Bronchiectasis has the characteristics of long course,gradual aggravation,easy recurrence and difficult to treat.The characteristics are similar to those arouse by incubative pathogenic factors.Based on the theory of incubative pathogenic factors,this disease is often related to the incubative pathogenic factors in the body's areas with deficient healthy qi,which occur at regular times.The etiology can be external,congenital,or internal.Treatment should focus on different characteristics of incubative pathogenic factors.Attention should be paid to clearing and dispersing in external pathogenic factors,while attention should be paid to supporting and promoting healthy qi in congenital pathogenic factors,and do not forget to remove internal pathogenic factors.

Objective:To explore the curative efficacy of Dingke Decoction in the treatment of post infectious cough based on the the real-world clinical data.Methods:Retrospective cohort study was conducted. 245 patients with cough after infection in the hospital of Jingan Chinese Medical Hospital from July 2021 to July 2022 were set as study objects. The fact that whether the patients with Dingke Decoction or not were divided into control group (90 cases, without Dingke Decoction) and treatment group (155 cases, with Dingke Decoction). By using propensity nearest neighbor 1:1 matching to balance the confounding factors before treatment, 56 cases were successfully matched in both groups. The control group was treated symptomatically according to the actual clinical situation, while the treatment group was treated with modified Dingke Decoction on the basis of symptomatic treatment in the control group. The treatment for both groups lasted for 2 weeks. TCM symptom scores and cough severity score were evaluated using the Leicester Cough Quality of Life Questionnaire (LCQ) before and after treatment. Levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were detected through ELISA; adverse reactions during the treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate of the treatment group was 91.07% (51/56), while that of the control group was 76.79% (43/56), with a statistically significant difference between the two groups ( χ2=4.24, P=0.040). The daytime cough symptom score (1.03 ± 0.67 vs. 1.20 ± 0.66, t=7.40) and nighttime cough symptom score (0.74 ± 0.62 vs. 1.26 ± 0.54, t=6.27) in the treatment group were lower than those in the control group after treatment ( P<0.001). After treatment, the LCQ physiological (5.30 ± 0.79 vs. 4.78 ± 1.09, t=-2.44), psychological (5.33 ± 0.92 vs. 4.70 ± 1.12, t=-2.39), and social (5.23 ± 0.94 vs. 4.60 ± 0.81, t=-2.86) scores in the treatment group were higher than those in the control group ( P<0.05). After treatment, he treatment group serum IL-6 [(14.29 ± 3.94) ng/L vs. (19.99 ± 5.17) ng/L, t=4.80] and TNF-α [(36.23 ± 7.83) ng/L vs. (42.44 ± 7.63) ng/L, t=3.11] were lower than those in the control group ( P<0.01). The incidence of adverse reactions in the control group was 8.92% (5/56) and 5.36% (3/56), respectively, without statistical significance ( χ2=0.54, P=0.716). Conclusion:Based on the real-world research method, medicine Dingke Decoction can improve the clinical efficacy and the quality life of post infectious cough patients, and the mechanism may be related to reducing airway inflammation response.

Objective:To establish the norm of clinical nursing teachers' competency in tertiary first-class hospitals in northwest China.Methods:From August 2019 to February 2020, 1 077 clinical nursing teachers were selected from 12 tertiary first-class hospitals in northwest China by stratified, random and proportional sampling, and were investigated with the Clinical Nursing Teacher Competency Evaluation Scale. Descriptive statistics were carried out on the sample data, and univariate variance analysis and pairwise comparison were carried out on the multi-classification variables of age, nursing age, professional title, teaching years and the number of teachers per year. The verified data were exported to SPSS 26.0 for statistical analysis, variance analysis was used for multi-group comparison, and LSD test was used for pairwise comparison between groups.Results:①The corresponding mean norm was established by grouping the total score and the first-class index; the percentile norm was made with 5% spacing; P10, P30, P70 and P90 were selected as the grading demarcation points, and the demarcation norm was constructed. ②Factor analysis showed that there were statistical differences in personality characteristics among different ages, nursing ages and professional titles ( P<0.05), and also in professional attitudes among different nursing ages and professional titles ( P<0.05). Conclusion:The establishment of norm provides references for individuals or units to evaluate teachers' competence.

ICU patients with continuous renal replacement therapy (CRRT) are at high risk of intensive care unit acquired weakness (ICU-AW) and early activity is an important measure to prevent ICU-AW. This article reviews the concept and significance, influencing factors, safety and implementation methods of early activities for ICU patients during CRRT treatment, in order to provide a reference for constructing early activity programs for ICU CRRT patients.

Objective:To construct a shared decision-making scheme for early activities of ICU patients, so as to provide guidance for carrying out early activities of ICU patients and improving patient activity compliance.Methods:From July to December 2021, a total of 16 medical and nursing experts engaged in shared decision-making research were selected as correspondence experts using the purposive sampling method, and the Delphi expert correspondence method was used to construct a shared decision-making plan for early activities of ICU patients.Results:A total of 2 rounds of expert correspondence were conducted. The effective recovery rates of the questionnaires were 100%, the expert authority coefficients were 0.94 and the Kendall's harmony coefficients were 0.254 and 0.393, respectively ( P<0.01) . Finally, a shared decision-making plan for early activities of ICU patients with 3 stages (preparation stage, decision-making and execution stage and evaluation stage) , 12 basic steps and 65 specific contents was formed. Conclusions:The shared decision-making scheme for early activities of ICU patients constructed in this study is scientific and feasible, which can provide a reference for improving the activity compliance of ICU patients.

Objective:To investigate the clinical effect of cluster nursing on the prevention of perioperative urinary catheter associated urinary tract infection (CAUTI) in patients with spinal fracture.Methods:A retrospective case-control method was used to select 160 patients with spinal fracture admitted to the department of spinal cord injury in emergency care from January 2018 to March 2020 in the Department of Orthopaedics General Hospital of Chinese People′s Liberation Army as study subjects, 80 patients admitted to the department of spinal cord injury from January to December 2018 were set as the control group, and 80 patients admitted from January 2019 to March 2020 as the observation group. The control group was given standardized clinical nursing measures during the perioperative period, while the observation group was given cluster nursing measures. The duration of indwelling of catheters, the incidence of catheter reinsertion and the incidence of CAUTI were compared between the two groups.Results:The catheter indwelling time in the observation group was (3.37±0.64) days, lower than that in the control group (6.35±1.52) days. The incidence of catheter insertion and CAUTI was 5.00%(4/80), 3.80%(3/80) in the observation group, lower than 11.30%(9/80), 11.60%(13/80) in the control group. The differences were statistically significant ( χ2 values were -2.927, -2.654, all P<0.05). Conclusions:Cluster nursing intervention for patients with spinal fracture in the perioperative period can effectively shorten the catheter indwelling time, reduce the incidence of catheter re-insertion and the incidence of patients with CAUTI, significantly improve the quality of clinical care in the department, and have positive significance for the treatment and rehabilitation of patients.

Objective:To construct a training program based on competency evaluation of clinical nursing teachers.Methods:From August 2019 to July 2020, based on Competency Evaluation Scale, through literature review and expert group discussion, the competency training program for clinical nursing teachers was constructed through expert consultation.Results:The effective recovery rates of the three rounds of expert inquiry were all 100%, the expert authority coefficient was 0.935 and the Kendall coordination coefficients of expert opinions were respectively 0.21, 0.27 and 0.35. The final training program included basic ability training module and advanced ability training module, including 3 modules, 14 projects, 25 courses and 3 modules, 8 projects and 8 courses, respectively.Conclusions:The clinical nursing teacher training program based on the competency evaluation scale is comprehensive and specific in content and it has good practicality, which provides a reference for the training of clinical nursing teachers.

Objective:To explore the current status and training needs of clinical nursing teachers in Class Ⅲ Grade A hospitals in China, and provide a reference for further construction of clinical nursing teachers.Methods:From October 2017 to February 2019, by purposive sampling with a ratio of 1︰10, the clinical nursing teachers from 141 ClassⅢ Grade A hospitals in 30 provinces, autonomous regions and municipalities in China received a cross-sectional study with the Basic Information Questionnaire of Clinical Nursing Teachers in China's Class Ⅲ Grade A hospitals. A total of 11 594 questionnaires were collected, and 10 266 were valid questionnaires, with an effective rate of 88.55%.Results:Among the 10 266 clinical nursing teachers, 49.64% (5 096/10 266) were senior nurses; 51.27% (5 263/10 266) were between 30 and 39 years old; 78.42% (8 051/10 266) were those with a bachelor degree or below; 41.33% (4 243/10 266) had taught for less than 5 years; 41.84% (4 295/10 266) were selected and designated by managers; 38.78% (3 981/10 266) often or always felt the pressure of teaching; 56.31% (5 781/10 266) thought that they were competent for clinical teaching; 50.54% (5 188/10 266) occasionally participated in teaching training, and had a strong demand for training. The top three demands were teaching methods and skills, frontier knowledge of specialties, and nursing research. Clinical teachers with different teaching years, academic qualifications and professional titles are in basic theories of education, teaching methods and skills, nursing management, and nursing research. There was statistically significant difference in the training needs for the frontier knowledge of specialist subjects between clinical nursing teachers with different teaching years, educational background and job titles ( P<0.05) . Conclusions:The clinical nursing teachers in China's ClassⅢ Grade A hospitals are mainly senior nurses, and the overall initial academic qualifications are low. There are problems in the selection of clinical nursing teachers in teaching management, and the lack of teachers' participation in teaching training. It is recommended that the relevant departments establish a competency-oriented and demand-oriented selection and management system for clinical nursing teachers, thereby promoting the construction of the teaching staff.

Objective To study the constituents of urinary stones in patients in Zhejiang,and analyze the composition difference between patients from northern Zhejiang province and southern Zhejiang province.Methods From October 2012 to October 2018,clinical data of 4 423 urinary stone patients treated in Sir Run Run Shaw Hospital,the Second Affiliated Hospital of Wenzhou Medical University,and Huzhou First People's Hospital was retrospectively analyzed.Infrared spectrum was used to analyze urinary calculi constituents.Among 4 423 patients,there were 3 041 males and 1 382 females,male to female ratio was 2.2∶ 1,and the mean age was (51.2 ±16.5) years.There were 2 974 northern Zhejiang patients and 1 449 southern Zhejiang patients.High incidence age group was 41-60 years [48.2％ (2 136/4 423)].The distribution characteristics of urinary calculi constituents in different groups of sex,age,and region were analyzed.Results Among the 4 423 cases,the mixed urinary stones were dominant in the urinary calculus [73.1％ (3 235/4 423)],in which,the most component was the calcium oxalate monohydrate + calcium oxalate dehydrate + carbonated apatite [36.2％ (1 604/4 423)];among the pure stones,the most component was the calcium oxalate monohydrate [16.3 ％ (719/4 423)].Carbonated apatite stones [70.1％ (970/1 382) vs.61.0％ (1 856/3 041),P ＜0.05] and magnesium ammonium phosphate stones [12.7％ (176/1 382) vs.4.9％ (150/3 041),P ＜ 0.05] were both more prevalent in females than males,but uric acid stones[10.6％ (325/3 041) vs.5.8％ (81/1 382),P ＜0.05] were more common in males than females.The proportions of calcium oxalate stones[90.6％ (961/1 060) vs.76.2％ (935/1 227),P ＜0.05],carbonated apatite stones [77.6％ (823/1 060) vs.50.7％ (623/1 227),P ＜ 0.05],and magnesium ammonium phosphate stones[9.1％ (97/1 060) vs.6.5％ (80/1 227),P ＜0.05] of 0-40 years group were all higher than ＞ 60 years group,however,uric acid stones were more frequent in ＞ 60 years group [3.5％ (38/1 060) vs.17.0％ (209/1 227),P ＜ 0.05].The proportion of calcium oxalate stones in southern Zhejiang was lower than northern Zhejiang [79.0％ (1 145/1 449) vs.89.4％ (2 661/ 2 974),P ＜ 0.05].However,carbonated apatite stones [71.5％ (1 037/1 449) vs.60.1％ (1 789/2 974),P ＜ 0.05],magnesium ammonium phosphate stones [15.1％ (220/1 449) vs.3.5％ (106/ 2 974),P ＜ 0.05],and uric acid stones [10.7％ (156/1 449) vs.8.4％ (250/2 974),P ＜ 0.05] were more prevalent in southern Zhejiang than northern Zhejiang.Conclusions The distribution of constituents of urinary stones in Zhejiang was different in genders,age,and regions.Carbonated apatite stones and magnesium ammonium phosphate stones were more prevalent in females and young people,and uric acid stones were more common in males and old people.Calcium oxalate stones were more common in youths.Moreover,calcium oxalate stones were more frequent in northern Zhejiang,and carbonated apatite stones,magnesium ammonium phosphate stones and uric acid stones were common in southern Zhejiang.

With the improvement of people's living standard and the increasing demand of nursing care, the development of nursing specialty has a broad prospect. From the beginning of new China's nursing industry, the rapid development of nursing services after the reform and opening up to the major changes brought about by the "healthy China" strategy in the new era, the nursing service mode has been continuously innovated, the nursing specialty has been expanded rapidly, the nursing professional level has been improved significantly, and China's nursing industry has been developing vigorously. It is of great significance to review the 70 years' nursing development process since the founding of new China and summarize the development experience in planning of the development of nursing specialty in the future.