The incidence of falls, as well as the consequent fear of falling among aged hemodialysis patients, is notably high. Such fear contributes to both psychosomatic damage and a diminished quality of life, constituting a significant risk factor for mortality in this demographic. This article comprehensively reviews the overview of fear of falling in aged hemodialysis patients, its effects on these individuals, the current prevalence, influencing factors, and intervention measures. It aims to provide a scientific foundation for formulating effective strategies to counteract the fear of falling in aged hemodialysis patients.

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.

Sepsis is a systemic inflammatory syndrome induced by infection and other factors， with the number of patients worldwide exceeding 10 million each year. The pathophysiological mechanism is of this disease complex. Sepsis is often accompanied by endotoxin translocation， gastrointestinal dysfunction， inflammatory cytokine activation， immune dysregulation， coagulation disorder， multiple organ function impairment and many other body imbalances， as well as systemic inflammation， apoptosis， oxidative stress injury and other cell damage mechanisms. This disease causes a heavy medical burden due to the difficult diagnosis and treatment and the poor prognosis. Great progress has been achieved in the diagnosis and treatment of sepsis with traditional Chinese medicine （TCM） and western medicine. The value of western medicine in the diagnosis and treatment of sepsis is limited due to antibiotic resistance， hormone abuse， and high medical costs. Sepsis is classified as a warm disease or typhoid fever in TCM. Da Chengqitang is a classical formula in the Treatise on Typhoid Fever to deal with the excess syndrome of Yang brightness Fu-organ. Modern medicine has proved that Da Chengqitang has the effect of inhibiting oxidative stress， reducing inflammation， and delaying apoptosis by improving gastrointestinal dynamics and regulating intestinal microecology. On the basis of the previous theoretical basis and the rich experience in the medication， medical practitioners have proposed a new therapeutic concept of using Da Chengqitang in combination with western drugs from a holistic view involving both bacteria and toxicity for treating both the symptoms and the root cause， which has a wide range of application. The article reviews the classical research and latest findings of Da Chengqitang in the treatment of sepsis， with a view to clarifying the mechanism and advantages of this formula in the adjuvant treatment of sepsis， exploring its potential efficacy， and providing timely， adequate， and scientific theoretical support for the promotion of this formula in the clinical practice.

To know the status of nursing training about physical restraint among nurses in the domestic and overseas. Summarized the forms, content and the appraise tools of the results of physical restraint nursing at home and abroad so as to provide reference of nursing training about the physical restraint among nurses in the domestic.

Objective:To carry out the Meta-integration of Intensive Care Unit (ICU) nurses' real experience of palliative care.Methods:The qualitative study that met the criteria in the Cochrane Library, PubMed, EMbase, Web of Science, China Biology Medicine Literature Service System, China National Knowledge Infrastructure (CNKI) , VIP and Wanfang Data were searched by computer from the establishment of the database to June 30, 2020. The quality of the included literature was evaluated using the critical appraisal checklist for qualitative researches of the Australia Joanna Briggs Institute (JBI) Evidence-based Health Center (2017 edition) . The collective integration method was used to integrate the results.Results:A total of 17 articles were included, involving 16 in English and 1 in Chinese. Finally, it was summarized into 11 categories, and 4 integrated results were collected, which were the complex palliative care (multiple roles of ICU nurses in palliative care, patient care, and family care) ; insufficient preparation for palliative care (lack of professional skills, communication skills and psychological preparation) ; insufficient support from palliative care organizations (inadequate psychological support, multidisciplinary team cooperation, and lack of professional palliative care service systems) ; insufficient legal support for palliative care (lack of decision-making power for palliative care, ethics and legal issues in palliative care) .Conclusions:ICU nurses lack the ability to palliative care and lack a reliable support system. Managers should pay attention to the negative experience and needs of ICU nurses for palliative care, and gradually carry out education and training to improve the level of care and the quality of life of dying patients.

Hepatectomy is the best treatment for primary liver cancer at present, but patients often face various pain problems after surgery, affecting the rapid recovery of the body. This paper reviews the occurrence of pain in patients after hepatectomy, its influencing factors, assessment tools and intervention strategies, so as to provide reference for standardized pain management of patients after hepatectomy.

Objective:To use the methods of Health Care Failure Mode and Effects Analysis to reduce the paediatric wards noise pollution, Ensure the physical and mental health of medical staff and children, and maintain a good medical environment.Methods:The sampling method is adopted, noise investigation questionnaire was used in our study and we use the noise instrument to monitor the sound, and the focus source, the key time period and the key section of the room noise are obtained, then the HFMEA is carried out, we listed the work flow of the pediatric ward, and the flow is analyzed and discussed, calculate the Risk Priority Number (RPN). Then, some improvement measures were carried out aimed at the failure mode ,the noise survey questionnaire were used for evaluation.Results:After the implemented the HFMEA , The RPN value was significantly decreased ( P < 0.05). the degree of noise interference of children and their families decreased from 38 to 29, the difference was statistically significant ( χ2 value was 21.82, P<0.05) , and the satisfaction with control noise was improved from 18 to 30, the difference was statistically significant ( χ2 value was 36.28, P<0.05) .The intensity of noise key areas, The intensity of noise source and intensity in each period of the day were significantly improved and the difference was statistically significant ( P < 0.05), and the critical value was significantly decreased. Conclusion:Applying HFMEA can reduce ward noise pollution, improve patient satisfaction, ensure the physical and mental health of medical staff and children, and create a good medical environment.

Objective: To develop an instrument for measuring nursing outcomes classification in Chinese cerebral hemorrhage patient and test its reliability and validity. Methods: Based on Nursing Outcomes Classification, the primary item pool was formulated through literature review, semi-structured interviews and group meeting, the items were selected by expert consultation. Totally 186 elderly adults were selected to test the reliability and validity. Results: The final scale consisted of 5 dimensions and 34 items. The content validity index of the total scale was 0.912, the content validity index of each item was 0.833-1.000. Exploratory factor analysis extracted five common factors and the cumulative variance contribution rate was 63.189%; and the correlation coefficient between the total scale and each dimension were 0.760-0.874. The correlation coefficient of Stroke-Specific Quality of Life between total scale and each dimension were 0.789, 0.568-0.659. The Cronbach α was 0.960 for the total scale, the Cronbach α of dimensions were 0.858-0.932. The intraclass correlation coefficient of the scale and each dimension were 0.965, 0.885-0.935. Conclusions Cerebral Hemorrhage Patient Nursing Outcomes Classification Assessment Scale has good reliability and validity, which can be used to evaluate cerebral hemorrhage.

Objective: To discuss the application effect of Nursing-Mini-Clinical Evaluation Exercise (Nursing-Mini-CEX) based on the theory of extended skill circle to construct and implemented the clinical practice teaching scheme. Methods: Applied convenient sampling in a hospital in Dalian and taked 42 grade 2012 undergraduates as control group, which will be given Nursing-Mini-CEX teaching model. 47 students of grade 2013 undergraduates as observation group, given on the Nursing-Mini-CEX teaching model based on extended skill circle theory, At the end of the clinical practice, we used the Nursing-Mini-CEX tools and the Teaching ability of Clinical Teaching Teachers questionnaire and the satisfaction scale of Nursing students' practice to evaluate the effect of the Nursing-Mini-CEX teaching model based on extended skill circle theory. Results: The score of control group in Special care, nursing examination, nursing diagnosis, humanistic care, organizational effectiveness and overall evaluation were (6.26±1.01) 、(6.40±1.00) 、(6.37±1.11) 、(6.77±1.03) 、(6.37±1.17) 、(7.06±1.11) 、(6.89±1.11) , The experimental group students′ performance was higher than the control group in the Special care, nursing examination, nursing diagnosis, humanistic care, organizational effectiveness and overall evaluation, The scores were(7.10±1.14), (6.90±0.81), (7.19±0.86), (7.12±0.97), (7.43±0.91), (7.43±0.91), (7.43±0.80), with significant differences (t=1.523~3.640, P˂0.05) . The scores of clinical teachers′ teaching ability were higher than that of the control group (80.27 ± 13.90) ,the score was (86.68 ± 12.21) , With significant differences (t=3.83,P˂0.05) ,and the satisfaction degree of the experimental group was higher than that of the control group, With significant differences (t=0.827,P˂0.05) . Conclusion Nursing-Mini-CEX teaching model based on extended skill circle theory made the clinical teaching more systematic and standardized. It can improve clinical teaching quality and the nursing students′ clinical ablity, and it is well worth to apply in clinical.

The status of fear of recurrence and its psychosocial interventions among cancer survivors, including incidence of fear of cancer recurrence in various cancer populations, common measurement tools, influencing factors and its psychosocial interventions. It aims to improve medical staff's attention to the mental state of cancer survivors, provides a theoretical basis for the subsequent research.