Objective To study the clinical efficacy of live combined bacillus subtilis and enterococcus faecium enteric-coated capsules combined with trimebutine maleate and psychological intervention in the treatment of functional diarrhea. Methods 100 patients with functional diarrhea treated in our hospital from May 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with trimebutine maleate treatment, the experimental group were treated with live combined bacillus subtilis and enterococcus faecium enteric-coated capsules trimebutine therapy and psychological intervention, pay attention to the psychological status of patients and patients, strengthen communication and exchanges, increase confidence in the treatment and the treatment compliance of patients. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the effective rate was 92.0％ in the experimental group and 84.0％ in the control group. The difference was statistically significant (P<0.05). There was no obvious adverse reaction in the experimental group and the control group. After treatment, the number of diarrhea in the experimental group was (3.0±0.3), significantly less than that of the control group (4.3±0.3), the difference was statistically significant (P<0.05). Conclusion The clinical effect of live combined bacillus subtilis and enterococcus faecium enteric-coated capsules combined with trimebutine maleate and psychological intervention in the treatment of functional diarrhea is good, can improve clinical symptoms in a large extent, has the meaning of promotion.

Objective·To explore the effect of online courses combined with the teach-back method among patients with laryngectomy and their family caregivers.Methods·Convenience sampling was used to select patients with laryngectomy treated in the Department of Otolaryngology,Shanghai Changhai Hospital from July 2022 to June 2023 and their family caregivers.The participants were divided into a control group and an observation group using the random number table method.The intervention was conducted in two different wards.General information of the two groups of patients and caregivers was collected.After admission,the control group watched offline videos recorded by the department.The videos introduced laryngocarcinoma-related knowledge and standard procedures of airway stoma care,suctioning,nasal feeding,etc.,which were divided into 4 sessions with 30 min each.The patients watched one session per week.The observation group watched the same videos(8 lessons)online on their own after admission,while the nursing staff used the teach-back method for health education,consolidating 2 lessons once a week,45 min/session for 4 weeks.The effectiveness of the intervention was evaluated by using Caregiver Preparedness Scale(CPS),Family Caregiver Task Inventory(FCTI),and Chinese Quality of Life Instruments for Cancer Patients-Head and Neck Cancer(QLICP-HN)at baseline(1st week),before discharge(4th week),and one month after discharge(8th week),as well as the incidence of adverse events during home care.Results·The study included a total of 120 pairs of patients and caregivers,with 60 pairs in each group.Five pairs in each group were excluded due to various reasons,leaving a total of 55 pairs in each group.There were no statistically significant differences between the two groups in terms of general information of the patients and the caregivers,QLICP-HN scores of the patients,and CPS and FCTI scores of the caregivers at baseline(P＞0.05).Before discharge and 1 month after discharge,the CPS scores of the caregivers and the QLICP-HN scores of the patients in the observation group were significantly higher than those in the control group,and the FCTI scores were significantly lower(lower scores indicating better nursing care),with statistically significant differences(P＜0.05).Within 1 month after discharge,the incidence of adverse home care events in the observation group was lower than that in the control group(5.5%vs 29.1%),and the difference was statistically significant(P＜0.05).Conclusion·The online courses combined with the teach-back method help improve the readiness to care and caregiving competence of family caregivers of post-laryngectomy patients,improve patients'quality of life,and reduce the incidence of adverse events during home care.

Objective To investigate the value of cerebral state index (CSI) in monitoring the consciousness state of patients with brain trauma.Methods The consciousness sates of 218 patients with craniocerebral trauma were assessed by three experienced specialists by Glasgow Coma Scale (GCS),and the CSI of the patients were measured by Cerebral State Monitor.Correlation between GCS and CSI as well as the distribution of CSI in various consciousness defined by GCS were discussed.The predictive value of CSI in discriminating different conscious states of the patients was also analyzed.Results The Cochran Q test showed that there was a consistency of the GCS judged by three specialists (P ＞ 0.05),and the CSI of the patients was positively correlated with the GCS (r=0.819,P＜0.001).A gradual decrease in the CSI was found across categories of the various consciousness states,including sobriety,somnolence,confusion,light coma,coma in moderate depth and deep coma.The receiver operating characteristic curve (ROC) analysis showed that CSI could significantly discriminate the different consciousness states of the patients (P ＜0.001).The area under the curve (AUC) for the consciousness was 0.995 for deep coma,0.984 for sobriety,0.815 for coma in moderate depth,0.769 for somnolence,0.768 for light coma and 0.695 for confusion,respectively.Conclusion CSI can be used to monitor the severity of craniocerebral trauma.

Objective To investigate the value of cerebral state index (CSI) in monitoring the consciousness state of patients with brain trauma.Methods The consciousness sates of 218 patients with craniocerebral trauma were assessed by three experienced specialists by Glasgow Coma Scale (GCS),and the CSI of the patients were measured by Cerebral State Monitor.Correlation between GCS and CSI as well as the distribution of CSI in various consciousness defined by GCS were discussed.The predictive value of CSI in discriminating different conscious states of the patients was also analyzed.Results The Cochran Q test showed that there was a consistency of the GCS judged by three specialists (P ＞ 0.05),and the CSI of the patients was positively correlated with the GCS (r=0.819,P＜0.001).A gradual decrease in the CSI was found across categories of the various consciousness states,including sobriety,somnolence,confusion,light coma,coma in moderate depth and deep coma.The receiver operating characteristic curve (ROC) analysis showed that CSI could significantly discriminate the different consciousness states of the patients (P ＜0.001).The area under the curve (AUC) for the consciousness was 0.995 for deep coma,0.984 for sobriety,0.815 for coma in moderate depth,0.769 for somnolence,0.768 for light coma and 0.695 for confusion,respectively.Conclusion CSI can be used to monitor the severity of craniocerebral trauma.