Objective:To explore the influence of head nurse empowerment on nurses′ voice behavior and the mediating and moderating effects of nurses′ job crafting and proactive personality.Methods:A total of 805 nurses from the 4 grade A hospitals in Shandong province from February to March 2022 were selected by convenience sampling method, the Nurse Managers′ Empowering Behavioral Scale For Staff Nurses, Job Crafting Scale, Voice Behavior Scale and Proactive Personality Scale were used for cross-sectional survey. The mediating effect was analyzed by SPSS 26.0 and Process 3.4 macro.Results:The total score of nurses′ perception of head nurse empowerment was (4.01 ± 0.57) points, the total score of nurses′ job crafting was (4.19 ± 0.66) points, the total score of nurses′ voice behavior was (4.12 ± 0.62) points, and the total score of nurses′ proactive personality was (6.07 ± 0.90) points. Head nurse empowerment, nurse job crafting, voice behavior and proactive personality were positively correlated with each other ( r values were 0.483-0.824, all P<0.01). The mediating effect of job crafting was 0.541, accounting for 86.4% of the total effect; proactive personality had a positive moderating effect on the first half path of the mediation model ( ? R 2=0.163, P<0.01). Conclusions:Head nurse empowerment influenced voice behavior of nurses directly and indirectly through the mediating role of job crafting, proactive personality can moderate the effect of head nurse empowerment on nurse job crafting. It is suggested that the head nurse appropriately delegate power to the nurses and actively authorize them, identify nurses with high proactive personality, stimulate their job remodeling and voice behavior, and improve the quality of nursing work.

Objective To explore the effect of circ_0038467 on angiotensin Ⅱ(Ang Ⅱ)-induced cardiomyocyte damage and its possible mechanism.Methods Ang Ⅱ was used to induce rat cardiomyocyte H9C2 to establish a cell injury model.si-NC,si-circ_0038467,miR-NC,miR-495 mimics were transfected into H9C2 cells and then treated with 1 μmol/L Ang Ⅱ for 24 h.si-circ_0038467 and anti-miR-NC,si-circ_0038467 and anti-miR-495 were co-transfected into H9C2 cells and treated with 1 μmol/L Ang Ⅱ for 24 h.qRT-PCR method was used to detect the expression levels of circ_0038467 and miR-495.A kit was used to detect the level of MDA and the activity of LDH and SOD.Flow cytometry was used to detect the rate of apoptosis.The dual lu-ciferase reporter experiment was used to detect the targeting relationship between circ_0038467 and miR-495.Western blot was used to detect the protein expression of cleaved Caspase-3 and cleaved Caspase-9,Bcl-2,p-P65 and p-IKBa.Results The expres-sion of circ_0038467 in H9C2 cells induced by Ang Ⅱ was increased(P＜0.05),while the expression of miR-495 was decreased(P＜0.05).After transfection of si-circ_0038467 or miR-495 mimics,the activity of LDH and the level of MDA were decreased(all P＜0.05),the rate of apoptosis and the protein levels of cleaved Caspase-3,cleaved Caspase-9 were decreased(all P＜0.05),while the activity of SOD was increased(P＜0.05).Circ_0038467 could target miR-495.Co-transfection of si-circ_0038467 and anti-miR-495 could antagonize the effect of si-circ_0038467 on Ang Ⅱ-induced oxidative stress and apoptosis of H9C2 cells.In addition,circ_0038467 could activate the NF-κB pathway by targeting miR-495.Conclusion circ_0038467 regu-lates oxidative stress and apoptosis of cardiomyocytes by targeting miR-495/NF-KB pathway.

Objective:To investigate the value of radiomics based on three-dimensional high resolution MR vessel wall imaging (3D HRMR-VWI) for identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.Methods:The clinical and imaging features of 117 patients (139 middle cerebral artery plaques) with cerebrovascular diseases in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2018 to October 2020 were respectively reviewed. Stratified random sampling was used to divide 139 plaques into training set (97 plaques) and validation set (42 plaque) at the ratio of 7∶3. The plaques were divided into 69 culprit plaques and 70 non-culprit plaques based on plaque MR features and clinical symptoms. The clinical and imaging characteristics of culprit plaques and non-culprit plaques were compared by independent sample t-test, Mann-Whitney U test and χ 2 test, and factors with significant difference between two groups in univariate analysis were further analyzed by multivariate logistic regression to find out the independent predictors of culprit plaques. Radiomics features were extracted, screened and radiomics model was constructed using pre-and post-contrast 3D HRMR-VWI based on the training set. The combined model was constructed by combining the independent predictors and radiomics model. Receiver operating characteristic curve and area under curve (AUC) were used to evaluate the efficacy of each model, and DeLong test was used to compare the efficacy of different models. Results:Significant difference was found in intraplaque hemorrhage, lumen area of stenosis, stenosis diameter, stenosis rate, plaque burden and enhancement rate between culprit and non-culprit plaques (all P<0.05). Multivariate logistic regression analysis confirmed that only intraplaque hemorrhage was the independent predictor for culprit plaques (OR=7.045,95%CI 1.402-35.397, P=0.018). In the validation set, the AUC of the pre-contrast 3D HRMR-VWI model was lower than that of the post-contrast 3D HRMR-VWI model ( Z=-2.01, P=0.044). The AUC of pre+post-contrast 3D HRMR-VWI model was not significantly different from that of post-contrast 3D HRMR-VWI model ( Z=0.79, P=0.427). The AUC showed no significant difference between combined model and pre+post-contrast 3D HRMR-VWI model ( Z=-0.59, P>0.05). The combined model showed the best performance in predicting culprit plaques of middle cerebral artery (AUC=0.939), with the sensitivity, specificity and accuracy of 95.24%, 76.19% and 85.71%. Conclusion:Radiomics based on 3D HRMR-VWI has potential values in identifying culprit plaques in symptomatic patients with middle cerebral atherosclerosis.

Objective: To develop a model incorporating radiomic features and clinical factors to accurately predict acute ischemic stroke (AIS) outcomes. Materials and Methods: Data from 522 AIS patients (382 male [73.2%]; mean age ± standard deviation, 58.9 ± 11.5 years) were randomly divided into the training (n = 311) and validation cohorts (n = 211). According to the modified Rankin Scale (mRS) at 6 months after hospital discharge, prognosis was dichotomized into good (mRS ≤ 2) and poor (mRS > 2); 1310 radiomics features were extracted from diffusion-weighted imaging and apparent diffusion coefficient maps. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator logistic regression method were implemented to select the features and establish a radiomics model. Univariable and multivariable logistic regression analyses were performed to identify the clinical factors and construct a clinical model. Ultimately, a multivariable logistic regression analysis incorporating independent clinical factors and radiomics score was implemented to establish the final combined prediction model using a backward step-down selection procedure, and a clinical-radiomics nomogram was developed. The models were evaluated using calibration, receiver operating characteristic (ROC), and decision curve analyses. Results: Age, sex, stroke history, diabetes, baseline mRS, baseline National Institutes of Health Stroke Scale score, and radiomics score were independent predictors of AIS outcomes. The area under the ROC curve of the clinical-radiomics model was 0.868 (95% confidence interval, 0.825–0.910) in the training cohort and 0.890 (0.844–0.936) in the validation cohort, which was significantly larger than that of the clinical or radiomics models. The clinical radiomics nomogram was well calibrated (p > 0.05). The decision curve analysis indicated its clinical usefulness. Conclusion The clinical-radiomics model outperformed individual clinical or radiomics models and achieved satisfactory performance in predicting AIS outcomes.

Objective:To investigate the status and their relationship of new nurses ′ transition shock, spiritual climate and nurses ′ intention to stay on the job, to explore the mediating effect of transition shock between spiritual climate and intention to stay among newly graduated nurses. Methods:A convenient sampling method was used from October to December in 2019 to investigate 231 new graduate nurses from four hospitals in Qingdao City with the general data questionnaire, the New Nurses ′ Transition Shock Scale, the Nurses ′ Intention to Stay on the Job Scale and the Spiritual Climate Scale. Results:The total score of new nurse retention intend was (20.65 ± 4.30) points, spiritual climate score was (63.20 ± 19.28), and transition shock score was (82.92 ± 22.33) points. Transition shock was negatively correlated with spiritual climate and intention to stay ( r values were -0.451, -0.548, P<0.01) ; spiritual climate was positively correlated with intention to stay ( r value was 0.450, P<0.01). Transition shock played a partial mediating role in spiritual climate and intention to stay (37%). Conclusions:Spiritual climate of the work environment can directly or indirectly affect the intention to stay through the transition shock among newly graduate nruses. Managers can take appropriate intervention measures to improve the spirit climate of the department, alleviate the impact of new nurses ′ transformation and stabilize nursing team.

Objective:To construct an early warning score model for the identification of hand-foot-mouth disease (HFMD) in children using the decision tree, and to provide scientific evidence for early recognition of critical HFMD in clinical practice.Methods:The medical records of 2 488 children with severe and critical HFMD hospi-talized in Qingdao Women and Children′s Hospital from January 2014 to December 2016 were retrospectively analyzed.Multivariate Logistic regression analysis was made to screen the independent risk factors of critical HFMD.An early warning score model for identifying children with HFMD was established by using the chi- square automatic interactive detection method in the decision tree, and the effectiveness of the model was evaluated by the receiver operating characteristic curve (ROC). Results:The multivariate Logistic regression analysis identified 5 independent risk factors of critical HFMD, including age<3 years old, blood sugar≥8.0 mmol/L, body temperature≥39.0 ℃, limb shaking and trembling, and hand-foot herpes.Two risk factors, i.e., blood sugar and body temperature, were included in the tree chart through the decision tree, and scoring criteria were established according to the tree chart.Combining the early warning scoring system for children, the warning model were finally set up, which consisted of 5 dimensions and inclu-ded 9 evaluation indicators: consciousness, skin color, heart rate, capillary refill time, respiratory frequency, participation of respiratory muscles, oxygen therapy, blood sugar and body temperature.Each dimension ranged from 0 to 3 points, totaling 0-15 points.The area under the ROC, sensitivity, specificity, maximum Youden index, and cut-off value of the model were 0.911, 0.910, 0.774, 0.684, and 6.5, respectively. Conclusions:The early warning score model established in this paper can accurately identify critical HFMD, with high sensitivity and specificity.

Objective To evaluate the effectiveness of perioperative fasting abbreviation in traumatic patients undergoing selective surgeries.Methods The traumatic patients undergoing selective surgeries from November 2016 to January 2017 at our department were selected for this prospective cohort study.They were divided into an intervention group (69 patients) and a control group (121 patients) according to the wards where they stayed.The intervention group was fasted for solids 6 hours prior to surgery and received oral solution with maltodextrin 2 hours prior to surgery.After surgery,they were allowed to drink liquids as soon as they were awakened.Normal food was allowed 2 hours later.The control group was fasted for either liquids or solids the night before surgery.After surgery,the patients who had received brachial plexus block only were allowed liquids with no limitation while the other patients were allowed liquids 6 hours after surgery and then were free for solids and liquids if no discomfort was observed.The time periods for preoperative liquids and solids fasting and for postoperative intake of liquids and solids were recorded and compared between the 2 groups.The perioperative well-beings (including anxiety,thirst,hunger,nausea,fatigue,dizziness,sweating and stomach discomfort) and serum glucose levels were compared between the 2 groups.Adverse reactions were observed.Results The preoperative fasting time for liquids for the intervention group (4.5 ± 2.9 hours) was significantly shorter than that for the control group (14.3 ±3.9 hours) (P ＜ 0.05).The preoperative fasting time for solids for the intervention group (17.6 ± 3.0 hours) were significantly longer than that for the control group (16.1 ±3.8 hours) (P ＜ 0.05).The postoperative fasting time periods for both liquids [1 (0,3) h] and solids [2 (1,4) h] for the intervention group were significantly shorter than those for the control group [6(6,6) h] hours and [6(6,6) h] (P ＜ 0.05).Compared with the control group,the perioperative anxiety,thirst,hunger,nausea,fatigue,dizziness and stomach discomfort were significantly improved in the intervention group (P ＜ 0.05).The average serum glucose level was similar in both groups upon admission (P ＜ 0.05);it was significantly higher in the intervention group immediately before surgery (P ＜ 0.05) but was gradually decreased after surgery until there was no significant difference between the 2 groups (P ＞ 0.05).No major adverse reaction was observed in either group.Conclusion The protocol of perioperative fasting abbreviation may be safe and feasible in traumatic patients for selective surgeries,showing benefits of decreased anxiety,thirst,hunger,nausea,fatigue,dizziness and stomach discomfort.

Objective To explore the effect of transitional care model on health recovery in discharged elderly patients with angiocardiopathy.Methods A group of transitional care of geriatric department was formed by physicians and nurses of geriatric department, physicians and therapists of rehabilitation department and so on. A total of 81 discharged patients with angiocardiopathy of geriatric department in the Second People's Hospital of Nantong were selected as research group from July 2015 to February 2016 using purposive sampling. They accepted transitional care. A total of 85 elderly patients with angiocardiopathy were recruited as control between December 2015 to June 2016 with routine health education. The effect and the patients' satisfaction were compared between two groups.Results The compliance rate of medication of patients was 93.6% in research group and 65.8% in control group in the second week after leaving hospital with a significant difference (χ2=20.447,P<0.05). There was a statistically significant difference in satisfaction between research group [(95.21±1.98)%] and control group [(88.34±1.84)%] (t=32.7470,P<0.05).Conclusions The transitional care can improve the medication compliance in discharged elderly patients with angiocardiopathy, help them build up health lifestyle and improve the quality of life of patients.

Objective To investigate the risk factors of falls and balance force in community elderly patients with orthostatic hypotension,so as to prevent from fall risk.Methods The elderly fall risks assessment tool and the elderly balance force test table were investigated in community elderly patients with orthostatic hypotension in community.Results The average score in fall risk assessment of 189 elderly patients with orthostatic hypotension in community was (6.78±5.49)and the average score in balance ability was(5.42±5.23), and there were statistically significant differences in occupation, gender and marital status(P<0.05).The fall risk assessment was positively correlated with the balance ability(r=0.637,P< 0.01).Conclusions The elderly patients with orthostatic hypotension in community have a higher risk of falls and balance problems, so the community should carry out comprehensive measures to improve the environment of community and home, strengthen the balance ability training,and reduce the risk of falls.

We wished to assess the role of chlamydia micro virus capsid protein Vp3 in recombinant molecules, chart its molecular evolution, screen the wild-type strain, and reveal its value in clinical research. Using a protein BLAST multiple-alignment program, we compared various strains of Chlamydia micro virus capsid protein Vp3 sequences. Using a "distance tree" of those results, we created a phylogenetic tree. We applied the Karplus-Schulz method of flexible-region analyses for highly conserved alignments of amino-acid sequences. Gamier-Robson and Chou-Fasman methods were employed to analyze two-level structures of sequences. The Emini method was used for analyses of the accessibility of surface epitopes. Studies of hydrophilic proteins were undertaken using Kyte-Doolittle and Hopp-Woods methods. Analyses of antigen epitopes helped to reveal the antigen index using the Jameson-Wolf method. All sequences in the six strains of chlamydia micro virus capsid protein Vp3 were highly conserved, with the main differences being between Vp3 protein in Chp1 and the other five strains of the micro virus. The viral strain of Vp3 protein was based mainly on micro-alpha helix structures, and multiple epitopes were noted in highly conserved regions. Vp3 protein was highly conserved structurally, and was an important protein of the chlamydiaphage capsid. Vp3 protein has a complicated molecular structure, highly conserved regions with strong immunogenicity, and has considerable research value.
Amino Acid Sequence ; Capsid Proteins ; chemistry ; genetics ; immunology ; Chlamydia ; genetics ; immunology ; Conserved Sequence ; Epitope Mapping ; Evolution, Molecular ; Molecular Sequence Data ; Recombination, Genetic