Objective:To conduct a scoping review of health behavior-related assessment tools for pregnant women with gestational diabetes mellitus (GDM).Methods:A total of 6 Chinese and English databases, including CNKI, Wanfang Database, China Biomedical Literature Database, PubMed, Web of Science Core set and Embase, were systematically searched by the terms of “gestational diabetes mellitus”，“health behavior”，“assessment”. The relevant contents of GDM health behavior-related assessment tools were retrieved for systematic analysis, and the results were normalized reported. The search period was from the establishment of the databases to February 1, 2023.Results:A total of 2 657 literatures were retrieved, and 41 literatures were finally included after screening, including 16 literatures on the development and verification of assessment tools, 2 literatures on localization of assessment tools, and 23 literatures on the application of the assessment tools. A comprehensive analysis was conducted on 18 assessment tools, including 16 original assessment tools and 2 localized assessment tools, spanning the years 1987 to 2020. The assessment content covered dietary behavior, physical activity behavior, medication adherence, blood glucose monitoring behavior, treatment adherence, self-management behavior, and health-promoting lifestyles. Among them, 7 assessment tools were validated for reliability and/or validity in pregnant women with GDM. Among the 23 studies that covered the implication of the assessment tools, the Pregnancy Physical Activity Questionnaire and Health-Promoting Lifestyle Ⅱ were the most commonly utilized tools for assessing health behaviors in pregnant women with GDM.Conclusions:There is a wide variety of assessment tools related to health behaviors in pregnant women with GDM, and the assessment content is relatively rich. However, most of the assessment tools have not been validated for their reliability and validity within the GDM population, limiting their clinical application and promotion.

Platform method is a modeling method that forces experimental animals to stand on the platforms for a long time without rest by taking advantage of the rodent's fear of water. The application time and node of platform method in model construction can be adjusted according to the needs of different types of animal models. At present， the research hotspot of platform method focuses on constructing animal models of sleep deprivation， anxiety and depression and other mental diseases as well as fatigue. In recent years， with the development of the modernization of traditional Chinese medicine （TCM）， this method has been gradually applied to the study of TCM syndrome model and TCM disease and syndrome combination model with "heart"，"liver" and "spleen" as the centers. Due to the extensive application of platform method and the diversity of modeling diseases， there is still a lack of systematic discussion on this method as the core. This paper systematically summarized the research in China and abroad and explored the application of platform method in animal models of human diseases from three dimensions： its development process， current application and problems and future development. In addition， through the analysis of the research hotspots on sleep deprivation， mental diseases， fatigue， TCM syndrome model and TCM disease and syndrome combination model，the ideas and specific applications of platform method in construction of various animal models were discussed. This paper was expected to provide reference for researchers and promote further exploration and research of this modeling method.

Objective:To explore the application status and development trend of massive open online course (MOOC) in the field of higher medical education in China, so as to provide the reference for future research in this field.Methods:The related literatures collected from China National Knowledge Infrastructure (CNKI), Wanfang Data service platform, VIP database and China Biology Medicine disc were searched from their inception to March 1st, 2020, and the statistical analysis was carried out on the annual volume, journal distribution, fund support, author distribution, cited frequency, literature type and high-frequency keywords by using the bibliometrics method. The extracted data was set up in Excel 2010, and descriptive statistics was made by frequency analysis.Results:The study collected 754 articles, which were included in 262 journals, mainly medical education journals. The funding rate reached 50%. Huang Ping, Zhang Xin, Li Xinhui and seven others were core authors. Basic medical curriculum application research represented by human anatomy was the most. MOOC application research focused on theoretical curriculum. The curriculum evaluation included such five aspects as terminal evaluation, formative evaluation, platform assessment, comprehensive ability and autonomous learning ability. The research focus was the mixed teaching mode based on MOOC and its application in nursing education, traditional Chinese medicine education and continuing medical education.Conclusion:In the past five years, MOOC has developed rapidly in China's higher medical education, and the core authors have formed, but there is a lack of in-depth cooperation. In the future, we should increase the applied research of experimental (training) courses, and further improve the design of experimental research and curriculum evaluation system.

Objective:To understand the user experience of Nursing-Online Practice Promotion Application ("N-OPP" APP) .Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 537 nursing students who had practiced in the Affiliated Hospital of Qingdao University from August to November 2020 and had used "N-OPP" APP were selected as the research objects. The general data questionnaire and the "N-OPP" APP user experience evaluation questionnaire were used for the investigation. A total of 537 questionnaires were distributed in this study and 529 valid questionnaires were recovered, with an effective recovery rate of 98.51%.Results:The total average score of the "N-OPP" APP user experience evaluation questionnaire items of 529 nursing students was (3.89±0.47) , and the average scores of items of operation performance, service performance, user experience and risk were respectively (3.87±0.65) , (4.04±0.60) , (3.90±0.70) and (3.42±0.62) . There were statistically significant differences in the use experience and operation performance dimensions of nursing students from different educational backgrounds, contact time of mobile learning APP, use time and use frequency of "N-OPP" APP ( P<0.05) . The service performance dimension items of nursing students with different educational background and frequency of "N-OPP" APP were compared, and the differences were statistically significant ( P<0.01) . The risk dimension items of nursing students with different "N-OPP" APP use frequencies were compared, and the difference was statistically significant ( P<0.01) . Conclusions:The development of "N-OPP" APP can solve some problems in the traditional teaching and training of clinical nursing skills, help nursing students to consolidate their nursing skills and obtain high recognition from nursing students, which can be used as an auxiliary tool for teaching and training of clinical nursing skills.

Objective:To systematically evaluate the relationship between sedentary behavior (SB) and the risk of developing gestational diabetes mellitus (GDM).Methods:PubMed, Medline, EMBASE, CINAHL, the Cochrane Library, the Rehabilitation & Sports Medicine Source, the Sedentary Behavior Research Database (SBRD), Wanfang Database, the China Journal full-text database, and the China Biomedical Literature Database were searched for cohort studies, case-control studies, and cross-sectional studies concerning the risk of SB and GDM from the establishment of the database to January 2021. Two researchers screened the literature, extracted data, evaluated the quality of the data according to the inclusion and exclusion criteria, and, finally, produced a descriptive analysis of the results.Results:A total of 11 studies were included, including eight cohort studies, two cross-sectional studies, and one case-control study. The overall quality of the studies was moderate. The prevalence of GDM was 5.04%-26.81%, and the prevalence of SB before and during pregnancy was 39.47%-40.21% and 28.86%-93.50%, respectively. In terms of the prevalence of SB before pregnancy, four moderate-quality studies reported no association with GDM risk. In terms of SB during pregnancy, four moderate-quality studies reported no association with GDM risks, and four studies (one of high quality and three of moderate quality) reported an association with GDM risks, two of which focused on the second trimester. There was considerable heterogeneity between studies on the diagnosis of GDM and SB.Conclusion:SB before pregnancy is not associated with the risk of GDM, while the relationship between SB and the risk of GDM is unclear, but the level of SB in the second trimester of pregnancy may be positively associated with the risk of GDM.

Objective:To explore the impact of primary immune thrombocytopenia (ITP) on patient's quality of life and emotional well-being, and both the physician and the patient's perception of the treatment.Methods:This study was a Chinese Subgroup analysis of I-WISh survey, including 102 physicians and 286 ITP patients invited to complete the survey. A descriptive analysis of the results of the physician-patient survey was conducted in three parts: symptoms, impact of ITP on quality of life and emotion, and treatment perception.Results:Fatigue and anxiety about unstable platelet counts were the main symptoms after treatment. Physicians reported inadequate frequency of anxiety and fatigue. In terms of quality of life, over 90.0% of patients thought that ITP had a negative impact on their working life/studies, daily tasks, energy, capacity to exercise, and sexual life. With regard to emotion, 60.8% (174/286) patients thought that ITP had a greater impact on overall emotion, concerns about the fluctuation in platelet level (74.8%, 214/286) , disease itself (71.7%, 205/286) and disease progression (68.9%, 197/286) were the common issues, which were similar to the physicians' evaluations. Both physicians and patients agreed that reducing spontaneous bleeding, maintaining a healthy blood count and improving quality of life were the top three important treatment goals. Physicians considered reducing bleeding risk as the most important factor for decision making. Physicians believed that patients receiving glucocorticoid (54.9%, 56/102) were most likely to succeed in achieving sustained response while patients had the best response to thrombopoietin receptor agonist (TPO-RA) treatment, with about 83.9% (240/286) being satisfied with the overall effectiveness of TPO-RA.Conclusions:Physicians in the I-WISh Chinese subgroup had low awareness on patients' fatigue and anxiety. The quality of life and emotion of patients were significantly negatively affected by ITP. There are differences in the selection of treatments between physicians and patients, suggesting that physicians should raise concerns about the quality of life of ITP patients and make individualized treatment options through physician-patient shared decisions.

Objective:To construct the continuous nursing need index system based on discharge readiness for patients with spinal cord injury so as to guide the clinical nursing practice.Methods:From January 2017 to July 2018, this study selected 115 spinal cord injury inpatients of Spine Surgery Department at a ClassⅢ Grade A hospital in Qingdao as subjects by convenience sampling. The Readiness for Hospital Discharge Scale (RHDS) was used to investigate those patients. According to the investigation results, this study primarily built the continuous nursing need index system for spinal cord injury patients. Delphi method was used to select 25 experts for two rounds of consultation so as to establish the final the continuous nursing need index system for spinal cord injury patients.Results:Among 115 spinal cord injury patients, the total score and item average score of RHDS were (60.39±22.12) points and (5.27±2.75) points respectively. Among two rounds of consultation, the authoritative coefficients of experts were 0.78 and 0.81 respectively, and the coordination coefficients were 0.343 and 0.423. In the second round of consultation, the variation coefficients ranged from 0.09 to 0.18. The final the continuous nursing need index system for spinal cord injury patients included 5 first-level indexes and 33 second-level indexes.Conclusions:The continuous nursing need index system for spinal cord injury patients has a high level of authoritative coefficients and is scientific practical which can provide a basis for discharge health instruction in spinal cord injury patients and promote the safe transition in hospital-community-family as well as comprehensive rehabilitation.

Objective: To integrate the best evidence of venous thromboembolism (VTE) prevention into practice, improve nurses′ compliance, and reduce the incidence of VTE in orthopaedic department. Methods: Guided by the standard procedure in the JBI-Paces program, collected the best evidence from online databases and set the standards. Collected data through field observation, interviews and review of nursing records. A total of 167 patients and 36 nurses we recruited in the study and audited twice. We judged the result by the knowledge level of nurses and patients, nurses′ compliance with the evidence and the incidence rate of VTE. Results: In baseline review, three criteria of poor compliance, "the correct situation of daily inspection of VTE risk assessment", "Wear gradient pressure stockings correctly for VTE high-risk patients", "Intermittent pneumatic compression device (IPCD) used twice a day for 30 minutes each time", were significantly improved after the application of evidence, increased from 47.22% (17/36) ,36.11% (13/36) ,36.11% (13/36) to 86.11% (31/36) , 86.11% (31/36) , 91.67 (33/36) respectively (χ²=12.25, 18.94, 24.08, all P < 0.05); The incidence of VTE decreased from 2.7% to 0 (P=0.195); the correct rate of VTE risk assessment, awareness rate of health education among patients, implementation rate of physical preventive measures and qualified rate of VTE-related knowledge and skills among nurses increased from 82.43% (61/74) ,74.32% (55/74) ,83.78% (62/74) ,77.03% (57/74) to 97.85% (91/93) ,91.40% (85/93) ,97.85% (91/93) ,96.77% (90/93) respectively (χ²= 8.86-15.24, all P < 0.01) . Conclusion The integration of best evidence standardize nurses′ behaviors, reduce the incidence rate of VTE, improve the quality of clinical care and promote the satisfaction of patients continuously.

Objective? To explore the establishment and effects of preventive nursing sensitivity indicators for venous thromboembolism (VTE) in orthopedic patients. Methods? Preventive nursing sensitivity indicators for VTE in orthopedic patients were established using Delphi expert consultation method. Totally 160 patients before the preventive nursing sensitivity indicators for VTE were carried out (May 2017) were selected as the control group, while another 201 patients after the indicators were carried out (November 2017) were selected as the study group. Patients in the control group received conventional preventive nursing care for VTE, whereas patients in the study group received monitoring and management using the self-developed preventive nursing sensitivity indicators for VTE. Patients' incidence rate of VTE, satisfaction with VTE prevention, accuracy of VTE risk assessment, awareness rate of health education knowledge, implementation rate of physical prevention measures, achievement rate of nurses' VTE-associated knowledge and skills before and after the indicators were carried out. Results? Patients' incidence rate of VTE was 25‰ before the indicators were carried out, while that after the indicators were carried out was 5‰ (P=0.175); patients' satisfaction before the indicators were carried out was 78.12%, while that after the indicators were carried out was 93.53% (χ2=18.344, P＜0.001); and there were statistically significant differences in accuracy of VTE risk assessment, awareness rate of health education knowledge, implementation rate of physical prevention measures and achievement rate of nurses' VTE-associated knowledge and skills before and after the indicators were carried out (P＜ 0.01). Conclusions? The establishment and application of preventive nursing sensitivity indicators for VTE can effectively improve the nursing quality of VTE prevention as well as patient's satisfaction.

Objective To investigate the effect of ultrasound-guided serratus plane block onefficacy of postoperative analgesia in patients undergoing radical mastectomy. Methods From January 2013 to December 2016, sixty-eight ASA physical statusⅠorⅡ patients scheduled for radical mastectomy under general anesthesia were randomly divided into two groups (n = 34 each): SP block group (observation group) and control group. After induction of anesthesia, ultrasound-guided homolateral SP block was performed, and 0.375% ropivacaine 20 ml was injected in observation group, while the equal volume of normal saline was used instead in control group. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation in two groups. The scores of prince henry pain scale (PHPS) were evaluated at the 2nd, 4th, 8th, 12th and 24th hour (T1, T2, T3, T4, T5) after operation. The consumption of sufentanil, propofol and remifentanil was recorded.Meantime, the times of successfully delivered doses (D1) and attempts (D2) within 24 h after operation were added up, and D1/D2 was calculated. The adverse effects were also recorded. Results The scores of PHPS at T1 [(1.4 ± 0.5) scores vs. (3.1 ± 0.6) scores], T2 [(1.5 ± 0.6) scores vs. (2.9 ± 0.8) scores], T3 [(1.7 ± 0.5) scores vs. (2.8 ± 0.7) scores], and the consumption of sufentanil [(53.4 ± 16.7)μg vs. (87.8 ± 24.5)μg], remifentanil[(288.7 ± 42.1)μg vs. (376.5 ± 61.6)μg] were significantly lower in observation group than those in control group, while D1/D2 (0.89 ± 0.12 vs. 0.57 ± 0.18) was higher (P<0.05). The incidence of adverse reactions was significantly lower in observation group: 0 vs. 20.6% (7/34), P<0.05. Conclusions Ultrasound-guided SP block reduces the perioperative opioids consumption and enhances the efficacy of postoperative analgesia in patients undergoing radical mastectomy.