Coverage of internal iliac artery during endovascular abdominal aortic aneurysm repair may cause ischemic complications in buttock,intestine,lower extremity and genital.We reported nursing care of 72 patients in our center to investigate the key points of nursing.Our experience were as follows:individualized blood pressure management and doctor-nurse cooperation in pain management were key points in preoperative nursing;close postoperative observation was focused on ischemic colitis,buttock claudication and ischemic buttock skin;cooperation with ostomy care group improved pertinency of nursing care;rounding by integration of doctors and nurses obtained high satisfaction and improved patients' compliance.

Objective To explore the effect of workshop on postoperative function of affected limb in patients with breast cancer. Meth-ods From August, 2015 to June, 2016, 70 patients with breast cancer after modified radical mastectomy were randomly divided into control group (n=35) and observation group (n=35). The control group was instructed by the primary nurse bedside based on the traditional method, while the observation group was guided with workshop mode. Results Ten days and one month after surgery, the range of motion of the shoulder joint in the observation group was superior to the control group (t>2.030, P<0.01);the incidence of lymphedema of the affected limb in the observation group was lower than that in the control group (u=2.195, P<0.05). Conclusion Functional exercise guided with work-shop mode could improve postoperative function of affected limb in patients with breast cancer.

Objective To screen out the sonogram features for the differential diagnosis of benign and malignant thyroid small nodules (≤ 1.0 cm) by Logistics regression analysis, to establish the binary Logistic regression model of sonogram features as independent variable and investigate the value of wall configuration of ultrasonogrophic nodules in the differential diagnosis of benign and malignant thyroid small nodules.Methods A total of 208 thyroid nodules ≤ 1.0 cm in diameter in 190 patients were evaluated.With postoperative pathological examination or fine needle aspiration biopsy, 106 nodules were confirmed as benign and 102 as malignant.Ultrasonic features of thyroid nodules were evaluated for the differential diagnosis of benign and malignant small thyroid nodules based on pathological diagnosis as a gold standard, a Logistic model was obtained, and the odds ratio of variables were compared.The margin of thyroid nodule was divided into regular or irregular margin, and the latter was divided further into four subtypes: strip,triangular, antler and papillary.The border was divided into clear, fuzzy or both.The periphery was divided into those with normal and abnormal echo;.The calcification included no calcification, microcalcification and non-microcalcification.Results Four statistically significant features were obtained finally by Logistics regression analysis, including margin, border, periphery and calcification.A formula was constructed by two-variables logistic regression analysis and probability of malignancy =1/(1 + e-z), in which z =5.026 × margin +4.218 × border + 4.024 × periphery + 3.892 × calcification-15.247.The odds ratio of margin was higher than the other independent variables.Conclusions Logistics regression analysis indicates that the calcification, border, periphery, and especially margin of thyroid nodules are significant features for differentiating benign and malignant thyroid nodules.The margin score was more intuitionistic for the differentialtion of benign and malignant thyroid nodules.

Objective To analyze the effect of stratified nursing intervention based on aspiration risk assessment strategy in ICU mechanical ventilation patients. Methods Totally 156 patients with ICU mechanical ventilation admitted between January 2016 and December 2017 were selected as study subjects, and 78 patients were divided into treatment group and control group by random number table method. The control group was given routine nursing interventions for ICU patients undergoing mechanical ventilation, and the treatment group was combined with stratified nursing interventions based on aspiration risk assessment strategy. Compare the two groups of nurses'knowledge, attitude and practice of aspiration prevention, the complications of patient aspiration, patient satisfaction and other indicators. Results The scores of nurses′knowledge, attitude and practice of prevention of aspiration in the treatment group were (46.32 ± 3.24), (51.41 ± 3.56), and (49.36 ± 4.85), respectively, which were significantly higher than those of the control group (41.25 ± 5.32), (47.12 ± 5.45), (44.42 ± 5.46), The difference was statistically significant (t=4.815, 3.899, 4.002, P<0.05);The rate of aspiration, reflux, asphyxia, aspiration pneumonia in the treatment group was 7.69％ (6/78), 19.23％ (15/78), 1.28％ (1/78), 2.56％ (2/78), which were significantly lower than 29.49％ (23/78), 39.74％ (31/78),12.82％ (10/78),20.51％ (16/78) in the control group. The difference were statistically significant (χ2=7.892-12.309, P<0.05 or 0.01);Patient satisfaction 97.87％ (74/78) was significantly higher than the control group 83.33％ (65/78), The difference was statistically significant (χ2=5.347, P<0.05). Conclusion The stratified nursing intervention based on the aspiration risk assessment strategy can help develop nurses′ability in knowledge, attitude and practice of aspiration prevention, reduce the occurrence of complications such as aspiration, and improve patient satisfaction.

Objective To summarize the application and effect of all kinds of ordinary and special nursing marks in the ICU of neurosurgery .Methods All kinds of nursing marks used in the ICU of neurosurgery were designed from July 2012 to December 2012 , and were applied to 484 patients in ICU of neurosurgery ( the observation group ) , and 478 patients in ICU of neurosurgery from July 2011 to December 2011 received the routine nursing ( the control group ) .The data were compared by the retrospective analysis , and the effect of nursing marks on quality of nursing was analyzed .Results The rates of pulmonary infection , accidental extubation and pressure ulcer were respectively 0.41%, 0.21%, 0.21%in the observation group, which were lower than 1.88%, 1.46%,1.46%in the control group , and the differences were statistically significant (χ2 =4.60, 4.61, 4.61, respectively; P<0.05).The average scores of quality of basic and special nursing were respectively (96.22 ±3.10), (95.17 ±3.82) in the observation group, which were higher than (93.20 ± 3.34), (92.15 ±3.55) in the control group, and the differences were statistically significant (t=6.80, 6.77, respectively;P<0.05).The satisfaction rates of patients and nurses were respectively 97.93%, 100.00% in the observation group, which were higher than 95.40%, 73.33%in the control group, and the differences were statistically significant (χ2 =4.81, 4.62, respectively;P<0.05).Conclusions Nursing marks can not only reduce the occurrence of nursing errors , improve the quality of nursing , but also are conducive to the establishment of nurse-patient relationship .

Objective To explore the effects of team management model on the prevention and control of incontinence dermatitis in patients with paraplegia.Methods A total of 113 patients with paraplegia and incontinence who were treated in Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from March 2016 to February 2018 were enrolled in the study.They were divided into observation group and control group according to the sequence of admission.The patients who were admitted from March 2016 to February 2017 were assigned as the control group,with 56 cases.The patients who were admitted from March 2017 to February 2018 were assigned as the observation group,with 57 cases.The control group was treated with routine intervention.Team management was applied in the observation group on the basis of routine nursing for 4 weeks.The incidence of incontinence dermatitis and negative emotion were compared between the two groups.Results After intervention,the incidence of incontinent dermatitis of the observation group (5.26％) was significantly lower than that of the control group (14.29％),and the difference was statistically significant (P＜ 0.05).The scores of Self-Rating Anxiety Scale and Self-Rating Depression Scale of the observation group were (38.70 ± 6.83) and (41.07 ± 5.62),which were both lower than those of the control group (46.39 ± 8.15) and (47.31 ± 6.52) respectively,and the differences were statistically significant (P ＜ 0.05).Conclusions Team management can effectively reduce the incidence of incontinence dermatitis and negative emotions in paraplegic patients,which is worthy of clinical promotion.

Objective? To systematicaLLy review the respiratory training on swaLLowing function and respiratory function among patients with dysphagia so as to provide a reference for rehabiLitation nursing of patients with dysphagia. Methods? From estabLishing the database to 30th ApriL 2018, we retrieved the randomized controLLed triaLs (RCTs) on respiratory training of patients with dysphagia in PubMed, EMBASE, Web of Science, Cochrane CentraL Register of ControLLed TriaLs, CINAHL, Physiotherapy Evidence Database, Chinese BioMedicaL Literature Database (CBM), China NationaL KnowLedge Infrastructure (CNKI) and WanFang Data by computer. The Literatures were screened and quaLity of the incLuded Literatures were evaLuated according to the system evaLuation method of the Cochrane coLLaboration. The RevMan5.3 was used to statisticaL anaLysis. ResuLts? A totaL of 9 Literatures were incLuded, and three of them were with the LeveL A of Literature quaLity and the rest were with the LeveL B. Meta-anaLysis showed that compared with routine dysphagia nursing, respiratory training couLd improve the swaLLowing function evaLuated by water swaLLow test [RR=1.33, 95%CI (1.17, 1.53), P＜ 0.01], forced vitaL capacity (FVC) [MD =0.47, 95%CI(0.11, 0.82), P＜ 0.01], forced expiratory voLume in one second (FEV1) [MD=0.47, 95%CI(0.20,0.74), P＜0.01], peak expiration fLow (PEF) [MD=1.00, 95%CI(0.91, 1.10), P＜0.01]and reduce the score of penetration-aspiration scaLe (PAS) [MD=-1.05, 95%CI (-1.70, -0.41), P＜ 0.01]of patients with dysphagia. ConcLusions? Compared with routine dysphagia nursing, respiratory training couLd improve the swaLLowing function evaLuated by water swaLLow test, FVC, FEV1, PEF and reduce the score of PAS of patients with dysphagia. However, the findings stiLL need be vaLidated by Large sampLe, muLticenter and high quaLity RCTs.

Objective:To systematically assess the effects of "internet +" nursing intervention model on rehabilitation outcomes in stroke patients so as to provide an evidence-based basis for clinical nurses to carry out "internet +" nursing service new model in stroke patients.Methods:Randomized controlled trials (RCTs) related on effects of "internet +" nursing intervention model on rehabilitation outcomes in stroke patients were retrieved in China Biological Medicine (CBM) , Chinese National Knowledge Infrastructure (CNKI) , WanFang Data, PubMed, Embase, Cochrane Central Register of Controlled Trials by computer from building database to May 2019. RevMan 5.3 was used to the systematic review for literatures meth the inclusion criteria.Results:A total of six literatures were included involving 637 samples. Systematic review showed that "internet +" nursing intervention model could improve the motor function [ MD=13.87, 95% CI (7.93, 19.81) , Z=4.57, P<0.01]and activity of daily living [ MD=14.43, 95% CI (6.15, 22.71) , Z=3.41, P<0.01]of stroke patients during rehabilitation. Conclusions:"Internet +" nursing intervention model provides a good channel for rehabilitation and health education for stroke patients after going back to family and community, helps stroke patients to improve motor function during rehabilitation and activity of daily living, but that still exhibits the problems needed to be perfected and solved by medical staff exerting themselves.

Objectives:To investigate the effect of body mass index(BMI)on perioperative and long-term prognosis of patients with severe aortic stenosis(AS)after transcatheter aortic valve replacement(TAVR). Methods:This retrospective study imcluded 180 patients with severe AS who received TAVR in Fujian Provincial Hospital from January 2019 to January 2022.According to the BMI,patients were divided into four groups:low weight group(BMI<18.5 kg/m2,n=23),normal weight group(18.5 kg/m2≤BMI<24.0 kg/m2,n=65),overweight group(24.0 kg/m2≤BMI<28.0 kg/m2,n=57),obesity group(BMI≥28.0 kg/m2,n=35).The general clinical characteristics,imaging parameters,perioperative indexes,all-cause death and the incidence of other adverse cardiac events during(18.0±6.8)months follow-up were compared among different groups.Risk factors for the perioperative complications and long-term outcomes of TAVR were evaluated. Results:The prevalence of hypertension and diabetes,left ventricular end-diastolic diameter,ventricular septal thickness and left ventricular posterior wall thickness were significantly higher in the obese group than in normal weight group(all P<0.05).The level of prealbumin in low weight group was lower than in normal weight group(P<0.05).The total perioperative complications in low weight group were higher than in normal weight group(60.9%vs.12.3%,P=0.042).During(18.0±6.8)months follow-up,the incidence of all-cause death in the low weight group was significantly higher than that in normal weight group,overweight group and obese group(17.4%vs.4.6%vs.3.5%vs.5.7%,P=0.003).Kaplan-Meier survival analysis evidenced higher mortality rate in low weight group at 18 months after TAVR(log-rank P<0.01).Multivariate Cox regression analysis showed that the risk of long-term adverse cardiovascular events was significantly higher in low weight group than in normal weight group(HR=7.633,95%CI:1.012-57.564,P=0.049). Conclusions:Low weight patients with severe AS have a higher incidence of perioperative complications and a poor long-term prognosis.Such patients should appropriately strengthen their nutritional intake and adjust their body weight to normal levels before performing TAVR.

Objective To evaluate the postoperative imaging features of lung ultrasound on patients undergoing lung transplantation ,and to provide the evidence for diagnosis and therapy . Methods Between October 2016 and March 2017 ,51 patients undergoing lung transplantation ( unilateral:37 ,bilateral:14 ) admitted to the ICU in Wuxi People′s Hospital were examined by bedside lung ultrasound ,and imaging features were analyzed . Results The main features on ultrasound of 51 patients undergoing lung transplantation were:①Pneumothorax :The A-line arising at the pleural line was shown in all of 51 patients , mainly on anterolateral parts of the chest wall initially ,then fade away towards anterosuperior parts over time . ② Hydrothorax :An anechoic fluid collection was detected ( up to 50 mm in width ) ,and became narrow over time in most patients . A mass of floccules or progressive growth of pleural effusion indicated the need for emergency surgery ,and were confirmed bleeding after surgery . ③Subcutaneous emphysema:The E-line was detected mainly in anterior and lateral parts around the surgical incision of postoperative patients ,and gradually fade away over time . ④Pulmonary edema:On the first postoperative day ,multiple B-lines were shown in 49 cases ,lung consolidation in 36 cases ( mainly in the inferior and inferoposterior parts) ,lung consolidation sonographic air bronchogram in 12 cases . Then the area of consolidation and B-lines reduced ,the air bronchogram sign became more prevalent ,and the shred sign appeared on the border of consolidation over time . Conclusions The imaging features of lung ultrasound provides clinic diagnostic and therapeutic value for postoperative patients undergoing lung transplantation .