Objective:To evaluate the effects of the defect situational objective structured clinical examination (OSCE) in the training of specialized nurses in the operating room, and provide a new idea for the training of specialized nurses in the operating room.Methods:A quasi experimental study was used in this study. A total of 78 nurses who participated in the training of the operating room specialized nurses in Henan Province in 2022 and 2023 which were organized by the First Affiliated Hospital of Zhengzhou University were selected by cluster sampling method. The nurses who participated in the training in 2022 and 2023 were assigned to the control group (38 participants) and the experimental group (40 participants), respectively. Nurses in the experimental group received defect situational OSCE, while nurses in the control group received conventional teaching. After the training, the effect of the two teaching methods was evaluated by skill operation assessment results and Clinical Thinking Ability Assessment Scale.Results:There were 4 males and 34 females in the control group, aged (30.03 ± 4.33) years old, and 3 males and 37 females in the experimental group, aged (29.93 ± 3.95) years old. The scores of the verification and handover of surgical patients, surgical position placement and the occupational exposure protection were (91.80 ± 2.95), (90.38 ± 3.66), (91.10 ± 3.26) points in the experimental group and were (89.08 ± 3.21), (87.84 ± 3.49), (88.39 ± 4.21) points in the control group, the differences between the two groups were statistically significant ( t = 3.91, 3.13, 3.18, all P<0.05). The total score of clinical thinking ability in the experimental group was (80.66 ± 1.85) points, which was higher than (77.77 ± 1.62) points in the control group, the difference between the two groups was statistically significant ( t = 7.31, P<0.05). The evaluation of the teaching effect in the experimental group was better, and the satisfaction rate was 92.5%(37/40)-100.0%(40/40). Conclusions:The application of defect situational OSCE teaching method in the training of operating room nurses could better improve the operational ability and help to improve the clinical thinking ability of nurses. The training effect is superior to the conventional teaching method, and it is worthy of clinical application.

Objective:To construct a competency evaluation indicator system for infection prevention and control nurses in Operating Rooms (hereinafter referred to as "IPC") and provide an objective basis for the management of IPC nurses.Methods:From June to November 2022, an initial competency evaluation indicator system for IPC nurses was developed through literature review and semi-structured interviews. The Delphi method was employed to consult 20 experts from 11 provinces and municipalities across the country. Analytical Hierarchy Process (AHP) and mean distribution method were applied to quantify and determine the weight of each level of indicators within the system.Results:Nineteen experts were finally included, with two rounds of questionnaire recovery rates of 95.00% (19/20) and 100.00% (19/19), respectively. The authority coefficients of the experts were 0.858 and 0.861, familiarity coefficients were 0.850 and 0.853, and coefficients of judgment basis were 0.865 and 0.868, respectively. The Kendall's W coefficient of concordance for the two rounds of inquiries were 0.139 and 0.202 ( P<0.05), respectively. The final IPC nurse competency evaluation indicator system included six primary indicators, 22 secondary indicators, and 66 tertiary indicators. Conclusions:The constructed IPC nurse competency evaluation indicator system is scientific, reasonable, objective, and comprehensive, providing a valuable reference for the capability training, assessment, entry standards, and qualification certification of IPC nurses.

ObjectiveTo study the mechanism of matrine in the treatment of inflammatory bowel disease （IBD） based on the zebrafish model and network pharmacology. MethodThe IBD model of zebrafish was established using 2，4，6-trinitro-benzenesulfonicacid （TNBS）， and the intestinal phagocytic function， goblet cell secretion， and neutrophil aggregation were evaluated using neutral red staining， alcian blue staining， and neutrophil number changes. Changes in tumor necrosis factor （TNF）-α and cholecystokinin （CCK） content in zebrafish were determined by using relevant reagent kits. Network pharmacology and molecular docking techniques were used to predict the potential mechanism of matrine in the treatment of IBD. Gene expression of relevant targets was verified through Real-time polymerase chain reaction （Real-time PCR）. ResultCompared with the model group， the matrine administration group can increase the neutral red staining area in a dose-dependent manner and improve intestinal phagocytic function（P<0.05，P<0.01）. It can reduce the staining area of alcian blue and affect the secretion of intestinal goblet cells（P<0.01）. It can reduce the number of neutrophil granulocytes， relieve its aggregation， significantly reduce TNF-α content（P<0.01）， and increase the CCK content. Network pharmacology analysis identifies 28 potential targets for matrine in the treatment of IBD. The top five targets by protein-protein interaction （PPI） network analysis are CHRNA7， DRD1， CHRNA4， SLC6A3， and GRM5. The Kyoto encyclopedia of genes and genomes （KEGG） results show that the treatment of IBD with matrine may be related to neuroactive ligand-receptor interaction， cholinergic synapse， and neutrophil extracellular trap formation. Real-time PCR results show that matrine can affect the expression level of related target genes. Conclusionmatrine has a certain therapeutic effect on IBD and can affect the inflammatory response of IBD. Its therapeutic effect may be related to neuroactive ligand-receptor interaction and other pathways.

The survival rate of cancer patients was improved due to the development of cancer treatment techniques, and thus the fertility protection for young female cancer patients has attracted increasing attention. Radiotherapy, as one of the comprehensive cancer treatment, could cause ovarian damage in adolescent and child-bearing women, which leads to fertility decline and a series of side effects. Radiation can cause ovarian damage not only by acting on biological macromolecules directly, but also by increasing oxidative stress between oocytes and ovarian granulosa cells indirectly. At present, the fertility preservation of female cancer patients undergoing radiotherapy mainly includes physical protection, drug protection and biological protection. Recently, the development of new technologies for the preservation of fertility in female cancer patients has also brought new hope, including factors such as protective effects, patient age, and the selection of specific cancer treatment measures, which are the main considerations in the selection process of fertility preservation measures. This article reviews the research progress on radiation-induced ovarian damage, with a focus on the introduction of the fertility preservation measures and new technologies for young female tumor patients receiving radiotherapy.

Objective:To understand the real feelings and needs of postgraduate nursing students during standardized training, and provide a reference for managers to formulate more complete standardized training programs in the future.Methods:Using the phenomenological research method, totally 12 postgraduate nursing students of the First Affiliated Hospital of Zhengzhou University who had completed the two-year standardized training were selected by purposive sampling and received semi-structured interviews from August to October 2018, and the Colaizzi 7-step method was used to organize and analyze the data.Results:A total of 5 themes were extracted, namely, increased self-efficacy and improved core competence, negative psychological experience, demand for policy guarantees for scientific research, demand for personalized training programs and high-standard teaching staff, and demand for the promotion system and salary.Conclusions:The recognition of various aspects is dominant in postgraduate nursing students, but they have also many negative emotions and unmet needs. Managers should pay attention to their feelings and needs, and properly formulate suitable training programs, thereby giving full play to the advantages of standardized training.

Objective? To explore the effects of health failure mode and effect analysis(HFMEA) in the safety management of intraoperative radiotherapy(IORT). Methods? The HFMEA group was set up to analyze the potential risks of breast cancer patients undergoing intraoperative radiotherapy from January 2014 to April 2018. The group listed the failed modes that need to be improved, identified the invalid steps that need intervention, determined the causes of the failure and calculated the risk priority number (RPN), created the safety management plans and put them into action. Finally, the outcomes were observed and analyzed. Results? After the improvement of the HFMEA, the patients' healing rate of stage-Ⅰ incision increased from 85.42% to 98.18% with statistical significance (χ2=4.184,P＜0.05). The patients' satisfaction degree scored (98.21±3.98)from the patients and (99.02±5.89)from the surgeons, both higher than those before improvement with statistical significance (t=5.24, 3.07;P＜0.05). After the improvement, the absorbed and scattered dose of the affected and contralateral skin of thyroid gland, and the absorbed and scattered dose of the affected and contralateral skin of lens were lower than those before improvement. Conclusions? Through prospectively controlling non-standard operation behaviors and optimizing the process, the application of HFMEA in the intraoperative irradiation after conservative surgery for breast cancer can ensure patients' safety and improve the quality of surgeries.

Objective To investigate the clinical features of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) associated hypertrophic pachymeningitis (HP).Methods Clinical data of 4 casesdiagnosed with MPO-ANCA vasculitis complicated with HP in our hospital were analyzed retrospectively and the related literaturewere reviewed.Results Four male patients with an age range from 44 to 66 years were diagnosed with ANCA-associated HP.The main clinical manifestations included headache and withvarious degree ofmultiple cranial paralysis.During active phase of the disease,all patients showed perinuclear(p)-ANCA positive,elevated levels of inflammatory biomarkers and titers of MPO-ANCA,whereas renal function,cytoplasmic (c)-ANCA and protease 3 (PR3)-ANCA were negative.Contrast-enhanced cranial magnetic resonance imaging (MRI) scan showed obviously thickened dura mater and sinusitis or mass in paranasal sinus.Four patients were sensitive to glucocorticoid.Three patients had a relapse during glucocorticoid tapering and were undercontrol when the dosage of glucocorticoid was increased and immunosuppressive agents were added.Levels of inflammatory biomarkers,titers of MPO-ANCA and p-ANCA recovered to normal,and the dural thickness on MRI was reduced in the remission stage.Conclusion MPO-ANCA associated HP is a type of central nervous system involvement in ANCA associated vasculitis (AAV).It involves the upper respiratory tract more frequently,and less frequently progresses to systemic AAV.This should be taken into consideration when middle-aged and elderly patients presented with headache and multiple cranial neuropathies.Enhanced MRI is the preferred examination for diagnosis,and dural biopsy should be done when necessary.

Objective To investigate the team-based learning(TBL) combined with microteaching method in the teaching of undergraduate first aid courses. Methods Totally72 undergraduate nursing students randomly divided into the observation group and control group each including 36 cases by lottery. Nursing students in the observation group received TBL combined with microteaching, while nursing students in the control group received conventional teaching. Results The average score of objective structured clinical examination (OSCE) in observation group was (86.66±5.09) points and the control group was (84.47 ± 5.78) points, the difference was statistically significant (t=3.38, P<0.05). After training,the total score of Critical Thinking Disposition Inventory Chinese Version (CTDI-CV) and 5 dimensions′were (329.39 ± 25.56), (49.33 ± 4.42), (45.11 ± 6.08), (48.17 ± 6.14), (51.08 ± 6.55), (45.06 ± 5.19) points in observation group, and (325.17±27.26), (48.19±4.97),(44.42±6.30), (47.47±6.27), (50.36±7.12), (44.56± 5.13) points before training, the differences were statistically significant (t=2.11- 4.95, P<0.05). Conclusions TBL combined with microteaching method in first aid training course can improve the undergraduate nursing students′first aid ability, critical thinking ability.

Objective To explore the effects of modified herringbone-Trendelenburg position during gynecological laparoscopic operation of the elderly. Methods A total of 60 elderly patients undergoing gynecological laparoscopic operation under general anesthesia were recruited and assigned to the observation group (30 cases) and control group (30 cases) by random digits table method with 30 cases each according to admitting time;Patients in the control group were placed in conventional Trendelenburg position, while the patients in the observation group were positioned in modified herringbone-Trendelenburg position .Intraocular pressure (IOP) were measured in the patients at anesthesia induction (T1),5 minutes after general anesthesia in supine position (T2) , and 5 minutes after pneumoperitoneum while in the operation position (T3) , every 30 minutes (times 4 to 11), while supine at the end of pneumoperitoneum (time 12) and before awakening (time 13);Patients were followed up at 24 h and 48 h after surgery, researcher investigate and record the scores of the Operation Position Comfort Questionnaire, the situation of the pain in the shoulder and postoperative complications of the lower limbs. Results There was no statistically significant difference (t=-1.098,-0.772,-0.656, P>0.05) of the IOP at T1, T2, T13. The IOP in the observation group had statistically significant difference compared with the control group at T3 to T12 (t=6.523-19.866, P<0.01). The incidence rate of the postoperative complications of the lower limbs in the observation group was 6.7%(2/30) lower than 26.7%(8/30) of the control group (χ2=4.320, P<0.05) and the VAS scores of the patients in the two groups was statistically significant (t=2.471, P<0.05). The incidence rate of the postoperative shoulder pain in the observation group was 10.0%(3/30) lower than 43.3%(13/30) of the control group (χ2=8.523, P<0.01), and the Visual Analogue Scale scores of the patients in the two groups was statistically significant (t=3.575, P<0.05).The scores of the Operation Position Comfort Questionnaire in the observation group was higher than the control group (t=-2.319, P<0.05). Conclusions Modified herringbone- Trendelenburg position can reduce the elevation of intraocular pressure in elderly patients without affecting the operation ,and effectively improve the comfort of the operation position of the patients, reduce the incidence rate of the shoulder pain and postoperative complications of the lower limbs, is conducive to the operation safety of elderly patients.

Objective To clarify the relationship between the basivertebral foramen (BF) and the retropulsed bone fragment (RBF) in thoracolumbar burst fracture (TLBF) and further explain the mechanism of RBF formation.Methods From June 2013 to June 2016,Sixty-two patients suffering from TLBF with RBF were collected.The characteristics of RBF as well as the parameters of vertebral body were studied using CT reconstruction imaging.In the transverse images,the lengths of RBF (RL) and vertebral body (VL) were measured.In median sagittal images,the heights and widths of RBF (RH,RW) and vertebral body (VH,VW) were also obtained.The ratios of different parameters of RBF and vertebral body (RL/VL,RW/VW,RH/VH) were calculated,and then defined the location relationship of RBF and BF.Eight frozen cadaveric spine were selected and evaluated by Micro-CT scans.Each vertebral body was divided into three layers (Superior,Middle,Inferior).Each layer was further divided into 9 regions (R1-R9),named as SR1-SR9,MR1-MR9,IR1-IR9.Microarchitecture parameters of each region in each layer,including bone volume fraction (BV/TV),bone mineral density (BMD),trabecular connectivity (Corn.D),and trabecular number (Tb.N) and thickness (Tb.Th) were calculated,and their differences were also analyzed to see if the trabecular bone distribution would be affected by BF.In vitro study,burst fractures were simulated on cadaveric spines by using bursting fracture simulator,aiming to observe the RBF morphology and imaging findings to future investigate the relationship between RBF and BF.Results The length and height of RBF were close to half of vertebral body length and height (RL/VL:0.497±0.059,RH/VH:0.485±0.036).The width of RBF was usually one-third of vertebral body width (RW/VW:0.319±0.025),which indicated that the fracture block was often located in the posterior of vertebral body above the BF.BV/TV,Tb.N in the MR2 and MR5 regions were lowest than other regions and the SMI of MR2 and MR5 was largest than others.SR5 was the lowest region in superior lawyer that was corresponded to regions most affected by burst fracture.In simulated burst fractures,the fracture line of RBF went across the vertex or upper surface of the BF and the lower boundaries of RBF were also the upper bound of the BF.Moreover,the damage sites of posterior longitudinal ligament were mainly located at the edge of the BF.Conclusion At the bone defect region,the BF is the weakest area in the vertebral body which may affect the distribution of trabecular bone surrounding it.When subjected to vertical violence,these regions undergo fracture first which impact the anterior and lower boundaries of RBF.Ultimately,RBF was produced upon the BF,involving all or part of the upper bound of the BF.