随着全球化时代的到来和我国经济的快速发展，高职英语课程的地位和重要性日益凸显。在此背景下，如何将思政教育与高职英语课程相结合，以提高学生的综合素质，已成为高职教育领域的一项重要任务。在贯彻和落实《高等职业教育专科英语课程标准（2021年版）》（简称《高职英语课标（2021年版）》）背景下，本文以探究和实践高职英语课程思政教育模式为主题，从理论基础、探究与实践研究等方面展开分析。首先，论文回顾了高职英语课程的地位与重要性。接着，本文探讨了高职英语课程思政教育模式的理论基础。在此基础上，文章提出了内容整合模式

Breast cancer‐related lymphedema (BCRL) is one of the common postoperative complications that severely affects the functions of the arm and quality of life. Since lymphedema is difficult to treat and prone to recurrence, early prevention of lymphedema is crucial.

Objective:To search for the related literature and summarize the best evidences for preventing and treating subcutaneous seroma after breast cancer surgery.Methods:Following the "PIPOST" model, we identified a question, constructed a search strategy and proposed the inclusion and exclusion criteria. Then we systematically searched the databases in Chinese (CNKI, Wanfang Data, CQVIP, CBM and Medlive) and English (PubMed, Embase, Web of Science, Cochrane Library, National Institute for Health and Care Excellence, Cumulative index to nursing and allied health literature, Joanna Briggs Institute Library, National Comprehensive Cancer Network and American Society of Breast Surgeons) for literature related to prevention and treatment of subcutaneous seroma after breast cancer surgery from the establishment to June 10, 2022. Two researchers, who had received evidence-based training, evaluated literature quality and extracted evidence independently.Results:A total of 23 articles were retrieved, consisting of 6 traditional reviews, 2 expert consensuses and 15 systematic reviews. We summarized 30 items of evidence and categorized them into 6 aspects: surgical skills, pharmacological treatment, drain management, flap fixation, postoperative exercises and fluid monitoring and removal.Conclusion:The summarized best evidence can provide guidance for preventing and treating subcutaneous seroma after breast cancer surgery. Healthcare professionals should consider real-world clinical settings and cautiously apply the summarized evidence in seroma treatment and nursing.

目的 了解陕西省医院护理人员化疗职业防护知信行现状,为提高护士化疗职业防护水平提供依据.方法 采用问卷对陕西省二、三级医院接触化疗药物的护理人员进行便利抽样调查,问卷包括一般资料和化疗职业防护知识、态度、行为4部分.结果 共回收有效问卷2173份.护理人员化疗职业防护知识、态度、行为得分分别为(13.17±3.11)分、(41.58±5.18)分、(74.06±12.70)分,总体处于中等水平.多元回归分析显示,最高学历、医院等级、科室、是否接受过化疗防护培训是护理人员化疗职业防护知信行的影响因素(P<0.05).结论 陕西省二、三级医院护理人员化疗职业防护知信行水平有待进一步提高,尤其是低学历、二级医院、非肿瘤科及未接受过化疗防护培训的护理人员.医院管理者应建立和完善护理人员化疗职业防护管理体系,并重视化疗职业防护培训.

目的 研究乳腺癌患者术后使用宽郁舒气方和乳清蛋白的作用.方法 将我院收治的90例乳腺癌患者按随机数字表法分为对照组和观察组,各45例.两组患者均行乳腺癌根治术,术后采用不同的营养支持方案进行干预,对照组给予常规营养+乳清蛋白,观察组在对照组的基础上加用宽郁舒气方.比较两组患者营养状况、生活质量、心理负面情绪等方面的差异.结果 干预后,观察组患者体质指数(BMI)、上臂肌围(MAMC)、血清血红蛋白(Hb)水平、白蛋白(ALB)水平分别为(18.4±2.8)kg·m-2、(28.7±4.5)cm、(40.5±4.2)g·L-1、(46.4±4.1)g·L-1,改善程度均优于对照组,差异有统计学意义(P<0.05);观察组患者SAS评分和SDS评分[(37.68±2.16)、(38.68±1.65)]均低于对照组[(57.75±2.15)、(42.58±2.89)],差异有统计学意义(P<0.05),情绪改善效果更为明显;观察组患者生活质量评分亦明显高于对照组(P<0.05).结论 宽郁舒气方联合乳清蛋白可改善乳腺癌患者术后生存状况,值得临床推广应用.

目的 通过分析咸阳市中心血站在医院开展血费直接报销工作后的献血招募情况,探讨医院直报血费对献血招募工作的影响.方法 调查在医院直报血费和到市血站报销血费的献血者或代报销者,比较2种血费报销方式的便捷度、对报销者献血积极性的影响和知晓医院直报血费对献血招募的影响.结果 在医院直报血费人均花费22 min,无往返路程和交通费用,报销方式满意率、自愿长期献血率、自愿动员他人献血率分别为98.11％、91.89％、82.56％,均高于到血站报销血费的方式(P＜0.01);对知晓医院直报血费的献血者进一步调查统计,其中献血2～3次者、献血3次以上者、报销方式满意率、自愿长期献血率、自愿动员他人献血率分别为35.16％、38.90％、98.56％、94.24％、93.37％,均高于不知晓在医院直报血费者(P＜0.05).结论 医院直报血费的报销方式不仅提高了血费报销的便捷度和效率,更通过报销方式满意度的提高增加了献血者参与无偿献血的积极性,对献血招募工作具有良好的促进作用.

目的:探讨品管圈(QCC)活动在缩短乳腺外科患者入院当日床位等候时间中的应用效果。方法:成立QCC小组，选定主题为"缩短乳腺外科患者入院当日床位等候时间"。通过QCC实施方法，商讨改进措施，优化常规入院流程。比较措施实施前后乳腺外科患者入院当日床位等候时间的变化。结果:开展QCC活动后，患者入院当日床位等候时间由活动前的(316.2±128.4)min降低到(121.0±48.2)min，差异有统计学意义( P<0.05)。此外，患者的满意率由87.0%提升至94.0%，差异有统计学意义( P<0.05)；且圈员们的解决问题的能力、积极性、责任感、沟通配合、成就感等各方面能力均有提高。 结论:QCC管理工具在缩短乳腺外科患者入院当日床位等候时间方面具有显著的临床效果，在提升工作效率的同时也强化了医务人员的相互协作意识、工作积极性与责任感。

Objective: Fatigue, sleep disturbance, and depression (FSD) are highly prevalent among breast cancer (BC) patients undergoing adjuvant chemotherapy, constituting a common symptom cluster (i.e., FSD cluster). Exercise is effective in relieving fatigue, alleviating sleep disturbance, and improving the quality of life (QoL) during adjuvant chemotherapy among these women. Therefore, this study aimed to assess the feasibility and acceptability of a dance program with social support elements for managing this symptom cluster. Methods: A prospective randomized controlled design combined with a semi-structured interview was utilized. Twenty consented eligible participants were randomly assigned to a dance group or an attention control group after baseline assessment but before chemotherapy. The feasibility of recruitment, retention, intervention, and data collection procedures and the acceptability of exercise modality, hospital-based instruction, and home-based practice were collected by retrieving information from research documents and interviews by the principal investigator 4 weeks after the start of intervention. Results: The recruitment and retention rates were 86.96% and 100.00%, respectively. Participants took about 30-40 min to complete the questionnaire. All the items were comprehensible. The baseline characteristics were comparable between groups, indicating that randomization was successful. The implementation procedure progressed smoothly. Dancing was considered interesting and easy, and participants would like to practice at home. Only minor adjustments would be needed for future studies. Conclusions: This study demonstrated that the proposed dance program was feasible and acceptable for BC patients in hospital and home settings. A full-scale study is warranted to examine its effects on managing the FSD cluster and promoting QoL.

目的 分析血站管理工作中实施7S现场管理法的效果.方法 随机抽取本血站2017年1月至2018年12月的2000例血液标本,以7S现场管理法实施时间为界限,将血液标本分为实施前组(1000例,2017年1～12月)和实施后组(1000例,2018年1～12月).比较两组的传染性疾病检出率、采供血差错事件发生情况及血站质控考核评分.结果 7S现场管理法实施后组的抗-HIV、抗-TP、抗-HCV、HBsAg阳性检出率均明显低于实施前组,采供血差错事件总发生率明显低于实施前组,血站质控考核评分明显高于实施前组(P<0.05).结论 7S现场管理法可显著提高血站血制品质控结果,降低差错事件发生率,值得将该管理模式进一步推广.

目的 检索乳腺癌术后上肢淋巴水肿预防方法的相关证据,并评价总结出最佳证据,为医护人员临床决策提供依据.方法 应用PIPOST模式确定循证问题,并构建合适的检索策略和纳排标准,使用计算机检索PubMed、Embase、Cochrane Library、NBOCC、CINAHL、JBI图书馆、NICE指南网、维普、中国知网、万方、CBM数据库中所有关于乳腺癌术后上肢淋巴水肿预防策略的证据.由2名经过循证培训的人员对纳入的文献进行质量评价并且对符合标准的文献进行证据提取.结果 共纳入24篇文献,其中指南4篇,证据总结3篇,系统评价8篇,RCT8篇、类实验1篇.最终总结出锻炼方法、皮肤保护、航空旅行、控制体质量、物理疗法、自我监测、日常生活注意事项共7个方面,48条关于乳腺癌术后预防上肢淋巴水肿策略的最佳证据.结论 乳腺癌术后患者需注重上肢淋巴水肿的预防,临床医护人员可依据乳腺癌术后上肢淋巴水肿预防策略的最佳证据,对患者进行规范的健康教育,降低患者的淋巴水肿发生率.

目的 探讨乳腺癌患者重返工作的工作心理负荷现状及其影响因素.方法 使用方便抽样,选取2018年2-12月在西安交通大学第一附属医院门诊复查和参加病友联谊会的433例乳腺癌患者作为研究对象.使用基本资料调查表、任务负荷指数量表、领悟社会支持量表和记忆症状评估量表简表收集资料.结果 乳腺癌患者重返工作的工作心理负荷得分为54.68±11.19,领悟社会支持得分为56.74±10.12,总体困扰指数为28.43±7.22.多元线性回归结果显示,总体困扰指数、病休时间、领悟社会支持、锻炼情况和年龄可影响乳腺癌患者重返工作的工作心理负荷,且可解释总变异的52.9％.结论 临床医务工作者应关注乳腺癌患者重返工作的心理负荷状况,尤其是年龄较大的患者,提高患者对乳腺癌症状群的认识,鼓励患者每天适度锻炼,调动社会支持系统,以降低其工作期间的心理负荷水平,提高生活质量.

目的 探析乳腺癌患者应用临床护理路径干预,在改善患者癌性疲乏,提升生活质量方面的作用效果.方法 将我院在2020年6月至2020年8月期间收入的乳腺癌患者共计74例划分为两组,对照组37例给予常规护理;观察组37例应用临床护理路径进行护理干预,对比两组患者的癌性疲乏与生活质量评分.结果 观察组的癌因疲乏占比低于对照组,观察组各项生活质量评分高于对照组,两组间差异具有统计学意义(P<0.05).结论 乳腺癌患者应用临床护理路径护理干预后,可改善患者的癌因性疲乏,使患者的生活质量有效提升.

Background: Primary treatments for early-stage breast cancer can cause adverse effects, such as pain, fatigue, and sleep disturbance, that can markedly affect the patients' health-related quality of life. Objective: This study aimed to evaluate the benefits of a WeChat-based multimodal nursing program on early rehabilitation in postoperative women with breast cancer. Design: Clinical randomized controlled trial. Setting: Surgical breast cancer department of a general hospital in Shaanxi Province, China. Participants: Women with breast cancer were recruited via convenience sampling. The inclusion criteria were (1) age = 18 years, (2) newly diagnosed with breast cancer, (3) stage I-III disease, and (4) indicated for surgery with adjuvant therapy. Exclusion criteria were (1) comorbidity with other malignant tumors and infections and (2) cognitive or psychiatric disorders. Methods: We recruited patients with breast cancer and randomly allocated them to the intervention (n = 56) and control (n = 55) groups. The former was subjected to the WeChat-based multimodal nursing program plus routine nursing care for 6 months, whereas the latter received only routine nursing care. The primary endpoint (health-related quality of life) and secondary endpoints (pain, fatigue, and sleep) were measured using the Functional Assessment of Cancer Therapy-Breast version 4.0 (FACT-Bv4.0) and the Numerical Rating Scale at 4 time points (i.e., pre-surgery and 1, 3, and 6 months post-surgery). Results: The intervention group had significantly improved total FACT-Bv4.0 scores owing to the effects of group (F = 16.28, P < 0.001), time (F = 28.82, P < 0.001), and group-time interaction (F = 5.35, P = 0.001). Similar improvements were also found in social/family well-being and functional well-being (P < 0.05). Emotional well-being was improved based on the effects of time (F = 42.12, P < 0.001) and group-time interaction (F = 10.20, P < 0.001). The 'breast cancer-specific subscale for additional concerns' was affected by group (F = 21.55, P < 0.001) and time (F = 28.96, P < 0.001), whereas physical well-being was only affected by time (F = 35.39, P < 0.001). Pain, fatigue, and sleep were not significantly influenced by group effects. Conclusions: We found a significant improvement in the health-related quality of life of postoperative women with breast cancer who used the WeChat-based multimodal nursing program during early rehabilitation. This demonstrated that the program is an effective intervention for postoperative rehabilitation in such patients. Findings of the study will provide evidence for eHealth services in clinical and transitional nursing care. (C) 2020 Elsevier Ltd. All rights reserved.

目的 探究医院输血科与血站信息系统联网对输血安全性的影响.方法 选取2017年5月至2019年11月于我院行手术治疗并需输血的患者186例,将其随机分为研究组(93例,医院输血科与血站信息系统联网)与对照组(93例,医院输血科未与血站信息系统联网).比较两组血液发放的正确性、及时性、工作成本、工作效率、输血不良事件发生情况及输血科管理质量.结果 研究组的血液品种、血型、数量正确率均高于对照组,发血时长短于对照组,差异具有统计学意义(P<0.05).研究组的纸质、人工成本及工作效率评分均高于对照组,差异具有统计学意义(P<0.05).研究组的输血不良事件总发生率明显低于对照组(P<0.05).研究组输血科管理质量各维度评分及总分均高于对照组(P<0.05).结论 医院输血科与血站建立信息系统联网能有效确保患者用血安全性,可避免出现血源性感染,降低医院与血站的工作成本,提升血液质量、工作人员效率及输血科管理质量,值得临床推广应用.

目的:探讨分析PDCA循环管理模式对乳腺良性肿瘤切除术后美容效果的影响.方法:选择2016年4月-2017年3月在笔者医院行乳腺良性肿瘤切除术患者78例作为对照组,选择2017年4月-2018年3月83例患者作为观察组.在相同的乳腺良性肿瘤切除术下,对照组采取常规护理措施,观察组采取PDCA循环管理护理方案.比较两组患者手术前后抑郁、焦虑状态,出院时对护理满意度以及术后6个月乳房美容效果.结果:出院时两组患者HAMA、HAMD评分均较术前显著降低,且观察组患者HAMA、HAMD评分显著低于对照组,差异有统计学意义(P<0.05).观察组患者护理满意度显著高于对照组,差异有统计学意义(P<0.05).术后6个月,观察组患者乳房形状、切口瘢痕、色素沉着、乳头(晕)感觉评分均显著高于对照组,差异有统计学意义(P<0.05).结论:PDCA循环管理模式可有效改善乳腺良性肿瘤切除术患者术后不良心理情绪,有助于术后美容效果的提高,并提高患者护理满意度,值得临床推广.

目的 探讨年轻乳腺癌患者的依恋现状,并分析其对生育忧虑的影响.方法 使用方便抽样,选取2017年1-12月间,参加西安市2所三甲医院乳腺肿瘤病友联谊会和门诊随访复查的264例年轻乳腺癌患者作为研究对象.使用基本资料调查表,癌症后生育忧虑量表和亲密关系体验问卷进行调查.结果 研究对象的生育忧虑总分为57.49±6.11,依恋回避得分为3.31±0.74,依恋焦虑得分为3.54±0.85.安全型依恋人数为105人,占39.8％.经多元线性回归分析,生育意愿、依恋焦虑、化疗疗程和宗教信仰可影响年轻乳腺癌患者的生育忧虑水平.结论 医务工作者应关注年轻乳腺癌患者的生育忧虑状况,了解患者的生育意愿、依恋类型和社会支持状况,有针对性地进行干预,降低其生育忧虑水平,提高患者生活质量.

目的 探讨叙事护理对直肠癌造口患者病耻感的影响.方法 采用便利抽样选取2016年2月至2017年2月的直肠癌造口患者共102例参与研究,最终完成研究89例,采用随机分组将研究对象分为干预组和对照组,对照组采用笔者所在医院常规出院健康宣教及复诊,干预组在对照组措施的基础上加以叙事护理干预.分别于出院后第1、3、6个月采用社会影响量表(SIS)对干预后两组患者的病耻感进行评定.结果 两组患者出院时和出院后1个月SIS得分差异无统计学意义(P>0.05);出院3个月、6个月的SIS得分干预组均低于对照组,差异有统计学意义(P<0.05).结论 叙事护理能够帮助直肠癌造口患者疏泄不良情绪、重拾生活信心,有助于降低其病耻感.

The use of peripherally inserted central catheters (PICCs) is increasing rapidly worldwide. A number of patient-related, clinical-related and device-related characteristics might be risk factors for PICC-related thrombosis. We retrospectively reviewed a database of 320 consecutive patients who underwent PICC insertion between December 2014 and December 2015 at the First Affiliated Hospital of Xi'an Jiaotong University to explore the potential associations between risk factors and PICC-associated thrombosis. A novel nomogram for predicting risk was developed based on the data. The nomogram prediction model included ten risk factors that were derived from different relevant estimates. The nomogram prediction model showed good discriminatory power (Harrell's C-index, 0.709) and a high degree of similarity to actual thrombosis occurring after calibration. Furthermore, principal component analysis was performed to identify the factors that most influence PICC-related thrombosis. Our novel nomogram thrombosis risk prediction model was accurate in predicting PICC-related thrombosis. Karnofsky performance scores, D-dimer and blood platelet levels and previous chemotherapy were principal components. Our findings might help clinicians predict thrombosis risk in individual patients, select proper therapeutic strategies and optimize the timing of anticoagulation therapy.

Objective To explore the efficacy evidence-based nursing in reducing in postoperative complications in patients with breast cancer undergoing peripheral vein inserted central venous catheter (PICC).Methods Randomly selected 98 patients with breast cancer treated at The First Affiliated Hospital of Xi'an Jiao Tong University from May 2013 to December 2015.Using a random number table,patients were divided into an observation group and a control group.On the basis of conventional nursing,the observation group was given evidence-based nursing and the control group were only given conventional nursing.Incidence of postoperative complications were caompared and recorded in the two groups.Results There was no statistically significant difference in complications within 30 days after the surgery between the two groups (P ＞ 0.05) but at 2 months after the surgery,the incidence of complications was significantly lower in observation group than in the control group (P ＜ 0.05).No difference was noted in the first puncture success rate between the two groups (P ＞ 0.05).Conclusion Evidence-based nursing can significantly reduce the incidence of postoperative complications and prolong the in vivo retention time of PICC in breast cancer patients.

Objective To explore the short and long-term efficacy of extralevator abdominoperineal excision (ELAPE)vs.conventional abdominoperineal excision (APE)on distal rectal cancer.Methods Relevant studies were identified by search of Medline,EMBASE,and Web of Science published between January 1,2008 and February 28,2015,and included in the systematic review and meta-analysis with Stata software (version 12.0). Results Our Meta-analysis included 14 studies involving 3278 patients,of whom 1843 (56.2%)underwent ELAPE and 1435 (43.8%)underwent APE.Compared with patients undergoing APE,those undergoing ELAPE had a significantly reduced risk of intraoperative bowel perforation (IBP)involvement (OR=0 .55 ,95% CI= 0 .37-0 .85 ),but no significant reduction in the occurrence of CRM positivity (OR=0 .81 ,95% CI=0 .52-1 .25 ), local recurrence (LR)(OR=0.49,95% CI=0.18-1.30),wound complications (WCs)(OR=0.93,95% CI=0.65-1.35)or in-hospital death (IHD)(OR=0.89,95% CI=0.47-1.71).Conclusion ELAPE can reduce the risk of IBP but not for CRM positivity or LR when compared with APE.Therefore,more higher-quality studies are needed to verify the short-and long-term effects of ELAPE procedure on distal rectal cancer.