Objective To explore the threshold of 4 m-walking speed for predicting falls in patients with stroke and to evaluate its clinical significance. Methods A total of 1 079 cases of stroke patients in Neurology Surgery Department and Neurology Medicine Department of the Second Affiliated Hospital of Wenzhou Medical University from July 2015 to May 2017 were selected as the research subjects by convenience sampling method. Data of physical examination, body composition measurement, blood biochemistry, muscle strength and 4 m-walking speed were collected by questionnaire. According to the results of 4 m-walking speed test, the receiver operating characteristic curve (ROC) of subjects was drawn to determine the critical value of 4 m-walking speed for stroke patients, and the predictive value of the critical value of 4 m-walking speed for the risk of falling was analyzed by logistic regression. Results The incidence of falls was 37.5% in stroke patients. The 4 m-walking speed for male and female with stroke was (0.75±0.02) m/s and (0.82±0.06) m/s respectively. ROC curve showed that, in male patients, the critical value of 4 m-walking speed was 0.84 m/s, the area under curve (AUC) was 0.71 (0.65, 0.75), the sensitivity was 87.5%, and the specificity was 65.9%. In female, the critical value of 4 m-walking speed was 0.79 m/s, the AUC was 0.68 (0.62, 0.73), the sensitivity was 75.3%, and the specificity was 78.6%. Logistic regression analysis showed that after adjusting for age, BMI, smoking, alcohol consumption, exercise and disease history, compared with the elderly population below 4 m-walking speed threshold, the OR values of falls in male and female stroke patients above the 4 m-walking speed threshold were 2.97 (1.94, 4.56) and 2.25 (1.40, 3.60) respectively. Conclusions The incidence of fall is high in stroke patients. The threshold of 4 m-walking speed to predict the fall risk of male and female patients with stroke was 0.84 m/s and 0.79 m/s respectively. The determination of the threshold of 4 m-walking speed can provide reference for the prevention of falls in stroke patients and is worthy of clinical popularization and application.

Objective To study the application of the family centered escort system in neurosurgical intensive care units (NICU). Methods 416 cases of NICU patients from January 2015 to December 2016 were selected, 197 cases of the patients from January to December 2015 serving as the control group subject to a restrictive visit system. 219 cases of patients from January to December 2016 were used as the study group subject to the family centered escort system. The two groups were compared as to the anxiety state and satisfaction of the family members, the job satisfaction of nurses, the duration and cost of the patients in NICU, the ratio of the patients subject to sedation and restraint bands, and the incidences of adverse events of patients during NICU. Results Scores of anxiety state of the family members showed that the control group (52. 76 ± 5. 21) was significantly higher than that of the study group (34. 61 ± 5. 98). The dimensions of " information acquisition" and " access to patients" as found in the satisfaction survey of the family members showed the study group as higher than the control group, a difference of statistical significance between two groups (both P＜0. 01). The dimensions of " state at work" and " interpersonal relationship at work" showed the study group as higher than the control group, a difference of statistical significance between two groups ( P ＜ 0. 05 ) as found in the job satisfaction survey of nurses. The comparison between the two groups in NICU duration and expenses showed no significant statistical difference (P＞0. 05). The ratio of sedation treatment and restraint band usage of control group was significantly higher than that of the study group, a difference of statistical significance (P＜0. 01). The incidence ratio of lower extremity venous thrombosis showed that the control group (13. 7%, 27/197) was higher than that of the study group (6. 8%, 15/219), a difference of statistical significance (P ＜0. 01). There was no significant difference as to the incidences of other adverse events of the two groups ( P ＞ 0. 05 ). Conclusions Compared with the restricted visiting system, the family centered escort system in NICU is beneficial to both the nurses and patients, justifying the humanity of the latter system.