Objective To investigate the practice effect of WeChat software on extended care for patients with anterior resection syndrome. Methods From August 2014 to August 2015, 50 patients with anterior resection syndrome were chosen as control group. From September 2015 to August 2016, 50 patients with anterior resection syndrome were chosen as experimental group. Patients in experimental group could use WeChat software independently. Control group got extended care by telephone, while experimental group was carried out through WeChat platform. They were followed up for 6 months. WeChat software offered patients professional guidance on evaluation and exercise methods of defecation function by video and text with some figures. The questions from patients were answered through WeChat software during followed up. Results The defecation function after 1 month of surgery for patients with excellent, good, average, poor was 15, 20, 12, 3 cases respectively in the experimental group, and 9, 15, 19, 7 cases respectively in the control group. The defecation function after 3 month of surgery for patients with excellent, good, average, poor was 19, 21, 8, 2 cases respectively in the experimental group, and 12, 18, 17, 3 cases respectively in the control group. The difference of the defecation function after 1,3 months of surgery were statistically significant (χ2=8.395, 8.251, P<0.05). But the difference of the defecation function after 6 months of surgery had no statistical significance (χ2=7.505, P>0.05). The compliance of medication, diet and rehabilitation exercise, regular review after 6 months of surgery for patients was (2.14 ± 0.72), (7.21 ± 1.63), (11.20 ± 0.63), (5.04 ± 0.78) points respectively in the experimental group, and (1.37 ± 0.58), (5.72 ± 1.32),(9.75 ± 1.56),(4.72 ± 0.43)points respectively in the control group, and the differences were statistically significant (t=2.68-5.75, P< 0.01).Conclusion WeChat software can improve defecation function and treatment compliance, thus greatly improve the quality of life of patients with mid-low rectal cancer.

The paper is to report the establishment of a population pharmacokinetic model for flurbiprofen (FP), an active metabolite of flurbiprofen axetil (FA). 246 FP serum concentration and clinical data were perspectively collected from 23 general anaesthesia patients receiving FA intravenously before operation in Dentofacial Surgery and Otorhinolaryngology Department of the First Affiliated Hospital of Fujian Medical University. Population pharmacokinetic data analysis was performed using NONMEM software. The measure of Bootstrap was applied for internal validation, while Visual Predictive check was adopted for external validation. The data of FP correspond with two-compartment model. The body weight (WT) had conspicuous effect on clearance and volume of central compartment, while sex, age and daily dose of administration had no marked effect on pharmacokinetic parameter of FP. The basic model was described as follows: CL (L x h(-1)) = 1.28x EXP(ETA(1)), V1 (L) = 5.03x EXP(ETA(2)), Q (L x h(-1)) = 8.5 x EXP(ETA(3)), V2 (L) = 4.39 x EXP(ETA(4)). The final model was described as follows: CL (L x h(-1)) = 1.32 x (WT/60) x EXP(ETA(1)), V1 (L) = 5.23 x (WT/60) x EXP(ETA(2)), Q (L x h(-1)) = 8.45 x EXP(ETA(3)), V2 (L) = 4.37 x EXP(ETA(4)). The population typical value of CL, V1, Q and V2 were: 1.32 L x h(-1), 5.23 L, 8.45 L x h(-1) and 4.37 L, respectively. Bootstrap and visual predictive check show that the final model of FP is stable, effective and predictable. A novel population pharmacokinetic model is developed to estimate the individual pharmacokinetic parameter for patients intravenous injecting FA in terms of patients' characteristics and dosing history, and to design a prior dosage regimen.

Objective:To establish and evaluate the effect of graded training mode of clinical nutrition nursing in general hospital.Methods:A clinical nutrition nursing group was established, including core management group, quality control group, education and training group and liaison nurse group. Hierarchical training and practice of clinical nutrition nursing was conducted throughout the hospital, and effect of training was evaluated.Results:The nurses' nutrition knowledge increased from (66.60±9.72) to (85.06±7.85) points, nutrition attitude increased from (72.38±5.55) to (92.50±5.10) points, nutrition behavior increased from (66.87 ± 6.83) to (88.76 ± 7.60) points, and the differences were statistically significant ( t values were -15.520, -11.128, -12.238, P<0.01). The nutritional risk screening rate and nutritional intervention rate of patients were improved to 100%, and the academic level of nurses in nutritional nursing was further improved. Conclusion:The application of graded training mode of clinical nutrition nursing can improve nurses' nutritional knowledge and skills, improve nurses' professional and academic level, and improve patient clinical outcomes.

Objective:To investigate the effect of early gradual diet on reducing delirium in elderly patients with hip arthroplasty.Methods:From January 2018 to January 2020, 74 cases of hip arthroplasty patients aged over 65 years old who were treated in the Third Affiliated Hospital of Sun Yat-sen University were selected as the observation objects. They were randomly divided into experimental group and control group with 37 cases in each group. The experimental group was given early gradual diet on the basis of routine postoperative care, while the control group was given routine postoperative diet on the basis of routine postoperative care. The incidence of postoperative delirium, Pittsburgh Sleep Quality Index (PSQI), patient satisfaction rate, average hospitalization days and average hospitalization expenses were used to evaluate the effect of early gradual diet on reducing delirium in elderly patients with hip arthroplasty.Results:The incidence of delirium in the experimental group was 2.70% (1/37) and 16.22% (6/37) in the control group, the difference was statistically significant ( χ2 value was 3.945, P<0.05); the hospitalization days of the experimental group were (10.68±5.13) d, (13.62±7.19) d in the control group. The difference of hospitalization days was statistically significant ( t value was 2.877, P<0.01). The incidence of difficulty in falling asleep and the satisfaction rate of the experimental group were 8.11% (3/37) and 94.59% (35/37) respectively, and those in the control group were 29.73% (11/37) and 78.38% (29/37) respectively, and the differences were statistically significant ( χ2 value was 5.638, 4.163, P<0.05). Conclusions:Early gradual diet after operation can reduce the incidence of delirium in elderly patients with hip arthroplasty, shorten the average hospitalization days, reduce the incidence of difficulty in falling asleep, improve patients' satisfaction, and help patients to pass through the perioperative period more safely and comfortably.

Objective To study the characteristics of symptom distress and its inlfuencing factors in patients with primary liver cancer after transcatheter arterial chemoembolization (TACE). Methods A total of 108 patients with primary liver cancer receiving TACE in Department of Hepatobiliary Surgery, the Third Afifliated Hospital of Sun Yat-sen University from January 2012 to January 2013 were voluntarily enrolled in this study on the 3rd day after operation by convenience sampling method. There were 94 males and 14 females with age ranging from 26 to 72 years old and median age of 51 years old. The informed consents of all patients were obtained and the ethics committee approval was received. Cross-sectional study and questionnaire survey were used in the research. The questionnaire survey included questionnaire of general information, M.D. Anderson Symptom Inventory (MDASI), Social Support Measuring Questionnaire (SSS) and Medical Coping Modes Questionnaire (MCMQ). Multiple linear regression analysis was used to identify factors inlfuencing the symptom distress. Results The mean score of MDASI symptom subscale of patients during therapy was 3.0±1.6 with a mild degree of symptom distress. The score of MDASI life distress subscale of patients was 3.4±1.7, also with a mild degree of symptom distress. Work was most influenced by the symptoms, followed by emotion, joy of life, common activity, relation with others and walks. Fever, discomfort of stomach, abdominal distention, icteric skins and weight loss were common symptoms in sequence which distressed patients. The total score of social support was 42.2±6.7 which was at the middle level, and the sore of use of social support was 7.9±2.2. The score of 3 dimensions facing, avoiding, surrender were 2.5±0.5, 2.4±0.5, 2.0±0.6 respectively. Facing and avoiding were the common coping modes. Patients who had college educational degree or above, no job after being ill, low level of subjective support, surrender coping mode were more distressed by symptoms than the other patients (RR=0.320, 0.254, 0.569, 0.217;P<0.05). Conclusions Patients with primary liver cancer have mild symptom distress after TACE, and patients with college educational degree or above, no job after being ill, low level of subjective support, surrender coping mode are more distressed by symptoms than the other patients.

Objective:To construct an evaluation framework with detailed indices for demonstration units (wards) of enteral nutrition nursing, in order to improve the competence of nurses in enteral nutrition nursing and inform the specialized development of enteral nutrition demonstration units (wards).Method:On the basis of literature review and expert discussion, a preliminary draft was developed, and the Delphi expert consultation method was used to conduct two rounds of consultation with 15 clinical experts in the field of enteral nutrition nursing from 15 tertiary hospitals.Results:The effective response rates of questionnaires in two rounds of consultations were both 100%. The first round of expert consultation showed an authority coefficient of 0.90 and a coefficient of variation of 0 to 0.167, while the second round showed an authority coefficient of 0.93 and a coefficient of variation of 0 to 0.113. The Kendall harmony coefficients were 0.338 and 0.368, respectively. Finally, the evaluation framework with detailed indices for the demonstration unit (ward) of enteral nutrition nursing was formed, which consisted of 3 primary indicators, 16 secondary indicators, 54 tertiary indicators, and 62 detailed items.Conclusions:The evaluation framework we developed for the demonstration unit of enteral nutrition nursing follows the diagnosis and treatment process of enteral nutrition management for inpatients, including the triad of structure, process, and outcome. The framework is objective and practical, and can inform the daily practice of enteral nutrition nursing demonstration units (wards) and the development of enteral nutrition nursing specialties.

Objective:To understand the nutritional nursing competence in the enteral nutrition demonstration wards at this stage, so as to inform subsequent training plan.Methods:From September to October in 2023, nurses from 287 institutions involved in the enteral nutrition demonstration ward construction project were selected using convenience sampling. Questionnaires on general characteristics and self-assessment scale on nutrition nursing competence were used for online survey. The status quo and influencing factors of nutrition nursing competence in included institutions were analyzed.Results:A total of 5 409 valid questionnaires were collected, with a response rate of 62.63%. The total score of nutrition nursing competence was 74.74±16.11, with the least subtotals in the domain of nutrtion knowledge. Multiple linear regression showed that influencing factors of nutrition nursing competence includes years of working, department, registered dietitian or not, nutrition management specialist or not, completion of the curriculum in enteral nutrition demonstration ward construction project, and training/supervision arranged by their department concerning nutrtion nursing and relevant evaluation criteria ( P<0.05). Conclusions:The nutritional nursing competence of clinical nurses in the wards involved in enteral nutrition demonstration ward construction project still needs to be improved. Seniors should take into consideration the varying nutritional nursing competence among junior nurses and nurses from different departments, and strengthen the training on nutrition knowledge. It should be encouraged for nurses to actively participate in nutritionist training. Actions including enhancing nutrition specialist training, establishing the multidisciplinary collaborative nutrition care team and conducting regular supervision and assessment should be implemented in the future, to improve the nutritional nursing competence among nurses.

Objective: To explore the effect of individualized nutrition intervention mode based on dysphagia screening in postoperative patients with cerebellopontine angle occupying lesion. Methods: By developing nurses training, selecting special screening and evaluation tools, developing screening methods and individualized nutrition intervention measures and meal spectrum, making screening and intervention flow chart, and starting to be implemented in postoperative patients with cerebellopontine angle occupying lesion in July 2017. Forty-six patients with cerebellopontine angle occupying lesion in the previous year were reviewed as the control group, who were given routine treatment and nursing; One year after implementation, Another 48 patients were set as the experimental group, and were given individualized nutritional care based on screening of dysphagia. Results: The incidence rate of dominant aspiration(0), pneumonia (4.17%, 2/48) and diarrhea (2.08%,1/48) in the experimental group was lower than 4.35% (2/46), 21.74% (10/46), 19.57% (9/46) in the control group, especially the difference of incidence rate of pneumonia and diarrhea was statistically significant (pneumonia: χ²=0.010, P=0.013; diarrhea: χ²=0.006, P=0.007). The retention rate of gastric tube in the experimental group (31.30%, 18/48) was lower than that in the control group (58.70%, 27/46), the difference was statistically significant (χ²=7.158, P=0.007). Average retention time of gastric tube in the experimental group (4.47±1.13) d was less than that in the control group (5.11±0.70) d, the difference was statistically significant (t=2.296, P=0,027). The hospitalization time in the experimental group (8.69±1.36) d were less than those in the control group (12.57±2.95) d, the difference was statistically significant (t=8.248, P=0,000). The nutritional status of 7 days after operation of the experimental group was better than that of the control group, the differenc e was statistically significant (albumin: t=4.888, P<0.01; prealbumin: t=5.188, P<0.01; hemoglobin: t=4.039, P<0.01). The knowledge and skills of swallowing of general nurses improved significantly after the work, in particular, the accuracy of screening tests for Wa Tian drinking water increased from 5/8 to 20/20. The difference was statistically significant (χ²=8.148, P=0.017). Conclusions Individualized nutrition intervention based on screening for dysphagia can improve the clinical outcome of patients, improve the comprehensive ability of nurses and achieve a win-win situation of nurse - patient.