BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideli...Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.展开更多
Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for...Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.展开更多
Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential S...Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.展开更多
Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted t...Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.展开更多
With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their qual...With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their quality of life but also exerting negative effects on their physical and mental health and emotions.Therefore,in the clinical care of tumor patients,helping them relieve“cancer pain”and improving the quality and efficiency of medical care services have become important research topics.This paper takes evidence-based nursing as the starting point,analyzes the basic concepts and practical characteristics of evidence-based nursing,and then proposes the application process and effects of evidence-based nursing in cancer pain care for tumor patients.展开更多
Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk ass...Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk assessment criteria for medical adhesives in neonates by applying the best evidence in the management program for the reduction of medical adhesive-associated skin injuries in neonates, in terms of the use and removal of adhesives. Methods: A systematic search and quality assessment of topics related to medical adhesive-related skin injury in neonates was conducted to summarize the best evidence and to conduct a quality review in the neonatal unit. Results: After 2 rounds of review, medical and nursing staff in the neonatal unit had a 98% compliance rate for the knowledge of neonatal medical adhesive-related skin injury and a satisfactory compliance rate for the other 9 indicators;after the application of the evidence, the incidence of neonatal medical adhesive-related skin injury was significantly lower than that before the application of the evidence, and the differences were statistically significant (P Conclusion: The application of the best evidence-based management program in neonatal medical adhesive-associated skin injury can reduce the incidence of neonatal medical adhesive-associated skin injury, reduce neonatal infections, and improve the integrity of the protective skin barrier in neonates.展开更多
In this study,the evidence-based design(EBD)of naturalized decoration in hematopoietic stem cell transplantation(HSCT)wards of Peking University First Hospital was explored to improve patients’psychological state and...In this study,the evidence-based design(EBD)of naturalized decoration in hematopoietic stem cell transplantation(HSCT)wards of Peking University First Hospital was explored to improve patients’psychological state and rehabilitation environment by introducing natural elements.Based on questionnaire surveys and literature research,the EBD method was adopted to propose a naturalized decoration scheme for HSCT wards,and a satisfaction evaluation was conducted after construction and use.The research results show that naturalized decoration can effectively enhance the satisfaction and comfort of patients and medical staff,verifying its positive effects in HSCT wards.展开更多
BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other a...BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other adverse reactions.Standardized evidence-based nursing practices are essential for enhancing patient care by addressing both physical and psychological health issues.AIM To analyze the impact of standardized evidence-based nursing on psychological status and adverse reactions of patients undergoing endoscopic colonic polypectomy.METHODS Data from 200 patients who underwent endoscopic colonic polypectomy at the authors’hospital between January and June 2024 were randomly assigned to two groups:Control[received routine nursing care(n=100)]and study[received standardized evidence-based nursing intervention(s)(n=100)].Psychological status,visual analog scale,and Short-Form 36 Health Survey scores,adverse events,and satisfaction with nursing were compared between the two groups.RESULTS After the interventions,the study group exhibited significantly lower scores on the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale,along with a reduced incidence of adverse events compared with the control group(P<0.05).Short-Form 36 Health Survey scores and overall satisfaction with nursing care were also significantly higher in the intervention group(P<0.05).CONCLUSION Standardized evidence-based nursing interventions effectively reduced negative patient emotions and enhanced quality of life and satisfaction,demonstrating high safety.展开更多
Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods...Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods.The research adopts the method of combining theoretical analysis and practical application,and designs the evidence-based value-added evaluation framework,which includes the core elements of a multi-source heterogeneous data acquisition and processing system,a value-added evaluation agent based on a large model,and an evaluation implementation and application mechanism.Through empirical research verification,the evaluation system has remarkable effects in improving learning participation,promoting ability development,and supporting teaching decision-making,and provides a theoretical reference and practical path for educational evaluation reform in the new era.The research shows that the evidence-based value-added evaluation system based on data-driven can reflect students’actual progress more fairly and objectively by accurately measuring the difference in starting point and development range of students,and provide strong support for the realization of high-quality education development.展开更多
Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts in...Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts independently assessed the quality of the guidelines,extracted valuable evidence and recommendations,and initially formed a draft nursing program.Subsequently,an expert panel was organized to conduct a detailed discussion to review the practicality and effectiveness of the recommendations one by one,and the program was finally revised and improved.Results:The protocol covered four stages of patients’admission,preoperative,postoperative,and discharge,involving specific contents such as nutritional assessment,risk screening,dysphagia assessment,nutritional therapy,enteral and parenteral nutritional support,symptom management,and health education.The program included a total of 61 entries,with 33 class A recommendations and 28 class B recommendations.Conclusion:The constructed perioperative nutritional care program for esophageal cancer patients is scientific and practical,and can provide practical guidance for clinical care.展开更多
Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge tran...Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.展开更多
This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total ...This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.展开更多
BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case ...BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case series highlights 3 pediatric patients initially misdiagnosed with CMPA,emphasizing the need for a thorough evaluation.CASE SUMMARY Case 1:A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy.Surgical intervention involved a laparoscopic colostomy followed by a pull-through procedure,leading to a successful recovery.Case 2:A 2-month-old infant presented with greenish-yellow vomiting and abdominal distension.Initially misdiagnosed with CMPA,further investigation using barium studies revealed partial intestinal malrotation.The patient underwent a laparoscopic Ladd’s procedure and recovered well.Case 3:A 6-month-old infant with persistent vomiting and failure to thrive had been treated for CMPA.Detailed imaging studies indicated achalasia.The child underwent a Heller myotomy,which resulted in significant symptom improvement and weight gain CONCLUSION Thorough evaluation of gastrointestinal symptoms is necessary in children.A high suspicion for alternative diagnoses will prevent delays in accurate diagnosis and proper treatment,leading to improved outcomes.展开更多
BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptom...BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.展开更多
BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriat...BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriate treatment and prevention.CASE SUMMARY The main symptoms included black stool,hematochezia,haematemesis,blood in the nasogastric tube,and hemorrhagic shock.The mean age was 66.25 years old and the median onset time was 340 d after the surgery.The bleeding location comprised gastrointestinal anastomosis,bile duct-jejunum anastomosis,and extraluminal bleeding.The possible causes included marginal ulcer,jejunal varix,and abdominal infection.Endoscopic hemostatic clips,as well as a covered stent using angiography,were utilized to stop the bleeding and three patients survived.Only one patient died of gastrointestinal bleeding,abdominal bleeding,abdominal infection,hypovolemic shock,and disseminated intravascular coagulation.CONCLUSION Early and effective endoscopic intervention is the key to successful hemostasis in patients with gastrointestinal bleeding after pancreatoduodenectomy.展开更多
This study took the teaching practice of food-related majors in Chengdu University,a representative applied institution in China,as an example.Aligning with the course characteristics and educational objectives of Fun...This study took the teaching practice of food-related majors in Chengdu University,a representative applied institution in China,as an example.Aligning with the course characteristics and educational objectives of Functional Foods,it introduced the features of the BOPPPS teaching model and its implementation in course design.By incorporating research cases and presenting teaching examples,the steps and methods of BOPPPS-based teaching reform were explored while incorporating ideological and political elements into specialized instruction.This study provides insights and references for reforming other food-related courses and contributes to cultivating more food professionals with practical awareness and critical thinking.展开更多
BACKGROUNDGastrointestinal neuroendocrine carcinoma (GI NEC) has a low incidence rate andpoor prognosis. Most patients already have metastatic disease when they arediagnosed. Platinum chemotherapy is the main means of...BACKGROUNDGastrointestinal neuroendocrine carcinoma (GI NEC) has a low incidence rate andpoor prognosis. Most patients already have metastatic disease when they arediagnosed. Platinum chemotherapy is the main means of treating metastatic GINECs. There is a lack of effective treatment methods after chemotherapy failure.Therefore, Therefore, selecting appropriate posterior-line treatment programs toimprove the prognosis of patients is urgently needed.CASE SUMMARYA 64-year-old female was diagnosed with stage IV NEC of the rectum due toabdominal pain and rectal bleeding. After multiline chemotherapy, the conditionprogressed, and the patient was treated with a combination of camrelizumab and surufatinib. The efficacy evaluation revealed partial remission (PR) and stable conditions, with the expression ofthe tumor marker neuron-specific enolase (NSE) returning to normal. The adverse reactions were controllable, andthe overall condition was good, with weight gain achieved in the past four years. Another 51-year-old femaleexperienced recurrence and metastasis of a duodenal NEC after surgery. After multiline chemotherapy, shereceived sintilimab combined with surufatinib. The curative effect fluctuated between PR and stability. Duringtreatment, she recovered from immune-related diabetes and later died due to deterioration of her condition.During the treatment, the patient’s NSE level returned to normal.CONCLUSIONThe combination of antiangiogenic targeted drugs and immunotherapy provides a new therapeutic approach forthe treatment of metastatic GI-NECs.展开更多
Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).W...Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.展开更多
BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry com...BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.展开更多
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
文摘Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.
基金supported by the Peking University Nursing Discipline Research Development Fund(No.TYZH2023001)。
文摘Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.
文摘Malaria remains a major public health challenge necessitating accurate predictive models to inform effective intervention strategies in Sierra Leone. This study compares the performance of Holt-Winters’ Exponential Smoothing, Harmonic, and Artificial Neural Network (ANN) models using data from January 2018 to December 2023, incorporating both historical case records from Sierra Leone’s Health Management Information System (HMIS) and meteorological variables including humidity, precipitation, and temperature. The ANN model demonstrated superior performance, achieving a Mean Absolute Percentage Error (MAPE) of 4.74% before including climatic variables. This was further reduced to 3.9% with the inclusion of climatic variables, outperforming traditional models like Holt-Winters and Harmonic, which yielded MAPEs of 22.53% and 17.90% respectively. The ANN’s success is attributed to its ability to capture complex, non-linear relationships in the data, particularly when enhanced with relevant climatic variables. Using the optimized ANN model, we forecasted malaria cases for the next 24 months, predicting a steady increase from January 2024 to December 2025, with seasonal peaks. This study underscores the potential of machine learning approaches, particularly ANNs, in epidemiological modelling and highlights the importance of integrating environmental factors into malaria prediction models, recommending the ANN model for informing more targeted and efficient malaria control strategies to improve public health outcomes in Sierra Leone and similar settings.
文摘Objective:To investigate the preventive effect of evidence-based preventive nursing on urinary tract infections(UTIs)in elderly female diabetic patients.Methods:Seventy-nine elderly female diabetic patients admitted to our hospital from March 2023 to March 2025 were selected and randomly divided into observation group(40 cases)and control group(39 cases)using the envelope method.The control group received routine nursing,while the observation group received evidence-based preventive nursing.The outcomes were compared between the two groups.Results:After treatment,blood glucose levels in both groups were significantly reduced,and the improvement in various indicators in the observation group was better than that in the control group(P<0.05).Additionally,quality of life scores were significantly improved in both groups,with the observation group showing better improvement than the control group(P<0.05).The duration of catheter indwelling and hospital stay in the observation group were lower than those in the control group(P<0.05).Conclusion:Evidence-based preventive nursing can systematically reduce the risk of urinary tract infections,improve patient outcomes,and provide effective references for clinical nursing practice.
文摘With the aging of China’s population,tumors have become a major disease affecting people’s normal life.In particular,“cancer pain”caused by tumors has a severe impact on tumor patients,not only reducing their quality of life but also exerting negative effects on their physical and mental health and emotions.Therefore,in the clinical care of tumor patients,helping them relieve“cancer pain”and improving the quality and efficiency of medical care services have become important research topics.This paper takes evidence-based nursing as the starting point,analyzes the basic concepts and practical characteristics of evidence-based nursing,and then proposes the application process and effects of evidence-based nursing in cancer pain care for tumor patients.
文摘Objective: In the Healthy Child Action Enhancement Program (2021-2025), it is proposed to ensure the safety and health of newborns and to promote high-quality development of health. Our department established risk assessment criteria for medical adhesives in neonates by applying the best evidence in the management program for the reduction of medical adhesive-associated skin injuries in neonates, in terms of the use and removal of adhesives. Methods: A systematic search and quality assessment of topics related to medical adhesive-related skin injury in neonates was conducted to summarize the best evidence and to conduct a quality review in the neonatal unit. Results: After 2 rounds of review, medical and nursing staff in the neonatal unit had a 98% compliance rate for the knowledge of neonatal medical adhesive-related skin injury and a satisfactory compliance rate for the other 9 indicators;after the application of the evidence, the incidence of neonatal medical adhesive-related skin injury was significantly lower than that before the application of the evidence, and the differences were statistically significant (P Conclusion: The application of the best evidence-based management program in neonatal medical adhesive-associated skin injury can reduce the incidence of neonatal medical adhesive-associated skin injury, reduce neonatal infections, and improve the integrity of the protective skin barrier in neonates.
基金Sponsored by the National Natural Science Foundation of China:Visual Perception Based Natural Intervention for Patients in HSCT Wards(52278045)Innovation and Entrepreneurship Training Programme for Students in 2024(10805136024XN139-91).
文摘In this study,the evidence-based design(EBD)of naturalized decoration in hematopoietic stem cell transplantation(HSCT)wards of Peking University First Hospital was explored to improve patients’psychological state and rehabilitation environment by introducing natural elements.Based on questionnaire surveys and literature research,the EBD method was adopted to propose a naturalized decoration scheme for HSCT wards,and a satisfaction evaluation was conducted after construction and use.The research results show that naturalized decoration can effectively enhance the satisfaction and comfort of patients and medical staff,verifying its positive effects in HSCT wards.
文摘BACKGROUND Endoscopic colon polypectomy is a common procedure used to remove polyps that may develop into colorectal cancer if left untreated.Despite these advantages,patients frequently experience anxiety and other adverse reactions.Standardized evidence-based nursing practices are essential for enhancing patient care by addressing both physical and psychological health issues.AIM To analyze the impact of standardized evidence-based nursing on psychological status and adverse reactions of patients undergoing endoscopic colonic polypectomy.METHODS Data from 200 patients who underwent endoscopic colonic polypectomy at the authors’hospital between January and June 2024 were randomly assigned to two groups:Control[received routine nursing care(n=100)]and study[received standardized evidence-based nursing intervention(s)(n=100)].Psychological status,visual analog scale,and Short-Form 36 Health Survey scores,adverse events,and satisfaction with nursing were compared between the two groups.RESULTS After the interventions,the study group exhibited significantly lower scores on the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale,along with a reduced incidence of adverse events compared with the control group(P<0.05).Short-Form 36 Health Survey scores and overall satisfaction with nursing care were also significantly higher in the intervention group(P<0.05).CONCLUSION Standardized evidence-based nursing interventions effectively reduced negative patient emotions and enhanced quality of life and satisfaction,demonstrating high safety.
基金This paper is the research result of“Research on Innovation of Evidence-Based Teaching Paradigm in Vocational Education under the Background of New Quality Productivity”(2024JXQ176)the Shandong Province Artificial Intelligence Education Research Project(SDDJ202501035),which explores the application of artificial intelligence big models in student value-added evaluation from an evidence-based perspective。
文摘Based on the educational evaluation reform,this study explores the construction of an evidence-based value-added evaluation system based on data-driven,aiming to solve the limitations of traditional evaluation methods.The research adopts the method of combining theoretical analysis and practical application,and designs the evidence-based value-added evaluation framework,which includes the core elements of a multi-source heterogeneous data acquisition and processing system,a value-added evaluation agent based on a large model,and an evaluation implementation and application mechanism.Through empirical research verification,the evaluation system has remarkable effects in improving learning participation,promoting ability development,and supporting teaching decision-making,and provides a theoretical reference and practical path for educational evaluation reform in the new era.The research shows that the evidence-based value-added evaluation system based on data-driven can reflect students’actual progress more fairly and objectively by accurately measuring the difference in starting point and development range of students,and provide strong support for the realization of high-quality education development.
文摘Objective:To construct an evidence-based practice plan for perioperative nutritional optimization in esophageal cancer patients.Methods:By systematically searching relevant guidelines at home and abroad,two experts independently assessed the quality of the guidelines,extracted valuable evidence and recommendations,and initially formed a draft nursing program.Subsequently,an expert panel was organized to conduct a detailed discussion to review the practicality and effectiveness of the recommendations one by one,and the program was finally revised and improved.Results:The protocol covered four stages of patients’admission,preoperative,postoperative,and discharge,involving specific contents such as nutritional assessment,risk screening,dysphagia assessment,nutritional therapy,enteral and parenteral nutritional support,symptom management,and health education.The program included a total of 61 entries,with 33 class A recommendations and 28 class B recommendations.Conclusion:The constructed perioperative nutritional care program for esophageal cancer patients is scientific and practical,and can provide practical guidance for clinical care.
文摘Objective: To develop a best-evidence-based optimal nutrition management plan for patients with chronic heart failure, apply it in clinical practice, and evaluate its effectiveness. Methods: Use the KTA knowledge translation model to guide evidence-based practice in nutrition management, and compare the nutritional status, cardiac function status, quality of life, and quality review indicators of chronic heart failure patients before and after the application of evidence. Results: After the application of evidence, the nutritional status indicators (MNA-SF score, albumin, hemoglobin) of two groups of heart failure patients significantly increased compared to before the application of evidence, with statistically significant differences (p Conclusion: The KTA knowledge translation model provides methodological guidance for the implementation of evidence-based practice for heart failure patients. This evidence-based practice project is beneficial for improving the outcomes of malnutrition in chronic heart failure patients and is conducive to standardizing nursing pathways, thereby promoting the improvement of nursing quality.
文摘This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.
文摘BACKGROUND Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy(CMPA),complicating diagnosis.This case series highlights 3 pediatric patients initially misdiagnosed with CMPA,emphasizing the need for a thorough evaluation.CASE SUMMARY Case 1:A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy.Surgical intervention involved a laparoscopic colostomy followed by a pull-through procedure,leading to a successful recovery.Case 2:A 2-month-old infant presented with greenish-yellow vomiting and abdominal distension.Initially misdiagnosed with CMPA,further investigation using barium studies revealed partial intestinal malrotation.The patient underwent a laparoscopic Ladd’s procedure and recovered well.Case 3:A 6-month-old infant with persistent vomiting and failure to thrive had been treated for CMPA.Detailed imaging studies indicated achalasia.The child underwent a Heller myotomy,which resulted in significant symptom improvement and weight gain CONCLUSION Thorough evaluation of gastrointestinal symptoms is necessary in children.A high suspicion for alternative diagnoses will prevent delays in accurate diagnosis and proper treatment,leading to improved outcomes.
文摘BACKGROUND Thirst management in convalescent patients recovering from a digestive surgery performed under general anesthesia requires attention.A simple,practical,and safe method can effectively relieve thirst symptoms in such patients.AIM To evaluate the enhanced recovery after surgery(ERAS)-based evidence-based care(EBC)plus ice stimulation therapy for thirst management of convalescent patients following digestive surgery performed under general anesthesia.METHODS A total of 191 patients convalescing after digestive surgery performed under general anesthesia between March 2020 and February 2023 and experiencing thirst were selected.In total,89 patients and 102 patients in the control and research groups received routine care and ERAS-based EBC plus ice stimulation therapy,respectively.The following data were comparatively analyzed:(1)Thirst degree(thirst intensity numerical rating scale)and thirst distress(TD)degree(TD scale);(2)Oral mucosal wetness;(3)Unstimulated whole salivary flow rate(UWSFR);(4)Adverse reactions(palpitation,fatigue,chapped lips,and nausea and vomiting);and(5)Nursing satisfaction.RESULTS After nursing,thirst degree and distress were statistically lower in the research group than in the control group.Additionally,compared with the control group,the research group exhibited a lower degree of oral mucosal wetness,higher UWSFR,fewer adverse reactions,and more total nursing satisfaction.CONCLUSION ERAS-based EBC plus ice stimulation therapy can effectively alleviate thirst in convalescent patients recovering from a digestive surgery performed under general anesthesia.It can alleviate xerostomia symptoms,reduce adverse reactions,and improve patient comfort.
文摘BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriate treatment and prevention.CASE SUMMARY The main symptoms included black stool,hematochezia,haematemesis,blood in the nasogastric tube,and hemorrhagic shock.The mean age was 66.25 years old and the median onset time was 340 d after the surgery.The bleeding location comprised gastrointestinal anastomosis,bile duct-jejunum anastomosis,and extraluminal bleeding.The possible causes included marginal ulcer,jejunal varix,and abdominal infection.Endoscopic hemostatic clips,as well as a covered stent using angiography,were utilized to stop the bleeding and three patients survived.Only one patient died of gastrointestinal bleeding,abdominal bleeding,abdominal infection,hypovolemic shock,and disseminated intravascular coagulation.CONCLUSION Early and effective endoscopic intervention is the key to successful hemostasis in patients with gastrointestinal bleeding after pancreatoduodenectomy.
文摘This study took the teaching practice of food-related majors in Chengdu University,a representative applied institution in China,as an example.Aligning with the course characteristics and educational objectives of Functional Foods,it introduced the features of the BOPPPS teaching model and its implementation in course design.By incorporating research cases and presenting teaching examples,the steps and methods of BOPPPS-based teaching reform were explored while incorporating ideological and political elements into specialized instruction.This study provides insights and references for reforming other food-related courses and contributes to cultivating more food professionals with practical awareness and critical thinking.
文摘BACKGROUNDGastrointestinal neuroendocrine carcinoma (GI NEC) has a low incidence rate andpoor prognosis. Most patients already have metastatic disease when they arediagnosed. Platinum chemotherapy is the main means of treating metastatic GINECs. There is a lack of effective treatment methods after chemotherapy failure.Therefore, Therefore, selecting appropriate posterior-line treatment programs toimprove the prognosis of patients is urgently needed.CASE SUMMARYA 64-year-old female was diagnosed with stage IV NEC of the rectum due toabdominal pain and rectal bleeding. After multiline chemotherapy, the conditionprogressed, and the patient was treated with a combination of camrelizumab and surufatinib. The efficacy evaluation revealed partial remission (PR) and stable conditions, with the expression ofthe tumor marker neuron-specific enolase (NSE) returning to normal. The adverse reactions were controllable, andthe overall condition was good, with weight gain achieved in the past four years. Another 51-year-old femaleexperienced recurrence and metastasis of a duodenal NEC after surgery. After multiline chemotherapy, shereceived sintilimab combined with surufatinib. The curative effect fluctuated between PR and stability. Duringtreatment, she recovered from immune-related diabetes and later died due to deterioration of her condition.During the treatment, the patient’s NSE level returned to normal.CONCLUSIONThe combination of antiangiogenic targeted drugs and immunotherapy provides a new therapeutic approach forthe treatment of metastatic GI-NECs.
基金Supported by Shaanxi Provincial Science and Technology Development Plan Project(No.2024SFYBXM-327).
文摘Dear Editor,We report two rare cases of ocular perforating injuries caused by acupuncture needles.Both cases were approved by the Ethics Committee of Xi’an People’s Hospital(Xi’an No.4 Hospital)(KJLL-Z-K-2023060).Written informed consents were obtained from the patients.Acupuncture is an integral part of traditional Chinese medicine,and is widely used for the treatment of systemic diseases and ophthalmologic diseases^([1-8]),such as paralysis caused by stroke^([4]),diabetes^([7]),dry eye disease^([8]),pigmentary degeneration of retina,macular degeneration,glaucoma,and optic atrophy^([6]).Improper acupuncture technique can lead to accidents.
文摘BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.
