Considering the professional caregivers needed to develop medical and nursing services，Shandong province has formulated the medical caregiver professional qualification standard.The standard specifies the professional definition，skill level，work environment，ability characteristics and other profiles of medical and nursing caregivers.It refines six major professional function modules，namely，life care，professional nursing care，rehabilitation care，psychological care，hospice care and educational guidance.It also formulates detailed work content and skill requirements for each module.It aims to unify the professional service behaviors of medical and nursing personnel and improve the quality of medical and nursing services.In order to provide a reference for the construction of standards in the field of medical and nursing integration， this paper reports the compilation in terms of the process and results，the framework， the innovations，and the significance of the implementation.

Objective： To evaluate the nutritional risk of patients in emergency intensive care unit （EICU） using mNUTRIC score and NRS-2002， and to compare the value of the two tools in assessing 28-day mortality Methods： Patients admitted to the EICU from February to May 2023 were selected. Data were collected from electronic medical records， and nutritional assessment was performed using NRS⁃2002 and mNUTRIC score within 24 hours of admission. Cox regression analysis was used to explore the effect of nutritional risk on 28-day mortality. ROC curve was drawn to evaluate the predictive value of NRS⁃2002， mNUTRIC， APACHE Ⅱ and SOFA for 28⁃day mortality. Results： A total of 152 patients were enrolled in this study. According to mNUTRIC score， 102 patients （67.1%） were at high nutritional risk（>5 points）. NRS⁃2002 score screened 67 patients（44.1%） with high nutritional risk （≥5 points）.The results showed that the results of the two scoring systems were inconsistent.Cox regression analysis showed that mNUTRIC （OR=1.782） and SOFA （OR=1.186） were risk factors for the death of critically ill patients in EICU.The AUC of mNUTRIC score for predicting 28⁃day mortality was 0.82［95%CI（0.73，0.90）］，and the best critical value was 6.The predictive value of mNUTRIC score was better than NRS⁃2002， APACHE Ⅱ and SOFA. Conclusions： mNUTRIC score can be used as an effective tool for nutritional risk assessment in critically ill EICU patients and is associated with 28⁃day mortality. However， the characteristics of patients in the acute stage and recovery stage should be considered to dynamically assess nutritional risk.

Objective： To investigate the level of osteoporosis health literacy of perimenopausal women in rural areas of Shanxi and analyze its influencing factors. Methods： A total of 2 760 perimenopausal women aged 40⁃60 years in rural areas of Shanxi were selected by convenient cluster sampling method on the basis of voluntary principle to investigate the health literacy of osteoporosis，and the related influencing factors were analyzed. Results： A total of 2 721 perimenopausal women were included，The total score of osteoporosis health literacy was （146.76±16.57）， and the health literacy availability rate was 21.65%.Health status and family history are the main influencing factors of osteoporosis health literacy. Conclusion： The health literacy level of osteoporosis in perimenopausal women in rural areas of Shanxi needs to be improved. Appropriate health education can be formulated based on related influencing factors to improve the health literacy level of osteoporosis in this population

Objective： To investigate the relationship between sarcopenia and the risk of carotid plaque in postmenopausal women. Methods： A total of 527 postmenopausal women who underwent physical examination in the health examination center of Huadong Sanatorium from March to October 2022 were selected as the research objects by random cluster sampling.The body composition analyzer （InBody720） was used to calculate the skeletal muscle mass of human limbs， appendicular skeletal muscle index （ASMI） was calculated and handgrip and walking speed were measured. Clinical data were collected， univariate combined with multivariate regression analysis was used to explore the relationship between sarcopenia and the risk of carotid plaque in postmenopausal women，and receiver operating characteristic （ROC） curve was used to explore the diagnostic value of ASMI in the occurrence of carotid plaque in postmenopausal women. Results： Among 527 postmenopausal women， 172 （32.6%） had carotid plaque. In postmenopausal women， ASMI in the carotid plaque group was significantly lower than that in the non-carotid plate group ［5.42（4.88，6.09）kg/m 6.63（5.73，7.78）kg/m，<0.001］. The incidence of sarcopenia in the carotid plaque group was significantly higher than that in the non-carotid plaque group （45.3% 18.0%， <0.001）.The lower the ASMI value in postmenopausal women，the higher the risk of carotid plaque （<0.001）.Multivariate logistic regression analysis showed that postmenopausal women with sarcopenia significantly increased the risk of carotid plaque（OR=3.486，95%CI 2.237-5.432）. ROC showed that ASMI had a higher predictive value for carotid plaque than waist circumference and body mass index （AUC=0.756）. Conclusions： Sarcopenia significantly increases the risk of carotid artery plaque in postmenopausal women，and ASMI can be used as a simple predictor of carotid artery plaque.

Objective： To construct an assessment tool for capacity management behavioral discrepancy in patients with chronic heart failure at home. Method： Through literature review，semi⁃structured interview， group discussion and expert meeting，the first draft of assessment tool for capacity management behavioral discrepancy in patients with chronic heart failure at home was formed.Two rounds of expert consultation were conducted by Delphi method，and each item of the assessment tool was revised to form the final assessment tool. Results： The positive coefficients of the two rounds of expert consultation were 88.00% and 90.91%.The authority coefficients were 0.891 and 0.900. The Kendall's W coordination coefficients were 0.108 and 0.206，both <0.001.The resulting assessment tool had a total of 49 items in 8 dimensions， including basic information （6 items），limiting fluid intake （6 items），monitoring fluid output （6 items） limiting sodium intake （8 items）， monitoring weight （8 items），monitoring symptoms and signs related to heart failure， blood pressure and heart rate （6 items）， paying attention to medical indications （4 items），and timing of diuretic adjustment （5 items）. Conclusion： The assessment tool for capacity management behavioral discrepancy in patients with chronic heart failure at home based on Delphi method is highly reliable，and can be used to investigate the status quo and influencing factors of capacity management behavioral discrepancy in patients with chronic heart failure at home， providing a reference for improving patients' out⁃of⁃hospital self⁃management ability， improving the status quo of volume management， and formulating intervention plans.

Objective： To analyze the characteristics and report quality of hospice care studies registered in ChiCTR. Methods： The clinical trials related to hospice care registered in ChiCTR were searched from the establishment of the database to January 13， 2024. Two researchers independently screened studies and extracted relevant information， and the completeness of each study's registration information was evaluated using the 20 minimum requirements for clinical trial registration of the World Health Organization International Clinical Trials Registry Platform. Results： A total of 59 studies were included，the earliest registration time was 2016， and the number of registrations was generally on the rise over time.Beijing and Sichuan had relatively more registered studies，10 （16.95%） and 7 （11.86%），respectively. Among the 59 palliative care studies，15 studies （25.42%） were multicenter studies，and 57 studies （96.61%） obtained ethical approval.According to the validity of registration information， the registration completeness of each item was calculated. The results showed that the unique trial registration number （ID）， trial registration date， main sponsor，secondary sponsor， public contact person， scientific contact person， public topic， and formal scientific topic of the 59 hospice care studies were all 100.00%. All studies indicated the funding situation， and most of them were provincial funding （15 items，25.42%）.The completeness of intervention measures and control measures was 10.17% （6 items） and 6.78% （4 items），respectively.All 59 studies described the type of study and the method of randomization， but only 29 （49.15%） studies described the implementation of blinding. All 59 studies reported the primary outcome， and 40 studies （67.80%） reported the secondary outcomes.The perfection of the outcome measures/measurement methods and the time point of main concern was ≤50.00%. Conclusions： The number of hospice care research registered in ChiCTR is generally increasing， but the overall number is still small.There are relatively many studies registered in Beijing，Sichuan and other places，and multi-center research and ethical review still need to be further improved.Hospice research reports registered in ChiCTR are not standardized and complete， and should be further improved in the future to improve the quality of reports.

Objective： To compare and explore the predictive value of three fall risk assessment tools，which were Morse Fall Assessment Scale （MFS），St Thomas's Risk Assessment Tool （STRATIFY Scale），and Short Physical Performance Battery （SPPB） in middle⁃aged and elderly people in nursing facilities. Methods： 4 041 cases of middle⁃aged and elderly people were randomly selected from a total of 80 nursing homes in 4 cities and prefectures in Hunan province using the General Information Questionnaire，MFS，STRATIFY Scale， and SPPB Scale.The ROC curves were used to assess the predictive effect of different fall assessment scales on falls. Results： A total of 4 041 cases of middle⁃aged and elderly people in nursing institutions were investigated，and 676 people （16.73%） had fallen within one year.The results showed that there were statistically significant differences between the fall group and the no⁃fall group in comparing middle⁃aged and elderly people in age，gender，whether they had comorbid chronic diseases， and whether they were depressed （<0.05）.The AUC of the MFS was 0.850 （95%CI 0.834⁃0.867），and the Jorden index was 0.597 when the total score was 37.5， and the scale had the greatest predictive value；the AUC of the STRATIFY was 0.764（95%CI 0.744⁃0.783），when the total score was 1.5，and the Jorden index was 0.407，and the scale had the greatest predictive value； the AUC of the SPPB was 0.675（95%CI 0.654⁃0.697），when the total score was 7.5，and the Jorden index was 0.293， and the scale had the greatest predictive value.The AUC of the MFS scale and the Jorden index were higher than the other two scales. Conclusion： MFS，STRATIFY，and SPPB all have predictive value for the fall risk of the elderly in nursing facilities，and the predictive value of MFS is higher than STRATIFY and SPPB.

Objective： To investigate the dynamic changes of serum oestrogen levels in patients with first⁃episode perimenopausal depression （PMD） and their correlation with cognitive function. Methods： 127 patients with first⁃episode PMD who visited Shanxi Fenyang Hospital from December 2021 to December 2022 were selected to be included in the PMD group，and 200 perimenopausal women who underwent a physical examination at our hospital during the same period were selected to be included in the control group.General information was collected and levels of sex hormones （oestrone （E1），oestradiol（E2），serum prolactin （PRL）），follicle⁃stimulating hormone （FSH），and luteinising hormone （LH），and norepinephrine （NE），dopamine （DA），brain⁃derived neurotrophic factor （BDNF），and 5⁃hydroxytryptophan （5⁃HT） were measured in both groups at the time of visit；sex hormone and neurotransmitter levels were measured at different time points （at the time of consultation，3 months，6 months and 12 months after consultation） and cognitive function was assessed using the Montreal Cognitive Assessment Scale（MoCA） in the PMD group；sex hormone and neurotransmitter levels were analysed in relation to cognitive function using pearson's correlation；and risk factors affecting PMD were analysed using either unifactorial or multifactorial logistic regression equations；patients were divided into a cognitively impaired group （=94） and a cognitively normal group （=33） based on their MoCA scores at 12 months after the consultation，and clinical data and serological indices were compared between the two groups； the risk factors analysed using multifactorial logistic regression modelling. Results： The levels of E1，E2，NE，DA，BDNF，and 5⁃HT in the PMD group were significantly lower than those in the control group（<0.05）；and the levels of PRL，FSH，and LH in the women in the PMD group were significantly higher than those in the control group（<0.05）.With the increase of time，the levels of E1，E2，NE，DA，BDNF，and 5⁃HT in PMD patients showed a trend of gradual decrease，and there was a significant difference in the comparison between time points （<0.05）；with the increase of time， the levels of PRL，FSH，and LH in patients in the PMD group showed a trend of gradual increase，and there was a significant difference in the comparison between time points （<0.05）.After gradual exclusion of confounders with covariance，there was still an independent correlation between hormone indicators and the risk of cognitive impairment in patients with PMD （all <0.001）. Conclusion： Different levels of sex hormones and neurotransmitter factors all affect the occurrence of PMD，and there is a certain correlation between the level of cognitive functioning and sex hormones and neurotransmitter factors of perimenopausal women. Sex hormone dynamic level monitoring can be carried out on perimenopausal women in order to intervene in PMD at an earlier stage.

Objective： To construct a perioperative rapid rehabilitation systematic nursing plan for mediastinal tumor resection under thoracoscopy，to provide references for postoperative rapid rehabilitation of patients with mediastinal tumor resection under thoracoscopy. Methods： Through systematic literature review and expert interviews，the Delphi method method was used to construct the perioperative rapid rehabilitation systematic nursing plan for mediastinal tumor resection under thoracoscopy. Results： The recovery rates of correspondence questionnaires of both rounds were 100%，and Kendall's W were 0.262 and 0.327（both <0.001），the expert authority coefficients was 0.832，0.873.The constructed perioperative enhanced recovery system nursing plan for thoracoscopic mediastinal tumor resection included 6 first⁃level indicators，18 second-level indicators and 49 third⁃level indicators， including preoperative preparation， preoperative pre⁃rehabilitation，intraoperative management， postoperative management， discharge guidance and post-discharge management. Conclusion： The systematic perioperative rapid rehabilitation nursing plan for thoracoscopic mediastinal tumor resection is scientific，reliable，comprehensive and specific，with strong clinical applicability.