To analyze the disease group structure and its trends in key departments of large public hospitals using diagnosis related group (DRG) data, explore the key points of intervention and optimization of disease groups in departments, and further promote the rational allocation of department resources.

Objective To explore the experiences and needs of patients making health behavior decisions after percutaneous coronary intervention(PCI),and to provide evidence for formulating targeted decision support strategies.Methods Based on the Ottawa decision support framework and descriptive qualitative study,16 patients with unhealthy behaviors 1 year after PCI were selected as research subjects in a tertiary A general hospital in Harbin from July to December 2022 by purpose sampling method,and their decisional experience and needs were deeply interviewed by semi-structured interview method.The data were sorted out and analyzed by content analysis method.Results After the analysis of the interview data,the 2 themes and 6 sub-themes were extracted,including the experience of health behavior decision(uncertainty about the benefits of health behavior,low recognition of health behavior,and worry about the negative impact of behavior change);health behavior decision-making needs(health behavior knowledge needs,medical resources needs,emotional support needs).Conclusion PCI patients have a variety of conflicting experiences and multi-dimensional health behavior decision-making needs.Clinical nurses should start from the experience and needs of patients,pay attention to and identify the conflict experience of patients early,meet the individual needs of patients from the aspects of knowledge,medical resources,emotional support,etc.,and promote the transformation and long-term maintenance of PCI patients'health behaviors.

AIM:To explore the mechanism of PX-12 induced apoptosis of hepatocellular carcinoma cells.METHODS:Human hepatoma cell line Huh7 was se-lected as the main research object.After the cells were treated with thioredoxin inhibitor PX-12,the cell viability was detected by CCK8 method,the cell mi-gration ability was detected by cell scratch test,the cell proliferation ability was detected by cell prolif-eration kit,the levels of intracellular reactive oxygen species and apoptosis were detected by flow cy-tometry,and the expression of apoptosis-related proteins were detected by Western blot.RESULTS:Compared with the control group,the cell viability,migration ability and proliferation ability of PX-12 treatment group were significantly decreased(P＜0.05),and the level of intracellular reactive oxygen species was increased(P＜0.05)in a concentration-dependent manner.Apoptosis inhibitor Z-VAD-FMK and antioxidant NAC could restore the cell viability,and NAC could reduce the accumulation of intracel-lular reactive oxygen species induced by PX-12 and restore the apoptosis induced by PX-12(P＜0.05).CONCLUSION:PX-12 induces apoptosis of hepato-cellular carcinoma cells through oxidative stress.

Objective:To investigate the status quo and influencing factors of the somatization of depressive emotions among college students, in order to provide a theoretical basis for the reform of mental health education and the formulation of operable mental health counseling for college students.Methods:Totally 297 college students from two institutions of higher education in Heilongjiang Province were selected by convenience sampling and investigated with the College Student Depressive Emotion Somatization Questionnaire, Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF), and the Type D Personality Scale (DS14) .Results:The total score for the College Student Depressive Emotion Somatization Questionnaire among the 297 students was (28.49±8.07), and the total score for the ATSPPH-SF was (21.98±2.73). Multiple linear regression analysis showed that the influencing factors for the somatization of depressive emotions in college students were professional psychological help-seeking attitudes and whether they had a Type D personality ( P < 0.05) . Conclusions:During university education, there should be a focus on students' personality traits and the positivity of their attitudes toward seeking professional psychological help in order to mitigate the occurrence of adverse psychological issues such as symptoms of depressive somatization.

Objective To investigate the correlations of serum cyclic adenosine monophosphate-responsive element binding protein regulator of transcription coactivator 3 (CRTC3) and oxidative stress indicators with carotid atherosclerosis in patients with coronary heart disease (CHD). Methods A total of 154 CHD patients in the hospital from June 2021 to June 2023 were selected as study group and divided into mild, moderate, and severe atherosclerosis groups based on the degree of carotid atherosclerosis; another 154 healthy individuals with physical examinations in the same period were selected as control group. Pearson method was used to analyze the correlations of serum CRTC3 and oxidative stress indicators with carotid atherosclerosis indicators. Results Serum CRTC3 and malondialdehyde (MDA), carotid plaque area and intima-media thickness (IMT) in the study group were significantly higher than those in the control group, while the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were significantly lower than those in the control group (P < 0.05). In the mild, moderate and severe atherosclerosis groups, serum CRTC3 and MDA levels, carotid plaque area, and IMT significantly gradually increased, while SOD and GSH-Px levels significantly gradually decreased (P < 0.05). Pearson correlation analysis showed that serum CRTC3 and MDA levels were positively correlated with carotid plaque area and IMT (P < 0.05), while SOD and GSH-Px were negatively correlated with carotid plaque area and IMT (P < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the combined diagnosis of severe carotid atherosclerosis by CRTC3, SOD, MDA and GSH-Px was 0.990 (95%CI, 0.982 to 0.998), with a sensitivity of 96.27% and a specificity of 76.28%. The diagnostic value of the combined application of these four indicators was significantly higher than that of each indicator alone (Z_{combined-CRTC3}=2.723, Z_combined-SOD=2.698, Z_combined-MDA=2.673, Z_{combined-GSH-Px}=2.803, P < 0.05). Conclusion The serum levels of CRTC3 and MDA are significantly increased while SOD and GSH-Px levels are significantly decreased in CHD patients. Both serum CRTC3 and oxidative stress levels are closely related to carotid atherosclerosis.

Objective To compare the diagnostic performance of PI-RADS v2.1 and PI-RADS v2 in the detection of clinically significant prostate cancer(csPCa) by Meta-analysis. Methods The major biomedical databases were searched (CNKI, CBM, Medline, and Embase) with the keywords "PIRADS v2.1" or "PI-RADS v2.1". The Quality Assessment of Diagnostic Accuracy Studies Tool v2 (QUADAS-2) was used to evaluate literature quality. Meta-analysis was performed using STATA17.0 and ReMan5.4 software. Forest plots were used to represent the sensitivity and specificity of PI-RADS v2.1 and PI-RADS v2 for each study. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were combined, and diagnostic performance was evaluated using asummary receiver operating characteristic curve (SROC). Subgroup analysis was performed on three covariables: tumor location, threshold, and the nationality of authors. Results A total of 12 studies were included, involving 3 158 patients and 3 243 lesions. Forall zones and the whole gland, PI-RADS v2.1 had a larger area under the SROC curve (AUC) for csPCa performance, compared with PI-RADS v2. Subgroup analysis: PI-RADS v2.1 also had a larger area under the SROC (AUC) to detect transitional zone csPCa. Different diagnostic thresholds: when a score of 4 was used for the threshold, PI-RADS v2.1 had the maximum area under SROC (AUC) for csPCa performance detection. Author nationality: Researches of PI-RADS v2.1 in Chinese authors had the largest area under the SROC (AUC) in detecting csPCa performance. Conclusion Compared with PI-RADS v2, the diagnostic performance of PI-RADS v2.1 in detecting csPCa is not obviously improved and overall specificity is still low.

Objective:To explore the status and influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Methods:This is a cross-sectional study. From January to February 2022, a total of 3 047 cardiovascular nurses in members of China Cardiovascular Health Alliance were selected as research objects by convenience sampling method. General data questionnaire and Cardiovascular Nurses Participated in the Cardiac Rehabilitation Questionnaire (CNPCRQ) were used to investigate cardiovascular nurses. Multiple linear regression analysis was used to investigate the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses. A total of 3 047 questionnaires were distributed in this study, and 2 704 valid questionnaires were effectively received, with an effective recovery rate of 88.74%.Results:The total score of CNPCRQ of cardiovascular nurses was (93.23±31.58), which was at a moderate level. Multiple linear regression analysis results showed that age, education, professional title, hospital location, hospital level, position type and hospital type were the influencing factors of participation in cardiac rehabilitation of cardiovascular nurses.Conclusions:The status of participation in cardiac rehabilitation of cardiovascular nurses in China needs to be improved. Role and job content of cardiovascular nurses should be further clarified, and cardiac rehabilitation knowledge and skills training should be strengthened in the future, so as to promote the profession development of cardiac rehabilitation and improve patients' health outcomes.

Objective:To explore the effect of network learning environment on critical thinking ability of nursing undergraduates.Methods:From September 2021 to January 2022, a total of 84 nursing undergraduates in the third grade of Nursing School of Harbin Medical University were selected as the research objects. The Online Learning Environment Scale and the Chinese version of Critical Thinking Ability Scale were used to investigate.Results:The total score of Online Learning Environment Scale of 84 nursing undergraduates was (63.21±15.29) , and the Chinese version of Crital Thinking Ability Scale was (248.71±36.35) . The total score of Online Learning Environment Scale of nursing undergraduates was positively correlated with the total score of Chinese version of Critical Thinking Ability Scale of nursing undergraduates ( P<0.01) . The results of multiple linear regression analysis showed that the influencing factors of critical thinking ability of nursing undergraduates included family economic situation, whether they could receive free online database resources from schools, and online learning environment ( P<0.05) . Conclusions:The online learning environment for nursing undergraduates is at a moderate level. It is suggested that nursing undergraduates should optimize the content and form of online learning and provide targeted learning support resources so as to improve the critical thinking ability of nursing undergraduates.

Objective:To explore the effect of online and offline blended scenario simulation teaching in the practice of nursing undergraduates.Methods:From August 2020 to May 2021, convenience sampling was used to select 76 nursing undergraduates in the class of 2017 who practiced in the Cardiology Department of the Second Affiliated Hospital of Harbin Medical University as the research object. The undergraduates were randomly divided into the experimental group and the control group, 38 in each group. The control group received the traditional graduation practice training, and the experimental group received online and offline blended scenario simulation teaching on this basis. After the practice, the clinical thinking ability of the two groups of students was evaluated by the Clinical Thinking Ability Evaluation Scale, the clinical practice ability of the two groups of students was evaluated by the Objective Structured Clinical Examination (OSCE) , and a teaching satisfaction survey was conducted.Results:The total score of clinical thinking ability, critical thinking ability, systematic thinking ability, evidence-based thinking ability, OSCE total score of the students in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The students in the experimental group thought that the teaching method was helpful for in-depth understanding and application of theoretical knowledge, improving nursing assessment skills, clinical coping skills and communication skills, and at the same time helping to cultivate critical thinking and teamwork awareness, and arouse learning enthusiasm, and the differences were statistically significant (all P<0.05) . Conclusions:The online and offline blended scenario simulation teaching can effectively improve the clinical thinking ability, clinical practice ability and teaching satisfaction of nursing undergraduates, and it has good effect in the graduation practice of undergraduate nursing students.

Objective:To explore the application and effect of mixed teaching based on Blackboard network teaching platform in basic chemistry teaching.Methods:The study included in 240 undergraduate students majoring in clinical medicine of Batch 2018 as the research subjects, and they were divided into the experimental group and the control group, with 120 students in each group. The control group was taught by the traditional teaching mode, and the experimental group was taught by mixed teaching method based on the Blackboard network teaching platform. A unified test was conducted for both groups of students. At the end of the course, a questionnaire survey was conducted among the students in the experimental group. SPSS 13.0 was used to process the data and independent sample t-test was performed. Results:The overall scores of the experimental group [(76.45 ± 2.62) points] were higher than those of the control group [(65.38 ± 3.09) points], with statistical significance ( t = 19.472, P < 0.001). The experimental group's satisfaction with the mixed teaching method was more than 75%. Conclusion:The mixed teaching method based on Blackboard network teaching platform is helpful to improve the quality and effect of basic chemistry teaching, and improve students' autonomous learning ability.