Objective:To investigate the current situation of community nursing needs of patients with middle and advanced Parkinson ′s disease, analyze the factors affecting the demand, and further explore the possible pathways of action between the factors, so as to provide the basis for formulating targeted community intervention measures in a more comprehensive way. Methods:A cross-sectional survey of 242 patients with middle and advanced Parkinson ′s disease from the Second Hospital Affiliated to the Army Medical University from November 2022 to January 2023 were selected by convenience sampling method, and the Community Care Need Scale, General Data Questionnaire, Readiness for Hospital Discharge Scale, Medical Coping Modes Questionnaire and the Self-management Effectiveness Questionnaire of Parkinson ′s disease patients were used. SPSS 26.0 was used to analyze the data, and investigated the relationship between readiness for hospital discharge, self-management efficacy, active coping styles, and community nursing needs. Results:A total of 234 valid questionnaires were collected, including 108 males and 126 females, aged 39-93 (67.25±8.93) years. The average score of all dimensions from high to low was: disease treatment dimension (4.16±0.42), daily care dimension (4.05±0.97), fall prevention dimension (4.04±0.80), extended care dimension (3.95±0.65), emotional support dimension (3.77±0.65) and self function (3.75±0.72). Univariate analysis indicated that there were statistically significant differences in community nursing needs scores among middle and advanced Parkinson ′s disease patients with different educational level and different family income ( F=5.11, 3.05, both P<0.05). Readiness for hospital discharge, self-management efficacy and positive coping style were negatively correlated with community nursing needs of patients with middle and advanced Parkinson′s disease ( r=-0.567, -0.412, -0.398, all P<0.01), and self-management efficacy and positive coping style played a partial mediating role between readiness for hospital discharge and community nursing needs. Conclusions:There is a wide range of community nursing needs that patients with middle and advanced Parkinson ′s disease, and patients with primary school and below, high school and above, and low family income are higher. It is suggested that the community disease management process should focus on this group of people. Medical institutions should help patients with middle and advanced Parkinson ′s disease improve their ability to manage the disease by improving discharge preparation services, so that they can smoothly transition from hospital to home, thereby reducing the needs for community nursing.

Objective:To explore the application of photoplethysmography (iPPG) for contactless vital signs monitoring in the intensive care unit (ICU).Methods:Ten tracheostomy patients in intensive care had their heart rate, oxygen saturation, and diastolic and systolic pressures monitored using iPPG technology and a 24-hour bedside monitor. The readings included periods at rest, during turning, during suctioning, and when undergoing vigorous physical therapy and occupational therapy. The monitoring lasted 3 consecutive days. The data collected by the two methods were compared to analyze the accuracy of the contactless vital signs monitoring system.Results:The oxygen saturation readings of the two systems showed no significant differences. The heart rates, diastolic pressures, and systolic pressures did, however, differ significantly.Conclusions:In the situations tested, contactless monitoring of oxygen saturation is effective, but there is still significant room for improvement in the three indicators of heart rate, systolic pressure, and diastolic pressure.

【Objective】 To evaluate the efficacy and safety of human coagulation factor Ⅷ developed by Shenzhen Weiguang Biological products Co, Ltd in the treatment of patients with hemophilia A. 【Methods】 A prospective, multi-center, open, single-group clinical study was conducted. A total of 65 subjects with hemophilia A were enrolled, and human coagulation factor Ⅷ(FⅧ) was injected according to the patients’ bleeding severity. The improvement score of bleeding symptoms and signs after the first infusion of the first bleeding event and the transfusion efficiency of FⅧ activity at 10 min and 1 hour after infusion were taken as the main efficacy indexes. The improvement scores of bleeding symptoms and signs after the first infusion and the increase of FⅧ activity at 10 min and 1 hour after infusion were the secondary efficacy indexes. 【Results】 The 65 subjects were enrolled in safety analysis set (SS) and full analysis set (FAS), and 58 of them were enrolled in protocol analysis set (PPS). Ten minutes and one hour after the first infusion, the level of factor Ⅷ activity in the subjects increased significantly, and the FⅧ activity increased by 100% or more in more than 79% of the subjects. The average infusion efficiency of FⅧ activity in all subjects was more than 100%. In 70% of the subjects, the pain was relieved rapidly and /or the bleeding symptoms were significantly improved 8 hours after each bleeding infusion, and the improvement rate of bleeding symptoms and signs reached 100% 72 hours after infusion. 【Conclusion】 After infusion of human coagulation factor Ⅷ, the activity level of factor Ⅷ in patients with hemophilia A significantly increased. The infusion efficiency can reach a optimal level, and the bleeding symptoms can be significantly improved.

【Objective】 To evaluate the clinical efficacy and safety of one kind of human prothrombin complex concentrate in treatment of patients with hemophilia B. 【Methods】 The clinical data of 36 patients with hemophilia B treated with human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. from May 2018 to April 2019 were retrospectively analyzed, and its clinical efficacy and safety were analyzed. 【Results】 A total of 35 subjects entered the full analysis set (FAS)and safety set (SS), 33 subjects entered the per protocol Set (PPS). Thirty minutes after the first infusion of FAS subjects, the activity of coagulation factor Ⅸ increased from (3.93±0.975) IU/dL to (25.61±9.337) IU/dL, and the infusion efficiency was (96.43±22.007)%. The increased value of coagulation factor Ⅱ activity was (73.25±14.874) IU/dL. The activity of coagulation factor Ⅶ was (42.79±16.847) IU/dL. The increased value of coagulation factor Ⅹ activity was (65.29±17.042) IU/dL. The increased value of coagulation factor Ⅸ activity was (21.68±9.434%) IU/dL. Twenty-four hours after the first infusion of FAS subjects, the improvement of bleeding symptoms and signs was excellent in 21 cases (60%), improved in 14 cases (40.0%), and the effective rate was 100%. The incidence of adverse reactions was 2.9%(1/35), and there was no antibody to human coagulation factor Ⅸ and new virus infection. 【Conclusion】 Infusion of human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. in the treatment of hemophilia B has significant clinical efficacy and good safety.

Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.

Objective:To investigate the correlation between the distribution of traditional Chinese Medicine (TCM) constitution and the syndrome of TCM and the performance under gastroscope in patients with hiatal hernia(HH).Methods:A total of 300 HH patients diagnosed in the Department of Gastroenterology, the Second Affiliated Hospital of Shandong University of TCM from January 2016 to December 2018 were enrolled in this study.The clinical information was collected to complete TCM constitution, TCM syndrome type and gastroscopic performance classification.Results:The composition ratio of TCM constitution in 300 patients with HH was not exactly the same(χ 2=88.140, P<0.05). From high to low, the order was: Qi stagnation(58 cases), Qi deficiency(56 cases), damp heat(51 cases), phlegm dampness(45 cases), Yang deficiency(27 cases), Yin deficiency(21 cases), peace(17 cases), blood quality(17 cases), special quality(8 cases). There was a significant attribute association between TCM syndrome type and TCM constitution classification(χ 2=129.753, P<0.05), among which: the syndrome of liver and stomach stagnation heat corresponded to damp heat and Yin deficiency; the syndrome of spleen and stomach dampness heat corresponded to phlegm dampness syndrome; the syndrome of spleen and stomach deficiency cold corresponded to Yang deficiency and Qi deficiency; the syndrome of Qi stagnation and phlegm corresponded to blood sputum and Qi stagnation; Qi deficiency and blood stasis syndrome corresponded to Qi deficiency.There was significant attribute association between gastroscopic performance and TCM constitution(χ 2=123.189, P<0.05), among which: no esophagitis corresponded to Yang deficiency, Qi deficiency, peace and phlegm dampness; the grade A reflux esophagitis corresponded to the dampness heat and the Qi stagnation; the grade B corresponded to the dampness heat and the Qi stagnation, the grade C had no obvious correspondence, the grade D corresponded to the Yin deficiency. Conclusion:The TCM constitution of HH patients is mainly characterized by Qi stagnation, Qi deficiency, damp heat and phlegm dampness, and there is a significant correlation between constitution classification and TCM syndromes type and gastroscopic performance.

Objective:To improve the standardized training effects of the first year graduate new nurses by the mini clinical evaluation exercise (Mini-CEX) .Methods:By cluster sampling, a total of 91 new nurses hired in 2017 of Xinqiao Hospital Affiliated to Army Medical University were in control group; and 120 new nurses hired in 2018 were in experimental group. Control group carried out routine training method. On the basis of that, experimental group implemented the Mini-CEX based clinical nursing core competence training and operational skill training once a month after changing routine teaching rounds and operational training, lasting 12 times. The scores of Mini-CEX for the first and twelfth time of experimental group were compared by paired sample t-test, the theoretical achievements and skill performances of new nurses between two groups were compared by independent sample t-test. Results:The scores of Mini-CEX of clinical nursing core competence training and operational skill training in experimental group for the twelfth time were (6.27±0.46) and (6.73±1.10) respectively, higher than those for the first time with statistical differences ( t=-8.48, -7.64; P<0.01) . Among new nurses in standardized training of the first year, the theoretical achievements and skill performances of department in experimental group were (87.70±11.32) and (92.90±8.22) , those of hospital were (85.50±11.83) and (89.67±8.99) respectively, higher than those in control group with statistical differences ( t=-2.71, -2.09, -2.24, -3.22; P<0.05) . Conclusions:Mini-CEX has significant effects in training for the first year among new nurses .

Multidisciplinary cooperation (MDC) chronic disease management model is a new care model, which is widely used in the specialty area of chronic kidney disease. However, there are still many problems in clinical practice, such as the lack of systematic and specific operating instructions. In this paper, we reviewed and summarized the practices of MDC in chronic kidney disease management in China. We also explained the concept of the MDC, composition, and division of labor in chronic kidney disease management, the specific operating model, intervention methods, clinical effects, and existing problems. This review provided references for the application of MDC in continuous care of chronic kidney disease cases management.

Objective? To explore the potential types of patients with chronic kidney disease (CKD) based on their self-management ability and hope level. Methods? A total of 133 patients who were selected as subjects from the follow-up cases in the Chronic Kidney Disease Management Center of Xinqiao Hospital Army Medical University from January to June 2017 using the convenient sampling method. CKD Self-Management Instrument and Herth Hope Index were used to assess the subjects and cluster analysis was used to identify patient types. Comparison of general information was conducted across different patient types. Results? A total of 121 valid surveys were collected. The 121 cases of CKD patients can be characterized into 3 types: Type I patients have high self-management ability with a high hope level; Type II patients have medium self-management ability with a high hope level; Type III patients have low self-management ability with a medium hope level. There were statistical differences in age, educational level, medical payment method, and CKD staging across patients of the three different types (P＜ 0.05). Conclusions? There are 3 types of CKD patients in this study. If health professionals can effectively identify patient types and offer individualized care accordingly, the health condition of CKD patients could greatly improve.

Nurse's professional identity is a positive evaluation of nursing profession by the nurses themselves,which directly affects the outcome of patients and nurses.Nursing practice environment can not only affect the formation of nurses' professional identity,but also affect the safety of patients and the development of hospitals through the influence of nurses.The research on professional identity and positive working environment of nurses in China started late and is still in the exploratory stage.This study analyzed the overview,research progress and relationship of nurses' professional identity and practice environment,and provided reference for nurses' professional identity training and the construction of positive nursing practice environment in China.