Objective:To form a nursing standard for shoulder-hand syndrome (SHS) after stroke in accordance with the clinical situation by expert argumentation in the best evidence systematically retrieved and screened for SHS after stroke with the method of Delphi expert consultation.Methods:According to the level of evidence, we systematically retrieved and screened relevant guidelines, evidence summary, systematic reviews, original studies and expert consensus. Two researchers who had received Joanna Briggs Institute (JBI) evidence-based training used the Appraisal of Guidelines for Research & Evaluation (AGREE) Ⅱ, JBI quality evaluation tools for systematic reviews, randomized controlled trials/experimental studies and expert consensus to evaluate the included guidelines, systematic reviews, original studies and expert consensus. The included literature was classified and summarized, and recommendations and conclusions related to SHS after stroke were screened and extracted. According to the results of the literature summary, the first draft of the clinical nursing standard for SHS after stroke was formed. Using the Delphi method, 25 experts in related fields were selected for two rounds of expert consultation to demonstrate the contents of the first draft.Results:This study included 8 guidelines including 1 evidence summary, 2 systematic reviews, 7 original studies and 2 expert consensus. The overall quality of the guidelines was Grade B; one piece of evidence summary was of good quality and was Grade B; the overall quality of two systematic reviews was low, and the overall quality of seven original studies was average. The first draft of the clinical nursing standard for SHS after stroke included 6 content frameworks and 29 recommendations. Two rounds of expert consultation were conducted, the questionnaire response rates were 89.28% and 100%, and the expert authority coefficients were 0.864 and 0.894, respectively. The Kendell's W of important content framework and recommended in the second round of expert consultation were 0.118 ( P<0.05) and 0.188 ( P<0.001) . According to the results of the expert consultation, the clinical nursing standard for SHS after stroke was formed, including 6 content frameworks and a total of 31 recommendations. Conclusions:The clinical nursing standard for SHS after stroke is based on the best available evidence and expert argumentation, which is in line with the clinical situation in my country and can be sed in clinical nursing work.

Objective:To construct a structured education course for patients with neurogenic bladder during the rehabilitation period.Methods:This study consisted three stages of current situation survey, literature search, and expert consultation. From February 2022 to February 2023, a current survey was conducted on the self-management needs of 62 patients with neurogenic bladder. In April 2023, a literature search was conducted to summarize the best evidence on nursing and management of neurogenic bladder, and form the initial version of course indicators and content. From April to May 2023, 14 experts were selected for consultation, and the Delphi method was used to demonstrate the course indicators and content, and to construct the final draft of the course.Results:A total of 62 patients with neurogenic bladder were included, they have requirements for water management, bladder function training, and dietary requirements, etc. A total of 2 053 articles were retrieved, and 14 articles were ultimately included, including eight guidelines, four evidence summaries, one expert consensus, and one systematic review. The expert authority coefficients for the two rounds of expert consultation were 0.93 and 0.92, respectively. The Kendall coordination coefficient of various indicators in the second round of expert consultation was 0.227 to 0.288 ( P<0.01). After two rounds of expert consultation, a structured education course for patients with neurogenic bladder during the rehabilitation period was finally developed, including six primary indicators, 21 secondary indicators, and 30 tertiary indicators. Conclusions:The structured education course for patients with neurogenic bladder during the rehabilitation period, based on current situation survey, high-quality evidence, and expert consultation, is comprehensive in content and reasonably designed, which can provide supportive assistance for future nursing health education and management for patients with neurogenic bladder.

Purpose Based on European lumbar spine phantom,to investigate the effect of different noise index(NI)combined with adaptive statistical interactive reconstruction-veo(ASiR-V)weights on the measurement of lumbar spine bone density,and to explore the optimal combination of the two parameters.Materials and Methods Using GE Revolution CT spectral imaging scanning,54 groups of scanning parameters with NI values of 4-20(interval 2)combined with ASiR-V weights of 0-100%(interval 20%)were selected for spectral scanning of European lumbar spine phantom.Regions of interest were placed in the middle of L1,L2 and L3,respectively.hydroxyapatite(HAP)-H2O based substances were selected to measure the HAP content of each vertebral body.The differences between the measured bone density value and the true value under different NI combined with different ASiR-V were compared to evaluate its accuracy.Results There were statistically significant differences in HAP measurements of L1,L2 and L3 vertebra in 54 groups of scanning conditions(all P<0.001).When NI=14,ASiR-V80%;NI=16,ASiR-V100%;NI=18,ASiR-V60%;NI=18,ASiR-V80%;NI=20,ASiR-V60%;NI=20,ASiR-V80%;NI=20,ASiR-V100%,there was no statistically significant difference between HAP measured value and true body model value(P>0.05).Conclusion With NI=18,ASiR-V60%,spectral CT can accurately measure lumbar spine bone density and significantly reduce the radiation dose.In clinical application,bone density can be measured by low dose scanning by increasing the weight of NI and ASiR-V.

Objective To evaluate short-term clinical efficacy of renal transplantation from the donation of pediatric donors.Methods Clinical data of 1 5 pediatric donors and 28 recipients (including 2 cases of bilateral renal transplantation)undergoing renal transplantation in the Department of Renal Transplantation of the First Affiliated Hospital of Xi'an Jiaotong University from November 201 3 to December 201 5 were retrospectively analyzed. Results Renal transplantation was successfully performed in 28 recipients.The median warm ischemia time of transplant kidney was 1 2.5 min (range:0-1 7.0 min)and 4.3 h (range:1 .5-7.7 h)for the median cold ischemia time.After operation,4 cases developed with delayed graft function (DGF),1 required dialysis,2 died from pulmonary infection,2 underwent renal resection due to renal anastomosis stenosis and renal thrombosis.Postoperative follow-up lasted for 1 -24 months.Twenty-six (93%)recipients survived after renal transplantation and 24 (86%)recipients survived with restored normal renal function.Conclusions Unilateral and bilateral renal transplantation from pediatric donors has relatively favorable short-term clinical efficacy.