tect the methylation of Twist1,Onecut2 and VIM genes in urine shed cells.PCR fluorescence probe fusion was used to detect the poly-morphism of folate metabolism-related genes in peripheral blood of patients,and collected the clinical data and immunological indica-tors,and to all the data for statistical analysis.Results:The methylation rates of hematuria,bladder irritation,Twist1,Onecut2 and VIM genes were significantly different between two groups(P<0.05).The area under ROC curve(AUC)of Twist1,Onecut2 and VIM genes methylation and their combined detection were 0.721,0.675,0.674 and 0.772,respectively.Sensitivity and specificity were 73.20%and 71.00%,56.10%and 79.00%,48.80%and 86.00%,80.50%and 69.00%,respectively.The AUC of hematuria and blad-der irritation were 0.661 and 0.652.The sensitivity and specificity were 60.20%and 72.00%,41.50%and 89.00%,respectively.The combined AUC of all indicators were the largest(0.858),and the sensitivity and specificity were higher.The frequencies of CC,CT,TT,and T alleles of MTHFR C677T in bladder cancer group were 21.64%,41.79%,36.56%and 57.46%,respectively.Compared with the control group,the difference was statistically significant(P<0.05).The T allele frequency was significantly different between methylated and unmethylated Twist1 groups(P<0.05).Others differences were not statistically significant,and there was no signifi-cant association with gene methylation(P>0.05).Conclusion:The methylation of Twist1,Onecut2 and VIM genes are highly ex-pressed in the urine cells of patients with bladder cancer,and the combination of hematuria and bladder irritation has a high predictive value for the diagnosis of bladder cancer.The MTHFR(C677T)T allele is associated with the methylation of Twist1 gene and may be one of the risk factors for bladder cancer.

Objective:To explore the potential categories of transformation shock levels among newly employed nurses and their influencing factors, in order to provide references for implementing targeted interventions.Methods:In March and April 2024, a convenience sampling method was used to select 208 nurses undergoing standardized training at Beijing Tiantan Hospital, Capital Medical University, as the study subjects. The Transformation Shock Evaluation Scale, the Chinese Registered Nurse Core Competency Scale, and the Work Confidence and Ability Scale were used for data collection. Latent profile analysis was employed to identify the potential categories of transformation shock levels among newly employed nurses, and multinomial Logistic regression was used to analyze the influencing factors for different categories.Results:A total of 208 questionnaires were distributed, with 195 valid ones returned, yielding an effective response rate of 93.75%. The overall transformation shock score of the 195 newly employed nurses was (2.10±0.84), the career core competency score was (179.30±35.32), and the work confidence and ability score was (80.01±10.64). The transformation shock levels of the newly employed nurses were divided into four categories: high transformation shock-negative coping group (22.56%, 44/195), moderate transformation shock-psychological barrier group (29.23%, 57/195), lower transformation shock-high communication effectiveness group (36.41%, 71/195), and low transformation shock-high coping ability group (11.79%, 23/195). Logistic regression analysis showed that education level, clinical nursing ability, leadership, communication, critical thinking and research ability were influencing factors for the different categories of transformation shock levels among newly employed nurses ( P<0.05) . Conclusions:The transformation shock levels among newly employed nurses exhibit distinct categorical characteristics. Nursing education and management personnel should provide targeted training based on the influencing factors of different categories to reduce the level of transformation shock.

Objective:To explore the current status and influencing factors of the core competencies of nursing interns based on a mixed-methods approach, with the goal of providing a reference for the reform of high-quality teaching models and the enhancement of nursing students' core competencies.Methods:An explanatory sequential research design of mixed-methods research was adopted. Using convenience sampling, 105 nursing interns who were on clinical practice at Beijing Tiantan Hospital, Capital Medical University, from July to August 2022, were selected as participants. A general information questionnaire and a core competency scale for nursing students were used for data collection, and multiple linear regression analysis was conducted to identify the factors influencing the core competencies. From September to October 2022, purposive sampling was used to select six nursing interns for semi-structured interviews. Thematic framework analysis was used to extract opinions, categorize inferences, and summarize themes.Results:The overall average score of the core competencies of the 105 nursing interns was (6.11±0.74). The highest mean score was for the "moral and responsibility" dimension, which was (6.36±0.93), while the lowest was for the "clinical biomedical science" dimension, with a mean score of (5.21±1.04). Parental recognition of the nursing profession was identified as a factor influencing the core competencies ( P<0.05). The qualitative interviews yielded three themes: the teaching ability of instructors directly impacts the enhancement of interns' core competencies; professional identity influences nursing interns' motivation to improve core competencies; clinical practice is an effective way to enhance the core competencies of nursing interns. Conclusions:In this study, the core competencies of nursing interns were found to be at a moderately high level, influenced by various factors. Insufficient teaching resources and clinical practice opportunities are objective factors affecting the development of core competencies. The ability of interns to gain recognition of the nursing profession through external or self-practice and gradually build professional confidence is an intrinsic motivation for the development of core competencies.

Objective:To investigate the application value of combined detection of urine genes Twist1,Onecut2,VIM methyl-ation and folate metabolism related genes MTHFR(C677T/A1298C),MTRR(A66G)polymorphisms in the screening and diagnosis of bladder cancer.Methods:A total of 134 patients with primary bladder cancer admitted to the Department of Urology of Qingyang Peo-ple's Hospital and the Second Hospital of Lanzhou University from January 2023 to January 2024 were selected(bladder cancer group),and a total of 130 patients with common benign urinary system diseases and other malignant tumors of urinary system treated with cystoscopy were admitted during the same period(control group).Methylation-specific polymerase chain reaction was used to de-tect the methylation of Twist1,Onecut2 and VIM genes in urine shed cells.PCR fluorescence probe fusion was used to detect the poly-morphism of folate metabolism-related genes in peripheral blood of patients,and collected the clinical data and immunological indica-tors,and to all the data for statistical analysis.Results:The methylation rates of hematuria,bladder irritation,Twist1,Onecut2 and VIM genes were significantly different between two groups(P<0.05).The area under ROC curve(AUC)of Twist1,Onecut2 and VIM genes methylation and their combined detection were 0.721,0.675,0.674 and 0.772,respectively.Sensitivity and specificity were 73.20%and 71.00%,56.10%and 79.00%,48.80%and 86.00%,80.50%and 69.00%,respectively.The AUC of hematuria and blad-der irritation were 0.661 and 0.652.The sensitivity and specificity were 60.20%and 72.00%,41.50%and 89.00%,respectively.The combined AUC of all indicators were the largest(0.858),and the sensitivity and specificity were higher.The frequencies of CC,CT,TT,and T alleles of MTHFR C677T in bladder cancer group were 21.64%,41.79%,36.56%and 57.46%,respectively.Compared with the control group,the difference was statistically significant(P<0.05).The T allele frequency was significantly different between methylated and unmethylated Twist1 groups(P<0.05).Others differences were not statistically significant,and there was no signifi-cant association with gene methylation(P>0.05).Conclusion:The methylation of Twist1,Onecut2 and VIM genes are highly ex-pressed in the urine cells of patients with bladder cancer,and the combination of hematuria and bladder irritation has a high predictive value for the diagnosis of bladder cancer.The MTHFR(C677T)T allele is associated with the methylation of Twist1 gene and may be one of the risk factors for bladder cancer.

Objective:To analyze the effect of hyperbaric oxygen therapy on peritoneal dialysis（PD）patients with cognitive impairment and its impact on quality of life.Methods:A total of 120 maintenance PD patients with cognitive impairment admitted to Linyi Central Hospital from December 2019 to December 2020 were divided into observation group and control group according to the random number table method，with 60 cases in each group. Patients in both groups received conventional treatments including PD for end-stage renal disease. The control group received cognitive training，and the observation group received hyperbaric oxygen therapy on the basis of the training of the control group. The changes of cognitive function and quality of life of the patients in the two groups were compared.Results:There was no significant difference in the levels of BUN，Scr，PaO 2，PaCO 2，and pH between the two groups before and after treatment（ P>0.05）. After treatment，Hb levels in the two groups were significantly higher than those before treatment，with statistically significant differences（ P<0.05），while there was no statistically significant difference between the two groups（ P>0.05）. After treatment，the Addenbrooke’s Cognitive Examination-Revised（ACE-R）total score and sub-scale scores of patients in both groups were significantly increased than those before treatment，with statistically significant differences（ P<0.05），and those scores in the observation group were significantly higher than those in the control group，with statistically significant differences（ P<0.05）. The serum BNDF level of the observation group was significantly higher than that before treatment. The serum Hcy and CRP levels of the two groups were significantly lower than those before treatment，with statistically significant differences（ P<0.05），and those two levels of the observation group were significantly lower than those of the control group，with statistically significant differences（ P<0.05）. The indicators of quality of life in the two groups were significantly improved than those before treatment，with statistically significant differences（ P<0.05），and the indicators of the observation group were better than those of the control group，with statistically significant differences（ P<0.05）. There was no statistically significant difference in the incidence of adverse events between the two groups during treatment（ P>0.05）. Conclusion:Hyperbaric oxygen therapy can significantly improve the cognitive function and quality of life of PD patients，and it is safe and reliable，which is worthy of clinical promotion.

Objective:To analyze the effect of hyperbaric oxygen therapy on peritoneal dialysis（PD）patients with cognitive impairment and its impact on quality of life.Methods:A total of 120 maintenance PD patients with cognitive impairment admitted to Linyi Central Hospital from December 2019 to December 2020 were divided into observation group and control group according to the random number table method，with 60 cases in each group. Patients in both groups received conventional treatments including PD for end-stage renal disease. The control group received cognitive training，and the observation group received hyperbaric oxygen therapy on the basis of the training of the control group. The changes of cognitive function and quality of life of the patients in the two groups were compared.Results:There was no significant difference in the levels of BUN，Scr，PaO 2，PaCO 2，and pH between the two groups before and after treatment（ P>0.05）. After treatment，Hb levels in the two groups were significantly higher than those before treatment，with statistically significant differences（ P<0.05），while there was no statistically significant difference between the two groups（ P>0.05）. After treatment，the Addenbrooke’s Cognitive Examination-Revised（ACE-R）total score and sub-scale scores of patients in both groups were significantly increased than those before treatment，with statistically significant differences（ P<0.05），and those scores in the observation group were significantly higher than those in the control group，with statistically significant differences（ P<0.05）. The serum BNDF level of the observation group was significantly higher than that before treatment. The serum Hcy and CRP levels of the two groups were significantly lower than those before treatment，with statistically significant differences（ P<0.05），and those two levels of the observation group were significantly lower than those of the control group，with statistically significant differences（ P<0.05）. The indicators of quality of life in the two groups were significantly improved than those before treatment，with statistically significant differences（ P<0.05），and the indicators of the observation group were better than those of the control group，with statistically significant differences（ P<0.05）. There was no statistically significant difference in the incidence of adverse events between the two groups during treatment（ P>0.05）. Conclusion:Hyperbaric oxygen therapy can significantly improve the cognitive function and quality of life of PD patients，and it is safe and reliable，which is worthy of clinical promotion.

Background and Objectives: Psoriasis is a chronic inflammatory skin disease, which the mechanisms behind its initiation and development are related to many factors. DMSCs (dermal mesenchymal stem cells) represent an important member of the skin microenvironment and play an important role in the surrounding environment and in neighbouring cells, but they are also affected by the microenvironment. We studied the glucose metabolism of DMSCs in psoriasis patients and a control group to reveal the relationship among glucose metabolism, cell proliferation activity，and VEC (vascular endothelial cell) differentiation in vitro, we demonstrated the biological activity and molecular mechanisms of DMSCs in psoriasis. Methods: and Results: We found that the OCR of DMSCs in psoriatic lesions was higher than that in the control group, and mRNA of GLUT1 and HK2 were up-regulated compared with the control group. The proliferative activity of DMSCs in psoriasis was reduced at an early stage, and mRNA involved in proliferation, JUNB and FOS were expressed at lower levels than those in the control group. The number of blood vessels in psoriatic lesions was significantly higher than that in the control group (p＜0.05), which the mRNA of VEC differentiation, CXCL12, CXCR7, HEYL and RGS5 tended to be increased in psoriatic lesions compared to the control group, in addition to Notch3. Conclusions We speculated that DMSCs affected local psoriatic blood vessels through glucose metabolism, and the differentiation of VECs, which resulted in the pathophysiological process of psoriasis.

Objective:To explore the recovery time of ovary in patients who underwent all embryo freezing after oocyte retrieval in in vitro fertilization (IVF) and the relationship between pregnancy outcome and embryo transfer time. Methods:This research included 53 patients who underwent all embryos freezing in the Reproductive Hospital of Shandong University from July to December in 2017. The baseline level of serum estradiol in the first menstrual cycle after oocyte retrieval and the ovulation time during the second menstrual cycle after oocyte retrieval was assessed in 53 patients. In addition, the pregnancy outcomes of all patients underwent frozen-thawed embryo transfer were followed up.Results:During the second to the fourth day of the first menstrual cycle after oocyte retrieval, 88.68% (47/53) of the patients had a blood estradiol level below 50 ng/L, which had no relationship with the age of the patients (≤30 years old, >30 years old) ( P=0.161), the method of ovulation induction ( P=0.516), with or without polycystic ovary syndrome ( P=0.661), the number of oocyte obtained (≤15, >15) ( P=0.671). Among patients without polycystic ovary syndrome and regular menstrual cycle, 76.00% (19/25) of patients had recovered ovulation in the second menstrual cycle after oocyte retrieval, and the median ovulation time was the 16th day of menstruation cycle. There was no significant difference in the pregnancy outcomes between patients who had embryo transfer during the second menstrual cycle and patients who had embryo transfer during the third menstrual cycle or later ( P>0.05). Conclusion:It is rational to transfer embryo earlier for patients who underwent all embryo freezing after oocyte retrieval in IVF.