Clinical Promotion Research Articles

Impacts of enhanced recovery after surgery nursing interventions on wound infection and complications following bladder cancer surgery: A meta-analysis.

A meta-analysis was executed to comprehensively examine the impacts of enhanced recovery after surgery (ERAS) care interventions on complications and wound infections following bladder cancer (BCa) surgery. Computer searches were carried out in Embase, Google Scholar, Cochrane Library, PubMed, Wanfang and CNKI, from their inception to November 2023, for RCTs regarding perioperative ERAS nursing interventions in patients with BCa. Two independent researchers performed literature screening, extracted data and carried out quality evaluations. Stata 17.0 software was utilized for the analysis of the data. Ultimately, 16 RCTs, involving 1190 patients, were included. The analysis showed that, in comparison with conventional nursing methods, perioperative ERAS nursing application in patients with BCa remarkably decreased the occurrence of wound infections (OR: 0.31, 95% CI: 0.16-0.59) and complications (OR: 0.19, 95% CI: 0.13-0.28). Our study indicates that perioperative care based on the ERAS concept remarkably decreased the occurrence of wound infections and complications following BCa surgery, demonstrating notable nursing efficacy and meriting widespread clinical promotion.

Treatment Efficacy of CT-Guided Percutaneous Kyphoplasty Combined with Three-Dimensional Coordinate Guidance System on Osteoporotic Vertebral Compression Fracture

Purpose: To investigate the clinical effect of percutaneous kyphoplasty (PKP) guided by computed tomography (CT) combined with the three-dimensional coordinate guidance system on the treatment of osteoporotic vertebral compression fracture (OVCF). Methods: 32 cases of OVCF in the elderly admitted to our hospital from October 2019 to March 2021 underwent CT-guided PKP combined with the three-dimensional coordinate guidance system, and 36 vertebrae were treated. The patients’ VAS pain scores (visual analog scale) and ODI (Oswestry disability index) were observed after surgery, and the paired t-test was used to compare these indexes. Results: The 36 vertebrae that were treated with CT-guided PKP combined with the three-dimensional coordinate guidance system underwent unilateral pedicle puncture according to the path planned by CT images. With the ideal position of the puncture needle and a high success rate of puncture, the puncture time was 1.2–2.6 minutes, with an average of about 1.5 minutes; the injected bone cement ranged from 3 to 5.5 mL, with an average of 4.2 mL, and there were no spinal nerve injuries or leakage of the cement in the canal. VAS score decreased from 7.65 ± 0.60 before the operation to 2.59 ± 0.28 one day after the operation (P < 0.01); ODI decreased from 62.3 ± 2.18 before the operation to 27.91 ± 1.32 after the operation (P < 0.01). Conclusion: The application of CT-guided PKP combined with the three-dimensional coordinate guidance system has the advantages of accurate puncture, short operation time, less intraoperative bleeding, and low complications. This treatment is safe, reliable, and satisfactory for patients, and is worthy of clinical promotion.

The impact of refined nursing intervention on neurological function recovery and prognosis improvement in patients undergoing intracranial aneurysm intervention

Background This study aims to explore the application of refined nursing intervention in patients undergoing unruptured intracranial aneurysm intervention, evaluating its impact on neurological function recovery and prognosis improvement. Methods Patients diagnosed with intracranial aneurysms and undergoing treatment at our hospital from February 2022 to June 2023 were included in this study. After applying complete inclusion and exclusion criteria to ensure sample representativeness, a total of 92 patients were enrolled. Using a randomization method, patients were divided into an observation group and a control group. The control group received routine nursing care, while the observation group received refined nursing intervention. Nursing effects were compared between the two groups, and statistical analysis was conducted using appropriate methods, with content analysis summarizing the results. Results The observation group, post-intervention, exhibited significantly improved Neurological Function Deficit (NFD) scores compared to the control group (p = 0.023). Additionally, the observation group showed higher proportions of Grade V patients in the Glasgow Outcome Scale (GOS) post-intervention (p = 0.031). Moreover, Fugl Meyer Assessment (FMA) scores for motor function were notably higher in the observation group than the control group (p = 0.003). The observation group also reported lower headache intensity and fewer adverse outcomes than the control group (p = 0.018, 0.038). Conclusion Refined nursing intervention in patients undergoing intracranial aneurysm intervention demonstrates better outcomes in terms of neurological function recovery and prognosis improvement. It reduces uncertainty in nursing practices, effectively enhancing nursing outcomes, and warrants clinical application and promotion.

Colonoscopy combined with laparoscopy can improve post‐operative quality of life in patients with colon cancer

AbstractAimThe study aimed to elucidate the clinical efficacy of colonoscopy combined with laparoscopic radical resection for patients with colon cancer.MethodsCases with colon cancer were divided into the control group (received laparoscopic radical resection) and the experimental group (received colonoscopy combined with laparoscopic radical resection). Inflammatory cytokines’ levels and immune functions were evaluated before and after the operation. The 36‐item Short Form Health Survey (SF‐36) was used to evaluate the living quality.ResultsRelative to the control group, individuals in the experimental group had a shorter hospital stay and post‐operative anal exhaust, and reduced intraoperative blood loss. Changes in serum interferon‐gamma (IFN‐γ), interleukin‐8 (IL‐8) and IL‐10 levels were minimal in the experimental group. Serum CD3+%, CD4+% and CD4+/CD8+ values of the two groups were significantly decreased compared with the preoperative values, which increased more significantly in the experimental group relative to the control group. After the operation, individuals in the experimental group presented higher SF‐36 scores than those in the experimental group. The experimental group presented a low incidence of post‐operative complications.ConclusionsColonoscopy combined with laparoscopic radical resection for colon cancer had only a little effect on immune function and inflammatory response. It can shorten the recovery time of patients and reduce post‐operative complications, which is worthy of further clinical promotion.

Advantages of edaravone dextrosanol in elderly patients with acute cerebral infarction versus edaravone: a preliminary study

Objective To analyze and compare the application advantages of Edaravone and Edaravone Dextrosanol in elderly patients with acute cerebral infarction (ACI). Methods A retrospective analysis of clinical data from 113 elderly AIS patients admitted to our hospital between January 2022 and January 2023 was conducted. Based on the treatment interventions received, patients were divided into a control group (n = 56) and an observation group (n = 57). The control group received Edaravone in addition to routine treatment, while the observation group received Edaravone Dextrosanol in addition to routine treatment. compared clinical outcomes, motor and neurological function, self-care ability, neural damage indicators, inflammatory markers, and adverse reactions between the two groups. Results ① Total effective rate in the observation group (91.23%) was significantly higher than that in the control group (75.00%) (p < 0.05). ② After treatment, higher FMA and Barthel scores, lower NDS score in observation group vs control group (p < 0.05). ③ After treatment, lower NSE and MMP-9 levels in observation group vs control group (p < 0.05). ④ After treatment, lower IL-1β, IL-6, and hs-CRP levels in observation group vs control group (p < 0.05). ⑤ No significant difference in adverse reaction incidence between groups (p > 0.05). Conclusion Edaravone Dextrosanol proves effective in treating elderly AIS patients. Compared to Edaravone, it boosts effectiveness, neurological recovery, motor & self-care abilities, and reduces neural damage & inflammation markers. Its safety profile is comparable to Edaravone, without significantly increasing adverse reactions. These findings suggest that Edaravone Dextrosanol is worthy of clinical promotion.

Effects of predictive nursing interventions on pressure ulcer in older bedridden patients: A meta-analysis.

To evaluate the effect of predictive nursing interventions on pressure ulcers in elderly bedridden patients by meta-analysis. Applied computer searches of PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases for randomised controlled trials (RCTs) on the effect of predictive nursing in preventing pressure ulcers in elderly bedridden patients from the database inception to November 2023. Two researchers independently screened the literature, extracted data and performed quality assessment based on inclusion and exclusion criteria. Stata 17.0 software was utilised for data analysis. Eighteen RCTs involving 6504 patients were finally included. The analysis revealed the implementation of predictive nursing interventions had a significant advantage in reducing the incidence of pressure ulcers in elderly bedridden patients compared with conventional nursing (odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.15-0.28, p < 0.001), while the patients' satisfaction with nursing care was higher (OR = 3.70, 95% CI: 2.99-4.57, p < 0.001). This study shows that the implementation of a predictive nursing interventions for elderly bedridden patients can effectively reduce the occurrence of pressure ulcers and significantly improve patients' satisfaction with nursing care, which is worthy of clinical promotion and application.

Effect of the AADE7 Self-Care Behaviors Framework on Diabetes Education Management in a Shared Care Model.

Diabetes self-management education (DSME) provides diabetic patients with knowledge of diabetes, requires attention and recording of dietary habits, and increases the frequency and accuracy of blood glucose monitoring. DSME also achieves better blood glucose control, thus benefiting diabetic patients and reducing the risk of diabetes complications. However, few studies have systematically examined whether DSME follows AADE 7 Self-Care Behaviors (AADE7™). Therefore, this study aimed to investigate the control effect of AADE7™-based management on laboratory test indicators of diabetic patients. The patients with diabetes who received shared care management in our hospital between June 2014 and April 2022 were analyzed retrospectively. According to the process of outpatient consultation, each patient received health education provided by diabetes education nurses and dietitians after consultation. Health education was a process from assessment to health guidance. The basic information of all patients was recorded, and AADE7™ behavior assessment and health education session were conducted through interviews. A total of 13,650 were given shared care management, requiring more than 6 follow-up visits per year, as well as health education. It was reassessed annually according to AADE standards. The impact of the patients' behavior change after the AADE7™-based management on the relevant test indicators was observed. After eight years of intervention, a total of 8319 samples were obtained after excluding the outliers. Stepwise regression analysis was performed, and the results showed that, with other conditions held constant, a greater number of days per week to follow a healthy diet, to take hypoglycemic medication as prescribed, to monitor blood glucose, and to exercise and higher education level were associated with lower levels of glycosylated hemoglobin. The change from drinking to nondrinking was associated with lower triglycerides. If low blood glucose was monitored, patients who reviewed and took immediate action showed lower levels of low-density lipoprotein, urine microalbumin, and urine microalbumin/creatinine ratio compared with those without review and immediate action. Significance tests for each term showed P value <0.05. The AADE7™ framework is a tool supporting patient-centered self-management and education. In the AADE7™ standards, successful self-management is considered as a key outcome in the care of patients with diabetes and related diseases. This tool can effectively improve patient compliance and increase the rate of blood glucose compliance rates in patients with diabetes and therefore is worthy of clinical promotion.

Ultrasimple size encoded microfluidic chip for rapid simultaneous multiplex detection of DNA sequences

Simultaneous multiplexed analysis can provide comprehensive information for disease diagnosis. However, the current multiplex methods rely on sophisticated barcode technology, which hinders its wider application. In this study, an ultrasimple size encoding method is proposed for multiplex detection using a wedge-shaped microfluidic chip. Driving by negative pressure, microparticles are naturally arranged in distinct stripes based on their sizes within the chip. This size encoding method demonstrates a high level of precision, allowing for accuracy in distinguishing 3–5 sizes of microparticles with a remarkable accuracy rate of up to 99%, even the microparticles with a size difference as small as 0.5 μm. The entire size encoding process is completed in less than 5 min, making it ultrasimple, reliable, and easy to operate. To evaluate the function of this size encoding microfluidic chip, three commonly co-infectious viruses’ nucleic acid sequences (including complementary DNA sequences of HIV and HCV, and DNA sequence of HBV) are employed for multiplex detection. Results indicate that all three DNA sequences can be sensitively detected without any cross-interference. This size-encoding microfluidic chip-based multiplex detection method is simple, rapid, and high-resolution, its successful application in serum samples renders it highly promising for potential clinical promotion.

Effects of cluster nursing interventions on the prevention of pressure ulcers in intensive care units patients: A meta-analysis.

A meta-analysis was conducted to comprehensively evaluate the impact of cluster nursing interventions on the prevention of pressure ulcers (PUs) in intensive care unit (ICU) patients. Computer searches were performed in databases including Embase, Google Scholar, Cochrane Library, PubMed, Wanfang and China National Knowledge Infrastructure for randomized controlled trials (RCTs) implementing cluster nursing interventions for PUs prevention in ICU patients, with the search period covering the database inception to November 2023. Two researchers independently screened the literature, extracted data and conducted quality assessments. Stata 17.0 software was employed for data analysis. Overall, 17 RCTs involving 1463 ICU patients were included. The analysis showed that compared with conventional nursing, cluster nursing interventions significantly reduced the incidence of PUs (odds ratio: 0.24, 95% confidence intervals [CI]: 0.17-0.34, p < 0.001) and also significantly improved the levels of anxiety (standardized mean difference [SMD]: -1.39, 95% CI: -1.57 to 1.22, p < 0.001) and depression (SMD: -1.64, 95% CI: -2.02 to 1.26, p < 0.001) in ICU patients. This study indicates that the application of cluster nursing interventions in ICU patients can effectively reduce the incidence of PUs, as well as improve patients' anxiety and depression levels, thereby enhancing their quality of life, which is worth clinical promotion and application.

"Five steps four quadrants" modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in laparoscopic pancreaticoduodenectomy.

Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment, the feasibility and safety of this approach for laparoscopic pancreaticoduodenectomy (LPD) require further clinical evaluation and investigation. To explore the application value of the "five steps four quadrants" modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients. A total of 52 patients who underwent LPD via the "five steps four quadrants" modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively. The patients' body mass index (BMI), preoperative laboratory indices, intraoperative variables and postoperative complications were recorded. The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed. Among the 52 patients, 36 were males and 16 were females, and the average age was 62.2 ± 11.0 years. There were 26 patients with pancreatic head cancer, 16 patients with periampullary cancer, and 10 patients with distal bile duct cancer. The BMI was 22.3 ± 3.3 kg/m², and the median total bilirubin (TBIL) concentration was 57.7 (16.0-155.7) µmol/L. All patients successfully underwent the "five steps four quadrants" modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage. Correlation analysis revealed significant associations between preoperative BMI (r = 0.3581, P = 0.0091), TBIL level (r = 0.2988, P = 0.0341), prothrombin time (r = 0.3018, P = 0.0297) and lymph node dissection time. Moreover, dissection time was significantly correlated with intraoperative blood loss (r = 0.7744, P < 0.0001). Further stratified analysis demonstrated that patients with a preoperative BMI ≥ 21.9 kg/m² and a TIBL concentration ≥ 57.7 μmol/L had significantly longer lymph node dissection times (both P < 0.05). The "five steps four quadrants" modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD. This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve; thus, it is worthy of further clinical promotion and application.

Utility, benefits, and risks of newborn genetic screening carrier reports for families.

Newborn genetic screening (NBGS) based on next-generation sequencing offers enhanced disease detection and better detection rates than traditional newborn screening. However, challenges remain, especially around reporting the NBGS carrier results. Therefore, we aimed to investigate the NBGS carrier parents' views on NBGS and NBGS reports in China. We distributed a survey querying demographic information, knowledge and perceptions of NBGS, the impact of NBGS on a total of 2930 parents, and their decision-making to parents of newborns reported as carriers in NBGS in Nanjing, China in 2022. The average age of the survey respondents was 30.7 years (standard deviation = 3.6). Most (68.38%) felt informed about NBGS, especially women, the highly educated, and high earners. Nearly all (98.74%) saw NBGS as crucial for early disease detection, with 73.18% believing it positively impacts their future. However, 19.16% felt it might cause anxiety, especially among the less educated. Concerns included potential discrimination due to exposed genetic data and strained family ties. Many suggested NBGS coverage by medical insurance to ease financial burdens. Through our study, we gained insights into parents' perspectives and concerns regarding the NBGS carrier result reporting, thus providing relevant information for further refinement and clinical promotion of the NBGS project.

Effect of Thoracoscopic Surgery under Spontaneous Respiration on Inflammatory Indicators and Postoperative Complications in Elderly Patients with Primary Spontaneous Pneumothorax

Background: In thoracoscopic surgery under spontaneous respiration, patients could breathe spontaneously during surgery without the need for mechanical ventilation via tracheal intubation. This technique can effectively avoid the injuries caused by tracheal intubation and mechanical ventilation and the side effects of muscle relaxants, thus reducing postoperative complications and benefitting patients. This study aims to explore the application of thoracoscopic surgery under spontaneous respiration in the elderly with primary spontaneous pneumothorax (PSP) and its effect on inflammatory indices and postoperative complications. Methods: The medical records of 181 elderly patients with PSP who underwent thoracoscopic surgery in our hospital from June 2021 to June 2022 were chosen for retrospective analysis. After excluding 15 patients who did not meet inclusion criteria, 80 patients receiving spontaneous respiration via laryngeal mask ventilation were included in the study group and 86 patients undergoing pulmonary ventilation via single-lumen tracheal intubation were included in the control group in accordance with the different schemes used in the surgery. Preoperative anaesthesia induction, surgical and hospitalisation times were compared, and the haemodynamics and inflammatory indices and complication incidences of the two groups were analysed. Results: Recovery time and hospitalisation time significantly differed between the two groups (p &lt; 0.001). Compared with the control group, the study group had significantly lower mean arterial pressure at T2 and faster heart rates at T2 and T3 (p &lt; 0.001). At T5, T6 and T7, the levels of interleukin-6, interleukin-8 and C-reactive protein in the study group were significantly lower than those in the control group (p &lt; 0.05). The incidence of intraoperative and postoperative complications did not significantly differ between the two groups (p &gt; 0.05). Conclusion: Thoracoscopic surgery under spontaneous respiration is safe and effective in the treatment of elderly patients with PSP. It reduces the levels of inflammatory factors and accelerates postoperative rehabilitation, showing certain value for clinical promotion.

Effect of fire needle combined with traditional Chinese medicine on psoriasis: A systematic review and meta-analysis.

The mechanism of action of fire acupuncture and Chinese medicine in psoriasis is unclear. In this paper, the efficacy of the 2 therapies was compared through a comprehensive analysis of their recurrence rates for clinical reference. In this meta-analysis, we searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, CQVIP, and CBM data from the establishment of the databases to May 2023. The study proposed to use randomized controlled trial research methods, excluding published literature, unpublished literature, literature with incomplete or inadequate information, animal experiments, literature reviews and systematic studies. Data were processed using STATA 15.1 software. Our group previous study found that the clinical efficacy of the fire-acupuncture group was significantly improved compared to that of Chinese herbal medicine alone (RR = 1.20, 95% CI: 1.13-1.27). Also, there were significant reductions in Psoriasis Area and Severity Index (PASI) score (SMD = -1.04,95% CI: -1.48 to -0.60), area of skin damage (SMD = -0.40,95% CI: -0.75 to -0.04), and pruritus (SMD = -1.04,95% CI: -1.32 to -0.76). Our previous study found that Dermatology Life Quality Index (DLQI) was significantly lower in the fire acupuncture group compared to herbal medicine alone (SMD = -1.61,95% CI: -3.08 to -0.15). The combined analysis found that the recurrence rate was significantly lower in the fire-acupuncture group compared to herbal medicine alone (RR = 0.21,95% CI:0.07-0.60). Fire needle can improve the efficacy of TCM in the treatment of psoriasis, including the area, severity and itching of skin lesions, and reduce the recurrence rate, which is worthy of clinical promotion.

Tonghua Liyan granules in the treatment of Laryngopharyngeal reflux disease with stagnation of phlegm and qi syndrome: a randomized, double-blind, placebo-controlled study.

Background: Laryngopharyngeal reflux disease (LPRD) is an extraesophageal syndromic manifestation of gastroesophageal reflux disease (GERD). Despite the increasing incidence of and concern about LPRD, treatment with proton pump inhibitors (PPIs) is unsatisfactory. Here, LPRD was treated with Tonghua Liyan (THLY) granules in combination with PPIs to evaluate treatment efficacy and possible adverse reactions. Methods: Seventy-six LPRD patients with stagnation of phlegm and qi syndrome (SPQS) were randomly divided into an experimental group and a control group. The experimental group received THLY granules combined with rabeprazole capsules. The control group received THLY granule placebo combined with rabeprazole capsules. A parallel, randomized, double-blind, placebo-controlled clinical trial was conducted with these two groups. The treatment cycle was 8weeks. The reflux symptom index (RSI), clinical symptom score, salivary pepsin content, reflux finding score (RFS) and gastroesophageal reflux disease questionnaire (GerdQ) were used to evaluate clinical efficacy. The final efficacy rate was evaluated according to the RSI and clinical symptom score. Results: Compared with those at baseline, all the indicators in the experimental group and control group significantly improved (p < 0.01). In terms of the RSI, clinical symptom score, and RFS, the experimental group had a higher degree of improvement (p < 0.05), and the overall efficacy rate was higher (p < 0.05). In terms of the salivary pepsin concentration and GerdQ, there was no significant difference between the test group and the control group (p > 0.05). Both groups of safety indicators showed no abnormalities and did not cause any allergic reactions in the body. Conclusion: Compared with PPIs alone, THLY granules combined with PPIs are more effective in the treatment of LPRD patients with SPQS in terms of symptoms and signs. This combination treatment, because of its higher clinical efficacy and lack of obvious adverse reactions, is worthy of clinical promotion and further in-depth study. Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR2100046614.

Retrospective study on the effect of Niaoduqing particles on outcome of non-diabetic patients with stage IV chronic kidney disease.

This study was to investigate the improvement value of Niaoduqing particles in the outcome of non-diabetic patients with stage IV chronic kidney disease (CKD). The non-diabetic patients with stage IV CKD who were to receive Niaoduqing particles were set as the study group (252 cases), and the patients with the same disease who only received Western medicine in the public database were set as the control group (220 cases). The follow-up visits were 3 months/time for 1 year. Deaths due to various causes, doubling of creatinine levels, and end-stage renal disease were used as hard end points to stop follow-up. The clinical indexes of the 2 groups were observed and compared. The results showed that the rate of compound outcome was significantly lower in the study group (28.17%) than in the control group (36.82%), the glomerular filtration rate was significantly higher than that in the control group, and the levels of uric acid and urea were significantly lower than that in the control group (P < .05). Niaoduqing particles can reduce creatinine and urea nitrogen, stabilize renal function, delay dialysis time, and improve the incidence of compound outcome in patients with non-diabetic stage IV CKD, which is worthy of clinical promotion.

The psychological intervention and clinical efficacy of Rosenthal effect and acupuncture bleeding on middle-aged and young patients with sudden hearing loss.

Combining traditional Chinese medicine theory and modern medical knowledge, this study explores the pathogenesis of sudden hearing loss in middle-aged and young people. Sixty-four young and middle-aged patients with sudden hearing loss who visited a public tertiary hospital in China are chosen as experimental objects. All experimental patients are broken into an experimental group (n = 32) and a control group (n = 32). The control group receive conventional Western medicine treatment regimen. The experimental group receive select acupoint acupuncture and bloodletting combined with Rosenthal effect for psychological intervention, and both groups have a treatment course of 14 days. The changes in the patient's condition before and after treatment are observed, and the differences in hearing threshold values, tinnitus, and dizziness clinical efficacy before and after treatment are observed and recorded. It evaluates the efficacy using the Anxiety, Depression Scale, and Hope Scale and statistically analyzes the data. The dizziness score of the experimental group decreased rapidly, the treatment onset time was shorter, and the improvement effect on dizziness symptoms was better (P < .05). After 1 month of intervention treatment, the intervention of the experimental group was better (P < .05). The hope level and self-efficacy of both groups of patients were raised in contrast with before treatment (P < .05). After 1 month, the intervention effect of the experimental group was more significant (P < .01). Both groups could improve patient ear blood circulation, but the experimental group had lower plasma viscosity, hematocrit, and red blood cell aggregation index, higher red blood cell deformation index, and more significant improvement effect (P < .05). The effective rates of improving hearing and tinnitus in the experimental group reached 87.5% and 81.5%, and the clinical treatment efficacy was better than that in the control group (P < .05). The level of depression and anxiety in the experimental group remained relatively stable, while that in the control group showed a significant rebound (P < .05). In conclusion, both groups had a certain effect in treating sudden deafness, both of which could effectively improve the patient's hearing. But in contrast with the control group, the experimental group had better clinical efficacy, higher safety, and better psychological intervention results, which is worthy of clinical promotion.

Effect of comprehensive nursing intervention on the quality of life and clinical outcomes of patients with thyroid nodules treated by ultrasound-guided microwave ablation.

To evaluate the effects of comprehensive nursing intervention on the quality of life and clinical outcomes of patients with thyroid nodules treated by ultrasound-guided microwave ablation. This was a prospective study conducted from December 2020 to December 2022 at The Fifth Medical Center of Chinese PLA General Hospital. One hundred and twenty patients with benign thyroid nodules undergoing microwave ablation were included. Patients were randomly divided into control group and experimental group. Patients in the control group were given conventional intervention mode during the perioperative period, while those in the experimental group were given comprehensive nursing intervention mode on the basis of the control group. The differences in quality of life, cognitive level before and after intervention and satisfaction between the two groups were compared and analyzed. The SF-36 scores in the experimental group were significantly higher than that in the control group after intervention. After the intervention, the SAS and SDS scores in the experimental group were significantly lower than those in the control group, with a statistically significant difference. The VAS scores in the experimental group were better than those in the control group at six, twelve and twenty four hour after operation, with statistically significant differences. After the intervention, the cognitive score of the experimental group was significantly higher than that of the control group. Comprehensive nursing intervention is worthy of clinical promotion in the treatment of patients with thyroid nodules treated by ultrasound-guided microwave ablation, leading to various benefits such as effectively improving patients' quality of life and relieving pain.

Design and application of a drainage tube dredging umbrella and anti-retrograde infection kit

The consensus has been reached on the benefits of surgical drainage. However, catheter-related blockage and retrograde infection remain bottleneck problems in the treatment process. To this end, with Huashan Hospital, Fudan University, as the main inventors, a drainage tube dredging umbrella and anti-retrograde infection kit have been designed and applied for the national utility model patent (patent number: ZL 2023 2 1300036.2). The main body of the kit consists of a catheter dredging umbrella, drainage tube, and drainage bag. Several isolation layers are installed in the drainage bag to form a maze structure and a reflux valve is added, thereby increasing the distance and resistance of liquid reflux, greatly reducing the possibility of liquid reflux entering the drainage tube, so as to reduce the risk of retrograde infection through physical means. When the drainage tube is blocked, the drainage tube and joint tube of the drainage bag can be separated, the unblocking umbrella can be inserted into the blockage through the guide wire, the cannula can be inserted along the guide wire, the guide wire is pulled to release the dredging umbrella in the contraction state, and the dredging umbrella can be pulled back in the expansion state until the blockage is removed from the drainage tube. The operating procedure is standardized and simple. While preventing retrograde infection (anti-retrograde infection kit), the catheter dredging umbrella could effectively address the issue of catheter blockage. It has certain clinical promotion and application value.

Dexmedetomidine nasal administration improves perioperative sleep quality and neurocognitive deficits in elderly patients undergoing general anesthesia

ObjectiveTo investigate the improvement of perioperative sleep quality and neurocognitive impairment in elderly patients under general anesthesia by nasal administration of dexmedetomidine.MethodsOne hundred and twenty patients admitted to our hospital for various laparoscopic elective gynecological surgeries lasting more than 1 h under general anesthesia from July 2021 to March 2023 were selected. All subjects were divided into 3 groups according to the random number table method. From 21:00 to 21:30 every night from one day before to 5 days after surgery, group A was given alprazolam 0.4 mg orally; group B was given dexmedetomidine 1.5ug/kg nasal drip; group C was given saline nasal drip. All subjects were observed for general information, sleep quality, postoperative cognitive function, anxiety status, sleep quality, adverse effects and complication occurrence.ResultsThe difference in general information between the three groups was not statistically significant, P > 0.05; the sleep quality scores of the three groups on admission were not statistically significant, P > 0.05. At the Preoperative 1d, postoperative 1d, 3d and 5d, the RCSQ scores of the subjects in group A and group B were higher than those in groups C, and with the postoperative RCSQ scores of subjects in group B were higher as the time increased; the assessment of anxiety status in the three groups 1d before surgery was not statistically significant, P > 0.05. The cognitive function scores of subjects in the three groups were not statistically significant in the preoperative 1d, P > 0.05. The postoperative 1d (24.63 ± 2.23), 3d (25.83 ± 2.53), and 5d (26.15 ± 2.01) scores of the subjects in group B were higher than those in groups A and C (P < 0.05), and the subjects in group B had better recovery of postoperative cognitive function with increasing time; the occurrence of postoperative delirium (POD) in group B (12.5%) were lower on postoperative 5d than those in groups A (37.5%) and C (32.5%) (P < 0.05). There was no statistical significance in the evaluation of anxiety state of the three groups on the first day before operation (P > 0.05). The scores in group B were lower than those in group C on the postoperative 1d, 3d, 5 d (P < 0.05). The overall incidence of adverse reactions and complications in subjects in group B was 17.5% significantly lower than that in groups A and C (P < 0.05).ConclusionDexmedetomidine can effectively improve the sleep disorder of elderly general anesthesia patients, reduce the damage to their neurocognitive function and the occurrence of POD, effectively reduce the anxiety of patients and the occurrence of adverse reactions and complications, and has better sedative, improve postoperative cognitive function and anti-anxiety effects, with a high drug safety, worthy of clinical application and promotion.

Clinical application of medical adhesive in endovascular embolization treatment of peripheral pseudoaneurysm.

This study explores the clinical application value of medical adhesive in endovascular embolization treatment of peripheral pseudoaneurysm. This was a retrospective review on 31 patients with peripheral pseudoaneurysm treated with medical adhesive endovascular embolization at the First Affiliated Hospital of Shihezi University from July 2021 to July 2023. Follow-up for 3-6 months was to observe the clinical efficacy and postoperative complications of medical adhesive embolization treatment. A total of 32 pseudoaneurysms were embolized in 31 patients with peripheral pseudoaneurysms. All pseudoaneurysms originated from visceral arteries. Among them, 29 pseudoaneurysms were embolized with medical adhesive alone, and three pseudoaneurysms were embolized with coil-assisted medical adhesive. After endovascular embolization with medical adhesive, all pseudoaneurysms were successfully embolized. Technical success was 100%. All patients experienced cessation of bleeding after endovascular embolization with medical adhesive, and there were no serious post-operative complications. Clinical success was 100%. During the follow-up period, two patients experienced recurrent bleeding but no pseudoaneurysm recurrence was observed. Endovascular medical adhesive embolization is a safe and effective method for treating pseudoaneurysm, with high hemostatic efficiency and permanent occlusion of the pseudoaneurysm after embolization, which is worthy of clinical promotion and application.