Objective To discuss the clinical application of medical coordination and hierarchical responsibility system in interventional nursing care which is carried out based on the “Henan Province Model”. Methods From November 2003 to April 2014 at authors’ hospital, medical coordination and hierarchical responsibility system was executed through setting up a ranking system of nursing position , optimizing shift process , dividing physician-nurse medical liability groups , strengthening medical training , implementing medical coordination service mode, etc. The clinical results were compared with those of conventional nursing care that were recorded during the period from May to Oct. of 2013. Results After implementation of medical coordination and hierarchical responsibility system, the quality of medical care, the patent’s satisfaction, the cooperation satisfaction of physicians and nurses were significantly improved. Compared with those before implementation of medical coordination and hierarchical responsibility system , the differences in the above indexes were statistically significant(P<0.01 or P<0.05). Conclusion Based on multidisciplinary joint diagnosis and treatment, and combined with coordination physician-nurse service mode, the enthusiasm of nursing staff can be motivated and the tacit understanding between physicians and nurses as well as the quality of nursing service can be improved. All of the above will promote the development of nursing discipline.

Objective To assess the safety, feasibility, short-and mid-term efficacy of wingspan stent for treating patients with symptomatic intracranial artery stenosis. Methods A total of 113 patients with severe symptomatic intracranial stenosis were enrolled and Gateway-wingspan stenting were performed on all patients. The technical success, the pre- and post-stenting stenosis, perioperative complications, clinical outcome and restenosis rates were recorded, and chi-square test was used for analysis of complication rate by comparing our results with the results of Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) study and NIH multi-center Wingspan stenting trial. Results The technical success rate was 99. 1% ( 112/113). The mean pre and post-stent stenoses were (80.7 ± 9.3)% and (27.7 ± 9.7)% (χ2 =9.397,P < 0. 05 ). The total complication rate was 4.4% (5/113 ) during the follow-up ( mean 14. 5 months, range 1-28 months), and the frequency of restenosis was 12. 5% (5/40) at 6 months. The primary endpoint events, ischemic stroke, and lesion-related ischemic stroke were lower in our study (4.5%, 3.5%,3.5% ) compared with the results of WASID trial (21.1%, 20. 4%, 15.0% ,P<0. 05). For those with poor outcome in the three high-risk sub-groups which were with more than 70% stenosis, or last event from the treatment was less than 17 days, or NIHSS was above 1, a better outcome was observed in our group (4. 5% ,4. 7% and 2. 0% in our study, 19.0%, 17.0% and 19. 6% in previous study, P < 0. 05). The medium-term efficacy in this group (4. 5% ) significantly improved compared with NIH study ( 14. 0% ,P <0. 05 ). Conclusions Wingspan stenting for symptomatic intracranial arterial stenosis is with good safety,feasibility and low perioperative stroke rate and mortality. The incidence of primary endpoint events and the ischemic events are lower than those of medication group, and the efficacy of stenting is significantly better than medication even in high-risk population.

Objective This paper analyzes the current development trends and present situation of health management specialist in China and aims to lay a foundation for an exploration of the new domestic health management model. Methods Using "health management specialist" as a theme in the CNKI database from June 2005 to May 2018, 476 results were retrieved after refining, and the CiteSpace software was introduced to analyze the network, organization, and time development trends of the key words. The family group was analyzed and verified. Results Research on health management specialist showed an increasing trend between June 2005 and May 2018. By 2013, the annual number of articles fluctuated from 15 to 35. Since 2014, the growth rate has been relatively fast, with the highest volume in 2018, reaching 75; the top four high-frequency keywords were"health management specialist""health management""health examination"and"hierarchical medical system". The regional and institutional distribution of health management specialist is mainly in southern cities. Conclusions The related research on health management specialist shows an increasing trend year by year, and is focused on health management, physical examination, and grading treatment. The distribution of health management specialist in China is obviously uneven.

Enhanced recovery after surgery (ERAS) can accelerate the recovery of patients through optimized perioperative management.As a new concept, ERAS has been applied in many perioperative areas in China.ERAS nursing mode is a nursing mode derived from ERAS concept.Through the integration of perioperative optimized nursing measures and multidisciplinary participation, the process of postoperative rehabilitation is accelerated. The application of ERAS nursing mode in the field of neurosurgery can reduce postoperative pain, promote the recovery of self-care ability, reduce postoperative complications,and improve nursing satisfaction.The implementation of ERAS needs multidisciplinary cooperation and rigorous prospective clinical research to provide high-quality evidence-based support, so as to jointly promote the development and continuous improvement of ERAS nursing model in the field of neurosurgery, so as to benefit the patients.

Objective:To summarize and evaluate the best evidence of perioperative nutrition management for patients with acoustic neuroma, and to provide evidence-based basis for clinical nurses.Methods:BMJ best clinical practice, UpToDate, Cochrane Library, Guidelines International Network, Scottish Intercollegiate Guidelines Network, the official website of Ontario Registered Nurses Association, JBI Australian evidence-based health care center, PubMed, Embase, CINAHL, Yimaitong, Chinese biomedical literature database, CNKI, Wanfang database and other domestic and foreign databases related to clinical practice guidelines, expert consensus, evidence summary, systematic evaluation, sysmtem analysis, clinical randomized scientific control were seached. The retrieval time was limited from June 1st, 2013 to June 1st, 2023. Evaluated the quality of the included literatures, and conduct evidence extraction, grade evaluation and summary analysis.Results:A total of 17 literatures were included, including 5 guidelines, 6 expert consensus, 2 best practices and evidence summary, 2 system evaluation and 2 randomized scientific control. A total 27 of best evidence was formed, covering five aspects: nutrition management team construction, screening and evaluation of nutrition and dysphagia, timing and implementation of nutrition support, specific measures of nutrition management, continuous nutrition management after discharge.Conclusions:This study summarized the best evidence of perioperative nutritional management of acoustic neuroma, and provides evidence-based basis for clinical nurses. However, its recommendations are not specialized, some of them are controversial, and come from many countries. In clinical practice, we should make a comprehensive analysis in combination with the actual clinical situation and other relevant factors, and make some choices, so as to promote the improvement of clinical nursing quality.

The management of drainage tube is an important part of nursing work. Patient restraint and tube fixation cannot effectively prevent unplanned extubation (UEX) when the tube is accidentally pulled by violence. The nursing innovation team of Henan Provincial People's Hospital designed a medical drainage tube anti-pull device in order to change the existing technology of preventing drainage tube disconnecting by means of restraint and fixation, and to interfere with the basic cause of drainage tube disconnection, and obtained the national utility model patent (patent number: ZL 2020 2 2843025.1). The design of sleeve and clasp is that when the drainage tube is pulled by accidental violence, the friction fastener clamps the drainage tube mechanically to achieve the purpose of braking the drainage tube and prevent the drainage tube from coming out. Card sleeve ring fracture design can be applied to drainage tubes of different diameters, and the buzzer device at the instant of the snap ring into the card set warning medical staff to the occurrence of risk events, so that the nurse can come in the first place for effective treatment, which is a fuse for surgical drainage tubes and is to timely and effectively prevent UEX.

Objective:To analyze the efficacy of the Post-stroke Depression Prediction Scale (DePreS) combined with the Early Symptom Measurement of Post-Stroke Depression-Short Form (ESMPSD-SF) in predicting post stroke depression (PSD).Methods:This study was a cross-sectional survey, using convenience sampling method to select 185 stroke patients admitted to Henan Provincial People′s Hospital from June 2019 to May 2021 as the research subjects. The DePreS, ESMPSD-SF, and general information questionnaire were used to investigate them.Results:The incidence of PSD was 36.76% (68/185). The DePreS and ESMPSD-SF scores in the PSD patients were (6.29 ± 8.77), (33.83 ± 6.78) points, respectively, significantly higher than those in the non-PSD patients (-2.05 ± 5.70), (26.51 ± 5.56) points, with statistically significant differences ( t=7.06, 7.97, both P<0.05). Logistic regression analysis showed that DePreS and ESMPSD-SF scores, marital status, and the number of comorbidities were predictive factors for PSD occurrence ( P<0.05). The AUC of DePreS for diagnosing PSD was 0.777, with an optimal diagnostic point of 2 points, a sensitivity of 59.42%, and a specificity of 80.71%; the AUC of the ESMPSD-SF for diagnosing PSD was 0.792, with an optimal diagnostic point of 28 points, a sensitivity of 78.26%, and a specificity of 74.14%. The sensitivity, specificity, and AUC of DePreS combined with ESMPSD-SF in the diagnosis of PSD were 82.61%, 83.62%, and 0.886, respectively. The differences were statistically significant compared to the AUC evaluated separately by DePreS or ESMPSD-SF ( Z=3.21, 3.49, both P<0.05). Conclusions:The combination of DePreS and ESMPSD-SF had a higher detection efficiency for PSD, and the combination of the two is more suitable for assessing PSD risk in stroke patients.