Doctor-patient communication not only depends on the medical group but is also affected by the patient group and the specific situation. Effective doctor-patient communication requires the doctors to improve their communication skills， the patients to have relevant knowledge regarding a certain symptom or disease， and mutual trust between the doctor and patient. The information ecology theory mainly analyzes the relationships between various ecological elements and the ecological development mechanisms in the process of information activities from the perspective of the ecosystem， as well as attaches importance to the mutual influences and roles of information subjects and objects， information contents， information environment， and information technology within the system， which is consistent with the influencing factors of doctor-patient communication. Based on the information ecology theory， this paper analyzed the new problems faced by doctor-patient communication under the information technology environment from the four dimensions， including information subjects and objects， information itself， information context， and information technology. It was proposed that effective doctor-patient communication required to re-examine the influencing factors of doctor-patient communication， as well as construct a doctor-patient community， including a community of knowledge， communication， emotion， and interest， so that the four factors of doctor-patient communication can form a new balance in the dynamic development， with a view to providing practical guidance for doctor-patient trust and effective doctor-patient communication.

Objective:To study and analyze the application effect of intervention plan based on unplanned readmission risk model (LACE) in the rehabilitation of patients with acute myocardial infarction (AMI) complicated with cardiac shock (CS) after percutaneous coronary intervention (PCI).Methods:Ninety-three patients with AMI complicated with CS who received PCI in Tianjin Union Medical Center from January 2019 to December 2020 were enrolled. The patients were divided into LACE intervention group ( n = 46) and routine intervention group ( n = 47) according to the different nursing intervention methods. The patients in the routine intervention group received routine interventions, including drug care, diet care, psychological care, health education and telephone follow-up, while those in the LACE intervention group were assessed for the risk of LACE, and then intervention measures were formulated according to the score of LACE index, including strengthening risk awareness, life behavior, daily life ability, self-care ability, health recovery and health needs. The follow-up period in both groups was 3 months. The changes of cardiac function, incidence of adverse cardiac events, readmission rate, self-management ability after intervention and quality of life level before and after intervention were compared between the two groups. Results:There was no significant difference in cardiac function or quality of life before intervention between the two groups. After intervention for 3 months, the cardiac function and quality of life in the two groups were improved as compared with those before intervention. The left ventricular ejection fraction (LVEF) in the LACE intervention group was significantly higher than that in the routine intervention group (0.533±0.076 vs. 0.492±0.072, P < 0.05), the left ventricular end diastolic diameter (LVEDD) was significantly lower than that in the routine intervention group (mm: 47.09±7.01 vs. 53.23±7.15, P < 0.01), and the World Health Organization Quality of Life-brief (WHOQOL-BREF) score was also significantly higher than that in the routine intervention group (66.32±6.19 vs. 55.79±7.26, P < 0.01). The scores of self-management ability in the coronary heart disease self-management scale (CSMS) after intervention in the LACE intervention group were significantly higher than those in the routine intervention group (adverse hobbies score: 17.37±3.24 vs. 14.21±2.73, symptoms score: 14.82±3.11 vs. 10.56±2.65, emotional cognition score: 16.17±2.83 vs. 12.95±2.41, first aid score: 11.85±1.94 vs. 10.62±1.56, disease knowledge score: 15.58±2.73 vs. 12.68±2.61, daily life score: 17.80±2.61 vs. 14.33±2.36, treatment compliance score: 11.47±1.84 vs. 8.56±1.23, all P < 0.01). The incidence of adverse cardiac events and readmission rate in the LACE intervention group were significantly lower than those in the routine intervention group (10.87% vs. 29.79%, 4.35% vs. 17.02%, both P < 0.05). Conclusion:The intervention plan based on LACE risk model can effectively promote postoperative rehabilitation of patients with AMI complicated with CS after PCI, and also help to improve patients' self-management ability and quality of life, which is worthy of clinical promotion and application.

Objective:To analyze the research status and research hot spots of pressure injury (PI) in the nursing field and provide ideas and reference basis for development of pressure injury research in China.Methods:Based on Web of Science database, literatures related to pressure injury published in the nursing field from establishment of databases to December 31, 2019 were searched. CiteSpace software was used to visualize the literature data of its country, research institutions, high-frequency keywords, etc.Results:A total of 927 English literatures were included. Research on PI in the nursing field began in 1999, and the overall trend was increasing since 2004. In 2016, the number of articles published was the largest, reaching 102. The hot spots of pressure injury in the nursing field were mainly the prevention, prevalence, risk factors, nursing, risk assessment and evaluation of PI. The research frontier of pressure injury in the nursing field mainly focused on the risk assessment of pressure injury, nurses' knowledge and attitudes towards pressure injury and so on.Conclusions:CiteSpace software can visually display the hot spots and trends of pressure injury in nursing field. The research frontier of pressure injury in nursing field in this study can provide references and directions for scientific research and clinical practice in pressure injury in nursing field in China.

Objective: To review the clinical characteristics of a pedigree with inherited hemorrhagic disease to explore its molecular pathogenesis. Methods: The clinical data of the pedigree with inherited hemorrhagic disease were collected. After extracting DNA, next generation sequencing was utilized to detect the potential gene mutation. The changes of RASGRP2 transcript of this proband and his parents were detected using RT-PCR to compare with normal control. Results: The phenotype of the proband in this pedigree with inherited platelet dysfunction and bleeding disorder was similar to variant Glanzmann’s thrombasthenia, the maximum aggregations of platelet in response to the physiological agonists including ADP, epinephrine and arachidonic acid were significantly lower, leading to severe spontaneous mucosal bleeding. Integrin αIIbβ3 gene mutation was not detected, but another gene mutation RASGRP2 IVS3-1 stood out. The mutation was homozygous in the proband and heterozygosis in both of his parents. Two transcript types were detected in the proband, without transcripts coding functional RASGRP2 protein, however, his parents had functional transcripts and abnormal transcripts, with the normal transcripts in the majority. Conclusions The RASGRP2 IVS3-1 gene mutation was responsible for the inherited hemorrhagic disease. The RASGRP2 IVS3-1 gene mutation led to abnormal alternative splicing, without formation of functional RASGRP2 protein. The RASGRP2 protein is at the nexus of calcium-dependent platelet activation and hemostasis after damage of blood vessels. Spontaneous mucosal bleeding was a result of the lack of the functional RASGRP2 protein. This was the first report of RASGRP2 gene mutation resulting in bleeding disorder in China, and also the first report of the mutation type of RASGRP2 IVS3-1.