Objective:To examine the relationship between perceived stress and clinical practice maladjust-ment,as well as the mediating roles of executive function and depressive symptoms in the relationship among intern nurses.Methods:A total of 624 nursing interns were recruited and followed up during this eight-month longitudinal study.Baseline data(Tl)were collectedon the day of internship orientation(July 2022)with the Perceived Stress Scale(PSS),Geurten Executive Function Questionnaire(G-QEF)and Patient Health Questionnaire Depression Module(PHQ-9).Follow-up data(T2)were collected shortly before the end of the internship(March 2023)with the PSS,G-QEF,PHQ-9,and Nursing Students Clinical Internship Maladjustment Scale(NSCPMS).The chain me-diation effect of executive function and depressive symptoms in the relationship between perceived stress and clini-cal practice maladjustment was analyzed.Results:The PSS scores at T1 significantly predicted the NSCPMS scores at T2(β=-1.00,P＜0.001).Executive function and depressive symptosm jointly mediated the relationship be-tween perceived stress and clinical practice maladjustment,with a mediation effect value of-0.01(95％CI=-0.026--0.004).Additionally,depressive symptoms alone significantly mediated the relationship between per-ceived stress at T1 and clinical practice maladjustment at T2,with a mediation effect value of-0.06(95％CI=-0.101--0.017).Conclusion:Perceived stress at the beginning of the internships may negatively impact long-term clinical adjustment among nursing interns,potentially through impaired executive function and depressive symptoms.This finding suggests that early prevention measures and interventions to reduce stress at the start of in-ternships are needed to help interns better adapt to clinical practice.

Objective:To observe the applying effect of teamwork cooperation model of encephalopathy in the clinical teaching of Neurology.Methods:Sixty undergraduate students who practiced in our hospital were randomly divided into the control group and the experimental group,with 30 students in each group.The control group was arranged for internship according to the traditional department-based model,while the experimental group was arranged according to the teamwork cooperation model of encephalopathy discipline group.The theoretical examination scores and clinical skills scores of the two groups were compared,and the Mini-Clinical Evaluation Exercise(Mini-CEX)scale was used for dual evaluation by teachers and students from seven aspects:inquiry skills,physical examination skills,humanistic care,clinical judgment,communication skills,organizational effectiveness,and overall clinical competence.Result:There were statistically significant differences between the experimental group and the control group in theoretical examination scores,clinical skills scores,and dual evaluation by teachers and students(P＜0.05).Conclusion:Compared with the traditional teaching model,the teamwork cooperation model of encephalopathy discipline group has achieved better results in the clinical teaching of Neurology.

Objective:To examine the relationship between perceived stress and clinical practice maladjust-ment,as well as the mediating roles of executive function and depressive symptoms in the relationship among intern nurses.Methods:A total of 624 nursing interns were recruited and followed up during this eight-month longitudinal study.Baseline data(Tl)were collectedon the day of internship orientation(July 2022)with the Perceived Stress Scale(PSS),Geurten Executive Function Questionnaire(G-QEF)and Patient Health Questionnaire Depression Module(PHQ-9).Follow-up data(T2)were collected shortly before the end of the internship(March 2023)with the PSS,G-QEF,PHQ-9,and Nursing Students Clinical Internship Maladjustment Scale(NSCPMS).The chain me-diation effect of executive function and depressive symptoms in the relationship between perceived stress and clini-cal practice maladjustment was analyzed.Results:The PSS scores at T1 significantly predicted the NSCPMS scores at T2(β=-1.00,P＜0.001).Executive function and depressive symptosm jointly mediated the relationship be-tween perceived stress and clinical practice maladjustment,with a mediation effect value of-0.01(95％CI=-0.026--0.004).Additionally,depressive symptoms alone significantly mediated the relationship between per-ceived stress at T1 and clinical practice maladjustment at T2,with a mediation effect value of-0.06(95％CI=-0.101--0.017).Conclusion:Perceived stress at the beginning of the internships may negatively impact long-term clinical adjustment among nursing interns,potentially through impaired executive function and depressive symptoms.This finding suggests that early prevention measures and interventions to reduce stress at the start of in-ternships are needed to help interns better adapt to clinical practice.

Objective:To observe the applying effect of teamwork cooperation model of encephalopathy in the clinical teaching of Neurology.Methods:Sixty undergraduate students who practiced in our hospital were randomly divided into the control group and the experimental group,with 30 students in each group.The control group was arranged for internship according to the traditional department-based model,while the experimental group was arranged according to the teamwork cooperation model of encephalopathy discipline group.The theoretical examination scores and clinical skills scores of the two groups were compared,and the Mini-Clinical Evaluation Exercise(Mini-CEX)scale was used for dual evaluation by teachers and students from seven aspects:inquiry skills,physical examination skills,humanistic care,clinical judgment,communication skills,organizational effectiveness,and overall clinical competence.Result:There were statistically significant differences between the experimental group and the control group in theoretical examination scores,clinical skills scores,and dual evaluation by teachers and students(P＜0.05).Conclusion:Compared with the traditional teaching model,the teamwork cooperation model of encephalopathy discipline group has achieved better results in the clinical teaching of Neurology.

Objective:To explore the factors influencing patient safety behavior of nursing students during clinical practice.Methods:A cross-sectional study was used, in which a total of 214 participants completed the online survey related to the undergraduate nursing students ′ clinical teaching satisfaction scale, safety attitude questionnaire and nurse safety behavior questionnaire. Results:The mean scores of clinical teaching satisfaction, safety attitude and nurse safety behavior were (3.83±0.81), (3.70±0.65) and (3.93±0.79) respectively. There were positive correlations between clinical teaching satisfaction, safety attitude with the nurse safety behavior ( r=0.82, 0.75, P<0.01). The results also showed that the same shifts with their clinical instructors, clinical teaching satisfaction and safety attitude could affect safety behavior of nursing students ( F=67.81, R2=0.753, ΔR2= 0.742, P=0.00), which accounted for 74.20% of total variation. Conclusions:The same shift arrangement for both clinical instructors and nursing students, enhancement of the demonstration and guidance from clinical instructors, as well as strengthening the cultivating patient safety attitude would be beneficial to promoting the safety behavior of nursing students during clinical practice.

Adult ; Female ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; pathology ; Obesity ; pathology ; Young Adult

OBJECTIVETo develop and evaluate a mouse model of nonalcoholic steatohepatitis (NASH) induced by a high-fat and high-fructose (HFHFr) diet.

METHODSSix-week-old C3H mice were randomly divided into groups for HFHFr diet experimental modeling, high fat-only (HF) diet controls, high fructose-only (HFr) diet controls, and standard chow (SC) diet controls. The standard HFHFr diet was modified so that it consisted of 76.5% standard chow, 12% lard, 1% cholesterol, 5% egg yolk powder, 5% whole milk powder, and 0.5% sodium cholate, along with 20% fructose drinking water. At the end of experimental weeks 4, 8, and 16, measurements were taken for the NASH-related parameters of body mass, serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), lipid profile, and wet liver weight (upon sacrifice). In addition, histological changes in the liver were evaluated by hematoxylin-eosin (HE) and oil red O staining. The significance of differences between groups was assessed by statistical analysis, using the

METHODSof t-test, Wilcoxon rank sum test, x2 test, F test or Fisher's test as appropriate.

RESULTSAs compared to the mice in the SC group at the corresponding time points, the mice in the HFHFr and HF groups showed significantly higher body mass and wet liver weight, as well as more extensive and robust lipid disposition in hepatic tissues as evidenced by oil red O staining. However, HE staining indicated that the HFHFr and HF groups had different degrees of macrosteatosis accompanied with intralobular inflammatory foci, with the former showing more remarkable NASH-related histological changes. Analysis at the end of week 16 showed that about 80% of the mice in the HFHFr group had developed NASH [nonalcoholic fatty liver disease (NAFLD) activity score (NAS): less than 5]. The levels of low-and high-density lipoprotein (LDL and HDL) cholesterol, as well as the levels of ALT and AST, were increased from the end of week 4 to the end of week 8 for the HFHFr and HF groups. At the end of week 16, the two groups differed in the extent of increase in total cholesterol and LDL and HDL cholesterol, with only the HFHFr group showing statistically significant changes. Specifically, at the end of week 16, the HFHFr group showed ALT levels of 108.5 +/- 93.34 U/L (F=5.099, P =0.005 vs. HF group: 44.30 +/- 35.71 U/L, HFr group: 46.70 +/- 17.95 U/L, SC group: 24.70 +/- 6.57 U/L), AST levels of 316.30 +/- 208.98 U/L (F=6.654, P=0.001 vs. HF: 132.12 +/- 75.43 U/L, HFr: 143.30 +/- 38.53 U/L, SC: 122.60 +/- 12.76 U/L), total cholesterol levels of 5.18 +/- 0.58 mmol/L (F=72: 470, P =0.000 vs. HF: 3.94 +/- 0.75 mmol/L, HFr: 2.30 +/- 0.50 mmol/L, SC: 2.02 +/- 0.24 mmol/L), HDL cholesterol levels of 3.05 +/- 0.49 mmol/L (F=25.413, P =0.000 vs. HF: 2.65 +/- 0.54 mmol/L HFr: 1.77 +/- 0.47 mmol/L, SC: 1.58 +/- 0.16 mmol/L), LDL cholesterol levels of 1.11 +/- 0.23 mmol/L (F =83.297, P =0.000 vs. HF: 0.72 +/- 0.17 mmol/L, HFr: 0.27 +/- 0.04 mmol/L, SC: 0.20 +/- 0.05 mmol/ L).

CONCLUSIONThe present study suggests that a mouse model of NASH can be successfully induced by a 16-week modified HFHFr diet.

Animals ; Diet, High-Fat ; Disease Models, Animal ; Fructose ; administration & dosage ; Male ; Mice ; Mice, Inbred C3H ; Non-alcoholic Fatty Liver Disease

Objective To investigate the current status of treatment on traumatic ruptured spleen in a regional medical center in Tianjin,China.Method Logistic analysis of 16 impact ffactors of treatment decision on 147 patients with traumatic ruptured spleen.Results The type of trauma,pulse rate at admission,result of abdominal puncture and CT grade were related to treatment decision making.Splenectomy was carried out in 89 patients (60.54％) which accounted for 89.90％ of all surgical procedures.Splenectomy was carried out in 50.85％ of patients with CT grade 1 or 2 (or 85.71％ of grade 1 and 2 surgery),and 100％ of CT grade 3 or 4.Spleen preservation surgery was carried out in 7 patients with CT grade 1 or 2.Conclusion Splenectomy was carried out in most cases in this study.It is necessary to investigate the treatment of splenic trauma in regional medical centers,and to develop more reliable surgical techniques to carry out more spleen-preservation surgery ffor CT grade 1 or 2 ruptured spleen.

ObjectiveTo investigate the effects of different amounts of iodine intake on the cellular and humoral immune in Grave's disease (GD) patients.MethodsThe clinical GD cases were diagnosed by thyroid fine needle Cytology examination.Patients in GD group are divided into GD group Ⅰ and GD group Ⅱ based on the median of urine iodine.The blood levels of FT4,FT3,TSH,TPOAb,TGAb,TRAb and TNF-t were detected.The difference and association of these parameters between these groups were analyzed.ResultsThe TNF-αt level in GD Ⅰ group was higher than that of GD Ⅱ group( P ＞ 0.05 ) ;The average level of TRAb of GD Ⅰgroup ( [ 1.4 ±0.2 ] U/L) were higher than that of GD Ⅱ group ( [ 1.2 ± 0.1 ] U/L) ( P ＜ 0.05 ) ;The positive rates of TGAb and TPOAb of GD Ⅰ group were higher than that of GD Ⅱ group ( P ＜ 0.05 ).The percentages of patients with high level of TGAb and TPOAb in GD Ⅰ group ( 78.9％ 、84.2％ ) were higher than that in GD Ⅱ group (50.0％,62.5％ ) ( x2 =6.79,10.70,P ＜0.05 ) ; Analysis showed a linear positive correlation of TNF-αwith TRAb and TPOAb ( r is 0.489 and 0.563,P ＜ 0.01 ).ConclusionIodine is an important factor to the development of Graves disease.Excessive iodine intake will exaggerate the GD condition and patients with GD should be controlled for iodine intake.