Objective To examine the cognitive status and influencing factors of spiritual care among neurosurgery nur-ses,providing a basis for developing a spiritual care management plan for neurosurgery nurses.Methods A convenience sam-pling method was used to select 741 neurosurgical nurses from 35 tertiary hospitals across 14 prefecture-level cities in Guangdong Province from October 2022 to March 2023.A self-developed general information questionnaire and the Chinese version of the Spiritual Care-Giving Scale(C-SCGS)were utilized for the questionnaire survey.Results The average cognitive score for spirit-ual care among neurosurgery nurses was 169.07±27.66.Factors influencing the total score and various dimensions of spiritual care cognition included educational background,receipt of spiritual care education,position,number of night shifts,marital sta-tus,and employment type(P＜0.05).Conclusion Neurosurgical nurses'spiritual care cognition is at a moderate level,indi-cating a need for targeted training programs to enhance their understanding and practice of spiritual care based on their status and characteristics.

Background Occupational stress has been shown to be an important factor affecting the mental health of workers. The role of affective commitment to the organization and overcommitment to work cannot be ignored. However, there is a lack of research on this topic in China. Objective To explore a potential mediating effect of affective commitment on how occupational stress affects the mental health of medical staff and a potential moderating effect of overcommitment on the mediating effect of affective commitment. Methods A total of 1372 health care workers in a tertiary Grade A hospital in Lanzhou City were selected as study subjects for a cross-sectional survey. The occupational stress, emotional commitment, and psychological distress of the subjects were evaluated by the Effort-Reward Imbalance Scale, Affective Commitment Scale, and Kessler 10 Scale. SPSS 26.0 was used for correlation analysis, mediation analysis, and moderated mediation analysis. Common method bias wasevaluated by Harman one-factor test. Results A total of 1372 questionnaires were distributed, of which 1277 valid questionnaires were returned, with a valid recovery rate of 93.08%. The mean occupational stress score was 1.14±0.23, the mean overcommitment score was 20.26±3.21, the mean affective commitment score was 20.25±3.34, and the mean psychological distress score was 26.26±7.90. The Spearman correlation analysis results showed that occupational stress among medical staff was positively correlated with overcommitment and psychological distress (r=0.153, 0.410, P＜0.01) and negatively correlated with affective commitment (r=−0.341, P＜0.01); overcommitment was negatively related to affective commitment and positively related to psychological distress (r=−0.107, 0.312, P＜0.01); affective commitment was negatively related to psychological distress (r=−0.464, P＜0.01). The positive effect of occupational stress on psychological distress of medical staff was significant (b=0.41, t=15.42, P<0.001); affective commitment presented a partial mediating effect on the relationship between occupational stress and psychological distress (effect value=0.13), accounting for 31.71% of the total effect; overcommitment moderated the process of occupational stress-affective commitment-psychological distress (P＜0.01). Conclusion Affective commitment of medical staff has a partial mediating effect on the relationship between occupational stress and psychological distress, and overcommitment plays a significant role in moderating the process of occupational stress-affective commitment-psychological distress.

Objective:To construct a scientifically standardized and promotable pneumonia prevention and nursing plan for acute stroke patients to guide clinical nursing practice.Methods:According to the evidence-based retrieval strategy, we systematically searched the domestic and foreign clinical decision support system, guideline networks, professional association websites and relevant databases. All databases were searched from January 2012 to November 2022. A preliminary pneumonia prevention and nursing plan for acute stroke patients was formulated after literature quality evaluation, evidence extraction, evidence integration and evaluation. The plan was further revised and improved through three rounds of Delphi expert consultation.Results:In the three rounds of expert consultation, the enthusiasm of experts was 100.0%, 100.0%, 83.3%, the authority coefficient of experts were 0.967, 0.967, 0.937, the coefficient of variation were 0.048 to 0.363, 0 to 0.177, 0 to 0.144, and the Kendal harmony coefficient were 0.221, 0.139, 0.339 ( P<0.001) . The final nursing plan included 8 modules, including pneumonia risk prediction, general nursing, swallowing and dietary management, airway management, oral management, position and exercise, condition observation, and health education, with a total of 30 items. Conclusions:The evidence and Delphi method based pneumonia prevention and nursing plan for acute stroke patients is scientific, reliable and applicable, which can provide a basis for nursing practice.

Objective: To investigate the awareness and identify the influencing factors of sexual knowledge among primary and middle school students in Butuo County, Sichuan Province, so as to provide insights into sex education. Methods: Six primary and middle schools were randomly sampled from 40 primary and middle schools in Butuo County using the cluster sampling method on March and April, 2021, and a class was randomly sampled from each of grades 4 to 6 of primary schools and grades 1 to 3 of junior high schools, with all students from the class as study subjects. Students' demographic features and awareness of sexual knowledge were investigated using self-designed questionnaires, and the factors affecting the awareness of sexual knowledge were identified among primary and middle school students using multivariable linear regression analysis. Results: A total of 980 questionnaires were allocated, and 957 valid questionnaires were recovered, with an effective recovery rate of 97.65%. The respondents included 458 boys ( 47.86% ) and 499 girls ( 52.14% ), and included 908 students with Yi Ethnicity. The respondents included 802 primary school students ( 83.80% ) and 155 junior high school students ( 16.20% ). The awareness of sexual knowledge was 21.94% among the primary and middle school students, and their sexual knowledge was predominantly derived from parents ( 338 students, 35.32% ) and teachers ( 335 students, 35.01% ). The awareness of sexual knowledge was significantly lower in boys than in girls ( 17.69% vs. 25.86%; χ2=8.344, P=0.004 ), and the awareness of sexual knowledge appeared a tendency towards a rise with age ( χ2trend = 63.908, P<0.001 ). Low awareness of sexual knowledge was seen in students with fathers going out for labor ( 19.54% ), mothers going out for labor (11.24%) and living in the countryside ( 14.32% ) ( χ2=7.790, 9.224 and 34.144, all P<0.01 ). Multivariable linear regression analysis showed that students living in the countryside, students’ mothers going out for labor, ages of 12 to 14 years and ages of over 14 years were factors affecting the score of sexual knowledge ( β'=-0.072, 0.341, 0.645 and 0.843, all P<0.05 ). Conclusions The awareness of sexual knowledge is low among primary and middle school students in Butuo County. Health education of sexual knowledge should be emphasized on male students, those living in the countryside and students with mothers going out for labor.

OBJECTIVE To study the improvement effects and mechan ism of thalidomide on Alzheimer ’s disease （AD）model of Caenorhabditis elegans . METHODS In this study ，the BR 5270 strain of C. elegans was used as AD model and BR 5271 strain as the control. The effects of thalidomide （0.5，2.0，6.0，15.0 mg/mL）on the motility of BR 5270 strains of C. elegans were studied by the basal slowing response assay ；the effects of thalidomide （0.5，2.0，6.0，15.0 mg/mL）on the survival time of BR 5270 strain of C. elegans were studied by life assay ；the effects of thalidomide （0.5，2.0，6.0 mg/mL）on learning and memory ability of BR 5270 strain of C. elegans were studied by short-term and long-term learning and memory assay. RT-PCR technology was used to study the effects of thalidomide （0.5，2.0，6.0 mg/mL）on mRNA expression of phosphatidylinositol 3-kinase（PI3K）/protein kinase B （Akt）signal pathway related genes （Age-1，Akt-1，Gsk-3）and calpain homologous gene （Clp-1）in BR 5270 strain of C. elegans . RESULTS After the intervention of thalidomide ，oscillation times of BR 5270 strain of C. elegans increased significantly within 30 s （except for 0.5 mg/mL group ），and the 10％ of maximum life span was prolonged significantly （only 0.5 mg/mL group ）；the short-term and long-term learning indexes were improved significantly （only 6.0 mg/mL group ）；mRNA expression of Age-1 and Akt-1（except for 0.5，2.0 mg/mL groups ）were increased significantly ，mRNA expression of Gsk-3（except for 0.5 mg/mL group ） and Clp-1 were decreased （P＜0.05 or P＜0.01）. CONCLUSIONS Thalidomide can ameliorate the dyskinesia of AD model of C. elegans，prolong the lifespan of this strain ，and enhance its learning and memory ability. Its mechanism of action may be related to activation of PI 3K/Akt signaling pathway and inhibition of calpain.

Objective To explore the effect of internet + continuing nursing education teaching methodflipped classroomin the teaching of Assessment of Consciousness among junior nurses. Methods A total of 98 nurses who have graduated within two years in the third hospital of Mianyang city in Sichuan province were selected and divided into experimental group and control group by random digits table method with 49 nurses each. The experimental group used flipped classroom teaching method and the control group used the traditional teaching method. After the training, the scores of examination and nurses′ learning satisfaction were analyzed and compared. Results The scores of nurses′ learning satisfaction in the experimental group was (100.35 ± 12.21) points, learning process, learning content, learning result, learning environment, interpersonal relationship of the dimensions were (26.85 ± 3.38), (22.02±3.07), (20.90±3.15), (17.19±2.50), (13.40±1.51) points. The scores of nurses′learning satisfaction in the control group was (86.00±11.63) points, learning process, learning content, learning result, learning environment, interpersonal relationship of the dimensions were (23.63±2.81), (19.67±3.06), (17.76±3.32), (15.20±2.46), (9.74±2.74) points. There were statistical differences between two groups(t=3.46-7.97, all P=0.000). The score of nurses′examination in the experimental group was (78.19±6.11) points,the score of nurses′ examination in the control group was (49.64 ± 14.42) points, and there was statistical difference between two groups(t=10.19, P=0.000). Conclusions Internet+continuing nursing education teaching methodflipped classroomcan improve junior nurses′learning satisfaction and the effect of the training, worthy of further promotion.

Objective To evaluate the validity and reliability of learning attitude scale among nurses in continuing nursing education in hospital.Methods We designed a nurse learning attitude scale in continuing education on the basis of a learning attitude questionnaire for teacher-training by Jiao Weiting. In July 2015, totally 207 nurses of the Third Hospital of Mianyang who received continuing education in hospital were selected as the research object by cluster sampling method. We investigated their learning attitudes. The reliability of the scale was assessed by Cronbach's α coefficient and test-retest reliability. The validity was assessed by factor analysis and Pearson's correlation.Results The test-retest reliability of the scale were as the following:cogni-tive level (0.82),experience of emotion (0.89),tendency of behavior (0.91),total scale (0.88);Cronbach's α co-efficients were as the following:cognitive level (0.85),experience of emotion (0.94),tendency of behavior (0.83), total scale (0.89). According to the result of Pearson's correlation,the total scale of learning attitude exhibited a positive correlation with cognitive level,experience of emotion and tendency of behavior (P<0.01). Four prin-cipal components were extracted by factor analysis and the constructs of the instrument obtained were consistent with the conceived concept in essence.Conclusions The scale learning attitude could measure the learning attitude of nurses in continuing nursing education with better reliability and validity.

Objective To explore the association between urinary lactate/creatinine ratio and neonatal asphyxia,and to clarify the application value of urinary lactate/creatinine ratio in forecasting the hypoxie-ischemic encephalopathy (HIE)in neonates.Methods Using case-control study design method,40 cases of neonatal asphyxia infants were selected as asphyctic group and 40 healthy infants were used as control group.The urinary lactate/creatinine ratio in the first day after birth, urinary N-Acetyl-β-D-glucosaminidase (NAG)/creatinine and the score of Apgar of 80 infants were detected.The relationship between the urinary lactate/creatinine ratio,urinary NAG/creatinine ratio, as well as the score of Apgar and HIE were analyzed and compared in asphyctic group and control group.Results The Apgar scores at 1 and 5 min in asphyctic group were significantly lower than those in control group (P<0.01). The urinary lactate/creatinine ratio and urinary NAG/creatinine ratio in asphyctic group 1 d after birth were significantly higher than those in control group(P<0.01).There was significantly negative correlation between the urinary lactate/creatinine ratio and the 1-min and 5-min Apgar scores(r=-0.636,P<0.001;r=-0.883,P<0.01),but there was a significantly positive correlation between the urinary lactate/creatinine ratio and urinary NAG/creatinine ratio(r=0.433,P<0.01).Conclusion The urinary lactate/creatinine ratio may have decisive roles in prognosis evaluation of neonatal asphyxia,and so as the important foundation for the prediction of HIE.

Objective To study the effects of early mechanical strain magnitude on formation and differentiation of osteoclasts. Methods RAW 264.7 cells induced by macrophage colony-stimulating factors and osteoclast differentiation factors were subjected to 0, 1 000, 1 500, 2 000, 2 500 and 5 000 με mechanical straining for three days. The morphological changes, number of osteoclasts and proliferation of precursor cells were determined at day 7. The activity of the tartrate-reaistant acid phosphatase (TRAP) in the culture medium was detected at days 4 and 7. Results The number of osteoclasts was decreased in 2 500 με group, while it was increased in 5 000 με group. The proliferation of precursor cells was increased in 2 000 and 2 500 με group, while it was decreased significantly in 5 000 με group. There was no significant difference in the number of osteoclasts and proliferation of precursor cells among 1 000 με group, 1 500 με group and 0 με group. The activity of TRAP was decreased in 1 000, 1 500, 2 000, 2500 and 5 000 με groups at days 4 and 7 when compared with με group. Conclusions Early mechanical straining plays a direct role in formation and differentiation of osteoclasts. The high strain magnitude within physiological load inhibits osteoclast formation, while high strain magnitude beyond physiological load stimulates osteoclast formation. Low strain magnitude has nearly no impact on formation of osteoclasts. Early mechanical straining may inhibit differentiation of osteoclasts.

HE Zi-huai is the heir of "He’s gynecology" in Hangzhou,Zhejiang province.According to many years,clinical experience,HE Zi-huai proposed a series of therapeutical methods for pregnancy diseases.For example,methods of suppressing hyperactive liver for preventing miscarriage,invigorating spleen for preventing miscarriage,tonifying kidney for preventing miscarriage,moistening lung for preventing miscarriage and eliminating pathogenic factors for preventing miscarriage have marked therapeutic effect in treating pregnant emesia,pregnant diarrhea,threatened abortion,pregnant cough,pregnant cold and stranguria during pregnancy.