Deep vein thrombosis (DVT) has attracted great attention because of its high morbidity in orthopedics department, which could easily cause lethal pulmonary embolism (PE). Based on the domestic and foreign findings from the prophylaxis and nursing of DVT, this thesis summarized the key problems in orthopedic patients. It firstly defined the conception of DVT,and then emphasized the morbidity and severity of DVT in orthopedics department. After that it reviewed the possible risk factors that contributed to DVT. Moreover it also pointed out some matters needing attentions through discussing and analyzing the nursing and prophylactic measures against DVT, and it also gave some recommendations on it. It expounded the nursing progress on prophylaxis of the deep venous thrombosis in department of orthopedics, so as to provide reference for clinical work and study.

Quality management and control of single disease is a means to continuously improve medical quality and safety by building a set of quality control indicators and evaluation systems based on the whole process of disease diagnosis and treatment. In the actual single disease management process, the reporting of each disease involved data from various systems such as electronic medical records, and the data integration was difficult. While the traditional manual reporting method took a lot of time and the data accuracy could not be guaranteed. In the development process of hospital informatization, a hospital has designed a set of intelligent full-closed loop single disease management platform based on the hospital information system, by integrating the existing human and information data resources of the hospital. This platform integrated functions of single disease intranet reporting, in-depth capture of reporting elements, single-disease quality index management, and single-disease real-time intelligent control, in order to promote more refined and intelligent disease management and thus steadily improve medical quality and safety.

This paper reviewed the research status on the existing perioperative pain control among patients with cataract surgery both here and abroad. The research status included influencing factors, assessment instruments of pain and pain control plan, so as to provide a basis for improving perioperative pain control plan of cataract patients and reducing the incidence of pain.

Objective:To investigate the efficacy and safety of tirofiban versus argatroban in the treatment of acute ischemic stroke. Methods:This study was a retrospective cohort study. Sixty-eight patients with acute ischemic stroke who were continuously admitted to Department of Neurology of The Third People's Hospital of Hubei Province from August 2022 to September 2023 were divided into tirofiban group ( n = 33) and argatroban group ( n = 35) according to the treatment regimen. Both groups were treated according to their respective treatment protocols for 7 days. Clinical outcomes were assessed based on the modified Rankin Scale (mRS) scores. The excellent clinical outcome (mRS score 0-1 points), good clinical outcome (mRS score 0-2 points), symptomatic intracranial hemorrhage, and mortality rates were compared between the two groups at 90 days post-treatment. Results:In the tirofiban group, the proportion of excellent clinical outcomes was 30.3% (10/33), which was significantly lower than the 65.7% (23/35) in the argatroban group (χ2 = 8.53, P = 0.003). However, the difference in the proportion of good clinical outcomes between the two groups was not statistically significant [54.5% (18/33) vs. 74.3% (26/35), χ2 = 2.90, P = 0.089]. There were no statistically significant differences between the two groups regarding symptomatic intracranial hemorrhage and mortality rates (both P > 0.05). Conclusion:For patients with acute ischemic stroke, the use of tirofiban or argatroban is effective and safe. Patients treated with argatroban are more likely to achieve excellent clinical outcomes; however, larger randomized controlled trials are needed for further confirmation.

Objective:To investigate the prevalence and risk factors of stroke in residents of Hanzhong community, Wuhan city, Hubei province, and develop subsequent prevention and treatment measures.Methods:A questionnaire survey, physical examination, and laboratory tests were conducted from May 1 to July 31, 2023, among a population of 801 residents aged 40 years and older in Hanzhong community, Wuhan city, Hubei province, using multi-stage whole cluster random sampling.Results:Among the 801 residents surveyed, 28 were found to have suffered from stroke, yielding a prevalence rate of 3.5%. Additionally, there were 255 individuals identified as high-risk, accounting for 31.8% of the population. The risk factors for stroke, ranked from highest to lowest in prevalence, were as follows: hypertension (24.3%), dyslipidemia (23.6%), lack of exercise (17.6%), smoking (13.1%), diabetes (12.0%), family history of stroke (9.0%), obesity or overweight (8.6%), and atrial fibrillation or valvular heart disease (3.0%). The prevalence of stroke is higher in men than in women, and it continues to increase with advancing age (χ 2 = 33.95, P < 0.001). Homocysteine is likely to contribute to the occurrence of stroke through its association with hypertension (χ2 = 42.63, P < 0.001). Additionally, homocysteine levels have emerged as another significant risk factor for stroke among individuals who are at high risk (χ2 = 5.74, P < 0.05). Conclusion:In Hanzhong community, Wuhan city, Hubei province, smoking, hypertension, overweight, and obesity are the major risk factors for stroke among residents aged 40 years and older. Homocysteinemia is closely related to these high-risk factors for stroke. Therefore, screening and prevention of elevated homocysteine levels will be one of the critical indicators for the subsequent screening and prevention of stroke.

Objective? To explore the real experience of newly recruited nurses during standardized training and to provide a basis for improving the means of standardized training. Methods? Totally 11 newly recruited nurses who received standardized training in a Class Ⅲ Grade A hospital were selected and interviewed by purposive sampling. The interview data were read repeatedly, analyzed, encoded, classified and finally refined to the topics using the phenomenological method in qualitative studies. Results? Totally 4 topics were refined in this study, including occupational cognitive imbalance, mental stress caused by workplace stimulus, physiological stress caused by workplace stimulus and thirst for knowledge. Conclusions? Newly recruited nurses have not fully become practitioners from the role of students. Schools and teaching hospitals need to pay attention to specialized training and pre-vocational transition education, provide relevant training and courses, and make the nurses under standardized training adapted to clinical work as soon as possible.

It introduced the definition of the caregiver and at home and abroad,and also reviewed influencing factors of family caregiver′s burden of the elderly patients. At last, it put forward the essentiality to perfect the nursing intervention and improve caregivers' coping capacity, as well as the transitional care model and the linkage"hospital-community-family",and improve national legislation and policy support in order to structure the social support system at the same time, so as to provide reference for study of reducing the family caregiver′s burden of the elderly patients.

Objective To explore the experience of the family caregivers of the old hip fracture patients with cognition impairment. Methods By using purpose sampling method,11 participants which treating from January to April 2017 were applied semi-structured in-depth interview,and then analysis the material. Results Four themes were analyzed about the caring demands of the family caregivers, including existing heavier caring burden,inadequate knowledge and skills,positive face to the caring task, desire to caregiver support system. Conclusions The family caregivers of the old hip fracture patients with cognition impairment exist heavier caring burden, the medical service institutions should call on national policy support and economic aid for caregivers, care about the mental health of caregivers and improve their coping ability, as well as provide professional knowledge and skills guidance and build a perfect caregiver support system at the same time in order to reduce the burden of caregivers early.

Objective:To investigate the effects of hyperuricemia on the prognosis of IgA nephropathy (IgAN) using propensity score matching (PSM) method.Methods:IgAN patients proven by biopsy were included. PSM was used to match patients. Kaplan-Meier method was used for survival analysis, and Cox regression analysis was used to analyze the effects of hyperuricemia on IgAN prognosis. Primary outcome events were defined as death, or end-stage renal disease (dialysis, transplantation), or a decrease in estimated glomerular filtration rate (eGFR) greater than 40%. Renal outcome was defined as end-stage renal disease (dialysis, transplantation), or a decrease in eGFR greater than 40%.Results:A total of 1 454 IgAN patients were included in this study, including 850 females and 604 males. Uric acid level was (368.26±92.87) μmol/L in the males, and (277.23±92.71) μmol/L in the females. The median follow-up time was 85.00(56.10, 106.33) months. During the follow-up period, a total of 134 patients reached the primary outcome events, including 5 deaths, 24 dialysis patients, 5 kidney transplant patients, and 100 patients with eGFR decreased by more than 40%. After 1∶1 matching, 131 males and 159 females in the hyperuricemia group were successfully matched with 131 males and 159 females in the normal uric acid group, and there was no significant statistical difference in each parameter in baseline between the hyperuricemia group and normal uric acid group after matching. Kaplan-Meier survival analysis showed that either before or after matching, the incidence of primary outcome events in male or female patients with hyperuricemia was higher than those with normal uric acid, but there was no statistically significant difference in incidence of primary outcome events between female hyperuricemia group and female normal uric acid group after matching (Log-rank test, χ2=3.586, P=0.058). Cox proportional hazard regression model showed that, in the pre-match fully adjusted model, the hazard ratio ( HR) of entering primary outcome events was 2.29-fold (95% CI 1.27-4.11, P=0.006) for men with hyperuricemia and 1.85-fold (95% CI 1.01-3.37, P=0.045) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering primary outcome events was 2.41-fold (95% CI 1.18-4.93, P=0.016) for men with hyperuricemia and 1.83-fold (95% CI 0.91-3.67, P=0.091) for women with hyperuricemia compared with those with normal uric acid. In the pre-match fully adjusted model, the HR of entering renal outcome events was 2.68-fold (95% CI 1.47-4.88, P=0.001) for men with hyperuricemia and 1.81-fold (95% CI 0.99-3.33, P=0.056) for women with hyperuricemia compared with those with normal uric acid. In the post-match fully adjusted model, the HR of entering renal outcome events was 2.89-fold (95% CI 1.36-6.15, P=0.006) for men with hyperuricemia and 1.81-fold (95% CI 0.88-3.72, P=0.106) for women with hyperuricemia compared with those with normal uric acid. Conclusion:Hyperuricemia may be associated with IgAN progression, and it has a more significant effect on male IgAN patients.