Objective:To explore the real work experience and needs of nursing assistants of elderly patients with disability and mental disorders, and provide reference for relevant institutions to develop a reasonable support system and promote their physical and mental health.Methods:From October to November 2022, purposive sampling was used to select nursing assistants of elderly patients with disability and mental disorders from the Affiliated Brain Hospital of Guangzhou Medical University as the research subject. The phenomenological method was used to conduct in-depth interviews, recordings, and transcripts of 12 nursing assistants. The Colaizzi analysis program was used to analyze, organize, refine, and summarize.Results:A total of five themes were extracted, including multiple emotional experiences, lack of rest and relaxation, insufficient professional identity and external support, lack of care knowledge and skills, heavy workload and poor treatment.Conclusions:Accompanying management institutions and hospitals need to strengthen their attention to nursing assistants, reduce their physical and mental burden, attach importance to skill training, increase welfare benefits, enhance professional identity, and improve the quality of care.

Objective:To summarize the best evidence for exercise intervention in elderly patients with sarcopenia in intensive care unit (ICU) through literature search, and provide a reference for clinical implementation of early exercise intervention in this population through evidence-based practice.Methods:① Summary of best evidence: relevant literature on exercise intervention for elderly patients with sarcopenia in ICU, including guideline, evidence summary, expert consensus, systematic review, and original study [quasi-experiment and randomized controlled trial (RCT)] from UpToDate Clinical Advisor, Ovid database, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed/Medline, SinoMed, CNKI, Wanfang Database, VIP, and Yimai Tong Guideline Network were systematically searched. The search period covered from the establishment of these databases up to August 24, 2023. The quality of the literature was evaluated by two researchers with methodological expertise in evidence-based medicine, and the evidences were extracted and summarized. ② Evidence-based practice: the elderly patients with high risk of sarcopenia who had been hospitalized in the ICU for more than 7 days from January to April 2024 were enrolled as the research subjects, and they were divided into a control group and an intervention group using convenience sampling method. The control group received routine intensive care nursing. The intervention group implemented exercise intervention based on the actual situation of the patients, the baseline review was conducted before evidence application, and the effectiveness of evidence application at 7 days and 14 days was evaluated.Results:① A total of 19 pieces of literature were included, including 4 guidelines, 1 summary of evidence, 4 expert consensuses, 4 systematic reviews, and 6 original studies (1 quasi-experiment, 5 RCT). After literature quality evaluation, all 19 articles were enrolled. Finally, 31 pieces of best evidence were extracted from eight aspects, including assessment and diagnosis, multidisciplinary cooperation, indication, preparation before intervention, intervention program, safety monitoring, post-intervention evaluation, and special task. ② Finally, a total of 30 patients were enrolled in the intervention group, of which 17 completed 14 days of rehabilitation exercise, and 13 completed 7 days of rehabilitation exercise. Twenty-seven patients were enrolled in the control group, of which 17 completed 14 days of monitoring, and 10 completed 7 days of monitoring. Clinical evidence application results showed that the patients in the intervention group did not experience adverse events such as increased heart rate, extubation, or physical discomfort. The skeletal muscle mass index (SMI) in both groups was gradually decreased with the prolongation of intervention duration, but the 7-day SMI in the intervention group was significantly higher than that in the control group (kg/m 2: 8.61±2.66 vs. 6.65±1.50, P < 0.01). Conclusion:By summarizing the best evidence and evidence-based practice of exercise intervention for elderly patients with sarcopenia in ICU, this study confirmed the feasibility due to safe and effective of implementing early exercise intervention for elderly sarcopenia patients in ICU.

Purpose: This study examined the diagnostic value of high-frequency ultrasound (HFUS) features in differentiating between benign and malignant skin lesions. Methods: A total of 1,392 patients with 1,422 skin lesions who underwent HFUS examinations were included in an initial dataset (cohort 1) to identify features indicative of malignancy. Qualitative clinical and HFUS characteristics were recorded for all lesions. To determine which HFUS and clinical features were suggestive of malignancy, univariable and multivariable logistic regression analyses were employed. The diagnostic performance of HFUS features combined with clinical information was evaluated. This assessment was validated using internal data (cohort 2) and multicenter external data (cohort 3). Results: Features significantly associated with malignancy included age above 60 years; lesion location in the head, face, and neck or genital regions; changes in macroscopic appearance; crawling or irregular growth pattern; convex or irregular base; punctate hyperechogenicity; blood flow signals; and feeding arteries. The area under the receiver operating characteristic curve, sensitivity, and specificity of HFUS features combined with clinical information were 0.946, 92.5%, and 86.9% in cohort 1; 0.870, 93.1%, and 80.8% in cohort 2 (610 lesions); and 0.864, 86.2%, and 86.6% in cohort 3 (170 lesions), respectively. However, HFUS is not suitable for evaluating lesions less than 0.1 mm in thickness or lesions exhibiting surface hyperkeratosis. Conclusion In a clinical setting, the integration of HFUS with clinical information exhibited good diagnostic performance in differentiating malignant and benign skin lesions. However, its utility was limited in evaluating extremely thin lesions and those exhibiting hyperkeratosis.

Objective:To investigate the relationship between serum microRNAs-27b (miR-27b) expression and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI).Methods:A total of 168 STEMI patients undergoing PCI treated in the Honghu People′s Hospital from February 2019 to April 2021 were selected as the observation group, and 154 healthy subjects who underwent physical examination during the same period were selected as the control group. The expression of serum miR-27b was detected by real-time fluorescence quantitative polymerase chain reaction (PCR), and the expression of serum miR-27b was compared between the two groups. The observation group was followed up for 6 months after PCI, and the occurrence of MACE was counted, and the patients were divided into the occurrence group and the non-occurrence group accordingly it, and the expression of serum miR-27b and general data of the two groups were compared. The influencing factors of MACE in STEMI patients after PCI was analyzed by using Logistic regression analysis method.Results:The expression of serum miR-27b in the observation group was higher than that in the control group : 2.26 ± 0.31 vs. 1.32 ± 0.26, P<0.05. During the 6-month follow-up period, there was no any loss of follow-up in 168 patients underwent PCI, and the incidence rate of MACE was 28.57%(48/168). The miR-27b expression in the occurrence group was higher than that in the non-occurrence group: 2.61 ± 0.49 vs. 2.13 ± 0.24, P<0.05. The results of multivariate Logistic regression analysis showed that history of diabetes mellitus, hypersensitive C-reactive protein, low left ventricular ejection fraction, high coronary Gensini score, high serum miR-27b expression, multi-vessel disease, degree of lesion stenosis grade Ⅲ to Ⅳ, and long duration of operation were independent risk factors for MACE in STEMI patients ( OR = 1.697, 2.680, 3.673, 2.121, 2.863, 1.846, 2.751, 3.007, P<0.05). Conclusions:The serum miR-27b in STEMI patients is abnormally high expression, which can increase the risk of MACE after PCI in STEMI patients.

Objective:To investigate the serum levels of myeloperoxidase (MPO), interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) in patients with hyperuric acid gout, and to analyze their correlation and interaction with uric acid.Methods:A total of 120 male patients with hyperuricemia (HUA) diagnosed and treated in the Tenth Affiliated Hospital of Guangxi Medical University (Qinzhou First People′s Hospital) from December 2019 to December 2022 were selected as the study objects, including 55 patients with gout as the observation group and 65 patients without gout as the control group. Serum levels of uric acid, MPO, IL-1β and TGF-β1 were compared between the two groups, Logistic regression was used to analyze the risk factors of HUA with gout, and Pearson test was used to analyze the correlation between serum uric acid level and MPO, IL-1β and TGF-β1 levels, the interactions were calculated by the likelihood ratio test.Results:The levels of serum uric acid, MPO, IL-1β and TGF-β1 in the observation group were higher than those in the control group: (559.63 ± 70.62) μmol/L vs. (448.24 ± 50.49) μmol/L, (0.37 ± 0.10) mmol/L vs. (0.29 ± 0.07) mmol/L, (49.83 ± 5.03) ng/L vs. (42.15 ± 4.77) ng/L, (34.15 ± 6.82) μg/L vs. (28.97 ± 5.14) μg/L, there were statistical differences ( P<0.05). The results of Logistic regression showed that serum uric acid, MPO, IL-1β and TGF-β1 levels were risk factors for hyperuric acid gout ( P<0.05). The results of Pearson test showed that serum uric acid were positively correlated with the levels of MPO, IL-1β and TGF-β1( r = 0.760, 0.775, 0.759, P<0.05), and there was interaction in the pathogenesis of hyperuric acid gout ( P<0.05). Conclusions:The high levels of MPO, IL-1β and TGF-β1 at the same time can increase the risk of hyperuric acid gout.

Purpose: This study examined the diagnostic value of high-frequency ultrasound (HFUS) features in differentiating between benign and malignant skin lesions. Methods: A total of 1,392 patients with 1,422 skin lesions who underwent HFUS examinations were included in an initial dataset (cohort 1) to identify features indicative of malignancy. Qualitative clinical and HFUS characteristics were recorded for all lesions. To determine which HFUS and clinical features were suggestive of malignancy, univariable and multivariable logistic regression analyses were employed. The diagnostic performance of HFUS features combined with clinical information was evaluated. This assessment was validated using internal data (cohort 2) and multicenter external data (cohort 3). Results: Features significantly associated with malignancy included age above 60 years; lesion location in the head, face, and neck or genital regions; changes in macroscopic appearance; crawling or irregular growth pattern; convex or irregular base; punctate hyperechogenicity; blood flow signals; and feeding arteries. The area under the receiver operating characteristic curve, sensitivity, and specificity of HFUS features combined with clinical information were 0.946, 92.5%, and 86.9% in cohort 1; 0.870, 93.1%, and 80.8% in cohort 2 (610 lesions); and 0.864, 86.2%, and 86.6% in cohort 3 (170 lesions), respectively. However, HFUS is not suitable for evaluating lesions less than 0.1 mm in thickness or lesions exhibiting surface hyperkeratosis. Conclusion In a clinical setting, the integration of HFUS with clinical information exhibited good diagnostic performance in differentiating malignant and benign skin lesions. However, its utility was limited in evaluating extremely thin lesions and those exhibiting hyperkeratosis.

Purpose: This study examined the diagnostic value of high-frequency ultrasound (HFUS) features in differentiating between benign and malignant skin lesions. Methods: A total of 1,392 patients with 1,422 skin lesions who underwent HFUS examinations were included in an initial dataset (cohort 1) to identify features indicative of malignancy. Qualitative clinical and HFUS characteristics were recorded for all lesions. To determine which HFUS and clinical features were suggestive of malignancy, univariable and multivariable logistic regression analyses were employed. The diagnostic performance of HFUS features combined with clinical information was evaluated. This assessment was validated using internal data (cohort 2) and multicenter external data (cohort 3). Results: Features significantly associated with malignancy included age above 60 years; lesion location in the head, face, and neck or genital regions; changes in macroscopic appearance; crawling or irregular growth pattern; convex or irregular base; punctate hyperechogenicity; blood flow signals; and feeding arteries. The area under the receiver operating characteristic curve, sensitivity, and specificity of HFUS features combined with clinical information were 0.946, 92.5%, and 86.9% in cohort 1; 0.870, 93.1%, and 80.8% in cohort 2 (610 lesions); and 0.864, 86.2%, and 86.6% in cohort 3 (170 lesions), respectively. However, HFUS is not suitable for evaluating lesions less than 0.1 mm in thickness or lesions exhibiting surface hyperkeratosis. Conclusion In a clinical setting, the integration of HFUS with clinical information exhibited good diagnostic performance in differentiating malignant and benign skin lesions. However, its utility was limited in evaluating extremely thin lesions and those exhibiting hyperkeratosis.

Objective To analyze the postoperative effect of probiotics combined with Peitu Shengjin moxibustion and cupping on adenomatous colorectal polyps (ACP).Methods Patients with ACP diagnosed and treated in Zhejiang Provincial Hospital of Traditional Chinese Medicine from August 2021 to May 2022 were recruited as study subjects,and were divided into control group(probiotics) and test group (probiotics combined with Peitu Shengjin moxibustion and cupping).The main outcome measure of this study was the 1-year recurrence rate of ACP.The secondary outcome measures were the treatment efficiency and the traditional Chinese medicine (TCM) syndrome scores at 4 weeks and 1 year after ACP surgery.Results The study finally included 199 patients,with 100 in the control group and 99 in the test group.The 1-year postoperative treatment efficiency of the test group was higher than that of the control group (P=0.012);the recurrence rate was lower than that of the control group (P<0.05).There was no statistically significant difference in the comparison of polyp size and number between the two groups of patients with recurrence (P>0.05).Before treatment,there was no statistically significant difference between the two groups in the comparison of stool habit score,stool nature score,blood in stool score,stool frequency score,abdominal pain score and total score (P>0.05).The stool habit score,stool nature score,stool blood score,stool frequency score,abdominal pain score and total score of the patients in both groups were significantly lower than those of the preoperative period at 4 weeks and 1 year after the operation (P<0.05).Stool habit score,stool nature score,stool blood score,stool frequency score,abdominal pain score and total score were lower in the test group than in the control group at 4 weeks and 1 year postoperatively (P<0.05).Conclusion Probiotics combined with Peitu Shengjin moxibustion and cupping can effectively improve the TCM syndrome scores after ACP surgery and reduce the recurrence rate of ACP.

Objective To discuss the feasibility,safety and surgical effect of the modified Prolene thread double-headed needle"U-shaped"suture combined with extra-and intracavity combination knotting method in thoracoscopic diaphragm plication in the treatment of diaphragmatic eventration in infants.Methods A retrospective analysis was conducted on clinical data of 70 infants who underwent thoracoscopic diaphragm plication in the treatment of diaphragmatic eventration in our hospital from May 2010 to May 2022.According to the different methods of suturing and knotting,the patients were divided into the improved group(modified Prolene thread double-headed needle"U-shaped"suture combined with extra-and intracavity combination knotting method,n =30)and the conventional group(intracavity suture knotting method,n = 40).The perioperative indicators,as well as whether there was knot loosening or recurrence of diaphragmatic eventration,were compared between the two groups.Results All the 70 operations were performed safely and successfully,without conversion to open surgery.The operation time in the improved group was significantly less than that in the conventional group[(35.3±7.4)min vs.(64.7±10.8)min,t =13.521,P =0.000].There were no statistically significant differences between the two groups in terms of intraoperative bleeding volume,indwelling time of thoracic drainage tube,postoperative hospital stay,preoperative,intraoperative,and postoperative pH values,PO2,and PCO2 in arterial blood gas,and postoperative slight diaphragm elevation(P>0.05).All the 70 cases were followed up for 6-24 months postoperatively,with a median follow-up time of 12 months,having no knot loosening or recurrence of diaphragmatic eventration.No death was reported.Conclusions The modified Prolene thread double-headed needle"U-shaped"suture combined with extra-and intracavity combination knotting method in thoracoscopic diaphragm plication in the treatment of diaphragmatic eventration in infants is safe,feasible,effective,and easy to operate.Doctors with a certain endoscopic surgery experience can master it quickly,which is suitable for promotion in qualified hospitals.

Purpose: This study examined the diagnostic value of high-frequency ultrasound (HFUS) features in differentiating between benign and malignant skin lesions. Methods: A total of 1,392 patients with 1,422 skin lesions who underwent HFUS examinations were included in an initial dataset (cohort 1) to identify features indicative of malignancy. Qualitative clinical and HFUS characteristics were recorded for all lesions. To determine which HFUS and clinical features were suggestive of malignancy, univariable and multivariable logistic regression analyses were employed. The diagnostic performance of HFUS features combined with clinical information was evaluated. This assessment was validated using internal data (cohort 2) and multicenter external data (cohort 3). Results: Features significantly associated with malignancy included age above 60 years; lesion location in the head, face, and neck or genital regions; changes in macroscopic appearance; crawling or irregular growth pattern; convex or irregular base; punctate hyperechogenicity; blood flow signals; and feeding arteries. The area under the receiver operating characteristic curve, sensitivity, and specificity of HFUS features combined with clinical information were 0.946, 92.5%, and 86.9% in cohort 1; 0.870, 93.1%, and 80.8% in cohort 2 (610 lesions); and 0.864, 86.2%, and 86.6% in cohort 3 (170 lesions), respectively. However, HFUS is not suitable for evaluating lesions less than 0.1 mm in thickness or lesions exhibiting surface hyperkeratosis. Conclusion In a clinical setting, the integration of HFUS with clinical information exhibited good diagnostic performance in differentiating malignant and benign skin lesions. However, its utility was limited in evaluating extremely thin lesions and those exhibiting hyperkeratosis.