Objective:To construct a perioperative venous thrombosis prevention program for patients with spinal surgery based on evidence-based nursing, and to discuss its application effect.Methods:Using the convenient sampling method, a total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from June 2019 to June 2020 were selected as the control group and received routine nursing management. A total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from July 2020 to July 2021 were selected as the observation group, and they were given a venous thrombosis prevention scheme based on evidence-based nursing. The prothrombin time, thrombin time, activated partial thromboplastin time, fibrinogen and D-dimer levels, blood flow velocity of common femoral vein, popliteal vein, iliac vein and occurrence of thrombosis were compared between the two groups.Results:The prothrombin time, thrombin time, fibrinogen and D-dimer levels in the two groups had interaction, and the differences were statistically significant ( Finteraction=6.079, 8.735, 6.918, 8.657; all P<0.01) . Postoperative prothrombin time, thrombin time and activated partial thromboplastin time all showed a trend of decreasing first and then increasing and the levels of fibrinogen and D-dimer showed a trend of increasing first and then decreasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, postoperative prothrombin time, thrombin time, and activated partial thromboplastin time in the observation group were longer than those in the control group, and the levels of fibrinogen and D-dimer were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The blood flow velocity of common femoral vein, popliteal vein, and iliac vein in the two groups were interacted, and the difference was statistically significant ( Finteraction=6.257, 3.281, 7.697; all P<0.05) . After operation, the blood flow velocity of common femoral vein, popliteal vein and iliac vein all showed a trend of first decreasing and then increasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, the postoperative blood flow rates of the common femoral vein, popliteal vein and iliac vein in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of venous thromboembolism in the observation group was 1.11%, which was lower than 6.67% in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The perioperative venous thrombosis prevention and management plan based on evidence-based nursing can provide individualized nursing intervention for spinal surgery patients according to different thrombosis risks, which can improve patients' coagulation and lower extremity venous function and effectively reduce the risk of thrombosis.

Objective:To construct a perioperative venous thrombosis prevention program for patients with spinal surgery based on evidence-based nursing, and to discuss its application effect.Methods:Using the convenient sampling method, a total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from June 2019 to June 2020 were selected as the control group and received routine nursing management. A total of 90 patients with spinal surgery who were admitted to Jinhua People's Hospital from July 2020 to July 2021 were selected as the observation group, and they were given a venous thrombosis prevention scheme based on evidence-based nursing. The prothrombin time, thrombin time, activated partial thromboplastin time, fibrinogen and D-dimer levels, blood flow velocity of common femoral vein, popliteal vein, iliac vein and occurrence of thrombosis were compared between the two groups.Results:The prothrombin time, thrombin time, fibrinogen and D-dimer levels in the two groups had interaction, and the differences were statistically significant ( Finteraction=6.079, 8.735, 6.918, 8.657; all P<0.01) . Postoperative prothrombin time, thrombin time and activated partial thromboplastin time all showed a trend of decreasing first and then increasing and the levels of fibrinogen and D-dimer showed a trend of increasing first and then decreasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, postoperative prothrombin time, thrombin time, and activated partial thromboplastin time in the observation group were longer than those in the control group, and the levels of fibrinogen and D-dimer were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The blood flow velocity of common femoral vein, popliteal vein, and iliac vein in the two groups were interacted, and the difference was statistically significant ( Finteraction=6.257, 3.281, 7.697; all P<0.05) . After operation, the blood flow velocity of common femoral vein, popliteal vein and iliac vein all showed a trend of first decreasing and then increasing, and the differences were statistically significant ( P<0.05) . Regardless of the time factor, the postoperative blood flow rates of the common femoral vein, popliteal vein and iliac vein in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of venous thromboembolism in the observation group was 1.11%, which was lower than 6.67% in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The perioperative venous thrombosis prevention and management plan based on evidence-based nursing can provide individualized nursing intervention for spinal surgery patients according to different thrombosis risks, which can improve patients' coagulation and lower extremity venous function and effectively reduce the risk of thrombosis.

Objective:To explore the clinical features of three early-onset infantile epileptic encephalopathy (EIEE) patients with variations in phosphofurin acidic cluster sorting protein 2 (PACS2) gene and to review related literature.Methods:The clinical data and genetic features of three early infantile epileptic encephalopathy 66 (EIEE66) patients with a PACS2 gene variant diagnosed by the Department of Neurology, Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2019 to January 2020 were retrospectively analyzed. A literature search with "PACS2 gene" "PACS2" "epileptic encephalopathy, early infantile, 66" and"early infantile epileptic encephalopathy 66" as key words was conducted at PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform (up to July 2020). Case reports of patients with PACS2 gene variants and related clinical data were chosen and reviewed.Results:Case 1, a girl aged 2 years and 2 months was hospitalized because of repetitive seizures within more than two years and 6 convulsions within 2 days due to fever. The seizures occurred at the age of 7 days, characterized by focal seizures and generalized tonic-clonic seizures. Sometimes, the frequency of seizures increased with high fever. Regular treatment had not been implemented in the early stage, later seizures were controlled by valproic acid treatment. Case 2, a female 5 months of age, was admitted due to recurrent convulsions in nearly five months. Focal seizures occured at the age of 5 days. And the brain magnetic resonance imaging (MRI) confirmed abnormal cerebellar hemispheres and cerebellar vermis, as well as cerebellar dysplasia. Several antiepileptic drugs and ketogenic diet were ineffective in the early months, and later seizures were controlled with the treatment with levetiracetam and valproic acid. Case 3, a five-month-old girl, was admitted because of recurrent convulsions for nearly five months. At the age of 3 days, she had tonic seizures, and showed good response to levetiracetam and valproic acid. All the three cases were accompanied by development delay and dysmorphic facial appearance, and got seizure-free with the treatment with valproic acid. All copy-number variant analysis and trio whole exome sequencing revealed a recurrent heterozygous missense variant (c.625G>A) in PACS2 gene. No related reports were found in Chinese journals, while 4 reports were found in English literature, describing 17 patients in total. With these 3 patients included, 20 cases had only two missense PACS2 gene variants, in whom 19 cases carried the variant c. 625G>A (p.Glu209Lys) and 1 case carried the variant c. 631G>A (p.Glu211Lys). Epilepsy was the first reported symptom in all patients, and 17 cases had seizures during the first week of life. Out of the various seizure types observed, focal seizures were the predominant types (13 cases), whereas tonic, clonic, tonic-clonic seizures and non-motor seizures (such as facial flushing) were also reported. Almost all patients showed facial dysmorphism and developmental delay to different degrees. Total of 16 patients had abnormal brain MRI recordings, and 13 cases had cerebellar hypoplasia. More specifically, 7 cases showed inferior vermian hypoplasia, and 3 cases showed hypothalamic fusion anomaly. The treatment was mainly aimed to control the symptoms. And the recommended effective treatment for epilepsy has not been reported yet.Conclusions:PACS2-related early infantile epileptic encephalopathy is an autosomal dominant disease, characterized by seizure onset within the first week of life in most cases, dysmorphic facial appearance, and various degrees of developmental retardation. Treatment with valproic acid showed good effect.

Objective To improve the survival rate and life quality of peritoneal dialysis(PD)patients,we es-tablished a retraining model based on ADDIE model,including optimizing the content,form and frequency.Methods From January 1,2022 to May 3,2023,based on the 5 stages of ADDIE model,we investigated the needs of pa-tients,invited 55 experts in the peritoneal dialysis field to design the final draft of the retraining model through 2 rounds of Delphi expert consultations,and 23 peritoneal dialysis patients were preexperimented to evaluate and re-vise the retraining model.Results The questionnaire recovery rates of the 2 rounds of expert consultation were 100％and 96.36％,respectively.The coordination coefficients of the first-level catalog were 0.379 and 0.384,and the coordination coefficients of the second-level catalog were 0.446 and 0.427,respectively.The Chi-square test showed that P＜0.05,indicating statistical significance.The content of the retraining model included 4 sections,33 subdirectories and 9 training forms,which were combined online and offline.The training frequency was different due to the different contents,and the single content of a single training form was mainly 15 min.Conclusion The PD patient retraining model constructed in this study is scientific,reliable and innovative.Its content is easy to un-derstand and diverse in forms.The training duration and frequency are in line with the memory rule,and the eval-uation takes into account both process and result.

OBJECTIVE: To establish an interference mode of group counseling for diabetic patients with depression and to evaluate the effectiveness of this mode on depression, treatment compliance and blood sugar level in the patients.
 METHODS: One hundred diabetic patients with depression were randomly divided into a counseling group and a control group (n=50 per group). Self-Rating Depression Scale (SDS) was applied to all the patients. The interference mode of group counseling was established through literature review, expert consultation or interview. The counseling group received counseling for 8 times within 2 months.
 RESULTS: There was a significant difference in the SDS scores at 0, 3, 6 or 12 months after the intervention between the 2 groups (P<0.001). For the counseling group, there was a significant difference in the SDS scores between pre-intervention and 3, 6 or 12 months after intervention (P<0.001). However, there was no significant difference in the SDS scores between any two time points after the intervention (P>0.05). There was a significant difference in the compliance between any two time points after the intervention (P<0.05). Fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPG) or glycosylated hemoglobin (HbA1c) was significantly different at any two time points after the intervention (P<0.05).
 CONCLUSION Group counseling can improve depression, compliance and blood sugar control in the diabetic patients.
Blood Glucose ; analysis ; Counseling ; Depression ; therapy ; Diabetes Mellitus, Type 2 ; psychology ; therapy ; Glycated Hemoglobin A ; analysis ; Humans ; Patient Compliance ; Psychotherapy, Group