Influencing factors

摘要： Background:This study aims to investigate the current status and influencing factors of evidence-based practice(EBP)with knowledge,attitude and practice(KAP)of ophthalmic nursing staffs in south China.Methods:Using a convenient sampling method,we selected 429 ophthalmic nursing staffs from 28 ophthalmology specialist hospitals or general hospitals in south China,and investigated their general information and implemented the evidence-based practice questionnaire(EBPQ).Results:The scores of EBP and KAP of ophthalmic nursing staffs in south China from high to low were as follows:practical attitude(4.85±1.07 points),practical behavior(4.42±1.14 points),practical knowledge and skills(4.30±0.65 points).The single factor analysis results showed that the first graduation degree,technical title,scientific research achievements,whether or not participate in EBP training,the frequency of reading literature at ordinary time,and whether or not participate in EBP project were the influencing factors of EBP level;the multi-factor analysis results showed that EBP attitude,EBP knowledge and skills,whether or not participate in EBP training were independent influencing factors of EBP.Conclusions:The ophthalmic nursing staffs in south China have a positive attitude towards EBP,however,their EBP knowledge,skills and behavioral capabilities need to be focused and improved.The ophthalmic nursing administrators should fully master the factors affecting the implementation of EBP,and take effective intervention measurement to improve the EBP abilities of ophthalmic nursing staffs,and promote the development of EBP in ophthalmology specialty.

摘要： BACKGROUND Breast cancer mainly occurs in young and premenopausal women;its incidence is increasing annually. Patients with triple-negative breast cancer(TNBC) have relatively high recurrence and transfer rates during the operation and 3 years after postoperative adjuvant chemotherapy. Currently, the treatment for patients with TNBC is mainly based on a comprehensive combination of surgery and chemotherapy. Therefore, identifying additional effective treatments to improve patient prognosis is important.AIM To explore and discuss the effects and prognostic factors of neoadjuvant chemotherapy in TNBC.METHODS In total, 118 patients diagnosed with TNBC from January 2016 to January 2020 in our hospital were selected and divided into the observation(n = 60) and control(n = 58) groups according to therapeutic regimen. The control group received routine chemotherapy, and the observation group received neoadjuvant chemotherapy. The therapeutic effects of the two groups were observed, and the survival of patients was followed up.RESULTS The karyopherin A2(KPNA2)-positive and SRY-related HMG box-2(SOX2)-positive expression rates of patients with TNBC with intravascular tumor thrombus and tumor-node-metastasis(TNM) stage IV were 92.00% and 91.67% and 96.00% and 95.83%, respectively, which were significantly higher than those of patients with no intravascular tumor thrombus and TNM stage Ⅲ(P < 0.05). KPNA2 was positively associated with SOX2 expression(rs = 0.514, P < 0.50). The short-term curative effect of the observation group was better than that of the control group(P < 0.05), and the total effective rate was 58.33%. After treatment, carcinoembryonic antigen, cancer antigen(CA) 19-9, and CA125 Levels in the observation group were 11.40 ± 2.32 mg/L, 19.92 ± 3.42 kU/L, and 54.30 ± 12.28 kU/L, respectively, which were significantly lower than those in the control group(P < 0.05). The median survival time of the observation group was 33 mo(95%CI: 31.21-34.79), which was significantly longer than that of the control group(P < 0.05). TNM stage, degree of differentiation, lymph node metastasis, KPNA2 and SOX2 expressions, and treatment plan were prognostic factors of TNBC(relative risk = 1.575, 1.380, 1.366, 1.433, 1.411, and 0.581, respectively, P < 0.05).CONCLUSION Neoadjuvant chemotherapy for TNBC treatment can achieve good curative effects. TNM stage, differentiation degree, lymph node metastasis, KPNA2 and SOX2 expressions, and treatment plan are prognostic factors of TNBC.

摘要： In the context of territorial spatial planning,the overall coordinated protection has become a consensus in the field of cultural heritage protection,and the study on the spatial and temporal pattern of trans-regional cultural heritage is of great significance to the overall protection.Based on the cultural relics protection units in Jingzhou area of national great site protection,the temporal and spatial distribution characteristics and influencing factors of cultural heritage resources were studied with the help of ArcGIS.The data show that on the whole,the cultural heritage in Jingzhou area of national great site protection presented the time series of “a large span,more at two ends” and the spatial distribution pattern of “one main,two secondary and three cores”.Cultural heritage in different historical periods had the characteristics of differentiated regional aggregation.The formation of the spatial pattern of different types of cultural heritage was closely related to the local historical and cultural background.Cultural heritage was affected by rivers,terrain,transportation,land,culture and other factors.It was mainly distributed along rivers in areas with little topographic fluctuation and low altitudes.The development and construction of cultural heritage sites were weak,and the ecological foundation was poor.However,the traffic accessibility was good,and the cultural heritage was deep.The research results are expected to provide a scientific basis for guiding the large site protection area to strengthen the integrated protection of cultural resources.

摘要： This study aims to clarify the factors influencing oil recovery of surfactant-polymer(SP)flooding and to establish a quantitative calculation model of oil recovery during different displacement stages from water flooding to SP flooding.The conglomerate reservoir of the Badaowan Formation in the seventh block of the Karamay Oilfield is selected as the research object to reveal the start-up mechanism of residual oil and determine the controlling factors of oil recovery through SP flooding experiments of natural cores and microetching models.The experimental results are used to identify four types of residual oil after water flooding in this conglomerate reservoir with a complex pore structure:oil droplets retained in pore throats by capillary forces,oil cluster trapped at the junction of pores and throats,oil film on the rock surface,isolated oil in dead-ends of flow channel.For the four types of residual oil identified,the SP solution can enhance oil recovery by enlarging the sweep volume and improving the oil displacement efficiency.First,the viscosity-increasing effect of the polymer can effectively reduce the permeability of the displacement liquid phase,change the oil-water mobility ratio,and increase the water absorption.Furthermore,the stronger the shear drag force of the SP solution,the more the crude oil in a porous medium is displaced.Second,the surfactant can change the rock wettability and reduce the absorption capacity of residual oil by lowering interfacial tension.At the same time,the emulsification further increases the viscosity of the SP solution,and the residual oil is recovered effectively under the combined effect of the above two factors.For the four start-up mechanisms of residual oil identified after water flooding,enlarging the sweep volume and improving the oil displacement efficiency are interdependent,but their contribution to enhanced oil recovery are different.The SP flooding system primarily enlarges the sweep volume by increasing viscosity of solution to start two kinds of residual oil such as oil droplet retained in pore throats and isolated oil in dead-ends of flow channel,and primarily improves the oil displacement efficiency by lowing interfacial tension of oil phase to start two kinds of residual oil such as oil cluster trapped at the junction of pores and oil film on the rock surface.On this basis,the experimental results of the oil displacement from seven natural cores show that the pore structure of the reservoir is the main factor influencing water flooding recovery,while the physical properties and original oil saturation have relatively little influence.The main factor influencing SP flooding recovery is the physical and chemical properties of the solution itself,which primarily control the interfacial tension and solution viscosity in the reservoir.The residual oil saturation after water flooding is the material basis of SP flooding,and it is the second-most dominant factor controlling oil recovery.Combined with the analysis results of the influencing factors and reservoir parameters,the water flooding recovery index and SP flooding recovery index are defined to further establish quantitative calculation models of oil recovery under different displacement modes.The average relative errors of the two models are 4.4%and 2.5%,respectively;thus,they can accurately predict the oil recovery of different displacement stages and the ultimate reservoir oil recovery.

摘要： Objective To explore the factors affecting consumers’online drug purchases,and construct models of these factors to provide references for the development and popularization of online pharmacies.Methods Through searching,classifying,integrating,and extracting evaluation indexes of online pharmacies in literature,the indexes of factors affecting online drug purchases were initially established.Then SPSS24.0 was used for data analysis,and finally factor analysis was applied for screening and combining the indexes.Results and Conclusion A model of influencing factors for online drug purchases is set up with 4 factors and 14 indexes.Convenient service is the most important factor affecting online drug purchases.Highly educated young people prefer to buy drugs online.At present,online drug purchase is only a supplement to the purchase of drugs in offline pharmacies,and the penetration rate is not high.Online pharmacies should give full play to their advantages in terms of drug types,prices,logistics and after-sales services to make online drug purchases more mainstream.

摘要： Grasping the spatial correlation structure of transportation carbon emission efficiency(TCEE)and its influencing factors is significant for promoting high-quality and coordinated development of the transportation industry and the relevant region.Based on the ideal point cross-efficiency(IPCE)model,the social network analysis method was employed herein to explore the spatial correlation network structure of China’s provincial TCEE and its influencing factors.The results obtained showed the following outcomes.(1)During the study period,China’s provincial TCEE formed a complex and multithreaded network association relationship,but its network association structure was still relatively loose and presented the hierarchical gradient characteristics of dense in the east and sparse in the west.(2)The correlation of China’s TCEE formed a block segmentation based on the regional boundaries,and its factional structure was relatively obvious.The eastern region was closely connected with the central region,and generally connected with the western and northeastern regions.The central region was mainly connected with the eastern and western regions,and relatively less connected with the northeastern region.Besides,the northeastern region was weakly connected with the western region.(3)Shanghai,Beijing,Zhejiang,Guangdong,Jiangsu,Tianjin,and other developed provinces were in the core leading position in the TCEE network,which significantly impacted the spatial correlation of TCEE.However,Heilongjiang,Jilin,Xinjiang,Qinghai,and other remote provinces in the northeast and northwest were at the absolute edge of the network,which weakly impacted the spatial correlation of TCEE.(4)Provincial distance,economic development-level difference,transportation intensity difference,and transportation structure difference had significant negative impacts on the spatial correlation network of China’s provincial TCEE.In contrast,the energy-saving technology level difference had a significant positive impact on it.The regression coefficients of transportation energy structure and environmental regulation differences were positive but insignificant;their response mechanism and effects need to be improved and enhanced.

摘要： In order to practice the concept of‘lucid waters and lush mountains are invaluable assets’and promote the green development of agriculture,it is necessary to improve the efficiency of agricultural energy utilization.Based on the panel data of 28 provinces from 1995 to 2018,this paper calculated China’s agricultural energy input from two categories of direct energy and indirect energy,and used EBM(Epsilon-based Measure)mixed distance function model to measure the energy efficiency of agriculture in China.The nuclear density function and spatial autocorrelation were used to analyze the dynamic evolution of agricultural energy efficiency,and the dynamic panel model was used to analyze the influencing factors of agricultural energy efficiency.The results showed that:①From 1995 to 2018,the total agricultural energy input had increased year by year in China,with an average annual growth rate of 2%.Energy input structure changed from indirect energy-based to direct energy-based.Agricultural energy efficiency showed an evolutionary trend of‘rising-stagnating-rising rapidly’in China.The agricultural energy efficiency was generally low in China,and there was a large space for improvement in agricultural energy efficiency.②From 1995 to 2018,the average annual growth rate of agricultural energy efficiency in the eastern,central and western regions was 2.7%,1.9%and 1.4%respectively.In 2018,the agricultural energy efficiency in the eastern,central and western regions was 0.81,0.71 and 0.59 respectively.The gap between regions was expanding rapidly,and the agricultural energy efficiency in the central and western regions needed to be improved.③From 1995 to 2018,the agricultural energy efficiency of each province was polarized and the absolute gap was widened.There was obvious improvement in agricultural energy efficiency in Guangdong,Shandong,Jiangxi,Jiangsu,Liaoning and Tianjin,while the agricultural energy efficiency of Xinjiang,Guizhou,Zhejiang,Shanghai,and Inner Mongolia deteriorated.④From 1995 to 2018,there was no global spatial correlation of China’s agricultural energy efficiency.However,local‘high-high’concentration gradually appeared in the eastern region since 2010.⑤The first lag of energy efficiency had a significant positive impact on agricultural energy efficiency,and agricultural energy efficiency improvement had a time lag.The level of human capital,per capita net income of farmers and the level of urbanizaton had a significant positive impact on agricultural energy efficiency.The disaster rate,the level of development of secondary and tertiary industries,and the level of opening up had a significant negative impact on agricultural energy efficiency.In the implementation of the strategy of rural revitalization,we should focus on the central and western regions,take the cultivation of professional farmers as the key,focus on improving agricultural production conditions,enhance the level of cooperation between regions,exert the leading role of the secondary and tertiary industries,and enhance the ability of agricultural disaster prevention and mitigation.

摘要： After hospitalization,the patient faces a brief fragile period of susceptibility to disease and a high incidence of adverse events(re-admission or death,etc.),which is described by cardiologist Harlan M.Krumholz as post-hospital syndrome(PHS).PHS is characterized by the risk of early re-hospitalization towing to physiologic stressors from the initial admission,including disruption in sleep-wake cycles,inadequate pain control,deconditioning,and changes in nutritional status.Almost 1 in 6 patients hospitalized for acute myocardial infarction and 1 in 5 of those admitted for heart failure are readmitted within 30 days of discharge.Notably,only 10% and 35% are readmitted for the same diagnosis as that of the original hospitalization,respectively.Through a systematic review,this paper discusses the related concepts,hazards and influencing factors of PHS,and summarizes the counter measures based on the domestic status,in order to provide reference for domestic clinical medical personnel to formulate relevant measures to reduce the incidence of PHS.

摘要： With the scale of actual utilization of foreign capital in our country appears to be increasing year by year with the increase of reform and opening up.Based on the data published by the National Bureau of Statistics from 1999 to 2018 on the actual use of foreign capital,we selected several reasonable indicators as the main influencing factors from an economic perspective,and constructed a econometric model.This paper examines and analyzes the factors affecting the actual use of foreign capital in China,and puts forward corresponding policy suggestions according to the empirical results.