Objective To use the semi-structural interview and the Delphi method to construct the nursing-mini-clinical evaluation exercise(Mini-CEX)index,to provide an effective assessment tool for the clinical care ability of emergency care.Methods Review the emergency nursing literatures,summarize and organize the inclusion criteria,select the evaluation indexes for emergency clinical nursing ability,interview 16 doctors and head nurses in the emergency department of Northern Jiangsu People's Hospital as the preliminary scale of Mini-CEX scale,and use Delphi method to form the final Mini-CEX scale.Results After two rounds of letter inquiry,Mini-CEX scale was constructed,including 4 first-level indicators(humanistic care,nursing consultation,practical ability and overall performance)and 10 second-level indicators(correctly and reasonably address patients,privacy protection,build a good nurse-patient relationship,effectively guide and use questions to ask,collection of complete medical history,effectively emergency drugs and usage,accurately grasp the use of emergency related instruments and precautions,accurate assessment of patients,nursing indications,evaluation time is reasonable,high overall efficiency,nursing process concise and smooth,accurate nursing measures implementation sequence).Conclusion The Mini-CEX scale constructed by semi-structured interview and Delphi method has a good guidance for emergence nursing teaching and can serve as an effective evaluation tool for the clinical nursing skills of emergency nurses.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To determine the content of Chikusetsu saponin Ⅳa in the roots, stems and leaves in Panacis japonici rhizoma, and explore its development value. Methods:By using High Performance Lliquid Chromatography (HPLC) method to determine the content of Chikusetsu saponin Ⅳa in the roots, stems and leave of Panacis japonici rhizoma. Inertsil ODS-sp (4.6 mm×150 mm, 5 μm) was used as the column and the acetonitrile-0.2% phosphoric acid (35:65) as the mobile phase. The flow rate was 1 ml/min with the temperature 35 ℃ under wavelength 210 nm. Results:The linear ranged from 1-10 μg of Chikusetsu saponin Ⅳa was good ( r=0.999 5). The content of Chikusetsu saponin Ⅳa in the roof, stem and leaf were 2.169%, 0.269%, 0.169%, respectively. Conclusions:The roof of Panacis japonici rhizoma contains the highest level of Chikusetsu saponin Ⅳa followed by stem and leaf. The roof part could be used as the medical part and its stem and leaf are also valuable for further development.

Objective:To investigate the effect of microRNA-124 (miR-124) expression on pathological changes of Tau in elderly patients with Alzheimer disease to provide a new target for early detection and early treatment of Alzheimer disease in the elderly.Methods:The serum of 50 patients with Alzheimer disease from June 2017 to June 2018 in the Third People′s Hospital of Qinghai Province Hospital was taken as the sample of the research group and the serum of 50 healthy people was taken as the control sample. The mRNA expression of miR-124 in serum was determined by real-time polymerase chain reaction. The double antibody sandwich enzyme-linked immunosorbent assay was used. The expression levels of Tau protein and phosphorylated Tau (PTau) protein (S396, T181 and T231) were examined; pathological changes of Tau protein were detected by positron emission tomography.Results:The mRNA expression of serum miR-124 in Alzheimer disease patients was significantly higher than that in the control group (6.91 ± 0.41 vs. 5.11 ± 0.37, P < 0.01). The expression levels of total Tau protein, PTau (S396) protein and PTau (T181) protein in Alzheimer disease patients was significantly up-regulated, compared with those of the control group: (195.16 ± 20.48) ng/L vs. (123.25 ± 20.26) ng/L, (69.35 ± 8.92) ng/L vs. (40.53 ± 4.36) ng/L, (66.83 ± 8.45) ng/L vs. (35.87 ± 2.18) ng/L, P < 0.05. The pathological changes of Tau protein were clinically manifested as brain deposition, and the main parts were frontal lobe, occipital lobe, parietal lobe and temporal lobe. The overexpression of miR-124 was positively correlated with high expression of PTau (S396), high expression of PTau (T181) and high expression of total Tau, and it was an independent influencing factor. Conclusions:Overexpression of miR-124 can promote the expression of total Tau protein and phosphorylation of Tau protein, which is clinically indicative of Tau protein deposition in the brain of Alzheimer disease patients. It is expected to be a prognostic biomarker for Alzheimer disease.

Objective To investigate the influence of ROI-C cervical implantation in the C5-6 segment on the C3-7 range-of-motion (ROM), biomechanical properties of the intervertebral disc and the vertebral body, and the mode of force transmission. Methods Two types of surgeries, ROI-C implantation and autograft fusion with plate fixation, were considered to establish the finite element model of cervical C5-6 segment degeneration. The ROM of C3-7 during flexion, extension, lateral bending, and axial rotation, as well as stress distributions on the adjacent discs, vertebral body, and implanted devices under two procedures, were analyzed. Results ROI-C implantation had a relatively small influence on the ROM of the adjacent segment. The stress on the vertebral discs was reduced, but the stress on the vertebral body increased significantly, with the C5 vertebral body stress increasing by 251%. In the fusion surgery model, the ROM of the surgical segment was reduced by 86%-91%, while the ROM of the adjacent segments and the stress on the vertebral disc and vertebral body increased significantly. Conclusions ROI-C implantation surgery has a relatively small influence on the cervical ROM and the intervertebral disc, and it has a greater impact on the vertebral body. The research findings provide a theoretical basis for the design of operation plans and clinical studies on ROI-C implantation and autograft fusion with plate fixation.

Objective To explore the relationship between leadership of head nurses and nurse job satisfaction. Methods By generalized stratified sampling, 207 nurses who were in accordance with the inclusion were selected from 2 hospitals in China. To evaluate leadership of head nurses that selected nurses perceived and the status of their job satisfaction, they were asked to complete a questionnaire consisting of transactional subscale and transformational subscale of MLQ, and job satisfaction measurement scale. Results Head nurses were more frequently to be transactional than transformational, and frequencies between the two kinds of leadership that head nurses showed had significant difference. Regarding job satisfaction, nurses had the highest score in colleague and the lowest score in payment. transformational leadership was one of the influential factors on nurse job satisfaction, and were positively correlated with the overall nurse job satisfaction, satisfaction with leaders, satisfaction with communication. Conclusions Head nurses can improve nurse job satisfaction by being more transformational.

OBJECTIVETo evaluate the extensive and degree of physical rehabilitation improvement of the quality of life in laryngectomees.

METHODSForty nine patients who underwent total laryngectomies were trained by esophageal voice rehabilitation successfully. The questionnaires of performance status scale for head and neck cancer patients (PSS-HN) and the functional assessment of head and neck cancer therapy (FACT-H&N) were answered by them before esophageal voice training and 3 months after successful vocal rehabilitation.

RESULTSTotal laryngectomy deteriorated the quality of life in laryngectomees. The mean scores of PSS-HN scale and FACT-H&N questionnaire were lower than the criteria scores after patients underwent total laryngectomy, the mean score were 131. 4,90.6 respectively, the difference was significant statistically (t =53. 673, P <0.001) , (t = 67.44, P <0.001). After successful esophageal speech training, the mean scores of the laryngectomees were improved both in PSS-HN scale and FACT-H&N which were 240.4 and 103.7 respectively, the difference was significant statistically (t = 18.209, P < 0.001) , (t = 21.389, P<0.001).

CONCLUSIONSThe quality of life in laryngectomees can be improved by physical rehabilitation and the esophageal voice training.

Adult ; Aged ; Female ; Humans ; Laryngectomy ; rehabilitation ; Larynx, Artificial ; Male ; Middle Aged ; Quality of Life ; Speech, Esophageal ; Surveys and Questionnaires ; Voice Training