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To explore nurses' experiences and perceptions of career growth and its influencing factors, as career growth is more closely associated with individual attitudes and behaviours in the new career era.A qualitative descriptive design was used.Thirty-one nurses from 10 secondary and 8 tertiary hospitals in Sichuan Province of China were purposively selected to participate in this study. The data were collected using individual semi-structured face-to-face interviews. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis.The nurses' perceptions of career growth fully described the nurses' experience and occurred in five dimensions: career promotion, career goal progress, professional ability and quality improvement, professional identity development and increase in personal prestige. The factors influencing career growth were identified at the organizational, individual and social levels. Career growth in nursing was complex, changed over time and showed several specific characteristics compared with other careers. The nurse-specific symbol of career growth was professional identity development, which reflected career progression characteristics.Career growth is a multi-dimensional concept with varying influencing factors. The meaning of career growth for nurses is distinct from that for employees in other careers.Nursing managers should guide nurses to comprehensively assess their career growth from multiple perspectives, and professional identity development deserves more attention. Both organizations and individuals should take responsibility for career management to pursue career growth.

PURPOSE The purpose of this study was to determine the effectiveness of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) on depression, quality of life (QoL), and glycosylated hemoglobin (HbA1c) in people with diabetes. DESIGN A systematic literature review and meta-analysis was conducted. METHODS Eight databases (PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane, PsycINFO, and three Chinese databases) were searched for relevant studies from inception to December 2019. Only randomized controlled trials (RCTs) of MBSR and MBCT interventions for people with type 1 and type 2 diabetes were included. FINDINGS Nine studies described in 11 articles were included in the review. Meta-analysis showed a significant effect favoring MBSR and MBCT on depression (standardized mean difference -0.84; 95% confidence interval [CI] -1.16 to -0.51; p < .0001), the mental health composite score of QoL (mean difference [MD] 7.06; 95% CI 5.09 to 9.03; p < .00001), and HbA1c (MD -0.28; 95% CI -0.47 to -0.09; p = .004). However, effects on the physical health composite score of QoL have not been found. CONCLUSIONS MBSR and MBCT are beneficial in improving depression, the mental health composite score of QoL, and HbA1c in people with diabetes. More well-designed trials using longer follow-up measurements are needed. CLINICAL RELEVANCE MBSR and MBCT could be considered as effective complementary treatment alternatives for people with diabetes.

Background Lack of adequate self-care, frequent admissions, and poor quality of life are common and serious problems in adult patients with systemic lupus erythematosus (SLE). Some studies have revealed that transitional care is effective in improving self-care and quality of life as well as reducing rehospitalization rates. However, limited studies explored its effects in adult patients with SLE. Therefore, we performed a study to examine the effects of transitional care on self-care, readmission rates, and quality of life in adult patients with SLE. Methods This study was a single-center, single-blind, and parallel-group randomized controlled trial comparing transitional care with usual care in SLE patients from a university hospital in China. Evaluations were conducted at baseline before discharge and at 3 months after discharge by using hospital readmission rate, the Exercise of Self-Care Agency Scale, and the Medical Outcomes Study Short Form 36-item Health Survey for self-care and quality of life. Data were collected between June and December 2016. Results Compared with the usual care group, the transitional care group reported significantly greater improvement in self-care and quality of life. Additionally, the 30-day readmission rate for the patients in the transitional care group was significantly lower than in the usual care group, and this effect remained significant at 60 and 90 days after patient discharge. Conclusion This study shows that transitional care improves self-care and quality of life in adult patients with SLE and reduces readmissions. However, further studies are needed. Trial registration China clinical trial registry, ChiCTR-IPR-16007708. Registered January 5, 2016. Electronic supplementary material The online version of this article (10.1186/s13075-018-1670-4) contains supplementary material, which is available to authorized users.

Objective To study the association between the serum creatine kinase (CK) level and aggressive behavior in patients with schizophrenia. Method This retrospective study recruited 2780 Chinese patients with schizophrenia from January 2009 to December 2013 at the psychiatric inpatient units of West China Hospital. The diagnosis was made according to the DSM-IV criteria. The serum level of CK was checked. Results Aggressive behavior was positively correlated with the serum CK level (r = 0.262, p = 0.000). The OR value is 8.084 when comparing the high CK group and normal CK group prior to admission. The aggressive behavior rate in the 5 times group (serum level ≥ 1130 U/L) after admission (28.2%) is higher than the rate prior to admission (16.5%). Conclusion The aggressive patients with schizophrenia displayed increased serum CK level. It may be useful to include a lab test of CK level in patients with schizophrenia and history of aggression. It would help the staff to take precautions to protect the patients and others.

This study investigates the anti-angiogenic effect of 3β, 12β, 20(S)-trihydroxy dammarane-3-O-β- d -glucopyranosyl(1–2)-β- d -glucopyranoside(HRG), a new chemical compound obtained by structure modification on Ginseng saponins Rg3, associated with the regulation of matrix metalloproteinases(MMPs) and its upstream signal-regulated molecule of vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(b-FGF) in vitro, which plays an critical role in angiogenesis during the process of carcinoma. In our study, to investigate the anti-angiogenesis effect of HRG in HUVECs, we utilized cell proliferation assay, tube formation assay, wound-healing assay, Semi-quantitative reverse transcription PCR, and Western blot assay. Our results demonstrated that HRG plays a major role in the regulation of proliferation, migration and tube formation of HUVECs by suppressing the expression of VEGF and b-FGF in both transcriptional and post-transcriptional levels. In addition, the expression of MMP-2 and MMP-9, which were related to the ECM degradation, were down-regulated after administration of HRG as well. Overall, our results revealed that HRG strongly inhibited the process of angiogenesis and shows better effectiveness than Rg3.

To analyze and summarize Professor LIU Feng-bin's clinical experience and academic thoughts on gastroesophageal reflux disease (GERD), the study group adopted the retrospective study for case series and expert interview, extracted the retrospective data, including the herbs, diseases, syndrome type, medical expense and quantity of herbs of GERD patients attended the First Affiliated Hospital of Guangzhou University of Chinese Medicine. Statistical description and binary Logistic regression were used for the identification and modification of syndrome type and initial core herbs. After expert interviews were performed for the syndrome type and herbs, the final scheme were formed. A total of 112 GERD patients ages（48.97±13.13）y; male: 35 (31.3%), female: 77(68.7%) were enrolled. The numbers of patients with liver and stomach incoordination syndrome, heat stagnation of liver and stomach syndrome, syndrome of dual deficiency of Qi and Yin, syndrome of spleen deficiency and dampness-heat, spleen-stomach disharmony syndrome were 40, 26, 19, 17 and 10, respectively. The patients used totally 80 herbs, and 26 of them had significant differences among different syndrome groups. According to the logistic regression analysis on the 23 herbs used by 112 patients, the herbs scheme was modified for the second time. After the expert interviews and modification, the final consensus was reached. The main causes for GERD were dietary irregularities, moodiness, and weak constitution. The basic mechanism of GERD was spleen deficiency with Qi adverseness. The spleen-stomach disharmony syndrome was deleted by expert interviews. The 10 core herbs for GERD treatment were Taizishen(Pseudostellariae Radix), Fuling(Poria), Baizhu(Atractylodismacrocephalae Rhizoma), Gancao(Glycyrrhizae Radix Et Rhizoma), Zhebeimu(Fritillariae Thunbergii Bulbus), Haipiaoxiao(Sepiae Endoconcha), Zhiqiao(Aurantii Fructus), Chenxiang(Alosewood), Pugongying(Taraxaci Herba), Zhizitan(Cape Jasmine Fruit). The modification and psychological and diet interventions were also identified. This study summarized Professor LIU Feng-bin's clinical experience and academic thoughts of chronic atrophic gastritis based on data mining of case series and expert interviews. The quality of methodologies and report were both well. The results provide a foundation and ideas for further study on the complex intervention for GERD, and can be directly applied in clinical practice.

Managing increasing numbers of diabetic patients is placing increasing pressure on healthcare providers, especially general practitioners, who usually serve in multiple roles. This situation has caused generally poor results in terms of diabetes management. However, community nurses in some countries have successfully and effectively controlled chronic diseases among their patients. Therefore, the effects of nurse-led management is worth further exploration in order to better understand and promote this mode of care.To explore the effects of community-nurse-led team management on diabetes patients.An experimental research design was adopted. Patients with type 2 diabetes were recruited from two community health centers (the first for the intervention group, the second for the control group) in Wuhou District, Chengdu City, China. The intervention group received nurse-led team management care for 2 years, while the control group received standard care. The evaluations were conducted before the intervention and at 6, 12, and 24 months into the intervention. Outcomes included glycosylated hemoglobin (HbA1c) level, body mass index, waist circumference, visual acuity, ankle brachial index, kidney function index, urinary protein level, and electrocardiogram.The 179 participants included 88 in the intervention group and 91 in the control group. After the intervention, HbA1c level, ankle brachial index, and waist circumference were all significantly better in the intervention group than in the control group (F = 28.894, p.01; F = 4.065, p.01; F = 5.540, p.01). The other outcome variables remained statistically similar between both groups throughout the study period.Community nurse-led team management is an effective mode of care in terms of controlling blood glucose control and preventing diabetes-related complications.探討護理人員引領社區第二型糖尿病照護之管理團隊模式成效.糖尿病患者人數不斷增長，給社區糖尿病管理帶來巨大壓力，在中國全科醫師常常身兼數職，以致糖尿病管理不佳，然而國際上已證實社區護理人員在慢性病管理中的的角色功能十分有效，因此，在中國推動護理人員主導的社區糖尿病管理模式，並且評價其成效日益重要。.探討社區護理人員引領的團隊管理對糖尿病患者的疾病改善效果。.採用試驗性研究設計，選取成都市武侯區2家社區衛生服務機構分別為試驗組和對照組，並於所在社區納入2型糖尿病患者作為研究對象。試驗組患者接受社區護理人員引領的團隊管理服務2年；對照組維持現有的管理服務。分別在介入前、介入後半年、1年及2年評價患者的糖化血色素（HbA1c）、身體質量指數、腰圍、視力、踝肱指數、腎病指數、尿蛋白及心電圖。.兩社區共納入研究對象179例，其中試驗組88例，對照組91例。通過介入，試驗組患者糖化血色素、踝肱指數、腰圍較對照組明顯改善（F = 28.894，p.01；F = 4.065，p.01；F = 5.540，p.01）；身體質量指數、視力、腎病指數、尿蛋白及心電圖與對照組差異無統計學意義，但維持了上述指標的穩定。.社區護理人員引領的團隊管理，可以改善患者的血糖控制，改善或維持併發症相關指標，在一定程度上起到了預防相關併發症的作用。.

Fast-track (FT) has been shown to enhance post-operative recovery. The aim of this study was to compare the effects of FT and traditional nutrition on post-operative rehabilitation, as well as evaluate the feasibility of applying FT in nutrition management of colorectal surgery. A prospective and randomized controlled trial was performed. This study included 464 patients who underwent colorectal surgery. The patients were randomly assigned into an FT group and a traditional group. The nutritional risk screening (NRS 2002) score, post-operative recovery index and surgical complications were compared between the FT and traditional groups. The NRS 2002 score in the FT group was better than the traditional group (p0.05). Serum indicators for nutrition (HGB, ALB, A/G) and immune function (lymphocyte rate [LYMPH%], IgA, and CD4+) in the FT group were superior to those in the traditional group (p0.05) on post-operative day 5. The first time to aerofluxus, defecation, oral intake and ambulation in the FT group was shorter when compared to the traditional group (p0.05). The complication incidence was significantly lower in the FT group than in the traditional group (p0.05). In particular, the occurrence rate of anastomotic leakage was higher in the traditional group than in the FT group (0.5% vs 2.8%, p0.05). Taken together, these data suggest that FT management can improve the nutritional condition and outcomes of colorectal surgical patients.研究证明加速康复外科能够促进手术患者康复。本研究的目的是比较加速康复 外科流程与传统流程下的营养支持对患者术后康复的影响，同时探究加速康复 外科流程在结直肠手术患者营养支持方案中的临床适用性。本研究前瞻性地纳 入464 例结直肠癌手术患者，随机分为加速康复外科流程组(FT 组)和传统流程 组。终点指标为NRS2002，术后康复指标，术后并发症。FT 组NRS2002 评分 低于传统流程组(p0.05)；FT 组血红蛋白，白蛋白，白球比及淋巴细胞比率、 IgA、CD4+等指标在术后第5 天均优于传统流程组(p0.05)；FT 组首次排气、排 便、经口进食及下床活动时间短于传统流程组(p0.05)；FT 组的并发症发生率低 于传统流程组(p0.05)；传统流程组的吻合口瘘发生率高于FT 组(2.8%比上 0.5%，p0.05) 。综上所述，本研究表明加速康复外科能够改善结直肠癌术后患 者的营养状态及临床效果。

To assess the QOL in rectal cancer patients after preventative anal operation and to discuss the influence of age on perceived quality of life.A prospective study of 342 patients with rectal cancer from May 2011 to January 2012 in the gastrointestinal surgery department was randomly selected and divided into the elderly group and the young group, and the differences in their QOL assessed by the questionnaire QLQ-C30, after preventative anal surgery (7 days) were compared.A total of 207 patients met the study criteria and were divided into the elderly group (≥60 years, 107 cases) and the young group (60 years, 100 cases). The incidences of complication with pneumonia (p=0.030), wound infection (p=0.024) and ileus (p=0.036) were higher in the elderly group. In the QLQ-C30 assessment, the physical function in the elderly group was worse (p=0.004). Additionally, the fatigue of symptom, sleep disturbance and poor appetite (p0.001), and global quality of life (p=0.002) were worse in the elderly group too. However, the role and emotional function were better in the elderly group (p0.001).The QOL in elderly patients is generally worse than young patients, and a targeted approach should be used.

To apply peripherally inserted central catheter (PICC) in critically ill neonates who require long-term parenteral nutrition.A retrospective review of 98 critically ill neonates who had a PICC inserted and received long-term parenteral nutrition from March to December 2011 was performed.The PICC insertion succeeded in 74.5% (73/98) of the cases at the first attempt. The catheter remained for an average of (19.7 +/- 2.0) days. Of the 98 cases, 92 underwent planned extubation after enteral nutrition was fully established; 10 developed complications within the follow-up period of 956 days. The PICC-associated complications occurred at a rate of 10. 5 per 1000 catheter-days, including infection (n=0), phlebitis (n=1), accidental dislodgement (n=3), catheter occlusion (n=3), and hemorrhage in puncture point (n=3).PICC can be used as a safe venous access for critically ill neonates for long-term parenteral nutrition. PICC-associated complications can be reduced through improving nursing skills, especially for catheter-related infection.

To evaluate the expression of epithelial sodium channel in nasal polyps and normal nasal mucosa and to characterize the ENaC-mediated Na(+) absorption and the mechanism of the liquid transport in human upper airway epithelia.The tissue from 12 patients with nasal polyps (NP) and the normal ethmoid cornu mucosa (ECM) from 5 patients were obtained through endoscopic surgery. The expression of ENaC was detected by Immunofluorescence and the concentration of ENaC alpha, beta, gamma-mRNA were detected by RT real-time PCR.The ENaC in NP group (35.79 +/- 5.47) was higher than that in ECM group (22.17 +/- 5.43, t = 4.687, P0.01). The expression of ENaC-alpha, beta, gamma mRNA in NP group (respectively 2.06 +/- 0.42, 1.97 +/- 0.32, 1.96 +/- 0.54) was higher than that in ECM group (respectively 1.01 +/- 0.10, 0.98 +/- 0.08, 0.97 +/- 0.06; t = 5.482, 6.659, 4.036, all P0.01). The mRNA expression of three subunits of ENaC was as follows: alphabetagamma in both groups. The mRNA expression of alpha, beta, gamma subunit of ENaC in NP group was higher than that in ECM group(P0.01). The expression of three subunits of ENaC was correlated respectively with that of mRNA in NP group.The up-regulation of ENaC in human NP was associated with the expression of ENaC mRNA, that made hydrops and might be one of the most important cause of the develop of nasal polyp.

To investigate the value of abnormal muscle response (AMR) monitoring during microvascular decompression (MVD) for hemifacial spasm (HFS) and compare the outcomes of the patients undergoing AMR or not.234 HFS patients, aged (45.2 +/- 12.5) (25 - 76), undergoing MVD were randomly divided into 2 groups:199 of them underwent AMR monitoring intra-operatively and 35 not. No muscle relaxant was used. The zygomatic branch of the facial nerve was stimulated electrically and the AMR of the ipsilateral mental muscle was recorded. The relationship between AMR monitoring results and final surgical outcome was analyzed.Before incision of dura mater, all patients showed characteristic AMR of HFS. AMR disappeared in 165 patients (82.9%) after MVD of the facial nerve root. HFS disappeared shortly after operation in 144 of the 165 patients with disappearance of AMR, and only in 8 of the 34 patients with persistent AMR. Follow-up lasting for more than 1 year showed that HFS disappeared in 157 of the 181 patients of the AMR group, and in 24 of the 35 patients who had not undergone AMR monitoring during operation.Helping differentiate the responsible vessel, to assess the effect of decompression, and to predict the postoperative course of MVD, AMR monitoring improves the long-term outcome of HFS treated with MVD.