Objective:To construct a risk prediction model for urinary retention in patients undergoing radical cervical cancer surgery based on machine learning, and the prediction effect of the model was internally verified and evaluated, in order to provide reference for the early prevention and treatment of urinary retention in patients undergoing radical cervical cancer surgery.Methods:A total of 981 patients who underwent radical cervical cancer surgery in the First Affiliated Hospital of Anhui Medical University from June 2017 to February 2022 were selected and divided into the training set (687 cases) and the test set (294 cases) according to a ratio of 7∶3. Through literature review and risk factor analysis, the influencing factors of urinary retention after radical treatment of cervical cancer were explored, and the risk prediction model of urinary retention was constructed by using XGBoost, random forest, support vector machine and decision tree in machine learning. The accuracy rate, recall rate, F1 value and AUC of four machine learning algorithms were calculated by using the method of 10-fold cross-validation, and the model with the highest predictive efficiency was selected.Results:Among the 981 patients included, the incidence of urinary retention after radical cervical cancer surgery was 18.86% (185/981). The median age of urinary retention group was 51 years old, and that of non urinary retention group was 50 years old. Statistically significant variables in the univariate analysis and influencing factors summarized by literature review were featured, including patient age, intraoperative blood loss, body mass index (BMI), cancer stage, surgical method, surgical resection scope, whether pelvic lymph node dissection was performed, comorbidities and residual urine. Among the four model building methods of machine learning, the random forest model has the best effect, its training set F1 value was 0.94, the test set F1 value was 0.77, the ROC was plotted and the AUC was calculated to be 0.73. Age, intraoperative blood loss, BMI, cancer stage and surgical method contributed significantly to the classification of random forest model.Conclusions:The prediction model of urinary retention risk after radical cervical cancer surgery based on random forest method has the best efficacy. It is useful to help nursing personnel evaluate the risk of the uroschesis for a patient and then take targeted nursing interventions to actively prevent postoperative urinary retention.

ObjectiveTo identify the pharmacodynamic material basis of Ruyi Zhenbaowan in relieving neuropathic pain by integrating the calculation of biological network proximity and pharmacokinetic characterization. MethodThe interaction network of "drug candidate target-related gene of disease" was constructed by Cytoscape 3.8.2， and the average shortest path value of each drug putative target acting on neuropathic pain-related genes in this network was calculated by Pesca 3.8.0 tool so as to evaluate the network proximity between them， and screen prescription candidate targets with strong intervention efficiency and their corresponding potential effect components. After that， plasma and cerebrospinal fluid samples were collected from rats after administration of Ruyi Zhenbaowan at set time points， and the contents of potential effect components in samples was quantified by ultra performance liquid chromatography-quadrupole-ion trap mass spectrometry（UPLC-Q-TRAP/MS）， and drug concentration-time curves were plotted， then the pharmacokinetic parameters were calculated by DAS 2.1.1. ResultBy evaluating the network proximity between candidate targets and neuropathic pain-related genes in the interaction network， a total of 40 putative targets of Ruyi Zhenbaowan with strong intervention effects on neuropathic pain-related genes， such as estrogen receptor 1（ESR1）， cyclic adenosine monophosphate（cAMP）-dependent protein kinase catalytic subunit alpha（PRKACA） and protein kinase B1 （Akt1）， and 10 corresponding potential effect components， such as glycyrrhizic acid and betulinic acid， were obtained. Pharmacokinetic characterization showed that among the 10 potential effect components， gallic acid， apigenin-7-O-glucuronide， glycyrrhizic acid and apigenin were well absorbed and metabolized in plasma and cerebrospinal fluid， with long onset time and good bioavailability. ConclusionFrom the perspective of efficacy-target-constituent-pharmacokinetic， this study analyzes the main effective materials of Ruyi Zhenbaowan， such as glycyrrhizic acid， gallic acid， apigenin-7-O-glucuronide and apigenin， which have a high exposure in plasma or cerebrospinal fluid and have a strong intervention effect on neuropathic pain. The related results provide reliable experimental evidences for clarifying the material basis and developing quality standards of Ruyi Zhenbaowan.

This paper reviewed the concept of organizational silence, elaborated on the content, evaluation methods, reliability, validity, characteristics, and other aspects of nurse organizational silence assessment tools, and compares the basic characteristics, content, and application of each tool. The aim was to provide reference for selection of appropriate assessment tools to identify nurse organizational silence, as well as for the development of comprehensive assessment tools and the early formulation of management strategies.

Objective To analyze the hot spots,rules and distribution on safety research of inhalation preparations at home and abroad in the past 20 years,and to summarize the current status of safety and risk control research on inhalation preparations.Methods This reaserch is based on the literature related to the safety and risk control of inhalation preparations in the core collection database of the Web of Science.With the help of Excel 2021 and CiteSpace6.1.R3,visualized processing and analysis were carried out on the annual number of publications,countries,institutions,authors,co-occurrence of keywords,clustering and prominence.Results A total of 365 articles were included,the annual publication number in the field of the safety and risk control of inhalation preparations was less than 30 per year from 2002 to 2018.But since 2019,the number of articles published this year has exceeded 30.Through the analysis of the cooperation network of countries and institutions,the top four countries in terms of publication volume are the United States,the United Kingdom,Germany,and China,and the top three institutions are AstraZeneca,GlaxoSmithKline and Pfizer.Through the analysis of the author cooperation network,the cooperation network between European and American authors was formed earlier,and a certain research group has appeared in 2002.In contrast,a more concentrated cooperation network has been formed in China in 2020.Conclusions In the past 20 years,the research on inhalation preparations has mainly focused on their safety and efficacy,while there are few studies on their risk control.There is a disconnect between safety assessment and risk assessment,and the future focus maybe focused on the adverse reaction assessment and risk management research of inhalation preparations.

Objective To explore the effect of a phased rehabilitation training programme to relieve shoulder dys-function in patients after neck dissection and to provide effective solutions for postoperative shoulder joint function recov-ery of patients.Methods This study has been reviewed and approved by the Ethics Committee,and informed consent has been obtained from patients.A phased rehabilitaiton training programme for the shoulder after neck dessection was developed through literature review and discussion,and 70 eligible patients from Hospital of Stomatology,Sun Yat-sen University from December 2020 to April 2021 were selected and randomly divided into the test group and control group(35 patients in each group).The control group underwent motor rehabilitation training from 6 weeks postoperative to 1 year after surgery,such as shoulder mobility and coordination training and small range of motion training of the neck,while the test group took part in a rehabilitation training program that included familiarization maneuver training,protective rehabilitation,exercise rehabilitation,and resistance training in the following four stages:preoperative,postop-erative general anesthesia and awake until the removal of stitches,the removal of stitches until 6 weeks after surgery,and 6 weeks after surgery until 1 year after surgery.The frequency of training in both groups was at least 3 days per week,and the length of each training session was 10-15 min.The intensity of exercise was 2-3 points on the Borg Conscious Ex-ercise Intensity Scale(i.e.,mild-to-moderate tachypnea or fatigue).The neck dissection injury index(NDII)was used to evaluate the quality of life related to shoulder joint function at four time points:preoperative,postoperative 3 months,postoperative 6 months,and postoperative 12 months.The higher the score,the better the quality of life.Results 28 cases in the test group and 32 cases in the control group completed a one-year follow-up.At 3 and 6 months postopera-tive,the NDII of the test group was significantly higher than that of the control group[3 months postoperative:test group(93.48±9.36)vs.control group(80.00±11.34)(P＜0.001),6 months postoperative:test group(98.21±4.76)vs.control group(90.70±9.12)(P＜0.001)];12 months after surgery,the NDII of the test group(97.23±4.88)was still higher than that of the control group(96.33±4.49),but the difference was not statistically significant(P=0.458).The difference in NDII scores among subjects at 3,6,and 12 months after surgery was statistically significant in each group(P＜0.001).Conclusion The application of the phased rehabilitation training method in neck dissection patients has a feasibility and could improve the quality of life of patients'shoulder joint function within 6 months after surgery.

BackgroundMental illness during pregnancy has become a major public health problem in China over the recent years， and depression is the most common psychological symptom during pregnancy. Current research efforts are directed towards the therapy on prenatal depression， whereas the construction of prediction model for prenatal depression risk has been little studied. ObjectiveTo construct a simple model for predicting the risk of prenatal depression， thus providing a valuable reference for the prevention of maternal depression during pregnancy. MethodsA total of 803 pregnant women attending three hospitals in Nanchong city were consecutively recruited from May 2021 to February 2022. A self-administered questionnaire was developed for the assessment of social demographic variables， obstetrical and general medical indexes and psychological status of all participants， and Self-rating Depression Scale （SDS） was utilized to screen for the presence of maternal depression. Subjects were randomly assigned into modelling group （n=635） and validation group （n=168） at the ratio of 8∶2 under simple random sampling with replacement. The candidate risk factors of maternal depression during pregnancy were screened using binary Logistic regression analysis， and the predictive model was constructed. Then the performance of the predictive model was validated using receiver operating characteristics （ROC） curve. Results① Lack of companionship （β=-0.692， OR=0.501， 95% CI： 0.289~0.868）， low mood during the last menstrual period （β=-1.510， OR=0.221， 95% CI： 0.074~0.656）， emotional stress during the last menstrual period （β=-1.082， OR=0.339， 95% CI： 0.135~0.853）， unsatisfactory relationship between mother-in-law and daughter-in-law （β=-1.228， OR=0.293， 95% CI： 0.141~0.609）， and indifferent generally relationship between mother-in-law and daughter-in-law （β=-0.831， OR=0.436， 95% CI： 0.260~0.730） were risk factors for prenatal depression in pregnant women （P<0.05 or 0.01）. ② Model for predicting the prenatal depression risk yielded an area under curve （AUC） of 0.698 （95% CI： 0.646~0.749）， the maximum Youden index was 0.357 in modelling group with the sensitivity and specificity was 0.606 and 0.751， and an AUC of 0.672 （95% CI： 0.576~0.767） and maximum Youden index of 0.263 in validation group with the sensitivity and specificity of 0.556 and 0.707. ConclusionThe simple model constructed in this study has good discriminant validity in predicting of the risk of prenatal depression. ［Funded by Nanchong Social Science Research Project of the 14th Five-Year Plan （number， NC21B165）］

Objective:To integrate the qualitative researches on nursing students' learning experience in high-fidelity simulation teaching, so as to provide a basis for the improvement of high-fidelity simulation teaching.Methods:The qualitative researches on nursing students' learning experience in high-fidelity simulation teaching was searched by computer in Embase, Web of Science, CINAHL, PubMed, Cochrane Library, Scopus, Wanfang Database, China Biology Medicine disc, CNKI and VIP. The search deadline was from establishment of the database to September 30, 2022. The quality of the literature was evaluated using the 2017 JBI Critical Appraisal Checklist for Qualitative Research, and the results were integrated by a pooled integration method.Results:A total of 13 articles were included, 29 research results were extracted, which were summarized into 6 categories, and 3 results were obtained by integration (positive and negative experience brought by high-fidelity simulation teaching, improvement of students' ability by high-fidelity simulation teaching and influencing factors for the effectiveness of high-fidelity simulation teaching) .Conclusions:Nursing students hold a relatively positive attitude towards high-fidelity simulation teaching, believing that it can closely combine theoretical knowledge with practice and strengthen their professional abilities. Future research needs to strengthen student-centered approaches and build a highly simulated and sustainable simulation environment to improve the effectiveness of high-fidelity simulation teaching for nursing students.

Objective:To explore the effects of stepwise acute pain management on acute pain and post-traumatic stress disorder (PTSD) in children with burns.Methods:From November 2018 to December 2019, 196 children with burns who were admitted to West China Hospital of Sichuan University and met the inclusion criteria were enrolled in the prospective randomized controlled study. The children were divided into traditional pain management group (97 children, 51 males and 46 females, aged 1 to 6 years) and stepwise pain management group (96 children, 55 males and 41 females, aged 1 to 6 years) according to the random number table. Children in traditional pain management group were treated with traditional acute pain care, while the children in stepwise pain management group were treated with stepped acute pain management (moderate pain was treated with oral administration of acetaminophen sustained-release dry suspension at the dose of 10 to 15 mg/kg once every 4 to 6 hours, and severe pain was treated with morphine intravenous injection at the dose of 0.1 to 0.2 mg/kg once every 4 hours) on the basis of traditional acute pain care after admission. The COMFORT behavior scale was applied to compare the resting pain levels of children in the two groups within post injury day (PID) 3 (1, 9, and 17 o'clock each day). The adverse reactions of children in the stepwise pain management group during the treatment period were recorded. The occurrence of PTSD within one month after injury was evaluated in both groups by the revised PTSD scale. Data were statistically analyzed with independent sample t test, Bonferroni correction, analysis of variance for repeated measurement, chi-square test, Wilcoxon rank sum test, and Fisher's exact probability test. Results:The pain scores of children in stepwise pain management group were significantly lower than traditional pain management group at 1, 9, and 17 o'clock on PID 1, 1, 9, and 17 o'clock on PID 2, and 1, 9, and 17 o'clock on PID 3 ( t=2.71, 3.44, 4.05, 4.18, 4.08, 4.19, 4.25, 3.69, 3.71, P<0.05 or P<0.01). The pain scores of children in both groups showed a decreasing trend over time. Of the 96 children in stepwise pain management group, 84 children were treated with oral administration of acetaminophen sustained-release dry suspension, and 12 children were treated with morphine intravenous injection. No adverse reaction occurred during the treatment period. The incidence of PTSD of children in stepwise pain management group within 1 month after injury was 3.12% (3/96), which was significantly lower than 14.43% (14/97) in traditional pain management group, P<0.05. Conclusions:The stepped acute pain management can relieve the acute pain and reduce the incidence of PTSD in children with burns.

Objective:To investigate the status of innovative behavioral ability of undergraduate nursing students, analyze the relationship between nursing students′ sense of benefit, self-transcendence and innovative behavioral ability, and explore the mediating effect of occupational benefit in self-transcendence and innovative behavioral ability.Methods:A convenient sampling method was used to select 223 undergraduate nursing students in the First Affiliated Hospital of Guangxi University of Chinese Medicine as the research object from October 2017 to April 2019. The cross-sectional survey was conducted using the occupational benefit, self-transcendment scale and nurses′ innovative behavior scale. Apply SPSS21.0 to analyze the correlation between self-transcendence, occupational benefit and innovative behavior of undergraduate nursing students, apply AMOS 22.0 for mediating effect test, and use the bias-corrected percentile Bootstrap method to estimate the median effect of occupational benefit 95% confidence interval.Results:The path coefficient of undergraduate nursing students′ self-transcendence to innovative behavioral ability was significant ( r value was 0.31, P<0.01). Self-transcendence had a significant positive effect on positive occupational sense ( r value was 0.36, P<0.05). The 95% confidence interval for the Bootstrap test of the indirect effect of positive occupationality was 0.02-0.07; the positive sense of occupation had a partial mediating effect between self-transcendence and innovative behavioral ability, with an effect value of 0.14 and a total effect value of 0.42. That was, the mediation effect value accounted for 33.3% of the total effect value. The path coefficient of the team's ability to feel innovative behavior was significant ( r value was 0.39, P<0.05), and self-transcendence had a positive impact on team belonging ( r value was 0.28, P<0.01). The 95% confidence interval for the Bootstrap test for the indirect effects of team belonging was distributed in 0.10-0.42. The sense of belonging of the team had a partial mediating effect between self-transcendence and innovative behavioral ability. The mediating effect value was 0.07, and the total effect value was 0.42, that was, the mediating effect value accounts for 16.7% of the total effect value. Conclusions:Self-transcendence of undergraduate nursing students can directly predict the ability of innovative behavior, and can also indirectly predict the ability of innovative behavior through the mediating role of positive career perception and team belonging in the sense of professional benefit. Improving the professional benefit and self-transcendence of nursing students in clinical teaching may be an effective way to improve the ability of innovative behavior.

Objective:To observe the effect of personalized nutritional support on postoperative rehabilitation and nutritional status in patients undergoing radical mastectomy and reconstruction of oral malignant tumor.Methods:Eighty-eight patients with oral malignant tumor admitted from January 2018 to December 2018 in Hospital of Stomatology, Sun Yat-sen University were divided into two groups according to the time of admission. 40 patients were selected as the study group and 48 patients were selected as the routine group. The routine group was given traditional health education and dietary guidance. In addition to dietary guidance, the study group was given personalized nutritional support according to the patients' body mass index and nutritional status before and after operation, including oral nutritional supplement before operation, personalized nutritional prescription after operation, and increased protein intake according to the nutritional indicators of the patients. The nutritional status, enteral nutrition complications and postoperative rehabilitation were compared between the two groups two weeks after operation.Results:Two weeks after operation, the hemoglobin, total protein, prealbumin were (107.93±16.19) g/L, (68.40±4.87) g/L, (189.02±55.19) mg/L in the study group, and (101.23±14.62) g/L, (63.11±6.42) g/L, (165.75±40.60) mg/L in the routine group, there were significant differences ( t values were -2.037, -4.271, -2.276, all P<0.05). The incidence of malnutrition, wound infection and gastrointestinal complications were 42.50%(17/40), 0, 5.00%(2/40) in the study group and 64.58%(31/48), 16.67%(8/48), 20.83%(10/48) in the control group, there were significant differences( χ2 values were 4.292, 7.333, 4.644, P<0.05). Conclusions:Perioperative personalized nutritional support can effectively improve the nutritional status, reduce enteral nutrition-related complications, improve immunity and reduce the risk of incision infection in patients undergoing radical mastectomy and simultaneous reconstruction of oral malignant tumors, which is helpful to improve the quality of life of patients and is worthy of clinical reference.