Objective To explore the necessities and clinical value of acute intestinal obstruction with com-puted tomography of whole abdomen in over 80 years old patients.Methods 50 patients with acute intestinal obstruc-tion were diagnosed in department of emergency surgery and underwent the abdominal CT examinations.The clinical data,CT and surgery pathology of all patients were compared and analyzed.Results All cases were verified by surgi-cal operation and pathological diagnosis,including colorectal cancer(n =21)and incarcerated abdominal external her-nia(n =21),appendicitis(n =2),adhesive intestinal obstruction(n =2),intestinal volvulus (n =2),and intestinal intussusception(n =1)and stercoral intestinal obstruction(n =1),12 cases were accompanied by bowel necrosis and perforation.12 patients were treated by laparoscope surgery,38 cases by open laparotomy,48 patients acquired good recovery,and 2 cases died from extensive bowel necrosis and multi -organ failure.Conclusion CT examination in whole abdomen could rapidly and accurately diagnose the cause of intestinal obstruction,evaluate complications and risks,so as to provide reasonable treatment choice and time,making patients acquired the effective effects as soon as possible,reducing the bad consequences.

Objective To establish a model of cervical spondylosis in rats. Methods Sixty SD rats (four months old) were ran-domly divided into control, muscle imbalance and posterior column instability group, ten rats in each group. Then the degeneration of X-ray film and motion function were evaluated by oblique board test. Results After analyzed the cervical films of control groups, the nature curve still existed, vertebral clearance had no abnormal. No ostensis spurs or ossifies in Luschka joint and joint processes were found. But in mus-cle imbalance and posterior column instability groups, the nature curve was disappeared or stiff, vertebral clearance were stenosis, osteosis spur formed, ossify or sclerosis emerged in Lnschka joint and joint process. Compared with control group in oblique board test, the muscle force decreased in muscle imbalance and posterior column instability group. There were no statistic significant difference between 2 and 4 months of control group, and also no difference in muscle imbalance and posterior column instability group, but there were significant differ-ence in 2 and 4 months of muscle imbalance and posterior column group. Conclusion Not only cervical posterior column instability but also muscle imbalance could result in cervical spendylosis, both muscle force balance and posterior column were important factors in maintaining spine stability.

Objective:To develop a post-stroke insomnia (PSI) evidence-based nursing practice protocol to provide reference for the implementation of insomnia nursing in stroke patients.Methods:In January 2022, a research team was formed. Based on evidence-based principles, systematically searched and summarized high-quality evidence of Western medicine care and Chinese medicine care related to PSI to develop the first draft of the evidence-based nursing practice protocol for PSI, invited medical experts and nursing experts in the field of stroke care, medical treatment, research and teaching, and the protocol was revised through 2 rounds of Delphi expert consultation to form the final draft of the protocol.Results:A total of 15 experts were invited, 3 males and 12 females; 2 between 31 and 40 years of age, 6 between 41 and 50 years of age, and 7 between 51 and 60 years of age.The positive coefficient for both rounds of expert consultation was 100% and the expert authority coefficient was 0.89; the Kendall coordination coefficients for the importance and feasibility scores of the entries in the 2 rounds expert consultation were 0.188 and 0.146, 0.224 and 0.188 (all P<0.01). The PSI evidence-based nursing practice protocol included 27 entries in 6 dimensions: assessment of sleep quality, diagnosis of PSI, development of an individualized plan, non-pharmacological interventions, Chinese medicine nursing interventions, preparation for discharge and follow-up. Conclusions:The PSI evidence-based nursing practice protocol is scientific, reliable and applicable, and can provide a reference for the nursing practice of PSI patients.

Objective:To summarize the best evidence of post-stroke insomnia nursing and provide basis for clinical practice.Methods:According to the "6S" pyramid model, the system searched UpToDate, Scottish Interhospital Guidelines Network, US National Guidelines Network, JBI Evidence Based Health Care Center Database, BMJ Best Clinical Practice, NICE Guidelines Network, China Medical Pulse Communication Guidelines Network, Ontario Registered Nurses Network, The Cochrane Library, PubMed, Web of Science, Medline, Embase, CINAHL, CNKI, Wanfang, VIP and Chinese Biomedical Literature Database and related association websites. Evidence on the post-stroke insomnia nursing, including guidelines, systematic evaluations, expert consensus, etc. The retrieval period was from the database construction to February 19, 2022. The quality of the literature was evaluated by the corresponding articles evaluation criteria.Results:A total of 24 articles were selected, including 6 guidelines, 16 systematic reviews and 2 expert consensus. Totally 26 pieces of the best evidence on 5 aspects including the evaluation of sleep quality, the diagnosis of post-stroke insomnia, the development of individual plan, non-pharmaceutical intervention, and traditional Chinese medicine nursing intervention were finally summarized.Conclusions:The summarized evidence of post-stroke insomnia nursing, for can be used to provides scientific and effective evidence-based basis for nursing staff to carry out clinical practice. It is suggested that the specific evidence should be selected according to the specific situation of patients in clinical application.

Objective:To construct a thirst management scheme for adult surgical patients and provide practical guidance for nurses to carry out perioperative thirst management.Methods:From April to May 2023, literature search was conducted to extract domestic and foreign evidence related to thirst, and after group discussion, a preliminary management plan for thirst in adult surgical patients was constructed. From May to June 2023, 18 experts were selected for two rounds of Delphi expert letter consultation, and a formal plan for thirst management of adult surgical patients was discussed and revised according to expert opinions.Results:A total of 18 experts completed two rounds of expert letter consultation. The effective recovery rate of the questionnaire was 100.00% and the expert authority coefficient was 0.915. The coefficients of variation for the importance and operability scores of the first round of expert inquiry were 0.05-0.25 and 0.06-0.42, respectively, and the Kendall's harmony coefficients were 0.224 and 0.184 ( P<0.01). The coefficients of variation for the importance and operability scores of the second round of inquiry were 0.05-0.23 and 0.06-0.24, respectively, and the Kendall's harmony coefficients were 0.166 and 0.154 ( P<0.01). The final thirst management scheme included five primary items (preliminary preparation, identification and evaluation, preoperative relief strategies, postoperative intervention measures and effectiveness evaluation) and 23 secondary items. Conclusions:The thirst management scheme for adult surgical patients constructed in this study is scientific and comprehensive, which can provide a reference basis for clinical practice.

Objective To compare the diagnostic accuracy of magnifying chromoendoscopy (MCE) and endoscopic ultrasonography (EUS) for preoperative endoscopic assessment of the invasion depth of colorectal laterally spreading tumour(LST).Methods Data of 104 cases of colorectal LST were included.With the final pathological diagnosis as the golden standard,the accuracies of MCE and EUS for preoperative assessment of the invasion depth of colorectal LST were compared.Results The diagnostic accuracies of MCE and EUS for evaluating the invasion depth of LST were 89.4％ (93/104) and 73.1％ (76/104),respectively(P＜0.05).The lesion size and the endoscopist could affect the accuracy of the EUS evaluation (P=0.017,OR=3.561;P=0.035,OR =1.399).The accuracy of EUS seemed to show a downward trend for colorectal LST of larger diameters.Conclusion Both MCE and EUS are effective for evaluating the invasion depth of colorectal LST,but the accuracy of MCE may be higher than that of EUS.Large diameter of the lesion and the doctor's experience inadequacy may be the risk factors for the accuracy of EUS.