Objective TO investigate the application of Nutritional Risk Screening 2002 (NRS 2002) and nutrition support in critically ill patients.Methods Totally 172 adult critically ill patients with a hospital stay equal to or above 3 days were consecutively enrolled from a Beijing-hospital from September 2011 to December 2011.Nutrition support was evaluated on a daily basis.NRS 2002,body mass index (BMI),and Acute Physiology and Chronic Health Evalnation Ⅱ (APACHE Ⅱ) were applied to assess the nutritional risks and nutrition status within 24 hours after admission.Results Among all the patients,the rates of nutrition support were 39.5％ and 67.9％ on the 1st and 7th day respectively.The rate of parenteral nutrition (33.6％ ～ 39.5％) was higher than that of enteral nutrition (4.1％ ～ 16.0％).NRS 2002,APACHE Ⅱ score,and BMI showed that 160 patients (93.0％) required nutrition support,but only 103 patients (64.4％) actually received nutrition support,among whom 92 (89.3％) were supplied with nutrition support within 3 days after admission.Conclusions The application of nutrition support in critically ill patients is insufficient in this hospital.Nutrition support is typically provided within 3 days after admission.Parenteral nutrition remains the most common type of nutrition support.

Objective To investigate the changes in prevalence of nutritional risk and undemutrition in patients with head and neck cancer during radiotherapy.Methods In this longitudinal observational study,a convenience sampling method was used to recruit patients with head and neck cancer who were receiving radiotherapy in Beijing Cancer Hospital.Nutritional Risk Screening 2002 (NRS 2002) was applied to assess the prevalence of nutritional risk in the patients,and Patient-Generated Subjective Global Assessment (PG-SGA) and body composition test to determine the prevalence of malnutrition (undernutrition) before,during and after radiotherapy.Results 56 patients finished the three follow-up exams.Along with the progress of radiotherapy,the scores of NRS 2002 increased gradually (1.64±1.09 vs.2.30 ±1.06 vs.3.14 ±1.07,x2 =46.639,P＜0.001),and the prevalence of nutritional risk also increased gradually (21.43％ vs.37.50％ vs.71.43％,x2 =29.700,P ＜0.001);the total scores of PG-SGA [1 (1-13) vs.6 (1-15) vs.12 (1-18),x2 =63.206,P＜0.001] and dimensions of weight [0 (0-4) vs.1 (0-4) vs.3 (0-6),x2 =40.798,P＜0.001],intake [0 (0-2) vs.1 (0-2) vs.2 (0-4),x2=64.707,P＜0.001] and symptoms [0 (0-7) vs.2 (0-10) vs.6 (0-11),x2 =61.562,P ＜ 0.001] all increased gradually with statistical significance.The prevalence of malnutrition in different stage of radiotherapy were significantly different (x2 =64.999,P ＜ 0.001).The body composition analysis in 40 patients showed that all the indicators of body composition decreased significantly along with the progress of radiotherapy.There was a great loss in patients' body weight during radiotherapy,especially the fat-free mass.Conclusions The prevalence of nutritional risk and undernutrition may increase in patients with head and neck cancer during radiotherapy.Lean body mass accounted for most of the weight loss.We should pay more attention to those patients' nutritional status during radiotherapy.

Patients with abdominal and pelvic cancer surgery are considered as one of the groups with the highest risk of deep venous thrombosis (DVT). Perioperative DVT preventive management is different from that of general surgery. However, current practice lacks uniform prevention norms. This paper summarized the high risk factors and risk assessment methods of DVT among patients with abdominal and pelvic cancer surgery. Besides, this paper emphatically introduced three kinds of preventive measures including daily care, physical machinery and anticoagulant drugs to explore the research findings of combined prevention and extension of prevention maturity so as to induce the perioperative DVT prevention programs reached a consensus for patients with abdominal and pelvic cancer.

Objective To investigate the taste alteration caused by radiotherapy and its relationship with nutritional status in head and neck cancer patients during and after radiotherapy.Methods From March to November 2017,172 patients with head and neck cancer receiving radiotherapy were recruited from Beijing Cancer Hospital including 86 patients completing all follow up visits.Chemotherapy-induced Taste Alteration scale was used to evaluate radiotherapy-induced taste alteration and the Patient-generated subjective global assessment (PGSGA) was used for nutrition evaluation at baseline,mid-treatment,post-treatment and 1-2 months after radiotherapy (follow-up).Generalized estimating equations was applied to analyze the influencing factors of taste alteration and its relationship with nutritional status.Results The incidence of taste alteration were 9.3％,84.9％,94.2％ and 77.9％ respectively at baseline,mid-treatment,post-treatment and 1-2 months after radiotherapy (follow-up).Taste alteration score increased with the increase of radiation dose,reached the highest at the posttreatment and decreased at follow-up visit which was still higher than the score at baseline.PG-SGA score increased with the increase of radiation dose.The incidence of severe malnutrition after radiotherapy was 95.3％,decreased to 45.3％ at follow up visit.Nutritional status was closely related to taste alteration.Total radiation dose and concurrent chemotherapy were the influencing factors of taste alteration.Conclusions The taste of patients with head and neck cancer is affected by radiotherapy.As radiotherapy continues,the taste alteration aggravates and PG-SGA score increases gradually,thus malnutrition becomes a prominent problem.Such effect will persist for a period of time after radiotherapy,which should be paid attention and interventions should be conducted to prevent or reduce this effect,in order that the lasting of malnutrition induced by taste alteration can be avoided.

Objective? To evaluate and summarize the best evidence for management of peristomal irritant dermatitis in patients with a urostomy. Methods? Clinical practice guidelines, evidence summary and systematic review related to peristomal irritant dermatitis were retrieved and screened from various guideline websites and databases (from their founding to July 2018). The quality of these literatures were evaluated with the Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) and the Joanna Briggs Institute Critical Appraisal Tools. Evidence was extracted and summarized from high-quality literatures. Results? Totally 7 literatures were included, including 5 clinical practice guidelines, 1 evidence summary and 1 systematic review. Evidence for recognition, evaluation, prevention, treatment, health education and follow-up visits of peristomal irritant dermatitis was summarized. Conclusions? It is recommended that medical institutions refer to the content of evidence summary, make evidence-based practice plans based on the conditions of clinical departments, use the evidence efficiently, and bridge the gap between evidence and practice.

Objective To investigate the status of the emergency nurses′ turnover intention and analyse its influencing factors in level two and three hospitals. Methods A total of 385 nurses in Emergency Department of 2-level or 3-level general hospitals were investigated by turnover intention scale and Mueller/ McCloskey satisfaction scale (MMSS). Results The average turnover intention score of nurses in 2-level general hospital (2. 95 ± 0. 52) was higher than that of the nurses in 3-level general hospital (2. 56 ± 0. 58) (t = 6. 948,P <0. 01). Regression analysis showed that the age, sex, the highest diploma, working time in Emergency Department, working style, monthly income, satisfaction level were the influencing factors of emergency nurses′turnover intention ( β′ = - 0. 158, 0. 181, 0. 350, - 0. 460, 0. 360, - 0. 171, - 0. 424, respectively). Conclusions The emergency nurses′ turnover intention is in the higher level influenced by multiple factors. Measures combining with the characteristics of different grade hospital should be taken to improve the nurses′satisfaction and reduce the turnover intention.

In order to clarify the characteristics and application status of the Ottawa Model of Research Use,this paper tries to expound its origin,development,core elements,assumptions and implementation steps,and summarize its characteristics.By analyzing the studies of evidence-based nursing practice using this model in recent years,the research aims to help researchers to further understand its implementation steps and provide reference for researchers to apply this model in evidence-based practice.

This article introduces Stetler's model of research utilization and its recent application in evidence-based nursing practice, and elaborates a study on evidence-based nursing practice using the model in order to offer frameworks, insights and methods for evidence-based nursing practice by China's nursing staff.

Objective:To observe the changes of nutrition impact symptoms (NIS) and fat-free mass and analyze the relationship between them in patients with head and neck cancer (HNC) during radiotherapy.Methods:A convenient sampling method was adopted to select HNC patients who received radiotherapy in the outpatient clinic of department of radiotherapy for head and neck cancer in a cancer hospital in Beijing from March 2017 to January 2020. The nutrition impact symptoms (NIS) were assessed by a nutrition impact symptoms checklist and the fat free mass was assessed by bioelectrical impedance analysis at three time points: before radiotherapy (T1), during radiotherapy (T2) and at the end of radiotherapy (T3). The Generalized Estimating Equations (GEE) was used to analyze the relationship between them.Results:A total of 542 HNC patients were included in the analysis. During radiotherapy, the patients' NIS number and score presented an increasing trend, reaching the highest level and peaked at the end of radiotherapy. The change of fat-free mass showed a decreasing trend and reached the minimum at the end of radiotherapy. Patients with higher NIS scores had more percentage loss of fat-free mass.Conclusions:During radiotherapy, patients with HNC showed an increase in NIS score and lost fat-free mass. Patients with higher NIS score lost more percentage of fat-free mass, which suggested that clinical medical staff should pay attention to NIS management and take comprehensive intervention measures in time to reduce the loss of fat-free mass.

Objective: To evaluate the feasibility, efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for neoadjuvant therapy. Methods: Eighty-six patients with stage ⅢA EGFR-mutant lung adenocarcinoma were assigned to 2 groups (n=43 in each group) according to the random number table method: neoadjuvant targeted therapy group (single oral dose of erlotinib 150 mg per day, for 9 weeks) and neoadjuvant chemotherapy group (2 cycles of pemetrexed combined with cisplatin chemotherapy followed by 3- week discontinuation). Surgical treatment was underwent after imaging efficacy evaluation. Results: In neoadjuvant targeted therapy group, 4 achieved complete response (CR), 25 achieved partial response (PR), giving an objective response rate (ORR) of 67.4%. In pathological response, 8 patients had grade Ⅰ, 20 patients had grade Ⅱ, giving a pathological response rate of 65.1%. The most frequent adverse events (AEs) were rash and diarrhea. In neoadjuvant chemotherapy group, 2 had CR and 17 had PR, giving an ORR of 44.2%. In pathological response, 3 patients had grade Ⅰ, 15 patients had grade Ⅱ, giving a pathological response rate of 41.9%. The main AEs were hematologic toxic effects. The ORR, histological efficacy and hematologic toxicity showed statistical significance between the two groups (P<0.05). The neoadjuvant targeted therapy group had 90.7% resection rate, (299.8±23.4) ml of hemorrhage volume during operation, (5.2±0.4) days of extubation time and 9.3% postoperative complication rate. Corresponding results were 83.7%, (308.9±22.7) ml, (5.4±0.6) days and 11.6% in neoadjuvant chemotherapy group, which showed no statistical significance (P>0.05). Conclusions Neoadjuvant targeted treatment for stage ⅢA lung adenocarcinoma harboring EGFR mutations. The regimen could be considered as a choice of neoadjuvant treatment for patients with stage ⅢA EGFR-mutant lung adenocarcinoma.