AIM:To examine the level of technophobia and identify its associated sociodemographic, occupational, and psychosocial factors among registered nurses in China. BACKGROUND:The rapid digital transformation of healthcare systems demands that nurses effectively adopt and use digital technologies. Technophobia-defined as negative emotional reactions toward technology-may impede nurses' adaptation to technological innovations. However, no study is currently available on technophobia and its associated factors in registered nurses. DESIGN:A multicenter, cross-sectional study. METHODS:A total of 1559 registered nurses from two university-affiliated tertiary hospitals in Northeast China were surveyed between September and October 2025. Data were collected using a self-administered questionnaire including sociodemographic factors, occupational factors, the validated Chinese version of the Technophobia Scale, the Multidimensional Scale of Perceived Social Support, and the Athens Insomnia Scale. A generalized linear model was fitted to identify independent predictors of technophobia. RESULTS:The nurses' median technophobia score was 26.00 (P25-P75: 13.00-39.00), indicating a low-to-moderate level overall. The generalized linear model revealed that male gender (β = 0.201), having one child (β = 0.130), living alone (β = 0.091), having a higher perceived workload (β = 0.048), and poorer sleep quality (β = 0.015) were independently associated with greater technophobia. Conversely, higher job satisfaction (β = -0.081) and stronger social support (β = -0.003) were independently associated with lower technophobia; however, the effect size for social support was relatively small, all p < 0.05. CONCLUSIONS:Technophobia among registered nurses in China is at a moderately low level. Interventions targeting modifiable factors-such as workload management, sleep health, job satisfaction, and social support-through structured digital literacy training, peer support mechanisms, and other supportive workplace strategies may help mitigate technophobia and enhance nurses' readiness for digital transformation. PATIENT OR PUBLIC CONTRIBUTION:Nurses voluntarily participated in the survey. The findings may indirectly benefit patients through improved nurse engagement with digital health systems and safer, more efficient care delivery.

Background:Bladder cancer ranks seventh in global cancer prevalence. Radical cystectomy and urinary diversion are standard for muscle-invasive bladder cancer. Family caregivers shoulder a substantial care burden, affecting their own quality of life, with repercussions extending to patients' health-related quality of life (HRQOL). Objective:This narrative review aims to highlight the major concerns perceived by the caregivers and efficacy of nurse-led interventions in alleviating their concerns and improving HRQOL. Methods:A systematic search of the PubMed, CINAHL, and Science Direct databases was carried out to identify studies published in the last 5 years (from Jan 2018 to Aug 2023) that have evaluated the concerns and problems of caregivers attending bladder cancer patients with urinary diversion. Additionally, studies evaluating the efficacy of nurse-led interventions in alleviating these concerns were also searched. Results:Overall, 6 studies involving 933 BC patients with UD and 1042 caregivers were identified as suitable for inclusion in this narrative literature review. Major concerns identified included psychological well-being, medical assistance needs, and peer support. Significant psychological impact was evident in the caregivers which operated in a dyadic manner. Nurse-led stoma education programs have demonstrated potential in enhancing caregivers' quality of life, although they remain restricted. Conclusion:Emphasizing caregivers' role and program effectiveness is critical. Our review addresses these gaps, focusing on caregivers' concerns and the impact of nursing education for improved patient outcomes. Implications for Practice:Holistic and collaborative approach could enhance the overall well-being and quality of life of bladder cancer patients and their caregivers.

Background:Bladder cancer is the most predominant cancer of the lower urinary tract and is the most common cause for urostomy or urinary diversion. Urostomy immensely affect the patient's everyday life from minor physical activity to social relations. Nurse-led interventions have been evaluated for improvement in quality of life in patients with urostomy.Objective:The main objective of this study was to review the medical literature in a systematic way to evaluate the nursing role in improving the health-related quality of life of patients undergoing urostomy.Methods:A systematic search of the PubMed, CINAHL, Embase, and Science Direct databases was carried out to identify studies that have evaluated the effect of nurse-led intervention on the self-efficacy and health-related quality of life in patients with urostomy. In addition, studies for factor affecting the quality of life were also investigated.Results:Overall, 10 studies were identified as suitable for inclusion in this review. Health-related quality of life was lower in these patients as compared to population norms and several factors such as age, employment, and living status were identified as the contributing factors. Preoperative education was critical in meeting the psychological needs while postoperative intervention was instrumental in improving the self-efficacy and health-related quality of life particularly when a continued nursing-patient interaction was existent.Conclusion:A comprehensive nurse-led intervention consisting of preoperative and postoperative components aimed at ostomy-related education, psychological counseling and compliant with patient factors is feasible and may result in greater improvement in self-efficacy and health-related quality of life in patients with urostomy. Larger clinical trials are warranted to validate these results.

Background. Hepatocellular carcinoma (HCC) is one of the most common and lethal cancers worldwide. Therefore, it is necessary to develop and validate a novel prognostic model for HCC patients. Objectives. To establish an innovative and valuable prediction model of long non-coding RNAs (lncRNAs) for HCC. Materials and methods. Transcriptome and clinical data from The Cancer Genome Atlas (TCGA) were analyzed globally using bioinformatic approaches. We used Cox and least absolute shrinkage and selection operator (LASSO) regression analyses to screen for prognostic lncRNAs, while receiver operating characteristic (ROC) and Kaplan-Meier curve analyses were used to evaluate the effectiveness of the models. Clinical data from our center were used as a validation set. Results. In the training set, a prediction model was established based on the expression of AP000844.2, LINC00942, SRGAP3-AS2, and AC010280.2 Hepatocellular carcinoma patients were divided into 2 groups (high-risk group and low-risk group) according to their risk score, and differences in survival were compared between the groups. The clinical data from our center served as a validation set to re-evaluate the effectiveness of the predictive model. The model had an excellent performance. The area under the curve (AUC) of 3-year survival was 0.771, while for 5-year survival it was 0.741, and the concordance index (C-index) was 0.756 (standard error (SE) = 0.023, 95% confidence interval (95% CI) = 0.620-0.891). Conclusions. The 4-lncRNA combination model is critically important in evaluating the prognosis of HCC. It is an effective independent prognostic factor, although prospective, multi-center studies are needed to validate our findings.

临床护理人员职业素养培训,不仅需要知识传播与技能培训,也要加入思想价值的引领.然而在我国临床护士职业素养培训中,并没有完全将思政元素融入其中,存在思政教育与职业素养培训相分离、对思政教育重视程度不足、师资思政教育内驱力不强等多方面问题,因此要在临床护理人员职业素养培训中融入思政元素,进而提升临床护士政治素养.本文简要分析了思政元素融入临床护理人员职业素养培训重要性、现状及目标,并通过创新思政教育与职业素养教育融合培训体系,进行一系列的实践措施,取得了良好的培训效果,切实加强和改进临床护理人员政治思想工作,提高护士礼仪素养与沟通服务技能,又实现了教育目标,为全面推进健康中国建设及新时代我国卫生与健康事业发展,实现"两个一百年"奋斗目标、中华民族伟大复兴的中国梦奠定坚实教育基础.

AIM To explore the sleep quality among Chinese nurses and identify the association between night shift and sleep quality and health. BACKGROUND Chinese nurses have many night shifts , the effect of it regarding nurses' sleep quality and health is still not being explored. METHODS This was a cross-sectional. There were 3206 nurse participants. The participants self-completed a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Cornell Medical Index (CMI). RESULTS Night shift nurses demonstrated relatively worse sleep quality (55.1%) and more health problems (20.7%). Night shift work was significantly associated with poor sleep quality (ß = 0.96, Confidence interval [CI] = 0.67-1.26) and poor health (ß = 2.01, CI = 0.15-3.88). Except for sleep medication (ß = 0.02, CI = -0.01,0.05) and psychological health (ß = 0.38, CI = -0.27,1.03), night shift work was significantly associated with other PSQI domains and physical health. CONCLUSION Night shift work was a risk factor for nurses' sleep quality and health. Night shift nurses have more sleep disorders and physical health problems. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers should pay attention to the impact of shift work on nurses' sleep quality and health and reform the rotating shift work system to improve nurses' occupational health.

Percutaneous coronary intervention (PCI) has increasingly been used in management of coronary artery diseases (CAD). Coupled that with an increasing incidence rate of CAD has augmented the hospital burden with consequential post-PCI patient management problems and dissatisfaction. Nursing care has a key role to play in upgrading the healthcare services and raising patients' satisfaction through enhanced patient education and engagement. In this regard, nursing-led intervention has shown some success in three main domains: risk reduction; psychological improvement; and quality of life. Urgent efforts are needed to formulize a structured follow-up with enhanced nursing role in post-PCI management to raise quality of healthcare.

Objective:To evaluate the feasibility and safety of optimized laparoscopic choledocholithotomy T-tube drainage (LCHTD) in the treatment of common bile duct stones.Methods:Retrospective analysis of clinical data from February 2018 to April 2020 for 54 patients with choledocholithiasis and gallstones who underwent optimized laparoscopic choledocholithotomy T-tube drainage.Result:Optimized laparoscopic choledocholithotomy T-tube drainage was completed successfully for 54 patients. The operative time was (152.4±51.2) min, the postoperative time of extraction of subhepatic drainage tube (4.3±1.4) d, the postoperative hospitalization time was (5.8±2.0) d. One patient had bile leakage after operation, with an incidence rate of 1.9%, One patient had residual stones after T-tube angiography 6-8 weeks postoperatively, with an incidence of 1.9%. Postoperative follow-up of 51 patients showed no calculus regeneration or bile stricture occurred.Conclusions:Optimized laparoscopic choledocholithotomy T-tube drainage is safe and effective for the treatment of choledocholithiasis. Optimized surgical procedures and novel common bile duct suture methods can ensure efficient and high-quality completion of the operation and reduce postoperative complications.

Objective:To investigate the clinical effects of Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG) in the treatment of recurrent obesity hyperlipidemia acute pancreatitis (HLAP).Methods:A retrospective study was conducted in 89 patients with recurrent obesity HLAP who underwent surgical treatment from October 2015 to October 2019. According to different surgical procedures, the patients were divided into LRYGB group (49 cases) and LSG group (40 cases), while patients underwent Laparoscopic Roux-en-Y gastric bypass surgery in the LRYGB group and patients underwent laparoscopic sleeve gastrectomy in the LSG group. Data analysis were performed by using SPSS 25.0 software. Measurement data, such as surgery-related indicators, weight loss effects, lipid-lowering effects, and glucose-lowering effects, were expressed as. The independent sample t-test was used for comparison between two groups. A P value of <0.05 was considered as statistically significant difference.Results:Compared with the LRYGB group, there were lower level in terms of intraoperative blood loss, operation time, time to get out of bed, anal exhaust time, and hospital stay in the LSG group respectively (P<0.05). There was no significant difference between two groups at 3 months after operation in terms of the percentage of extra body weight loss (EWL), body weight, body mass index (BMI), total cholesterol (TC), and triglycerides (TG) (P>0.05). Compared with the LSG group, there were lower level of the fasting blood glucose (FPG), fasting insulin (FINS), and oral glucose tolerance test (OGTT) at 3 months after operation in the LRYGB group respectively, with significant differences (P<0.05).Conclusion:Both LRYGB and LSG could achieve similar clinical effects in weight loss and lipid lowering in the treatment of repeated obesity-type acute hyperlipidemia pancreatitis, however LSG has simpler operation and quicker postoperative recovery, and LRYGB has Certain advantages in hypoglycemic aspects.

"以患者为中心"是优质护理服务的核心,面对患者多元化的健康教育需求,在临床护理教育咨询方面仍存在供需差距.中国医科大学附属盛京医院护理部自2009年首创"四师"培训项目,围绕患者从入院到出院全程所需的护理指导类型进行专科健康教育护士培养,"四师"包括心理护理指导师、饮食护理指导师、用药护理指导师和康复护理指导师.经过十余年的探索,不仅在管理培养使用方面形成了完整的体系,更在促进优质护理常态化、提升护理团队整体教育能力、构建"普通护士—四师护士—专科护士"人才梯队和护士分层次使用中表现出突出优势.

Objective:To investigate the status of caring burden, psychological resilience and psychological distress among spouses of dyskinesia stroke survivors and to explore the path relationship among three aspects.Methods:A total of 200 spouses of dyskinesia patients for 4 hospitals were investigated with Zarit Caregiver Burden Interview, Connor-Davidson Resilience Scale and Distress Thermometer from Jan 2017 to Dec 2017.Results:The overall caring burden was middle level, and 26.2%(49/187) was high, the score of Connor-Davidson Resilience Scale was 57.31±12.37, 70.6%(132/187) of all spouses with psychological distress. There was a significant difference in three aspects with different education level ( P<0.01). Whether there was a minor only child has an influence on the psychological resilience of the spouses( P<0.05). The score of Zarit Caregiver Burden Interview and Connor-Davidson Resilience Scale was negatively correlated( r value was -0.832, P<0.01). The score of Connor-Davidson Resilience Scale and Distress Thermometer was was positively correlated( r value was 0.867, P<0.01). The score of Zarit Caregiver Burden Interview and Distress Thermometer was negatively correlated( r value was -0.975, P<0.01). Furthermore,psychological resilience effected as a mediator in caring burden and psychological distress. Conclusions:The detection rate of care burden and psychological distress in the stroke patients with limb movement disorder are high, and the psychological resilience plays a mediating factor between them. The nursing staff should raise the awareness of the patient′s psychological nursing care while paying attention to the patients themselves. It can improve the physical and mental health and care ability of the spouse, improve the quality of life of the family.

目的 分析急性心肌梗死患者住院期间死亡的危险因素,为降低其死亡率提供依据.方法 收集某院2012年1月1日-2019年10月31日14354例急性心肌梗死出院患者病案资料,以出院时是否死亡做为因变量,以性别、年龄、住院天数、就诊时间、医疗保险、吸烟史、陈旧性心肌梗死病史、病变血管数量、有无PCI治疗和各种合并症为影响因素,进行二分类logistic回归分析.结果 年龄(OR:1.066,95％CI:1.055～1.077)、就诊时间(OR:1.155,95％CI:1.054～1.266)、糖尿病及其并发症(OR:1.712,95％CI:1.219～2.476)、液体-电解质紊乱(OR:1.240,95％CI:1.005～1.873)、心脏停搏(OR:6.184,95％CI:2.930～13.052)、心律失常(OR:2.354,95％CI:1.470～3.115)、脑梗死(OR:3.836,95％CI:2.165～4.936)、多根血管病变(OR:4.369,95％CI:3.105～6.149)和PCI治疗(OR:0.213,95％CI:0.118～0.384)对急性心肌梗死患者院内死亡的影响具有统计学意义(P<0.05).结论 对于年龄较大的老年AMI患者,入院后应早期或择期行PCI治疗,密切监护合并糖尿病并发症或循环系统疾病的患者,以降低急性心肌梗死住院患者的院内死亡率.

Background and aims: The relationships between dietary protein intake and risk of all-cause, cardiovascular disease (CVD), and cancer mortality are still unclear. We conducted a systematic review with meta-analysis of cohort studies to summarize the evidence. Methods and results: We searched PubMed and Web of Science for relevant studies through February 2020. The associations of total, animal, and plant proteins with all-cause, CVD, and cancer mortality were evaluated. Study-specific relative risks (RR) were pooled using the fixed effect model when no significant heterogeneity was detected; otherwise the random effect model was employed. Twelve cohort studies were eligible for the study. Increased total protein showed no clear association with risk of all-cause, CVD, and cancer mortality. In the stratified analysis by protein sources, higher plant protein intake was associated with a reduced risk of all-cause mortality (highest vs lowest intake: RR = 0.92; 95% CI: 0.88, 0.96; each 3% increment of intake: RR = 0.97; 95% CI: 0.94, 0.99), and may be associated with a reduced risk of CVD mortality (highest vs lowest intake: RR = 0.90; 95% CI: 0.80, 1.01; each 3% increment of intake: RR = 0.95; 95% CI: 0.91, 0.99). Moreover, higher intake of animal protein may be associated with an increased risk of CVD mortality (highest vs lowest intake: RR = 1.11; 95% CI: 1.01, 1.22; each 3% increment of intake: RR = 1.02; 95% CI: 0.98, 1.06). Conclusion: This study demonstrates that higher plant protein intake is associated with a reduced risk of all-cause and CVD-related mortality. Persons should be encouraged to increase their plant protein intake to potentially decrease their risk of death. (C) 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

BACKGROUND Obesity is an important factor to cause the obstructive sleep apnea-hypopnea syndrome (OSAHS). Higher body mass index (BMI) often results in more severe OSAHS. Currently, the common measures for controlling the weight mainly include diet control, increase exercise and so on. Motivational interviewing (MI) could explore the patient's internal state and make the patient realize his/her ambivalence, resulting in the change in his/her behavior. This process emphasizes respecting the patient's autonomy. AIM To evaluate the effect of MI on the weight control of patients with OSAHS. METHODS A randomized controlled study was conducted in 100 obese OSAHS patients undergoing surgical treatment at Shengjing Hospital of China Medical University. The patients were divided into an intervention group and a control group, with 50 cases each. The control group was given routine health education after the operation; in addition to the regular health education, the intervention group was given MI according to a predetermined plan. Obesity-related indicators, postoperative complications, and the sleep status of both groups were evaluated before and 6 mo after the intervention. RESULTS Patients in the intervention group had significantly improved body weight, BMI, and waist and neck circumferences compared with patients in the control group (P < 0.05). Regarding complications at 6 mo after operation, the incidence of cough and reflux in patients in the intervention group was significantly lower than that in the control group (P < 0.05). In addition, the Epworth Sleepiness Scale and Self-Rating Scale of Sleep scores of patients in the intervention group were significantly lower than those in the control group, and the sleep status of patients in the intervention group was improved (P < 0.05). CONCLUSION MI intervention has a significant advantage over postoperative routine health education. It can greatly change the lifestyle, further control the postoperative weight, reduce the occurrence of complications, improve the quality of sleep, and improve long-term postoperative efficacy in OSAHS patients.

目的 探索以Mini-CEX为培训模式在新入职护士规范化培训过程中的实践与效果,以期为新入职护士规范化培训方案的修订及全面推广提供借鉴.方法 随机抽取中国医科大学附属盛京医院2017年86名新入职护士分为观察组43人、对照组43人,医院护理部根据《新入职护士培训大纲(试行)》,制定《我院新入职护士规范化培训总则》,对两组人员统一安排为期两年的规范化培训,观察组在此基础上进行Mini-CEX培训.为期24个月的规范化培训结束后分别对两组护士进行核心能力评估.结果 在24个月末考核中观察组Mini-CEX成绩(53.78±2.63)分高于对照组成绩(46.85±6.71)分,差异有统计学意义(P＜0.05).观察组Mini-CEX分数与参加培训时长呈正相关(r=0.925,r2=0.857,P＜0.001).结论 以Mini-CEX培训新入职护士的规范化培训模式能够有效提高新入职护士核心能力,建议进一步进行研究和应用推广.

BACKGROUND:Abnormal microRNAs (miRNAs) expression is closely related to the development and poor prognosis of pancreatic ductal adenocarcinoma (PDAC). We aimed to elucidate the invasive mechanism and clinical significance of miR-10b in PDAC. METHODS:The RNA sequence data of pancreatic cancer were extracted from the TCGA database. R packages were performed to analyze the differential expression of RNAs. TargetScan, picTar, and miRanda were used to predict the target gene of miRNA. The expression level of the selected candidate was tested by western blot and RT-PCR in PDAC cells and tissues. Scrape and Transwell assays were determined the effect of candidate molecules on cell migration and invasion. The gain of function and loss of function was achieved by co-culture with mimics and vector. Luciferase reporters were generated based on the psiCHECK2 vector. The relative luciferase activity was measured with the Dual-Luciferase Reporter Assay System and Infinate M200 PRO microplate reader. RESULTS:Based on the TCGA data and bioinformatics analysis, we obtained seven differentially expressed miRNAs. Both TCGA data and our center clinical date indicated that miR-10b was contributed to the poor survival of PDAC. Based on the target gene prediction database, we found that E2F7 was a target mRNA of miR-10b. In subsequent experiments in molecular biology, miR-10b expression was downregulated in PDAC cells and tissues, while E2F7 was upregulated. Scrape and Transwell assay indicated that miR-10b could inhibit the invasion and migration of PDAC. MiR-10b was confirmed to be by the E2F7 targeting site by dual-luciferase report. Moreover, rescue experiments prove that miR-10b could inhibit the invasion and migration of PDAC cells by regulating E2F7 expression. CONCLUSION:Our results suggest that miR-10b could inhibit the progression of PDAC by regulating E2F7 expression and acts as an independent prognostic risk factor for PDAC.

Objective To develop a nomogram predicting the risk of pancreatic fistula (PF) in individual cases and to facilitate clinical frontline staff to predict risk of PF. Methods This study was based on the statistical analysis of the patients who were diagnosed as pancreatic diseases and underwent pancreatic resection in our hospital between 2000 and 2018.Patients were divided into two groups including PF group or non-PF (NPF) group. Risk factors of PF were determined by Logistic regression analysis. A PF risk nomogram was built by R soft.Results Age, gender, malignancy, operation time, method of surgical anastomosis, amylase level of the first day drainage after surgery were independent risk factors. The OR values were 3.8878, 3.277, 12.822, 7.900, 0.034 and 0.346, respectively (P＜0.05). The C-index of nomogram was 0.758. Conclusion We have developed a nomogram to predict the risk of PF with high consistency, which could be used in disease diagnosis.

The rapidly aging society gives rise to sizable demands for chronic disease nursing care. With IT development as backup, the hospital has developed a platform for regional collaborative nursing informationization within a medical alliance and a health management platform for home care of the elderlies. This practice can build an extended nursing care model, featuring the three main service lines of " hospital-family, hospital-medical alliance and hospital-community hospital-family". The model provides diversified, personalized, disease specific, informationization and multi-disciplinary coverage for nursing care, providing the primary level with high quality nursing resources.Medical alliances and corresponding communities share information, for a full-range, full region and full timeframe coverage of nursing health supervision and scientific guidance, thus effectively minimizing the rate of revisit to upper-level hospitals by patients and implementing the hierarchical medical system.

目的 探讨以双向需求为导向的新入职护士培训的实践效果.方法 护理部根据《新入职护士培训大纲(试行)》,制订《新入职护士培训总则》.81名2016年新入职护士为对照组,按照《新入职护士培训总则》进行培训.99名2017年新入职护士为试验组,在对照组组基础上,实施以双向需求为导向的新入职护士培训管理模式,主要包括完善新入职护士管理体系,应用护士岗位培训需求评估问卷进行双向需求调查,根据调查结果增加培训内容、创新培训和考核方式.培训1年后采用护士职业认同量表和中国注册护士核心能力量表评价两组护士的职业认同感和核心能力.结果 培训1年后,试验组职业认同感和核心能力得分均高于对照组,差异有统计学意义(P＜0.05).结论 以双向需求为导向的新入职护士培训可更好地提高新入职护士的职业认同感和核心能力.

目的:观察绝经前乳腺癌改良根治术后患者化疗期间行综合性护理干预的效果.方法:将本院94例乳腺癌患者作为研究对象,分为对照组于化疗后行常规护理干预及观察组于化疗期间行综合性护理干预,两组各47例.通过生存质量评价量表(QLQ-C30)评估患者护理后生活质量的情况.结果:观察组功能质量评分中的情绪功能、躯体功能、角色功能及社会功能的评分较对照组均显著升高（均P＜O.05）,而两组认知功能的评分并无明显差异(P＞0.05).观察组症状表现评分中的失眠、疼痛、恶心呕吐、疲倦、便秘、食欲下降的评分较对照组均显著降低（均P ＜0.05）,而两组腹泻及呼吸困难评分的比较,均无明显差异(均P＞0.05).结论:绝经前乳腺癌改良根治术后患者化疗期间行综合性护理干预能够明显减轻化疗反应,有效改善临床症状,有助于提高患者的生活质量.