BACKGROUND:The period of standardized training is a transitional stage when Generation Z newly graduated registered nurses (Gen Z NGRNs) change their role from student to nurse. Affected by the COVID-19, they lack clinical practice and practicum experience in emergency departments in their university studies. At the beginning of career, they are under great pressure. Resilience is one of the factors that reduce their stress level and increases endurance. It is of interest to understand how this representative group of nurses gained and played the experience of resilience early in their careers.OBJECTIVE:To explore Gen Z NGRNs' experience and process of resilience, to provide a new perspective and theoretical basis for psychological rehabilitation or intervention of medical staff who experienced transition shock.METHODS:This study employed a qualitative design based on the phenomenological approach. 18 nurses from a third-level class-A hospital in Shanghai who participated in standardized training in emergency department were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation.RESULTS:The investigation uncovered three themes and ten subthemes. Pressure and challenge contained high workload and high risk coexist, death's stress response, more emergencies and high professional requirements. Coping and adaptation contained team help, psychological restructuring, peer support, transformational leadership. Reflection and planning contained enhance learning, appreciate life.CONCLUSIONS:Our study described the embodiment and coping experience of the physical and mental stress faced by Gen Z NGRNs during their standardized training in the emergency department. It is emphasized that nurse educators should pay attention to the character and actual needs of Gen Z NGRNs, explore and formulate strategies, so as to guide NGRNs to quickly adapt and grow in the new role. The ultimate goal is to increase nurse retention and improve the quality of nursing.

Background With the aging of the population, the number of total hip replacement surgeries is increasing globally. Hip replacement has undergone revolutionary advancements in surgical methods and materials. Due to the short length of hospitalization, rehabilitation care is mainly home-based. The needs and concerns about such home-based rehabilitation are constantly changing, requiring continuous attention. Objective To explore effective methods for comprehensively identifying older patients’ self-reported outcomes after home-based rehabilitation for hip replacement, in order to develop appropriate intervention strategies for patient rehabilitation care in the future. Methods This study constructed a corpus of patients’ self-reported rehabilitation care problems after hip replacement, based on the Omaha classification system. This study used the Python development language and implemented artificial intelligence to match the corpus data on the cooperation platform, to identify the main health-related problems reported by the patients, and to perform statistical analyses. Results Most patients had physical health-related problems. More than 80% of these problems were related to neuromusculoskeletal function, interpersonal relationships, pain, health care supervision, physical activity, vision, nutrition, and residential environment. The most common period in which patients’ self-reported problems arose was 6 months post-surgery. The relevant labels that were moderately related to these problems were: Physiology-Speech and Language and Physiology-Mind (r = 0.45), Health-Related Behaviors-Nutrition and Health-Related Behaviors-Compliance with Doctors’ Prescription (r = 0.40). Conclusion Physiological issues remain the main health-related issues for home-based rehabilitation after hip replacement in older patients. Precision care has become an important principle of rehabilitation care. This study used a machine learning method to obtain the largest quantitative network data possible. The artificial intelligence capture was fully automated, which greatly improved efficiency, as compared to manual data entering.

Venous thromboembolism (VTE) is very common in patients with malignant cancer. We aimed to conduct a retrospective analysis on the risk factors of VTE and its survival prognosis of patients with malignant cancer, to provide evidence into the management of VTE. Patients with malignant cancer treated in our hospital were selected. The characteristic of patients and related lab detection results including activated partial thromboplastin time (APTT), plasma prothrombin time (PT) and thrombin coagulation time (TT), fibrinogen (FIB), thrombin AT-Ⅲ complex (TAT) and D-dimer (D-D) were collected and analyzed. And logistic regression analyses were performed to identify the potential risk factors. And ROC curves were established to evaluate their predictive ability of VTE for patients with malignant cancers. A total of 286 patients were included, of which 63 patients had VTE, the incidence of VTE in patients with malignant cancers was 22.03%. There were significant differences on the D-D, TAT level between VTE and no VTE patients (all P < 0.05). The survival condition of VTE patients was significantly worse than that of no VTE patients(P = 0.017). D-D (RR7.895, 3.228∼19.286) and TAT (6.122, 2.244∼16.695) were risk factors of VTE for patients with cancers (all P < 0.05). The area under the curve (AUC) of D-D, TAT and combined use was 0.764, 0.698, 0.794 respectively, and the cutoff value for D-D, TAT was 1.835mg/L and 4.58μg/L respectively. For cancer patients with D-D >1.835 mg/L and TAT >4.58 μg/L, early interventions are needed for the prophylaxis of VTE.

BACKGROUND:The needs of Chinese patients undergoing home-based rehabilitation after hip replacement surgery remain unclear. In this study, we qualitatively investigated the needs of Chinese patients undergoing home-based rehabilitation after hip replacement surgery.METHODS:A total of 21 participants undergoing home-based rehabilitation after hip replacement surgery were included in this study. Individual semi-structured interviews involving all participants were performed to determine the needs and experiences of this patient population during home-based rehabilitation. Data were subjected to qualitative content analysis.RESULTS:The patients had numerous needs during rehabilitation. Three substantive themes, namely, the need to obtain health-related knowledge, the need to obtain care and support, and the needs of those who cannot perform self-care, were identified from the qualitative data. The participants shared valuable insights into their needs during home-based rehabilitation after hip replacement and provided potential suggestions.CONCLUSIONS:Patients undergoing home-based rehabilitation after hip replacement have several strong needs and lack proper guidance. The initial and continuous engagement of rehabilitation professionals and the establishment of related policies based on patient's needs are potential approaches for improving the effectiveness of home-based rehabilitation after hip replacement.

Objective? To investigate the level of self-management and identify the influencing factors in elderly patients in Inner Mongolia with chronic heart failure(CHF). Methods? By convenience sampling, a total of 1 051 elder patients with CHF from 9 Class Ⅱ & Ⅲ hospitals in 5 cities of Inner Mongolia Autonomous Region were recruited to participate in this study from December of 2015 to July of 2018. The elderly CHF patients were investigated with General Data Questionnaire and Self-management Scale for Heart Failure Patients. Results? The total score of Self-management Scale for Heart Failure Patientsof 1 051 elderly patients with CHF was (47.9±7.7) with a scoring rate of 59.9%. Multivariate linear regression analysis showed that ethnicity,work status and marital status were the influencing factors of self-management level of elderly CHF patients. Conclusions? The self-management status of elderly CHF patients in Inner Mongolia is not ideal. Corresponding intervention measures should be formulated according to the influencing factors of self-management level of elderly CHF patients in Inner Mongolia.

BACKGROUND:Currently there is no reports on identifying molecular markers for pre-thrombotic state in animal experimental settings. It's necessary to explore the potential molecular markers for pre-thrombotic state to provide evidence for the pharmacotherapy of venous thromboembolism (VTE).METHODS:A total of 36 male rabbits were randomly divided into Sham, Tibia fracture, Lung cancer, Tibia fracture and lung cancer group. Pro-thrombin time (PT), thrombin time (TT), activated partial pro-thrombin time (APTT), fibrinogen (FIB), D-dimer (D-D) and anti-thrombin III (AT-III) at baseline, 1, 7, 14 and 21 days after operation were detected. Immuno-histochemical staining of tumor tissue sections was performed to observe the expression of CD31, VEGF and vWF. Western blot and qPCR were used to detect the expression levels of ANG and VEGF gene in tumor tissues. Furthermore, we analyzed the tumor tissue with HE staining, immunochemistry, qPCR and Western blot. all the data were statistically analyzed with GraphPad Prism 6.RESULTS:There were 0, 1, 2, 4 cases of VTE in sham, tibia fracture, lung cancer, tibia fracture and lung cancer group respectively. The level of PT, APTT, TT and AT-III were significantly decreased after operation (all P<0.05), whereas the level of FIB and D-D were significantly increased after operation (all P<0.05). The level of PT, APTT, TT and AT-III were gradually decreased in tibia fracture, lung cancer, tibia fracture and lung cancer group respectively (all P<0.05), while the level of FIB and D-D were gradually increased in tibia fracture, lung cancer, tibia fracture and lung cancer group respectively (all P<0.05). The medullary lymphocytes increased significantly in the lung cancer group, tibia fracture and lung cancer group (all P<0.05), and the number of medullary lymphocytes in tibia fracture and lung cancer group is significantly higher than that of lung cancer group (P<0.001). The expression of CD31, VEGF and vWF in Tibia fracture and lung cancer group is significantly higher than that of lung cancer group (all P<0.001). The expression ANG and VEGF in tibia fracture and lung cancer group is significantly higher than that of lung cancer group (all P<0.01).CONCLUSIONS:PT, TT, APTT, FIB, D-D and AT-III seem to be sensitive molecular markers for identifying the pre-thrombotic state. CD31, VEGF, ANG and vWF play an important role in the progression of the pre-thrombotic state.

Background: Cyclophosphamide (CTX) is a widely used antitumor drug that can suppress the immune system. The effects of regulating immune response and antitumor of beta-glucan from the cell wall of Candida albicans (CAIBG) have been confirmed. However, the effects of the combined use of CAIBG and CTX remain unclear and warrant further investigation. Methods: S180 tumor-bearing models were developed for CAIBG (100 mg/10 mL/kg) and CTX (30 mg/10 mL/kg) intervention. The weights of the body, tumor spleen, and Thymus were recorded to calculate the index of the spleen and Thymus. The spleen and Thymus were observed by hematoxylin and eosin staining, whereas the expression of tumor necrosis factor (TNF)-alpha and interleukin (IL)-1 beta was determined by Western blot. The survival times of mice were followed and recorded for analysis. Results: CAIBG, CTX, and combined use of CAIBG and CTX could down-regulate the tumor growth and prolong the survival time. The spleen and Thymus index significantly increased in the CAIBG + CTX group than in the CTX group, but it was lower than that in the CAIBG group. Moreover, the Thymus index was significantly lower in the CAIBG + CTX group than in the CAIBG group. The lymphocytes of the spleen and Thymus decreased significantly in the CTX group but improved significantly in the CAIBG and CAIBG + CTX groups. The expression level of TNF-alpha and IL-1 beta in the CTX + CAIBG group increased significantly compared with that in the CTX group. The survival time of the CAIBG group and CAIBG + CTX group was significantly higher than that of the CTX group. Conclusions: CAIBG has strong treatment potential in combating tumor growth and prolonging survival time of S180 tumor-bearing mice. Combined use of CAIBG and CTX can compensate the CTX-induced immunosuppression and provide antitumor effects. Future studies are necessary to elucidate the underlying mechanism.

Marie Unna hereditary hypotrichosis (MUHH) is a rare autosomal dominant genodermatosis characterized by coarse, wiry, twisted hair developing during early childhood, with subsequent progressive hair loss. Recently, mutations in U2HR, an inhibitory upstream open reading frame in the 5 untranslated region of the human hairless gene (HR), were identified as the underlying cause of MUHH. We investigated two unrelated Chinese multigenerational families with MUHH. By sequencing U2HR in the two families, we identified two previously reported mutations, c.1A>T (p.Met1?) and c.104A>G (p*35Wext1263*). Both these mutations cosegregated with the disease phenotype in the two families.

Objective To explore the application effect of comfortable care on C-section maternal during breast-feeding.Methods The lying-in mother from Dongfang Hospital affiliated to Tongji University between August 2011 and April 2012 were divided into observation group and control group,according to their admission date (single or double),with each group 50 people.The control group was given routine nursing care,while the observation group received Xiao' s Double-C comfortable nursing model.After intervention,mother' s milk secretion amount and pure breast-feeding situation on 2nd,3rd day after childbirth were observed and compared.And the American comfortable nursing expert Kolcaba' s simplified pleasant status scale was used to evaluate their degree of comfort,the sadness assessment scale (SAS) for evaluating the mother' s anxiety status.Results Observation group were significantly higher than that of control group in milk secretion amount (x2 =6.034,11.256,P =0.049,0.018) and pure breast-feeding on 2nd,3rd day after childbirth (x2 =3.071,5.586,P =0.038,0.009).And significant difference was found between observation group and control group in SAS score [(44.56 ± 4.86) vs (59.12 ± 6.54),t =-2.969,P =0.004],and pleasant status score (90.26 ±2.85 vs 72.56 ± 5.62,t =-3.465,P =0.001).Conclusions The application of comfortable care in C-section maternal breast-feeding can significantly improve the mother' s milk secretion amount and the success rate of pure breast-feeding situation on 2nd,3rd day after childbirth,improve their degree of comfort and reduce the mother's anxiety status.