Objective:To investigate the current situation and influencing factors of clinical nurses'clinical decision-making ability,and provide a reference and evidence for improving and enhancing the correct clinical decision-making ability of clinical nurses.Methods:A total of 300 clinical nurses in Shaanxi Province were selected as the research subjects by using the convenience sampling method.The General Information Questionnaire,Clinical Decision-Making Scale,and Comprehensive Decision-Making Style Scale were used to conduct the investigation and study.The influencing factors of clinical nurses'clinical decision-making ability were analyzed by using single-factor analysis and multivariate linear regression.Results:The total score of clinical nurses'clinical decision-making ability was(163.85±13.78)points,reaching the high-level standard of clinical decision-making ability(146.68-200.00)points.The results of Spearman rank correlation analysis showed that there was a significant positive correlation between the total score and the score of each dimension of clinical decision-making ability and the score of rational decision-making style(P<0.05).The score of the dimension of searching for information or new information was only negatively correlated with the score of intuitive-impulsive decision-making style(P<0.05).Avoidant decision-making style was negatively correlated with the scores of seeking information or new information,clarifying goals and values,the total score of clinical decision-making ability,and the dimensions of finding alternative solutions(P<0.05).The results of multiple linear regression showed that rational decision-making style can positively affect clinical nurses'clinical decision-making ability,while avoidance decision-making style can negatively affect it.Conclusion:The clinical nurses'clinical decision-making ability has been maintained at a relatively constant high level,and it is greatly influenced by rational and avoidant decision-making styles.Medical managers need to organize targeted training activities and other measures to promote the construction of clinical nurses'rational decision-making style and minimize the influence of avoidant decision-making style,thus improving the clinical nurses'clinical decision-making ability.

【Objective】 To investigate the control rate of blood glucose and its influencing factors in type 2 diabetes mellitus patients in Yulin area. 【Methods】 We selected the adult type 2 diabetes patients who visited our hospital from May 2020 to December 2021 as the subjects. Then we collected their basic information (gender, age, household income, type of medical insurance payment, education level, and duration of disease), measured their height and weight, calculated their body mass index (BMI), detected HbA1c, and measured their subcutaneous and visceral fat. The Chi-square test and multivariate Logistic regression methods were used to analyze the influencing factors. 【Results】 The total attainment rate of HbA1c (HbA1c<7%) among 877 adults with type 2 diabetes was 13.34%. The Chi-square test showed that statistical differences in the attainment rate of HbA1c among different ages, family annual income, type of medical insurance, and duration of disease. Further unconditional multivariate Logistic regression analysis model results showed that the HbA1c attainment rate in 18-44 years old group was 0.418 times higher than that in ≥60 years old group (95% CI=0.219-0.799, P=0.008). The HbA1c compliance rate of patients with employees’ medical insurance was 1.744 times that those with residents’ medical insurance (95% CI=1.131-2.782, P=0.013). The HbA1c attainment rate of diabetic patients with an annual family income of 30 000 yuan to 100 000 yuan was 1.873 times (95% CI=1.074-3.266, P=0.027), and with an annual family income of more than 100 000 yuan was 2.649 (95% CI=1.299-5.404, P=0.007) times than that of diabetic patients with less than 30 000 yuan. 【Conclusion】 The blood glucose control rate in adults with type 2 diabetes mellitus in Yulin area is lower compared with the level of the nation and other regions. Age, annual household income, and type of medical insurance payment are independent influencing factors.

Objective:To explore the effect of traditional Chinese medicine soothing and fixed pillow in patients after endothelial keratoplasty with anterior chamber gas injection.Methods:From October 2020 to May 2022, convenience sampling was used to select 60 patients who underwent endothelial keratoplasty in the Ophthalmology Ward of Beijing Tongren Hospital as the research object. The patients were divided into the intervention group and the control group by random number table method, 30 cases in each group. The control group was given routine perioperative nursing, while the intervention group was given the traditional Chinese medicine soothing and fixed pillow on the basis of the nursing of the control group. The General Information Questionnaire, General Comfort Questionnaire (GCQ) and Postural Compliance Questionnaire were used to evaluate the patients.Results:The total score and the scores of each dimension of GCQ in the intervention group were higher than those in the control group, on the day after operation, the first day after operation, and the second day after operation, the accumulative daily supine time were longer than those in the control group, and all the differences were statistically significant ( P<0.05) . Conclusions:The traditional Chinese medicine soothing and fixed pillow can improve the comfort of patients with endothelial keratoplasty in continuous supine position after operation, prolong the supine time after operation, and improve the compliance of postoperative position of patients with endothelial keratoplasty.

Objective:To explore the care experience of mothers of children with nanophthalmos and congenital cataract surgery.Methods:From January 2014 to December 2019, the qualitative research method was used to conduct in-depth semi-structured interview with mothers of children with nanophthalmos and congenital cataract in Ophthalmology Ward of Beijing Tongren Hospital of Capital Medical University, and carry out live recordings and transcripts. Colaizzi content analysis method was used to analyze data and refine themes.Results:A total of four themes were extracted, namely anxiety and concern about appearance, family and social relations were affected, desire to speak and be heard, and urgent need for family care skills.Conclusions:While caring for children with nanophthalmos and congenital cataract, the nursing staff should deeply understand the mother's inner experience, provide psychological support, and help the mothers of the children to establish positive coping styles and promote their physical and mental health.

Objective To explore the effect of cognitive education and behavioral intervention in solid-state high resolution esophageal manometry (HRM) examination. Methods From April 2016 to June 2017, 60 patients with solid-state HRM in the gastrointestinal motility room at the First Affiliated Hospital of Jiaotong University were as the research object. The 60 patients were divided into control group and experimental group with 30 cases each by the method of random numbers. The conventional methods was used in control group to conduct informed counseling before the examination and the coordination guidance in the examination. The conventional methods and cognitive behavioral intervention was used in experimental group at the same time. The successful rate of intubation, the time used for the examination, discomfort symptoms during intubation, the patient's satisfaction in the whole check process and self-evaluation of intubation pain experience in two groups of patients were compared. Results The time used in the experimental group examination was (28.50±8.75) min, and the control group was (33.13± 5.49) min. The difference between the two groups was statistically significant (t=2.584, P=0.015). In the experimental group, the number of nausea, vomiting, and coughing in the intubation process was 11, 0, and 1, respectively, and the control group was 20, 6, and 7, respectively. The difference was statistically significant (χ2=5.406, 4.630, 5.192, all P<0.05). In the experimental group, the scores of the 2, 3, 4, 5, 7, 8, 10, 11, 12, and 13 items of the intubation pain experience self-evaluation in the examination process were (1.00 ± 0.64), (1.37 ± 0.85), (2.80 ± 0.96), (1.50 ± 0.51), (0.87 ± 0.63), (0.77 ± 0.50), (0.60 ± 0.56), (1.07 ± 0.25), (0.57 ± 0.57), (1.50 ± 0.63) points, and the 2, 3, 4, 5, 7, 8, 10, 11, 12 and 13 scores of the control group they were (1.50 ± 0.51), (2.03 ± 0.76), (3.50 ± 0.82), (2.03 ± 0.76), (1.20 ± 0.61), (1.03 ± 0.41), (0.83 ± 0.53), (1.23 ± 0.43), (0.87 ± 0.57), (2.00 ± 1.05) points, respectively. The difference was statistically significant (t=-4.130--2.140, all P<0.05). Conclusions HRM is an important test before the clinical application of a wide range of clinical applications for the detection of esophageal motility disorders and gastroesophageal reflux disease. The degree of patient cooperation with the operation directly affects the high-resolution esophageal manometry test results and self-experience. Medical staff can give patients cognitive education and behavioral intervention before examination, which can effectively reduce the symptoms and pain caused by intubation, improve patient compliance, shorten the time for examinations, improve work efficiency, and improve patient satisfaction. It is worth further promotion and application in clinical examination.

Objective? To explore the effects of exercise-psychology-sleep nursing among esophageal cancer patients. Methods? From June 2016 to September 2018, we selected 200 esophageal cancer inpatients with intermediate and advanced stage in Surgery Department at the First Affiliated Hospital of Xi'an Jiaotong University by convenience sampling. All of the patients were divided into control group and experimental group according to admission order, 100 cases in each group. Control group carried out routine nursing. On the basis of routine nursing, experimental group implemented exercise-psychology-sleep nursing. After intervention, the intervention effects were compared with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Revised Piper Fatigue Scale (PFS-R) between two groups. Results? One month after intervention, the scores of function and general health of experimental group were (62.11±3.22) and (67.23±3.74) respectively higher than those of control group; the scores of symptoms and specificity of experimental group were (42.12±2.13) and (43.75±3.21) respectively lower than those of control group; the differences were all statistical (t=101.159,15.053,22.910,3.347;P＜0.01). The scores of cancer related fatigue of experimental group and control group were (3.36±1.25) and (5.14±1.04) respectively with a statistical difference (t=10.663,P＜0.01). Conclusions The application of exercise-psychology-sleep nursing in esophageal cancer patients can improve quality of life and relieve cancer related fatigue of patients which is worthy of being widely used in clinical application.

Objective To explore the status quo of cultivation for independently enrolled medical students (hereinafter referred to as independently enrolled students) and to provide a reference for medical talents cultivation in China's private vocational universities. Methods Totally 15 independently enrolled students and 11 teachers received deep semi-structural interview in a private vocational university using the methods of qualitative studies between January and April 2019. The data were analyzed by Colaizzi's seven-step analysis. Results Totally 4 themes were refined: insufficient advantages in learning, great difficulty in specialized courses, good professional identity, and sound practice and communication abilities. Conclusions The educators in vocational universities should optimize the cultivation model, modify teaching methods, and balance the overall quality and attainment of talents based on the objectives of talent cultivation.

Objective To investigate the effectiveness and feasibility of standardized nursing training in reducing the incidence rate of post-endoscopic retrograde cholangiopanography(ERCP) pancreatitis. Methods A total of 521 patients were collected from January 2015 to June 2016 in ERCP therapy as control group.The patients in this group did not have standardized nursing training.A total of 289 patients were selected from July 2016 to April 2017 in ERCP therapy as intervention group.The patients in this group were carried out the standardized nursing training. The incidence of hyperamylasemia and post-ERCP pancreatitis was observed in two groups. Results The incidence of hyperamylasemia and post-ERCP pancreatitis was 12.09%(63/521),7.87%(41/521)in control group,and 7.61% (22/289), 3.11% (9/289) in intervention group,the difference was statistically significant between two groups(χ2=3.972,7.258,P<0.05 or 0.01). Conclusions The standard nursing training and intraoperative coordination can reduce its risk factors, and to reduce the post-ERCP pancreatitis and hyperamylasemia has important meaning and function.

Objective To describe status of cancer-related fatigue (CRF) and its trajectory during three different time node for the operation, chemotherapy, and radiotherapy among breast cancer patients. Methods The convenience sampling method was used for 242 cases diagnosed with breast cancer which prepared for breast cancer resection, prepared to be treated with adjuvant chemotherapy and radiotherapy, and conformed to the sample standard from a tumor hospital and two affiliated hospital of medical college from February 2014 to November 2015 in a city. The follow-up survey of CRF was conducted respectively in the three different point-in-time for one week after the operation, at the end of chemotherapy and radiotherapy. Results After the operation mean rating for general fatigue was mild (2.59±2.41) points, and approximately 76.0% (184/242) patients experienced fatigue to low- grade degree; After the chemotherapy fatigue was significantly increased (6.57 ± 2.43) points, and 75.2% (182/242) patients accounted for severe fatigue; After the radiotherapy mean rating for fatigue was moderate (4.38 ± 2.46) points, and 57.0%(138/242) patients suffered to moderate fatigue. During the whole treatment period the level for general fatigue and four dimensions of fatigue were in the unstable state ofwaveof fluctuations with mild, severe, moderate, and fatigue were statistically different in three different stages of treatment ( F= 43.16,P=0.000). The age and operation method were associated with CRF in thephaseofoperation(age t=7.365, P=0.003; operation method t=5.166, P=0.009), chemotherapy (age t=9.835, P=0.000; operation method t=3.313, P=0.025) and radiotherapy (age t=9.014, P=0.000;operation method t=10.392, P=0.000). Conclusions There is a certain difference with CRF of breast cancer patients at different stage of rehabilitation treatment. There are two factors that could affect CRF such as age and operation method in the whole rehabilitation treatmentperiod.

APOBEC-1 Deaminase ; genetics ; Clustered Regularly Interspaced Short Palindromic Repeats ; Codon, Terminator ; Gene Editing ; methods ; Humans ; Zygote ; beta-Globins ; genetics