Objective:To evaluate the application effect and long-term benefits of in situ simulation combined with the forgetting curve training mode in trauma nurse training, and to provide a basis for further promoting the development of trauma nurse training.Methods:From June to September 2022, a total of 78 nurses in the Trauma Center of a grade A tertiary hospital in Changsha, China were selected by the purposive sampling method as the research objects. The nurses were divided into an experimental group and a control group according to the random number table method. The control group received theoretical teaching and skill operation training by traditional teaching methods. The experimental group was trained by the teaching method of in-situ simulation combined with the forgetting curve. The scores of theoretical and operational skills of the two groups were compared by the repeated measures analysis of variance (ANOVA) before training (T1), 1 day after training (T2), 1 month after training (T3), and 6 months after training (T4). The scores of core competence of trauma nurses before and after training were compared between the two groups by the t test. Results:There was no significant difference in theoretical, operational, and core competence scores between the two groups before training ( P>0.05). The results of repeated measures ANOVA showed significant differences in the time effect, inter-group effect, and interaction effect of theoretical and operational scores between the two groups ( P<0.001). The results of one-way repeated measures ANOVA showed that the theoretical and operational scores of the two groups increased first and then decreased with time. The results of multivariate ANOVA showed no significant difference in theoretical and operational scores between the two groups at observation time point T1 ( P>0.05), but significant differences at observation time points T2, T3, and T4, at which the scores in the experimental group were higher than those in the control group ( P<0.001). The results of independent samples t test showed that the core competence score of trauma nurses in the experimental group was significantly higher than that in the control group after training ( P<0.05). Conclusions:The training mode of in situ simulation combined with the forgetting curve is more effective than traditional training mode in improving the professional skill level of trauma nurses and brings long-term training effect and benefits.

Objective Establish a relationship model between the outcome of inpatient rehabilitation treatment and the influencing factors of rehabilitation effect,explore the evaluation method of inpatient rehabilitation service effect.Methods Using a neural network model to construct a functional relationship model between the outcomes of inpatient rehabilitation treatment and the factors affecting rehabilitation effectiveness,in order to predict the expected rehabilitation outcomes of patients receiving inpatient treatment.Compare the distribution of the difference between the actual discharge ICF total score and the predicted ICF total score to determine the effectiveness of rehabilitation treatment.Results As a result,a total of 1 334 hospitalized rehabilitation cases of brain injury patients were included in this study for analysis.Based on the evaluation indicators and standards of prediction accuracy,the optimal model was selected and the rehabilitation effect was evaluated.Conclusion Based on the ICF-RS-17 measurement of patient entry and exit function scores,the functional status of hospitalized rehabilitation patients themselves,and related possible influencing factors,a relationship model between inpatient rehabilitation treatment outcomes and influencing factors is constructed.It provides a certain scientific basis for establishing an effective evaluation method for the actual clinical rehabilitation effect,and also provides reference suggestions for the realization of value-based payment of rehabilitation medical insurance.

Objective Establish a relationship model between the outcome of inpatient rehabilitation treatment and the influencing factors of rehabilitation effect,explore the evaluation method of inpatient rehabilitation service effect.Methods Using a neural network model to construct a functional relationship model between the outcomes of inpatient rehabilitation treatment and the factors affecting rehabilitation effectiveness,in order to predict the expected rehabilitation outcomes of patients receiving inpatient treatment.Compare the distribution of the difference between the actual discharge ICF total score and the predicted ICF total score to determine the effectiveness of rehabilitation treatment.Results As a result,a total of 1 334 hospitalized rehabilitation cases of brain injury patients were included in this study for analysis.Based on the evaluation indicators and standards of prediction accuracy,the optimal model was selected and the rehabilitation effect was evaluated.Conclusion Based on the ICF-RS-17 measurement of patient entry and exit function scores,the functional status of hospitalized rehabilitation patients themselves,and related possible influencing factors,a relationship model between inpatient rehabilitation treatment outcomes and influencing factors is constructed.It provides a certain scientific basis for establishing an effective evaluation method for the actual clinical rehabilitation effect,and also provides reference suggestions for the realization of value-based payment of rehabilitation medical insurance.

Objective:To evaluate the application effect and long-term benefits of in situ simulation combined with the forgetting curve training mode in trauma nurse training, and to provide a basis for further promoting the development of trauma nurse training.Methods:From June to September 2022, a total of 78 nurses in the Trauma Center of a grade A tertiary hospital in Changsha, China were selected by the purposive sampling method as the research objects. The nurses were divided into an experimental group and a control group according to the random number table method. The control group received theoretical teaching and skill operation training by traditional teaching methods. The experimental group was trained by the teaching method of in-situ simulation combined with the forgetting curve. The scores of theoretical and operational skills of the two groups were compared by the repeated measures analysis of variance (ANOVA) before training (T1), 1 day after training (T2), 1 month after training (T3), and 6 months after training (T4). The scores of core competence of trauma nurses before and after training were compared between the two groups by the t test. Results:There was no significant difference in theoretical, operational, and core competence scores between the two groups before training ( P>0.05). The results of repeated measures ANOVA showed significant differences in the time effect, inter-group effect, and interaction effect of theoretical and operational scores between the two groups ( P<0.001). The results of one-way repeated measures ANOVA showed that the theoretical and operational scores of the two groups increased first and then decreased with time. The results of multivariate ANOVA showed no significant difference in theoretical and operational scores between the two groups at observation time point T1 ( P>0.05), but significant differences at observation time points T2, T3, and T4, at which the scores in the experimental group were higher than those in the control group ( P<0.001). The results of independent samples t test showed that the core competence score of trauma nurses in the experimental group was significantly higher than that in the control group after training ( P<0.05). Conclusions:The training mode of in situ simulation combined with the forgetting curve is more effective than traditional training mode in improving the professional skill level of trauma nurses and brings long-term training effect and benefits.

Objective To explore the advantages and safety of laparoscopic operation compared with open surgery for the treatment of acute appendicitis in pregnancy.Methods The clinical data of 22 patients with early,middle and late pregnancy acute appendicitis from November 2004 to April 2023 were retrospectively analyzed.They were divided into laparoscopic operation group(n=9)and open group(n=13)according to the operation method.The infection indicators and fetal outcome indicators were compared between the two groups.Results Comparison of hospitalization time,intraoperative bleeding,drain placement rate,C-reactive protein,procalcitonin,antibiotic use time,incision infection rate,abdominal infection rate,fertility preservation treatment time,pathological manifestations,preterm delivery rate,delivery mode,fetal survival rate between the two groups,the differences were not statistically significant(P＞0.05);the operation time of laparoscopic group was longer than that of open group,postoperative analgesic use time,postoperative time of first feeding and postoperative anal defecation time were shorter than those of open group,postoperative leukocyte count was lower than that of open group,the differences were all statistically significant(P＜0.05),and anesthesia mode was statistically significant(P＜0.05).Conclusion Laparoscopic surgery is safe and feasible for the treatment of appendicitis in pregnancy.Compared with laparotomy,it has the advantages of small incision,beautiful incision,fast intestinal recovery,early feeding,less infection,good maternal-fetal outcome and high fetal safety.

Gallbladder cancer constitutes the most prevalent malignant tumor of the biliary tract. It exhibits clinical characteristics such as challenging diagnosis in early stages, aggressive invasiveness, and poor prognosis. Studies have discovered that the occurrence, development, and metastasis of malignant tumors are closely associated with the inflammatory response, and the level of systemic inflammation within the body can be reflected by peripheral blood inflammatory indicators. This review delineates the research progress on the correlation between peripheral blood inflammatory markers and the prognosis of gallbladder cancer, with the intention of providing references for the diagnosis, treatment, and prognosis evaluation of gallbladder cancer.

Objective To investigate the diagnostic efficacy and clinical value of GNB4 and Riplet gene methylation alone and in combination in the diagnosis of primary liver cancer.Methods A total of 313 patients were selected,including 78 patients with primary liver cancer,41 patients with other digestive system tumors,17 patients with non-digestive system tumors,20 patients with postoperative liver cancer,and 157 patients with benign liver disea-ses.The levels of GNB4 and Riplet gene methylation in plasma were detected using quantitative methylation-specific PCR(qMSP).Serum alpha-fetoprotein(AFP)levels were measured by direct chemiluminescence.Results The sensitivity and specificity of AFP in diagnosis were 51.3％and 94.3％,respectively;the sensitivity and specificity of GNB4 gene methylation in diagnosis were 83.3％and 99.4％,respectively;the sensitivity and specificity of Riplet gene methylation in diagnosis were 73.1％and 99.4％,respectively.The sensitivity and specificity of GNB4 and Riplet gene methylation combined diagnosis were 92.3％and 98.7％,respectively;the sensitivity and specificity of AFP,GNB4 and Riplet gene methylation combined diagnosis were 92.3％and 98.7％,respectively;the sensitivity and specificity of combined diagnosis including age and gender were 93.6％and 97.5％,respective-ly.Conclusion The sensitivity and specificity of AFP in the diagnosis of primary liver cancer are limited,while the methylation levels of GNB4 and Riplet genes are higher,and the sensitivity and specificity of their combined de-tection are higher than those of AFP.The sensitivity and specificity of AFP,GNB4 and Riplet gene methylation combined diagnosis are significantly higher than those of AFP,GNB4 and Riplet gene methylation alone.

Objective:To explore the mediating effect of social support and exercise self-efficacy on the intrinsic capacity of community-dwelling older adults and healthy aging, so to provide a basis for improving the healthy aging of community-dwelling older adults.Methods:From January to July 2022, cluster random sampling was used to select 1 303 community-dwelling older adults from Urumqi City as the research subject. The survey was conducted using the General Information Questionnaire, Healthy Aging Instrument, Intrinsic Capacity Questionnaire, Social Support Rating Scale, and Exercise Self Efficacy Scale for Aged People in Community. The conceptual model was used to explore the relationship among social support, exercise self-efficacy, intrinsic capacity, and healthy aging in community-dwelling older adults. A total of 1 303 questionnaires were distributed, and 1 042 valid questionnaires were collected, with an effective response rate of 80%.Results:Among 1 042 community-dwelling older adults, the scores of the Intrinsic Capacity Questionnaire, Healthy Aging Instrument, Social Support Rating Scale, and Exercise Self Efficacy Scale for Aged People in Community were [1.00 (0, 2.00) ] , [146.00 (133.75, 155.00) ] , [41.00 (36.00, 46.00) ] and [51.00 (39.00, 61.00) ] , respectively. The intrinsic capacity of community-dwelling older adults was negatively correlated with social support, exercise self-efficacy, and healthy aging ( r=-0.112, -0.121, -0.120, P<0.01) , and social support and exercise self-efficacy were positively correlated with healthy aging (r=0.129, 0.113, P<0.01) . Bootstrap mediating effect test showed that the mediating effect of social support and exercise self-efficacy between the intrinsic capacity of community-dwelling older adults and healthy aging was established, with a mediating effect value of -0.477, accounting for 24.75% of the total effect. The path effect value of intrinsic capacity→ social support→ healthy aging was -0.262, accounting for 54.93% of the mediating effect value. The path effect value of intrinsic capacity → exercise self-efficacy→ healthy aging was -0.214, accounting for 44.86% of the mediating effect value. Conclusions:In the community elderly population, social support and exercise self-efficacy can play a mediating role between intrinsic capacity and healthy aging. Community health care providers should pay attention to the internal capacity of the older adults, improve social support and exercise self-efficacy, and thus promote the realization of healthy aging of the older adults.

Influenza is a worldwide infectious disease caused by influenza virus. It has posed great challenges on public health and social stability since 1918. At present, vaccination is the most effective way to prevent and control influenza epidemics. Broad-spectrum antiviral drugs and neutralizing antibodies against influenza virus have been widely studied in recent years. Hemagglutinin (HA), which is on the surface of influenza virus, plays an important role in the stage of viral invasion into host cells. It is the main effective antigenic component of current influenza vaccines, as well as the main target of broad-spectrum neutralizing antibodies and broad-spectrum antiviral drugs. This review summarized the progress in the development of novel influenza vaccines, neutralizing antibodies, and antiviral drugs based on influenza virus HA, as well as other prevention and control measures, hoping to present new ideas for future influenza prevention and control.

Objective:To explore the contents and methods of clinical comprehensive evaluation of microecologics, with the example of Bifidobacterium quadruple viable tablet, in order to provide evidence for clinical rational use of microecologics, and microecologics research, development and related decision-making, and to promote rational use of medications. Methods:Based on the research data collected from systematic literature search, health technology assessment methods such as evidence-based medicine and pharmacoeconomics evaluation were used to estimate the safety, efficacy, economics, suitability, accessibility and innovation of Bifidobacterium quadruple viable tablet. Results:In terms of efficacy, Bifidobacterium quadruple viable tablet showed significant therapeutic effects in the treatment of pediatric diarrhea, antibiotic-related diarrhea, diarrhea-predominant irritable bowel syndrome, and secondary diarrhea caused by diseases such as ulcerative colitis, as well as constipation and functional dyspepsia. It can also be used in the treatment of various diseases such as Helicobacter pylori related gastritis, liver cirrhosis, non-alcoholic fatty liver disease. In terms of safety, the incidence of adverse effects of this medication was low, and most were mild to moderate and transient symptoms. In terms of economics, compared with mesalazine alone in the treatment of ulcerative colitis, the incremental cost-effectiveness ratio of combination of Bifidobacterium quadruple viable tablet and mesalazine was 1 743.2. Besides, the daily treatment cost of Bifidobacterium quadruple viable tablet was lower than that of combination of Bifidobacterium triple viable and Bacillus licheniformis (1.87 to 2.80 yuan vs. 2.08 to 5.78 yuan). In terms of innovation, this medication had multiple patents and had been identified as a high-tech product in Zhejiang Province. In terms of suitability, the overall suitability of use and technical characteristics of medication were good. It could be further improved in the aspects of dosage form and system. In terms of accessibility, the price of the medication was stable, affordable and accessible to the general public. Conclusions:Based on the existing evidence, Bifidobacterium quadruple viable tablet presented effective with supported evidences, good safety, accessibility and innovation. The suitability can be further optimized. However, more in-depth and targeted research is needed in terms of economics and innovation in different clinical applications, and there is space for optimization in medication suitability.