Objective To understand of work status and professional ability of ICU specialist nurse,test their specialist ability level,improve and enhance the specialist nurse management to maximize their roles in promoting the development of clinical nursing.Methods 38 ICU nurse specialists who have got the nursing credentials more than one year were surveyed through self-questionnaire about working conditions,including general conditions,work status,income,self-assessment of specialist ability in future.Results 100％ ICU trained the younger nurses,and discuss the nursing management and problems.36.8％ nurses participated clinical nursing and night shift,5.3％ nurses have never joined ward inspection.Rates of reaching the standard were higher and above the 90％ in those three aspects: practice in clinical work,guided teaching and providing information for family member.Grasp of academic knowledge (86.8％),theory teaching (86.8％) and providing academic knowledge for nursing (86.8％) needed to be improved.Paper searching and reading (65.8％),paper writing (57.9％) and research design (47.4％) were relatively lower.Conclusions Culturing and using the specialist nurses in ICU lack the program and rationality; Specialist nurses have vague role; talent team was lacked; pay status needs increased; research ability needed enhanced; admittance,training and using criteria were lacked.

Objective To explore the impact of bundle prevention strategies on the CRBSI incidence.Methods Patients admitted to ICU with central venous catheter were given daily assessment and target monitor from 2008.2 to 2010.2,and divided into infected (117 cases) and non-infected ( 1 288 cases) group according to whether there was CRBSI.Analysis the relationship between the measures of bundle prevention strategies and the incidence of CRBSI,all data applications SPSS 10.0 for windows statistical software package for statistical analysis.Results In the study,1405 cases were collected,and 117 cases were infected while 1288 cases were non-infected.The total number of catheter day was 17 317 days,and the average was 12.85 d.Infection rate was 6.8 per 1 000 catheter days.Sex,age,type of skin plaster and time of changing skin plaster and infusion TPN were not different between the two groups (P＞0.05).The single variable analysis has shown that the in the infection group,severity of clinical patients (APACHE Ⅱ ＞ 20 points) was 78.63％,ICU stay time( ＞ 30days) was 38.46％,emergency intubation method was 17.95％,patients received the frequency of invasive procedures( ＞4 times) was 83.76％,catheter day longer than 7 days was 78.63％ were higher than those in the non-infection group (51.86％,15.53％,7.84％,35.02％ and 31.13％,respectively) and the difference was significant ( x2 =8.071,23.750,10.781,36.56,44.886,respectively; P ＜ 0.05 ) ; the pass rate of maximum sterile barrier (45.30％),the timeliness of joint disinfection on normal operation (68.38％) and catheterization in subclavian vein (40.17％ ) in infection group were lower than non-infeclion group (75.93％,94.33％ and 59.94％,respectively) and the difference was significant (x2 =9.303,4.604,5.076,respectively;P ＜0.05).Multiple regression analysis showed that the joint disinfection timeliness on normal operation was the independence factor of affecting CRBSI incidence ( OR =4.992,P ＜ 0,01 ).Conclusions The implementation of bundle prevention strategies and strengthening the management of catheter connector can reduce the incidence of CRBSI.

Objective To study the reasonable replacement time for closed suction tube.Methods Totals of 147 patients who had artificial airway for mechanical ventilation and closed suction tube for aspiration of sputum were randomly divided into 3 groups:Group A of 54 cases with replacement time of 24 hours,Group B of 52 cases with replacement time of 72 hours,and Group C of 41 cases with replacement time of 120 hours.Rates of bacterial colonization cultured in closed sputum aspirator tip and incidence rate of VAP were compared between three groups.Results The rate of bacterial colonization cultured in closed sputum aspirator tip in three groups was respectively 63.0％,71.2％ and 100％,and there was statistically significant difference (x2 =6.182,P =0.023).The incidence rate of VAP in three groups was respectively 7.4％,5.7％,4.9％,there was no statistically significant difference (x2 =0.244,P ＞ 0.05).Conclusions Replacement of closed suction tube every 72 hours can ensure patients' safety as well as save the cost.

Objective:To investigate the prevalence of overactive bladder (OAB) in Chinese boys and risk factors, and to evaluate the psychological and behavioral status of OAB patients.Methods:Cross-sectional study.From October 2020 to July 2021, 2 800 boys aged 6-15 years from 6 primary and secondary schools in a county of Henan Province were selected by stratified random cluster sampling method.An anonymous questionnaire was used to investigate the epidemiological situation of OAB, including the basic information, lower urinary tract symptoms, Overactive Bladder Score Scale (OABSS) scores, pediatric sleep questionnaire (PSQ) and strengths and difficulties questionnaire (SDQ). In addition, the correlation between OAB and residence, body mass index (BMI), nocturnal enuresis (NE), overuse of diapers, history of urinary tract infection, abnormal stool, phimosis, redundant prepuce, and concealed penis by Chi- square test, Logistic multivariate regression analysis, and t-test. Results:A total of 2 333 valid questionnaires were collected.The overall prevalence of OAB in boys was 6.0%(141/2 333 cases). NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, concealed penis were risk factors for OAB in boys ( OR>1, P<0.05), while BMI was not a risk factor for OAB in boys ( OR<1, P>0.05). The emotional symptoms[ (7.64±2.03) scores vs.(6.51±2.53) scores], conduct problems [(8.14±1.62) scores vs.(7.31±1.88) scores], hyperactivity[(5.64±2.27) scores vs.(4.98±2.03) scores], peer communication problems [(7.16±1.63) scores vs.(6.59±1.60) scores], difficulty scores[(30.26±6.48) scores vs.(27.69±6.44) scores] and PSQ scores [(5.36±3.00) scores vs.(3.94±2.53) scores] in OAB group were significantly higher than those of non-OAB group ( t=-5.117, -5.005, -3.310, -4.056, -4.553, -5.006, respectively, all P<0.05). Conclusions:OAB in boys is common and affects mental health and sleep quality.Meanwhile, NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, or concealed penis are the risk factors for OAB in boys.

Objective To identify the clinical characteristics and prognostic factors of young patients with sporadic rectal cancer liver metastasis(RCLM).Methods The clinical data of young RCLM patients at 45 years or under(n=40,as younger patient group)in Peking University First Hospital from January 2016 to January 2021 were reviewed,meanwhile,elder RCLM patient group were comprised of 82 patients older than 45-year-old in a 1:2 ratio.Proportions of categorical variables were compared between young patients and old patients.The clinicopathologic parameters were analyzed with univariate and multivariate Cox regression models and Kaplan-Meier method for demonstrating survival differences between the maximum diameter of liver metastasis and local therapy.Results One hundred and twenty-two RCLM patients were identified,the 1-,3-and 5-year survival rates of young patient group were 97.5%,47.5%,15.0%,those of elder patient group were 84.1%,26.8%,9.8%,respectively.The differences in BMI(P=0.008),primary tumor with obstruction and bleeding(P=0.006),synchronous rectal cancer liver metastases(P=0.005),the maximum diameter of liver metastasis>3 cm(P=0.019)were statistically significant between the two groups.And univariate and multivariate analyses showed that age(P=0.003),N stage(P=0.007),local therapy for liver metastases(P=0.047)and the maximum diameter of liver metastasis(P=0.030)were independent risk factors for influencing the prognosis of RCLM patients;curative resection or not of primary tumor(P=0.035)and the maximum diameter of liver metastasis(P=0.041)were independent risk factors for influencing the prognosis of young RCLM patients.Kaplan-Maier curve demonstrated survival differences between the maximum diameter of liver metastasis and local therapy for liver metastasis in RCLM patients(log-rank P=0.000).Conclusions Although with later staging of initial tumor station,young RCLM patients may obtain better survival benefit compared with old patients.Higher degree of lymph node metastasis,local therapy for liver metastases and the maximum diameter of liver metastasis>3 cm indicates poor prognosis in RCLM patients,and without curative resection of primary tumor and maximum diameter of liver metastasis are also considered as the independent poor prognostic factors of young RCLM patients.Local therapy for liver metastases appears to play an important role in the treatment strategy of RCLM patients.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.