Objective To evaluate the influencing factors of aspiration in neurological critically ill patients by Meta-analysis.Methods PubMed,Embase,Web of Science,CNKI,and Wanfang Data were searched from inception to 1 October,2023,to obtain relevant studies on influencing fac-tors of aspiration in neurological critically ill patients.The literature screening,data extraction and quality evaluation were completed by two researchers.RevMan 5.4 and Stata 13.0 software were ap-plied for pooled Meta-analysisand assessed publication bias,respectively.Results A total of 8 arti-cles,including 1,315 neurocritical care patients,were included in this study.Nine influencing factors related to aspiration were extracted for Meta-analysis.The Meta-analysis results showed that the three influencing factors that caused aspiration in neurocritical care patients were stroke history(OR=5.03,95％CI,2.71 to 9.32,P＜0.000 01),National Institutes of Health Stroke Scale(NIHSS)score＞10(OR=3.35,95％CI,1.75 to 6.42,P=0.000 3),and gastric residual volume＞150mL(OR=7.13,95％CI,2.55 to 9.96,P=0.001).Conclusion This study provides a scientific basis for clinical healthcare professionals to early identify high-risk patients for aspiration,take targeted inter-vention measures,and prevent the occurrence of aspiration.

Objective To explore the application value of predictive model based on nutritional status combined with clinical data in infectious complications after radical gastrectomy for gastric canc-er.Methods The clinical data on 394 gastric cancer patients who underwent radical gastrectomy at Suzhou Ninth Hospital Affiliated to Soochow University from January 2017 to July 2024 were retrospec-tively collected.According to whether the patients developed infection after surgery,they were divided into infection group(n=73)and non-infection group(n=321)based on whether they developed postoperative infections or not.The least absolute shrinkage and selection operator(LASSO)method was used to obtain the optimal related features associated with infectious complications after radical gas-trectomy for gastric cancer.Multivariate Logistic regression analysis was conducted to screen for risk factors of infectious complications after radical gastrectomy.R software was used to randomly select 70％of data as training set(for establishing the nomogram model)and 30％of data as test set.The area under the curve(AUC)of the receiver operating characteristic(ROC)curve,Bootstrap sampling validation,and decision curve analysis(DCA)were used to assess the value of the predictive model.Results of the 394 gastric cancer patients,73 developed postoperative infectious complications,in-cluding 53.42％with lung infections,17.81％with intra-abdominal infections,16.44％with uri-nary tract infections,and 12.33％with wound infections.Age,diabetes mellitus,preoperative nu-tritional risk,high preoperative PIV,combined organ resection,and prolonged operation time were identified as risk factors for infectious complications after radical gastrectomy(P＜0.05).In the training set,the AUC of the nomogram model was 0.898,and the AUC validated in the test set was 0.891.Bootstrap sampling validation with 1,000 iterations showed that the average errors between the predicted probabilities and actual values in the training and test sets were 0.019 and 0.024,re-spectively.DCA results indicated that the model had clinical utility.Conclusion Infectious com-plications after gastrectomy for gastric cancer are common,and the predictive model based on nutri-tional assessment combined with clinical data has high value in predicting the risk of infectious com-plications after gastrectomy.

Objective To explore the risk factors associated with the development of acute respir-atory distress syndrome(ARDS)in patients with severe traumatic brain injury(sTBI)and to construct and validate a risk prediction model for ARDS in these patients.Methods Clinical data from 371 sTBI patients admitted to Yangzhou Affiliated Hospital of Yangzhou University between January 2017 and December 2023 were retrospectively collected.Patients were randomly divided into modeling group(n=259)and validation group(n=112)at a 7-to-3 ratio.A nomogram model was constructed after screening for risk factors using the Least Absolute Shrinkage and Selection Operator(LASSO)and multivariate Logistic regression analysis.Model performance was evaluated using the receiver operating characteristic(ROC)curve,area under the curve(AUC),Hosmer-Lemeshow test,calibration curve,and deci-sion curve analysis(DCA).Results Statistically significant differences were observed in heart rate,respiratory rate,pupil size,percutaneous oxygen saturation(SpO2),Glasgow Coma Scale(GCS)score,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,head Ab-breviated Injury Scale(AIS)score,chest AIS score,emergency intubation,pulmonary infection,associated chest trauma,midline shift,blood transfusion within 12 hours of admission,fluid intake within 24 hours of admission,shock,mechanical ventilation,hemoglobin level,hematocrit,white blood cell count,prothrombin time,international normalized ratio,total protein,albumin,serum calcium,oxygenation index,and base excess between the two groups(P＜0.05).Multivariate Lo-gistic regression analysis revealed that SpO2,pulmonary infection,and fluid intake within 24 hours of admission were predictors of ARDS in sTBI patients.The Hosmer-Lemeshow test results for the modeling and validation groups showed good fit(x2=10.373,P=0.240;x2=13.21,P=0.105).DCA results for both groups indicated net benefit at threshold probabilities ranging from 0％to 72％and 0％to 50％,respectively.Conclusion SpO2,pulmonary infection,and fluid in-take within 24 hours of admission are risk factors for ARDS in sTBI patients.The model constructed using these factors demonstrates good performance and provides a reliable tool for clinical screening of high-risk ARDS populations among sTBI patients.

Asthma is one of the most prevalent chronic respiratory diseases in children.The im-plementation of digital health interventions can enhance self-management abilities in pediatric asthma patients and improve asthma control outcomes.This study summarized the intervention forms of digital health intervention in children with asthma and its application in health education,lung function moni-toring and chemical exposure monitoring,aiming to elaborate the current research status of digital health intervention in children with asthma and provide guidance and reference for the implementation of such intervention measures.

Objective To analyze the current status of interventional nursing studies registered in the Chinese Clinical Trial Registry(ChiCTR).Methods All intervention nursing studies registered in the ChiCTR self-establishment database from May 31,2024 were retrieved,and relevant information of the registered studies was included and extracted.Results A total of 462 nursing intervention stud-ies were included,among which 365 were pre-registered and 97 were supplementary registered.The number of registered items in 2020 and beyond accounted for 83.33％of the total number of registra-tions.Currently,the top three regions in terms of the number of registrations were Shanghai(56 items),Guangdong Province(50 items)and Beijing(49 items).A total of 12 units had registration number of ≥5,among which West China Hospital of Sichuan University had 18 registrations.Among all the projects,160 were self-funded(34.63％),and 48 were multi-center cooperative research(10.39％).There were 322 randomized parallel controlled trials,among which 281(87.27％)pro-vided further descriptions of randomization and 167(51.86％)provided further descriptions of blind-ing.The registered items for the research subjects of nursing staff were 94,mainly concentrated in the research fields such as nursing teaching,mental health,job burnout,stress and sleep.There were 368 registered items whose research subjects were patients or clinical problems,mainly concentrated in re-search fields such as rehabilitation nursing,quality of life,self-management and nutrition management.Conclusion The number of registrations of interventional nursing research in China on the ChiCTR platform has been increasing year by year.However,the registration regions and the distribution of funds are uneven,and the number of cooperative projects is relatively small,which is not conducive to the integration and exertion of multidisciplinary advantages.In addition,the application of ran-domization and blinding is not standardized,the registration information is incomplete,and the core research hotspots need to be further expanded and improved.It is suggested to start from aspects such as organizing registration training and strengthening the training of nursing research design to further improve the level of nursing scientific research.

Objective To analyze the current status of physical activity level and its influencing factors in parturients with advanced paternal age at 6 months postpartum,and to explore the correlation between physical activity level and the incidence of overweight/obesity.Methods A total of 399 par-turients with advanced paternal age were included as study subjects.Surveys were conducted using the International Physical Activity Questionnaire-Long Form,the Edinburgh Postnatal Depression Scale,the Pittsburgh Sleep Quality Index,and the Family Support Rating Scale.Univariate analysis and bina-ry Logistic regression analysis were used to investigate the influencing factors of physical activity level in parturients with advanced paternal age at 6 months postpartum.Spearman correlation analysis was used to explore the correlation between physical activity level and the incidence of overweight/obesity.Results Among the parturients with advanced paternal age at 6 months postpartum,134 cases(33.6％)and 265 cases(66.4％)were at low and moderate physical activity levels respectively,with no cases at a high physical activity level.The body mass at 6 months postpartum was(61.31±8.16)kg,and the body mass index(BMI)was(23.57±2.39)kg/m2.The incidence of over-weight/obesity was 42.9％.A negative correlation was observed between the physical activity level and the incidence of overweight/obesity in parturients with advanced paternal age at 6 months postpar-tum(r=-0.566,P＜0.001).There were significant differences in postpartum physical activity levels among with parturients with advanced paternal age at different pre-pregnancy BMI,sleep qualities,and family supports(P＜0.05).Conclusion A higher physical activity level at 6 months postpar-tum in parturients with advanced paternal age is associated with a lower incidence of overweight/obe-sity.The physical activity level is comprehensively influenced by pre-pregnancy BMI,sleep quality,and family support.

Atrial fibrillation is a prevalent rapid arrhythmia.Patients often develop kinesiophobia and avoidance behaviors due to reduced exercise tolerance and recurrent episodes of atrial fibrillation symptoms,which adversely affect cardiac rehabilitation outcomes.This study reviewed the definition,occurrence mechanisms,assessment tools,influencing factors,and intervention measures of kinesio-phobia in patients with atrial fibrillation,aiming to provide references for implementing nursing prac-tices and promoting exercise rehabilitation in these patients.

Objective To explore the economic toxicity perceptions and experiences of caregivers of colorectal cancer patients from the perspective of social ecological systems theory.Methods Using purposive sampling,18 caregivers of colorectal cancer patients hospitalized in the gastrointestinal sur-gery and oncology departments of a tertiary grade A hospital in Yangzhou were selected for semi-struc-tured interviews.The Colaizzi 7-step analysis method was employed to organize and analyze the data.Results Three main themes and nine sub-themes were extracted regarding the economic toxicity expe-riences and needs of caregivers of colorectal cancer patients.Microsystem included multiple negative experiences,impacted individual health,and difficulties in surrogate decision-making;mesosystem in-cluded heavy family financial burden,altered family lifestyle,and tense family atmosphere;macrosys-tem included needs for the scope and intensity of medical insurance reimbursement,needs for medical resources and services,and a desire for social support.Conclusion The ecological system of caregiv-ers of colorectal cancer patients is not optimistic,and is generally affected by economic toxicity.Inter-vention strategies can be sought from multiple aspects,including alleviating the negative experiences of caregivers,strengthening social support,and paying attention to the needs of caregivers,aiming to re-duce the level of economic toxicity among caregivers of colorectal cancer patients.

Objective To investigate the role of autophagy in contrast-induced acute kidney injury(CI-AKI)in rats and to explore its possible mechanism.Methods SD rats were randomly divided into control group,acute kid-ney injury model group(intravenous injection of contrast medium ioversol via tail vein;model),rapamycin(RAPA)group and hydroxychloroquine(HCQ)group.Blood urea nitrogen(BUN)and serum creatinine(Scr)con-tents were measured and the potential change foun in renal pathology was detected by HE staining and microscopy.Transmission electron microscopy was used to observe auto-phagy-related changes in ultrastructure.Western blot was used to observe the expression of microtubule-associated protein 1 light chain 3(LC3)Ⅱ/LC3Ⅰ,ubiquitin-binding protein p62 and Histone deacetylase 4(HDAC4).The expression of HDAC4 was also observed by RT-qPCR.Results Compared with control group,the level of BUN,Scr and HDAC4 expression in the model and HCQ group was increased(P＜0.01),the proximal tubules of the kidney were significantly damaged.In the model group,auto-phagososomes and autolysosomes increased,accompanied by an increase of LC3Ⅱ/LC3Ⅰ and a decrease in the p62 level(P＜0.05,P＜0.01);Compared with model group,there were more autophagosomes and autolysosomes were found in RAPA group(P＜0.01),accompanied by increased LC3Ⅱ/LC3Ⅰratio and decrease in the p62 and HDAC4(P＜0.05,P＜0.01).In contrast,the number of autophagy related structures decreased in HCQ group(P＜0.01),accompanied by the simultaneous increase of LC3Ⅱ/LC3Ⅰ,p62 and the increase of HDAC4(P＜0.01).Conclusions Ioversol may induce autophagy activation,while enhancing autophagy by RAPA alleviates CI-AKI induced renal dysfunction.The mechanism is potentially atributed to the regulation of HDAC4.

The current situation of the construction and application of orthopaedic subspecialty nursing quality standards at home and abroad is reviewed, and the overview of orthopaedic subspecialty nursing quality standards, theoretical foundations, the content of the standard construction, the form and results of the application, and the shortcomings and outlooks are elaborated and illustrated, with a view to providing theoretical references for the further improvement and application of China′s orthopaedic subspecialty nursing quality standard system, and providing scientific suggestions and reflections for the promotion of the high-quality development of orthopaedic subspecialty nursing.