Objective To make a reasonable evidence-based nursing scheme for the oxygen non-humidified of continuing nasal cannula oxygen therapy. Method Adopting the JBI clinical evidence application system, make sure the evidence baseline investigated before application, used during clinical application, and reviewed after application. Based on the now available best evidence, making examination standard and apply it to clinical care. During the application of evidence, 81 continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen patients were taken. Making assessment on the experiment group(oxygen non-humidified) and control group (oxygen humidified) in three aspects: the comfort level and effect of oxygen therapy, and humidification bottles contamination. Results During the application of evidence, the difference between experiment group and control group shows no statistical significance (P>0.05);the experiment group in oxygen therapy operating time was (162.93±40.18) s, the control group operating time was (258.60 ± 56.97) s, the difference of two groups in shows statistical significance (t=8.752, P<0.01). Conclusion The continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen therapy do not need humidification. And the clinical application of this best evidence standardizes the clinical nurses oxygen nursing behavior, reduces the nursing cost and enhances the quality of clinical nursing.

Objective:To explore the experience of self-management dilemma ofadults with emerging ankylosing spondylitis, and to provide reference for the construction of self-management intervention strategies for emerging adults with ankylosing spondylitis.Methods:Descriptive phenomenology was used to conduct in-depth interviews with 14 adults with emerging ankylosing spondylitis in the Rheumatology and Immunology Department of Drum Tower Hospital Affiliated to Medical College of Nanjing University from August 2022 to March 2023. The interview data were analyzed by Colaizzi′s seven-step analysis method.Results:A total of 14 patients completed the interview,10 males, 4 females, aged 21-30 years. In adults with emerging ankylosing spondylitis, there were dilemmas of role maladjustment and disease management disorder, including role maladjustment of disease management and social role maladjustment. Barriers to disease management included weak self-management awareness, insufficient support for self-management information, inadequate self-management skills, and poor compliance with self-management behaviors.Conclusions:The role adaptation and self-management ability of adults with emerging ankylosing spondylitis are seriously inadequate. It is urgent to construct health management strategies for adults with emerging ankylosing spondylitis to help them improve the level of role adaptation and disease management.

Objective:To investigate the status of transition preparation in patients with ankylosing spondylitis (AS) in emerging adulthood and analyze its influencing factors.Methods:The convenient sampling method was used to select 180 patients with AS in emerging adulthood who visited the outpatient department of Drum Tower Hospital Affiliated to Nanjing Medical School from November 2020 to July 2021. General Information Questionnaire, Self-Management and Transition to Adulthood with Rx Treatment Questionnaire (STARx) , Chronic Disease Self-Management Behavior Scale, Bath Ankylosing Spondylitis Disease Activity Index Inventory (BASDAI) , Bath Ankylosing Spondylitis Disease Activity Index Scale (BASFI) and Numerical Rating Scale (NRS) were used to survey patients. Multiple linear regression analysis was used to analyze the influencing factors of transition preparation in patients with AS in emerging adulthood.Results:The transition preparation score of patients with AS in emerging adulthood was (45.23±8.25) , and the score rate was 68.5%. The results of univariate analysis showed that the transition preparation total scores of patients with different gender, age, marital status, work situation, education level, monthly family income, payment method, type of medication, duration of disease, erythrocyte sedimentation rate, C-reactive protein, nocturnal pain and overall pain were compared, and the differences were statistically significant ( P<0.05) . The results of correlation analysis showed that self-management behavior was positively correlated with transition preparation ( P<0.01) , and AS disease activity index and AS disease function index were negatively correlated with transition preparation ( P<0.01) . The results of multiple linear regression analysis showed that, age and self-management behaviors could positively predict transition preparation scores (standardized regression coefficients were 0.414 and 0.211; P<0.01) , while medication type and AS disease function index could negatively predict transition preparation scores (standardized regression coefficients were -0.246 and -0.243; P<0.01) . Conclusions:The overall level of transition preparation of patients with AS in emerging adulthood is low, which is affected by age, medication type, AS disease function index and self-management behavior. Medical staff should pay more attention to patients with young age, oral medication use, high disease function index and low level of self-management behavior and formulate systematic and personalized interventions to improve their transition preparation.

Urinothorax is an uncommon complication following percutaneous nephrolithotomy. We present a case of dyspnea and fever after a percutaneous nephrostolithotomy, next chest CT indicated a significant left pleural effusion and urinothorax was confirmed by the pleural fluid analysis.Chest tube placement did not improve the patient’s dyspnea. The patient finally recovered after the thoracoscopic surgery.

Urosepsis caused by upper urinary tract stone obstruction is a common critically disease in urology.However, it rarely occurs in the patient who underwent a dialysis with uremia.We report a patient who underwent an implantation of ureteral stent to control the infection, and we saved the patient with perinephric hematoma following the surgery. We removed the stones in the left ureteral through a flexible ureteroscope two month later.The hematoma was completely absorbed 6 months after the implantation of ureteral stent.

Objective To systematically evaluate the prevalence of frailty in patients with rheu-matoid arthritis(RA).Methods A systematic search method for observational studies on the preva-lence of frailty in patients with RA was conducted,and literature screening,data extraction as well as evaluation of literature quality were performed in strict accordance with evidence-based medical re-search methodology.Meta-analysis and Egger's linear regression analysis were performed by Stata 16.0 software.Results Twenty-six literatures were included in the study,including a total sample size of 22,547 patients.The results of the analysis showed that the total prevalence of frailty in patients with RA was 36％(95％CI,0.26 to 0.45,P＜0.001),and the prevalence of pre-frailty was 43％(95％CI,0.36 to 0.50,P＜0.001).The results of subgroup analysis showed that the incidence of frailty was higher in RA patients with features of female,age over 60 years old,hospitalization,living in Europe-an region and evaluation with multi-dimensional comprehensive frailty assessment tool and the specific RA frailty assessment tool.Conclusion The overall incidence of frailty and pre-frailty in RA patients is high,and there are differences in the incidence of frailty among patients with different ages,gen-ders,environments,regions,and types of assessment tools.

Objective To systematically evaluate the prevalence of frailty in patients with rheu-matoid arthritis(RA).Methods A systematic search method for observational studies on the preva-lence of frailty in patients with RA was conducted,and literature screening,data extraction as well as evaluation of literature quality were performed in strict accordance with evidence-based medical re-search methodology.Meta-analysis and Egger's linear regression analysis were performed by Stata 16.0 software.Results Twenty-six literatures were included in the study,including a total sample size of 22,547 patients.The results of the analysis showed that the total prevalence of frailty in patients with RA was 36％(95％CI,0.26 to 0.45,P＜0.001),and the prevalence of pre-frailty was 43％(95％CI,0.36 to 0.50,P＜0.001).The results of subgroup analysis showed that the incidence of frailty was higher in RA patients with features of female,age over 60 years old,hospitalization,living in Europe-an region and evaluation with multi-dimensional comprehensive frailty assessment tool and the specific RA frailty assessment tool.Conclusion The overall incidence of frailty and pre-frailty in RA patients is high,and there are differences in the incidence of frailty among patients with different ages,gen-ders,environments,regions,and types of assessment tools.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.