Objective To learn the epidemiological characteristics of syphilis in Shihezi in recent three years and to provide bases for prevention .Epidemiological analysis with syphilis was conducted in our hospital from 2012 to 2014 ,which is about the detection rate ,age ,gender ,and the distribution in the department .Methods Serum were deteceted by using three methods and the data were analyzed .Results 1 281 syphilis cases in 74 798 patients were detected in our hospital during this period .The total positve rate of three years was 1 .71% .The positve rate was 1 .35% ,1 .83% and 2 .01% respectively .The results of three years was significant differences(χ2 =39 .877 ,P<0 .05) .The rate in gender was not significantly higher or lower(χ2 =1 .670 ,P=0 .434>0 .05) .The ca‐ses were mainly distributed in Han(581 ,45 .36% ) ,Uygur(43 ,3 .36% ) ,Kazak(23 ,1 .80% ) .353 cases were negative by RPR among 1 281 patients with syphilis(27 .56% ) ,and the negative rises year by year .Conclusion The incidence of syphilis increased slightly in Shihezi since 2012 .Though the detection rate between 2013 and 2014 was no significant difference .The focus was on 20- year′s old women of childbearing age .It is necessary to take strict measures to control the spread of syphilis and to do syphilis examina‐tion for all inpatients in order to prevent the infection of syphilis .

Objective:To systematically evaluate the predictive model of intensive care unit (ICU) -acquired weakness so as to provide objective basis for clinical workers to choose appropriate predictive model and provide reference for future model update and new model development.Methods:Sixth databases including PubMed, Embase, web of science, The Cochrane Library, CNKI and Wanfang were searched by the computer. The retrieval time was the construction of the database to October 15, 2019, and the language was limited to Chinese and English. A total of two researchers conducted independent screening of literature, data extraction and evaluated the quality of the included literature in turn, and then used prediction model risk of bias assessment tool (PROBAST) to evaluate the quality of the models included in the literature.Results:A total of 8 articles with high quality were included. The area under the ROC curve of the five models were all greater or equal to 0.7. The model risk of bias assessment showed that only Witteveen's model was rated as low bias, and the remaining 7 models all had a higher risk of bias, but all models had good applicability.Conclusions:The predictive performance of ICU acquired weakness model is good, but there are some biases in development and report. In the future, the whole process of model development and verification should be reported in a standardized way to reduce methodological bias and provide high-quality evidence for clinical practice. Future studies should focus on external validation and updating of models to continuously improve model prediction performance and provide practical models for clinical practice.

Intensive Care Unit (ICU) acquired weakness is a common complication in ICU critically ill survivors. Early intervention is an important measure to prevent and treat ICU acquired weakness. The scientific and standardized intervention has a positive effect on the prognosis of patients. In recent years, integrated care, as a management method for some specific patients, can effectively improve the quality of care, reduce the cost of care, and is gradually applied to the prevention and treatment of ICU acquired weakness. This paper describes the research status of integrated care clinical intervention on ICU acquired weakness, in order to provide the basis for the construction of practical plan of integrated care for ICU acquired weakness.

Objective:To evaluate the safety and effectiveness of rubber band-assisted endoscopic submucosal excavation (RB-ESE) for gastric submucosal tumors (SMT).Methods:A retrospective study was conducted on data of gastric SMT patients who underwent ESE in Affiliated Hospital of Yangzhou University from January 2017 to August 2022. A total of 48 patients were selected and divided into two groups: RB-ESE group ( n=20) and the conventional ESE (C-ESE) group ( n=28). The operation time, bleeding rate and perforation rate during operation, the retention rate of the mucosal cap, the number of clips, postoperative complications, and the hospitalization time were analyzed. Additionally, correlations between complications and tumor size/location and between bleeding and perforation were evaluated. Results:No significant difference was found in the general conditions between the two groups ( P>0.05). The operation time of RB-ESE group (14.82±2.31 min) was significantly shorter than that of C-ESE group (23.70±3.67 min) ( t=-9.539, P<0.001). The intraoperative bleeding rates were 20.0% (4/20) and 42.9% (12/28) in the RB-ESE group and C-ESE group respectively ( χ2=2.743, P=0.098), while the intraoperative perforation rates were 25.0% (5/20) and 46.4% (13/28) respectively ( χ2=2.286, P=0.131). Furthermore, the mucosal cap preservation rate was notably higher in the RB-ESE group at 60.0% (12/20) compared with 7.1% (2/28) in the C-ESE group ( χ2=15.777, P<0.001). The number of clips applied to close the wound was 8.05±1.40 and 10.43±1.96 in the RB-ESE group and C-ESE group respectively ( t=4.925, P<0.001). The postoperative hospital stays were 4.35±0.75 days and 5.00±0.86 days respectively in two groups ( t=2.724, P=0.009). No postoperative bleeding or perforation occurred in either group. The results showed that the occurrence of perforation and bleeding were associated with tumor diameter. Patients with tumor size ≥2 cm showed increased proportions of intraoperative bleeding [68.4% (13/19), P<0.001] and perforation [78.9% (15/19), P<0.001]. There was a correlation between intraoperative bleeding and perforation ( P<0.001). Conclusion:RB-ESE proves to be an effective and safe approach for managing gastric SMT, offering advantages such as reduced operation time and hospital stays, improved retention of the mucosal cap post-operation, and less clips use. The results suggest that RB-ESE could be widely adopted for treating SMT.

Objective:To summarize the best evidence of thirst management in ICU patients and provide evidence-based basis for dinical practice.Method:According to the "6S" evidence pyramid model, the literature on thirst management of ICU patients was systematically retrieved from relevant guidelines websites, evidence-based databases, association websites and original literature databases at home and abroad. The retrieval time was from the establishment of the database to June 31, 2022. Two researchers with evidence-based nursing training independently completed literature quality evaluation. To extract and summarize the evidence of the literature that meets the quality standard.Results:A total of 17 articles were included, including 8 randomized controlled trials, 5 quasi-experimental studies and 4 cross-sectional studies. The 18 pieces of best evidence were formed, including 5 aspects: basic requirements of thirst management, intervention evaluation, intervention methods, matters needing attention and health education.Conclusions:This study summarized the best evidence of thirst management in ICU patients. Nurses should translate and apply the best evidence in combination with the clinical situation and specific policies of the department to relieve the thirst symptoms of ICU patients.

Objective:To understand the clinical application status of the best evidence for airway clearance in Intensive Care Unit (ICU) patients, analyze the barriers and enablers in the process of evidence application, so as to provide reference for formulating transformation strategies.Methods:The literature on airway clearance in ICU patients was systematically searched in domestic and foreign databases and association websites. The best evidences were summarized based on the included literature, and corresponding review indicators were constructed based on the best evidence for clinical baseline review. From July to August 2022, convenience sampling was used to select 30 nurses and 30 patients from ICU of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. We conducted barriers and transformation strategy analysis based on the review results.Results:A total of 33 review indicators were formulated. The clinical execution rate of the review indicators was 0 to 100%, with 60.6% (20/33) of the review indicators having a clinical execution rate of <60%. The main barriers were that the specialized team for airway clearance involved great personnel and was difficult to organize, nurses had insufficient awareness and importance of airway clearance knowledge, the department lacked corresponding evaluation tools and equipment, the implementation standards for airway clearance treatment within the department were not sound, and the health education materials for airway clearance were incomplete. The transformation strategy mainly included strengthening leadership support, conducting knowledge training on airway clearance, introducing tools and equipment related to airway clearance, improving the implementation standards of airway clearance and health education materials for airway clearance.Conclusions:There is a significant gap between the best evidence for airway clearance in ICU patients and clinical practice. Timely improvement should be made on relevant barriers to promote the conversion of best evidence into clinical practice and improve patient clinical outcomes.