Objective:To explore the mediating effect of professional self-efficacy between professional values and willingness to work on gerontological care of nursing students in higher vocational colleges.Methods:A total of 391 nursing students from Chengdu area full-time university were investigated by general information questionnaire, gerontological nursing career motivation questionnaire, professional values scale, and professional self-efficacy scale. Pearson correlation analysis and descriptive statistical analysis were performed by SPSS 21.0. Amos 26.0 was used to establish mediating effect model and verify the mediating effect.Results:The total score of 391 nursing students' willingness to work on gerontological care was (47.05±6.93), the willingness to work on gerontological care was positively correlated with professional self-efficacy and professional values ( r = 0.826, 0.775, respectively, all P<0.01), and professional self-efficacy played a partial mediating role between professional values and willingness to work on gerontological care, accounting for 64.82% of the total effect. Conclusions:The willingness to work on gerontological care of nursing students in higher vocational colleges is at a middle level. Professional values not only directly affect the willingness to work on gerontological care, but also indirectly take function through the professional self-efficacy. Professional self-efficacy plays a mediating role in professional values and willingness to work on gerontological care of nursing students in higher vocational colleges.

Objective To explore the effects of a psychological nursing programme based on acceptance and commitment therapy on patients with end-stage cancer.Methods The convenience sampling method was adopted to select 120 patients with end-stage cancer who were hospitalized in the radiotherapy department of a tertiary A maternity and general hospital in Yuncheng from June 2021 to December 2022 as the research subjects.The Research Randomizer was used to divide them into an experimental group and a control group,with 60 cases in each group.The experimental group adopted the psychological nursing programme based on acceptance and commitment therapy,and the control group received the routine psychological nursing.The differences of psychological resilience,psychological pain,experiential avoidance level and quality of life before and after intervention were compared between the 2 groups.Results 57 cases in the experimental group and 58 cases in the control group completed the study.The scores of the 10-item Connor-Davidson Resilience Scale were(35.14±4.76)points in the experimental group and(33.17±2.97)points in the control group,and the difference between the 2 groups was statistically significant(t=2.664,P=0.009).After intervention,the scores of the Distress Thermometer in experimental group and control group were(4.14±1.88)points and(5.69±2.13)points,and the difference between the 2 groups was statistically significant(t=-4.138,P＜0.001).The scores of the Acceptance and Action Questionnaire-Ⅱwere(16.19±3.80)points in the experimental group and(23.93±2.46)points in the control group,and the difference between the 2 groups was statistically significant(t=-13.002,P＜0.001).The EORTC QLQ-C30 score in the experimental group was(117.00±8.50)points,and that in the control group was(101.45±11.88)points,and the difference between the 2 groups was statistically significant(t=8.066,P＜0.001).Conclusion The psychological nursing programme based on acceptance and commitment therapy can effectively reduce the level of psychological pain and experiential avoidance,improve psychological resilience and improve the quality of life of patients.

Rhythmic auditory stimulation(RAS)with repetitive and rhythmic sound sensory signals can improve motor functional recovery by inducing rhythmic movement for patients with motor dysfunction due to neurological impairment.As an emerging intervention for the treatment of post-stroke hemiplegic patients,RAS can improve the walking ability of post-stroke hemiplegic patients,correct abnormal gait,improve balance function,and improve patients'upper and lower limb function.Its mechanism of action may be related to the rhythmic entrainment motor system and auditory-motor synchronisation.In addition,RAS can be combined with various other rehabilitation techniques to better promote the recovery of motor function in stroke patients.This article reviewed the research progress of RAS in motor function recovery of post-stroke patients to provide guidance for clinical application.

Objective:To evaluate the testing capability of urinary iodine laboratories in Gansu Province and analyze the existing problems.Methods:Z-score method and uncertainty analysis were used to analyze the external quality control assessment results of urinary iodine laboratories in Gansu Province from 2017 to 2021 (data were collected from Gansu Center for Disease Prevention and Control).Results:From 2017 to 2021, the participation rate in the assessment of urinary iodine laboratories in the province was 100.0% (473/473), the feedback rate was 99.8% (472/473), and the pass rate was 91.9% (434/472). The pass rates for assessment from 2017 to 2021 were 82.7% (62/75), 93.9% (93/99), 94.9% (93/98), 92.0% (92/100), and 94.0% (94/100), respectively. The pass rates for provincial, municipal, and county assessments were 5/5, 98.6% (69/70), and 90.7% (360/397), respectively. The proportions of │Z│≤2, 2 <│Z│ < 3, and│Z│≥3 between laboratories in the province were 84.5% (399/472), 9.3% (44/472), and 6.2% (29/472), respectively. The proportions of│Z│≤2, 2 <│Z│ < 3, and│Z│≥3 within the laboratories were 88.6% (418/472), 9.1% (43/472), and 2.3% (11/472), respectively. There was a significant difference in the composition of │Z│ scores between laboratories annually (χ 2 = 24.60, P = 0.002), the proportion of│Z│≤2 increased from 66.7%(50/75) in 2017 to 90.0% (90/100) in 2021. The│Z│ scores between and within provincial laboratories were both ≤2. The proportion of │Z│≤2 between municipal and county-level laboratories was 91.4% (64/70) and 83.1% (330/397), respectively, the proportion of│Z│≤2 within laboratories was 92.9% (65/70) and 87.7% (348/397), respectively. There was no difference in the composition of│Z│ scores between and within provincial, municipal, and county-level laboratories( P < 0.05). The proportion of two concentration quality control blind sample results in the province that were both within the uncertainty range was 89.2% (421/472). From 2017 to 2021, they were 81.3% (61/75), 91.9% (91/99), 84.7% (83/98), 92.0% (92/100), and 94.0% (94/100), respectively, with statistically significant differences (χ 2 = 9.69, P = 0.021); provinces, cities, and counties were 5/5, 95.7% (67/70), and 87.9% (349/397), respectively, with statistically significant differences (χ 2 = 23.60, P = 0.023). Conclusions:Through continuous external quality control assessments of all established urinary iodine laboratories in Gansu Province, the overall testing capacity of urinary iodine laboratories at all levels has been continuously improved. However, in the future, it is still necessary to strengthen laboratory testing capabilities and improve the level of urine iodine detection.

From the perspective of welfare culture, this paper analyzed the current status of care modes in China and explained the ethical value of multiple care mode:the development of multiple care mode was conducive to resolving the dilemmas of interpersonal relationships and strengthening community interaction;resolving the dilem-as of family relations and carrying forward the tradition of honoring and respecting the elderly;strengthening insti-tutional ethics and highlighting social concerns. Finally, this paper put forward three feasible suggestions for the development of multiple care mode:carrying forward the traditional filial piety culture and cultivating the concept of pension in the new period; developing the welfare of the combination of medical treatment and endowment and strengthening the linkage between family, community and care institutions;enhancing the quality of service of care institutions and strengthening the ethical support of caregivers.

Objective To investigate the occurrence of common symptoms in breast cancer patients in different chemotherapy periods and to analyze the relationship with the chemotherapy periods. Methods A total of four hundred and fifty?six breast cancer patients receiving chemotherapy in Tangshan Cancer Hospital from August 2016 to August 2017 were investigated via common symptom questionnaire among breast cancer patients. The results of the investigation were statistically analyzed, and the relationship between chemotherapy related symptoms and chemotherapy periods was analyzed by multiple Logistic regression analysis. Results In terms of the 20 kinds of chemotherapy symptoms, among the patients whose incidence rate was >50％ had 9 kinds of symptoms. Multivariate Logistic regression analysis showed that alopecia (95％ CI=5. 820～562. 784,P=0. 001) ,skin allergy ( 95％ CI=0. 002～0. 157,P<0. 001) ,cancer caused insomnia( 95％ CI=1. 179～25. 638, P=0. 030) ,dry mouth ( 95％ CI=0. 008～0. 470,P=0. 007) ,vaginal dryness or burning heat ( 95％ CI=13. 368～647. 615 P<0. 001) ,oral ulcer ( 95％CI=0. 026～0. 654,P=0. 013) ,abnormal defecation ( 95％ CI=0. 025～0. 749,P=0. 022),memory loss (95％CI=1. 065～19. 415,P=0. 041),distal phalanges numbness (95％ CI=0. 004～0. 421,P=0. 007),poor appetite (95％ CI=1. 189～65. 964,P=0. 033),local skin irritation /ulceration ( 95％ CI=0. 003～0. 143, P<0. 001 ) were associated with the chemotherapy, the difference was statistically significant. The above symptoms can be divided into 3 symptom groups by factor analysis,and they were respectively medicine side effect symptom cluster, neuropsychiatric symptom cluster and mucocutaneous symptom cluster. Conclusion There are many symptom clusters that affect the life and rehabilitation level in patients with breast cancer during chemotherapy, and are closely related with the chemotherap cycle. Doctors should adopt a scientific model of symptom management and take measures to improve the survival state of the patients.

Objective The aim of our study was to explore the relationship between prostate cancer and four serum markers,including Prostate specific antigen (PSA),Beta 2 Microglobulin (β2M),Neutrophil-to-lympochyte ratio (NLR) and Lactic dehydrogenase (LDH),and their variation rules in development of prostate cancer.Then to find one or more markers that can increase the sensitivity and specificity of diagnosis to provide reference for clinic.Methods A total of 149 prostate cancer patients,40 patients with benign prostatic hyperplasia,80 healthy subjects in our hospital were analyzed,and subsequent the T-PSA,F-PSA,β2M,LDH and NLR were measured.The correlation between these markers and prostate cancer as well as its different types and Gleason score was assessed statistically.We determined the cut-off point of the NLR and T-PSA according to the specificity and sensitivity levels derived from area under receiver operator characteristic (ROC) curve.Results The level of T-PSA was significantly higher in patients of prostate cancer and benign prostatic hyperplasia,and the level of NLR was higher only in patients of prostate cancer.Based on the area under ROC,the cut-off value of T-PSA was determined to be 4.625 ng/ml,and NLR was 2.11,and combined NLR and T-PSA can increase the specificity of diagnose.There is a statistical difference in Gleason scores in patients with different NLR of prostate cancer (P =0.030).Conclusions It could increased the specificity when combined NLR and T-PSA to diagnose prostate cancer.And NLR has positive correlation with the prognosis of patients of prostate cancer as well.

Objective To explore the mutual relationship between serum uric acid (SUA) level with metabolic syndrome (MD) and its factors among the physical examination population.Methods A total of 8 285 people undergoing the physical check-up in a hospital in 2013 were selected by sampling and conducted the physical measurement and biochemical detection;the subjects were grouped according to the MS diagnostic standard,gender and SUA.Then the correlation between SUA and MS was analyzed.Results The age,BMI,SBP,DBP,FPG,TG and SUA in the MS patients were significantly higher than those in the patients without MS,while the HDL-C level was significantly lower.The occurrence rate of MS in males was higher than females.With the increase of MS factors,the SUA level showed the overall rising trend;the multiple stepwise regression analysis indicated that BMI,DBP and TG were positively correlated with SUA,and the HDL-C level was negatively correlated with the SUA level.The regression equation was Y =-2.135 + 0.066X1 +0.010X2 +0.155X3-0.379X4;the MS detection rate in the HUA group was higher than that in the non-HUA group;in the single factor Logistic regression analysis,the SUA level was significantly related with the MS occurrence (OR=1.007,95％CI 0.006-1.007,P＜0.05),in the SUA diagnostic value for M,AUC in male and female were 0.608 (95 ％CI 0.582-0.634,P＜0.01) and 0.744 (95 ％CI 0.705-0.783,P＜0.01) respectively,the MS best critical diagnostic points in male and female were 360.5 and 256.5,the corresponding diagnostic sensitivities in male and female were 46.49％ and 71.94％,the specificities in male and female were 69.94％ and 69.94％ respectively.Conclusion The SUA level is closely associated with MS,and SUA level has a good predictive effect for MS.

Objective To study the clinical efficacy and safety of icotinib hydrochloride tablets combined with whole brain radiotherapy (WBRT) in non-small cell lung cancer (NSCLC) brain metastasis.Methods Fifty-three patients with NSCLC brain metastasis who were unable to tolerate chemotherapy or chemotherapy failed were selected in Baotou Central Hospital from October 2010 to April 2015.The patients were divided into the observation group (n =27) and the control group (n =26) using random number table method.Two patients were dropped out,one in the control group and one in the observation group.The patients in the control group were given WBRT (30 Gy/15 Fx).On this basis,the patients in the observation group were given icotinib hydrochloride tablets 125 mg,3 times a day.The patients were followed up for 18 months after the end of WBRT.The adverse reactions,clinical efficacy and the median survival times of the two groups were compared.Results The objective response rate of the observation group was 88.5％,which was higher than that of the control group (64.0％),and the difference was statistically significant (x2 =4.238,P =0.040).The incidence rates of skin rash and liver function damage in the observation group were 76.9％ and 15.4％,which were higher than those in the control group (0,x2=31.638,P ＜ 0.001;x2 =4.173,P =0.041).However,most of them were degree Ⅰ-Ⅱ,and they were tolerable.There were no significant differences in the incidence of myelosuppression and gastrointestinal reactions between the two groups (26.9％ vs.20.0％,x2 =0.339,P=0.560;34.6％ vs.28.0％,x2 =0.259,P=0.611).The median survival time in the observation group (9.0 months) was longer than that in the control group (7.0 months).The one year survival rate of the observation group was 33.3％,which was higher than that of the control group (23.1％),but the difference was not significant (x2 =0.676,P =0.411).Conclusion Icotinib hydrochloride tablets combined with WBRT in the treatment of brain metastasis with NSCLC can significantly improve the curative effects of brain metastasis,and it has a survival advantage,with tolerable adverse reactions.