Objective To explore the application effect of the"ASK-T"aspiration prevention management model in reducing the risk of aspiration in elderly patients with chronic obstructive pulmonary disease(COPD)complicated by dysphagia.Methods 196 of 409 COPD patients with aspiration risk admitted to the Respiratory Disease Department of Guangdong Provincial Hospital of Chinese Medicine,Higher Education Mega Center Hospital from July 2021 to June 2024 were selected as the study object,and 102 COPD patients with aspiration risk admitted from July 2021 to December 2022 were set as the pre-improvement group.The patients in this group received the original nursing process and management mode of the department during hospitalization.94 COPD patients with aspiration risk admitted from January 2023 to June 2024 were set as the improved group,and the patients in this group were introduced into the department and implemented an innovative improvement project:"ASK-T"anti-aspiration management mode and then received nursing management.Patients in both groups were observed and followed up for 4 weeks.The risk grade of aspiration,SSA score,DHI score,aspiration pneumonia and aspiration pneumonia,nutritional status and satisfaction after intervention were compared between the two groups.Result in the improved group was significantly lower than that in the pre-improvement group(P<0.05),and the SSA score,DHI score and total DHI score of patients in the 2 groups were significantly lower than that before intervention(P<0.05).The SSA score,DHI score and DHI total score in the improved group were lower than those in the pre-improved group(P<0.05).The results of 4-week follow-up showed that the scores of NRS-2002 for nutritional risk screening in 2 groups were lower than before intervention(P<0.05),and the scores of NRS-2002 for nutritional risk screening in the improved group were significantly lower than those in the pre-improvement group(P<0.05).The comparison showed that the incidence of aspiration and aspiration pneumonia in the improved group was lower than that in the pre-improved group(P<0.05),and the satisfaction score of patients with the relevant preventive measures was higher than that in the pre-improved group(P<0.05).Conclusion The"ASK-T"aspiration preven-tion management model,when applied in the nursing of elderly patients with COPD complicated by dysphagia,can significantly reduce the risk of aspiration and the incidence of aspiration pneumonia,effectively improve patients' swallowing function and quality of life,and enhance their nutritional status.Furthermore,this model significantly improves patient satisfaction with intervention measures,providing a scientific and effective management strategy for clinical nursing of elderly patients with COPD complicated by dysphagia.It is worthy of promotion and application in clinical practice.

This study elaborates on the teaching reform of the "Five-year Traditional Chinese Medicine Talent Training Program for Traditional Chinese Medicine (Orthopedics Direction)" implemented by Department of Orthopedics in Guangzhou University of Chinese Medicine, including curriculum reform (restructuring courses, emphasizing Lingnan characteristics, and combining medical sciences with martial arts) and teaching model reform (increasing mentorship and learning from teachers, arranging one mentor for every two students, and assigning one teaching team leader for every 5-6 groups). A questionnaire survey conducted among the students of the classes 2022 and 2023 in the five-year TCM talent training program for traditional Chinese medicine (TCM) majors (orthopedics direction) showed that 86.25% (69/80) of the students were satisfied with the mentorship model of "arranging one mentor for every two students", and 87.50% (70/80) of the students agreed that "the assignment of a teaching team leader can help to control teaching intensity". In terms of restructuring the curriculum system, 90.00% (72/80) of the students believed that the establishment of characteristic teaching courses could help to stimulate the enthusiasm for exploring TCM sciences, and 88.75% (71/80) of the students recognized the unique integration of textbooks, believing that it could help to understand the Lingnan school of Orthopedics. In terms of professional qualities, 90.00% (72/80) of the students agreed that the learning model of "systematic education+learning from teachers" could significantly help with the integration of knowledge, and 88.75% (71/80) of the students suggested that this model could stimulate the interest in specialized knowledge fields and motivate students to learn independently. In terms of apprenticeships with teachers, 85.00% (68/80) of the students reported that they could receive answers from teachers when asking questions, and 93.75% (75/80) of the students believed that early apprenticeship with a teacher was necessary. Some students still had a lack of understanding of learning TCM Qigong methods and believed that continuous practice took up too much personal time, failing to cultivate a good thinking of "the combination of medical sciences and martial arts", and they also believed that there were still limited opportunities for practice. The results show that the teaching model of "systematic education+learning from teachers" helps to improve the degree of satisfaction among students and cultivate clinical skills and professional qualities.

Objective To explore the application effect of the"ASK-T"aspiration prevention management model in reducing the risk of aspiration in elderly patients with chronic obstructive pulmonary disease(COPD)complicated by dysphagia.Methods 196 of 409 COPD patients with aspiration risk admitted to the Respiratory Disease Department of Guangdong Provincial Hospital of Chinese Medicine,Higher Education Mega Center Hospital from July 2021 to June 2024 were selected as the study object,and 102 COPD patients with aspiration risk admitted from July 2021 to December 2022 were set as the pre-improvement group.The patients in this group received the original nursing process and management mode of the department during hospitalization.94 COPD patients with aspiration risk admitted from January 2023 to June 2024 were set as the improved group,and the patients in this group were introduced into the department and implemented an innovative improvement project:"ASK-T"anti-aspiration management mode and then received nursing management.Patients in both groups were observed and followed up for 4 weeks.The risk grade of aspiration,SSA score,DHI score,aspiration pneumonia and aspiration pneumonia,nutritional status and satisfaction after intervention were compared between the two groups.Result in the improved group was significantly lower than that in the pre-improvement group(P<0.05),and the SSA score,DHI score and total DHI score of patients in the 2 groups were significantly lower than that before intervention(P<0.05).The SSA score,DHI score and DHI total score in the improved group were lower than those in the pre-improved group(P<0.05).The results of 4-week follow-up showed that the scores of NRS-2002 for nutritional risk screening in 2 groups were lower than before intervention(P<0.05),and the scores of NRS-2002 for nutritional risk screening in the improved group were significantly lower than those in the pre-improvement group(P<0.05).The comparison showed that the incidence of aspiration and aspiration pneumonia in the improved group was lower than that in the pre-improved group(P<0.05),and the satisfaction score of patients with the relevant preventive measures was higher than that in the pre-improved group(P<0.05).Conclusion The"ASK-T"aspiration preven-tion management model,when applied in the nursing of elderly patients with COPD complicated by dysphagia,can significantly reduce the risk of aspiration and the incidence of aspiration pneumonia,effectively improve patients' swallowing function and quality of life,and enhance their nutritional status.Furthermore,this model significantly improves patient satisfaction with intervention measures,providing a scientific and effective management strategy for clinical nursing of elderly patients with COPD complicated by dysphagia.It is worthy of promotion and application in clinical practice.

This study elaborates on the teaching reform of the "Five-year Traditional Chinese Medicine Talent Training Program for Traditional Chinese Medicine (Orthopedics Direction)" implemented by Department of Orthopedics in Guangzhou University of Chinese Medicine, including curriculum reform (restructuring courses, emphasizing Lingnan characteristics, and combining medical sciences with martial arts) and teaching model reform (increasing mentorship and learning from teachers, arranging one mentor for every two students, and assigning one teaching team leader for every 5-6 groups). A questionnaire survey conducted among the students of the classes 2022 and 2023 in the five-year TCM talent training program for traditional Chinese medicine (TCM) majors (orthopedics direction) showed that 86.25% (69/80) of the students were satisfied with the mentorship model of "arranging one mentor for every two students", and 87.50% (70/80) of the students agreed that "the assignment of a teaching team leader can help to control teaching intensity". In terms of restructuring the curriculum system, 90.00% (72/80) of the students believed that the establishment of characteristic teaching courses could help to stimulate the enthusiasm for exploring TCM sciences, and 88.75% (71/80) of the students recognized the unique integration of textbooks, believing that it could help to understand the Lingnan school of Orthopedics. In terms of professional qualities, 90.00% (72/80) of the students agreed that the learning model of "systematic education+learning from teachers" could significantly help with the integration of knowledge, and 88.75% (71/80) of the students suggested that this model could stimulate the interest in specialized knowledge fields and motivate students to learn independently. In terms of apprenticeships with teachers, 85.00% (68/80) of the students reported that they could receive answers from teachers when asking questions, and 93.75% (75/80) of the students believed that early apprenticeship with a teacher was necessary. Some students still had a lack of understanding of learning TCM Qigong methods and believed that continuous practice took up too much personal time, failing to cultivate a good thinking of "the combination of medical sciences and martial arts", and they also believed that there were still limited opportunities for practice. The results show that the teaching model of "systematic education+learning from teachers" helps to improve the degree of satisfaction among students and cultivate clinical skills and professional qualities.

Objective:To analyze the occupational disease hazards in stone processing enterprises in Weihai City to provide scientific basis for occupational disease prevention.Methods:From January 2021 to December 2022, 107 stone processing enterprises in Weihai City were selected to collect the detection status of occupational hazard factors in the workplace through on-site investigation and on-site monitoring of occupational hazard factors. The diagnostic reports on occupational diseases and suspected occupational diseases of 780 workers were collected through the Occupational Diseases and Hazard Factors Monitoring Information System of the Chinese Center for Disease Control and Prevention, the occupational health monitoring files of the occupational health examination institutions and the information data of the occupational disease diagnosis institutions. The differences between the measurement data were analyzed by Chi-square test or Fisher exact probability method.Results:107 stone processing enterprises were mainly focused on granite processing, and the average free silica content in granite was 32.92% (12.78%-47.84%). The over-standard rate of silica dust was 0.31% (6/1920), and the over-standard rate of noise was 86.20% (1324/1536). Among them, the noise intensity of cutting position was the highest[120.5 dB (A) ]. The over-standard rates of noise in cutting, water grinding, dry grinding (polishing) and material preparation (forklift transportation) were 98.05%, 89.55%, 70.00% and 42.62%, respectively, and the differences were statistically significant ( P<0.05). Among 780 workers, 31 cases (3.97%) of suspected silicosis were detected, and 13 cases (1.67%) were diagnosed with silicosis. 51 cases (6.54%) of suspected occupational noise deafness were detected, and 11 cases (1.41%) were diagnosed with occupational noise deafness. Conclusion:Silicon dust and noise in some positions of stone processing enterprises in Weihai City exceed the standard, and supervision should be strengthened, prevention and control measures should be implemented to protect the occupational health of workers.

Objective:To analyze the occupational disease hazards in stone processing enterprises in Weihai City to provide scientific basis for occupational disease prevention.Methods:From January 2021 to December 2022, 107 stone processing enterprises in Weihai City were selected to collect the detection status of occupational hazard factors in the workplace through on-site investigation and on-site monitoring of occupational hazard factors. The diagnostic reports on occupational diseases and suspected occupational diseases of 780 workers were collected through the Occupational Diseases and Hazard Factors Monitoring Information System of the Chinese Center for Disease Control and Prevention, the occupational health monitoring files of the occupational health examination institutions and the information data of the occupational disease diagnosis institutions. The differences between the measurement data were analyzed by Chi-square test or Fisher exact probability method.Results:107 stone processing enterprises were mainly focused on granite processing, and the average free silica content in granite was 32.92% (12.78%-47.84%). The over-standard rate of silica dust was 0.31% (6/1920), and the over-standard rate of noise was 86.20% (1324/1536). Among them, the noise intensity of cutting position was the highest[120.5 dB (A) ]. The over-standard rates of noise in cutting, water grinding, dry grinding (polishing) and material preparation (forklift transportation) were 98.05%, 89.55%, 70.00% and 42.62%, respectively, and the differences were statistically significant ( P<0.05). Among 780 workers, 31 cases (3.97%) of suspected silicosis were detected, and 13 cases (1.67%) were diagnosed with silicosis. 51 cases (6.54%) of suspected occupational noise deafness were detected, and 11 cases (1.41%) were diagnosed with occupational noise deafness. Conclusion:Silicon dust and noise in some positions of stone processing enterprises in Weihai City exceed the standard, and supervision should be strengthened, prevention and control measures should be implemented to protect the occupational health of workers.

Objective To construct an evaluation index system of"Internet+Traditional Chinese Medicine nursing"service capability,in order to provide references for the standardized and effective evaluation of"Internet+Traditional Chinese Medicine nursing"service capability.Methods Literature analysis and semi-structured interview method were adopted,and three-dimensional quality structure model was used as the theoretical framework to initially construct the"Internet+Traditional Chinese Medicine nursing"service capability evaluation index item pool.From July to 0ctober 2022,the Delphi method was used to conduct 2 rounds of consultation with 16 experts from Guangdong Province,to evaluate the enthusiasm,authority,degree of opinion concentration and degree of opinion coordination of the experts in the correspondence consultation,and the weight of the index system was determined with the combination of chromatography analysis.Results 2 rounds of expert letter consultation were conducted.The questionnaire recovery rates were 100％,and the authority coefficients were 0.844 and 0.834,respectively.Kendall coordination coefficients were 0.161 and 0.110,respectively(P＜0.001).The first level indexes of the index system are structure evaluation,process evaluation and outcome evaluation.There were 3 first-level evaluation indicators,14 second-level evaluation indicators and 57 third-level evaluation indicators.Conclusion The evaluation index is scientific and practical,and it is carried out around the Internet+Traditional Chinese Medicine nursing capability,which provides a certain reference for the effective evaluation of the service capability of"Internet+Traditional Chinese Medicine nursing".

Objective:To analyze the causes and clinical characteristics of 9 cases of occupational acute poisoning with diethylene glycol monobutyl ether, and provide a basis for clinical diagnosis, treatment, prognosis, and prevention.Methods:The leakage accident of diethylene glycol monobutyl ether occurred in an electronic company in Janvary 2021, in Weihai City was analyzed. The clinical manifestations, laboratory examinations, diagnosis, treatment and prognosis of 9 cases of diethylene glycol monobutyl ether poisoning were summarized.Results:All 9 patients had moderate chemical eye burns and chemical conjunctivitis, and were immediately given symptomatic treatment. They fully recovered after 14 days.Conclusion:Patients who inhale diethylene glycol monobutyl ether for a short time have obvious eye burns, but early detection and timely treatment can achieve better prognosis.

Objective:To analyze the causes and clinical characteristics of 9 cases of occupational acute poisoning with diethylene glycol monobutyl ether, and provide a basis for clinical diagnosis, treatment, prognosis, and prevention.Methods:The leakage accident of diethylene glycol monobutyl ether occurred in an electronic company in Janvary 2021, in Weihai City was analyzed. The clinical manifestations, laboratory examinations, diagnosis, treatment and prognosis of 9 cases of diethylene glycol monobutyl ether poisoning were summarized.Results:All 9 patients had moderate chemical eye burns and chemical conjunctivitis, and were immediately given symptomatic treatment. They fully recovered after 14 days.Conclusion:Patients who inhale diethylene glycol monobutyl ether for a short time have obvious eye burns, but early detection and timely treatment can achieve better prognosis.

Objective:To explore whether the action research on the pre-service training evaluation system of "Internet + TCM Nursing" guided by CIPP (context, input, process and product) and Kirkpatrick Model can improve the training effect of nursing staff under the background of internet and TCM nursing service.Methods:Taking 211 nurses of "Internet + TCM Nursing" in Guangdong Provincial Hospital of TCM from 2019 to 2020 as the research objects, action teams were made, and the data were collected and analyzed by various methods. According to the collected data, the action teams constructed the training scheme of "Internet + TCM Nursing", the compilation requirements of "internet + TCM Nursing", the case optimization scheme of "internet + TCM Nursing" process, and the evaluation model of "internet + TCM Nursing". After the training, the nurses' knowledge, skills and related attitudes, the general reaction and feelings to the training programs, and the evaluation of nurses' work performance by the competent leaders, medical staff and clients were compared by comparing their scores and issuing self-made questionnaires. SPSS 20.0 software was used for statistical analysis.Results:The results showed that the theoretical scores of nurses after training were (85.16±6.22) points, and the case assessment scores after training [(81.22±7.03) points] were higher than the previous theoretical scores [(61.23±12.90) points] and the case assessment scores [(59.54±14.41) points], with statistical significance ( P<0.001). The results of self-made questionnaire showed that there were significant differences in theoretical knowledge, skills and related attitudes among nurses after training ( P<0.001). In the process of training, there were statistically significant differences in training content, teacher training, training implementation and training guarantee at the end of training ( P<0.001). After training, there were significant differences in the evaluation of nurses' job performance by leaders in charge, medical staff and clients improved in knowledge and skills, professional ethics, working process and learning ability, and the improvement rate ( P<0.001). Conclusion:Action research is an effective research method to continuously improve nursing training. The optimization scheme of "internet + TCM Nursing" nurses based on CIPP and Kirkpatrick Model through action research can effectively improve the training effect.