Objective To investigate the status of pain and influencing factors of patients with chronic wounds.Methods A convenience sampling was used to recruit 186 patients with chronic wounds from a tertiary hospital in Chongqing between January and August 2024.General information questionnaire,Numeric Rating Scale(NRS),and Chronic Wound Pain Status Questionnaire were used to collect data.Results The 186 patients had a median score for pain knowledge of 15(12,19),for pain attitude of 40(37,45),and for coping behaviors of 21(16,26).Generalized linear model analysis showed that age,education level,and per capita monthly household income were independent factors influencing pain knowledge(standardized regression coefficients:-1.625,2.071,1.209;95％CI:-2.479～-0.770,1.431～2.711,0.160～2.258,respectively;P＜0.05).Education level and baseline pain intensity were independent factors influencing pain attitude(standardized regression coefficients:3.036,-2.211;95％CI:2.146～3.926,-3.568～-0.854;P＜0.05).Education level and type of pain persistence were independent factors influencing coping behaviors to pain(standardized regression coefficients:1.001,-1.694;95％CI:0.194～1.809,-3.262～-0.126;P＜0.05).Conclusion Patients with chronic wounds have generally low levels of pain-related knowledge,attitudes,and coping behaviors.Age,per capita monthly household income,education level,and pain characteristics significantly influence their pain status.Education level plays a key role in influencing pain among patients with chronic wounds by shaping their access to pain-related knowledge,development of their attitudes toward pain,and execution of pain management behaviors.

Objective Under the guidance of nurses,an intelligent medical waste temporary storage equipment was developed and its application effect was evaluated,aiming to optimize the medical waste recycling process and save human resources.Methods A research and development(R&D)team was established to analyze the issues in the current medical waste temporary storage process.An intelligent medical waste temporary storage device was developed,equipped with functions such as categorized disposal,permission scanning,barcode recognition,intelligent weighing,overflow alarm,and ozone disinfection.From January 19th to February 20th,2023,an intelligent medical waste storage equipment was placed in the medical waste storage room on the 7th to 9th floors of the outpatient clinic of a tertiary hospital in Wuhan city as an experimental group;traditional medical waste storage bins were placed on the 4th and 5th floors of the outpatient department as a control group.The daily disposal indicators and environmental hygiene monitoring indicators of 2 groups of medical waste were compared.Results With the application of the intelligent medical waste temporary storage device,the disinfection rate of medical waste increased from 5.00％to 100％;the overflow rate decreased from 42.52％to 0％;the handover time reduced from 4.98±2.21 minutes to 1.07±0.35 minutes;the standardization rate of handovers rose from 15.83％to 100％.All these differences were statistically significant(P＜0.001).Additionally,the pass rate of bacterial colonies on the inner walls of bins increased from 53.33％to 67.78％,with a statistically significant difference(P=0.012).Conclusion The application of the intelligent medical waste temporary storage equipment significantly improves the efficiency and quality of medical waste management;at the same time,it also plays an active role in improving the storage environment,which can safeguard the environmental hygiene of hospitals and the safety of patients.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective:To analyze the epidemiological and clinical characteristics of pertussis cases identified through active surveillance.Methods:Active surveillance for pertussis was conducted in three sentinel hospitals in Yiwu, Zhejiang Province, and Yongcheng, Henan Province. The study population included cases that met the surveillance case definition and sought medical care at outpatient/emergency departments or were hospitalized between June 1, 2021, and May 31, 2022. Samples were collected for bacterial culture and PCR detection. Case information and clinical data were collected. Differences in rates were assessed using the chi-square test or Fisher's exact probability test, and the differences in cough time were compared using the Mann-Whitney U test. Results:Among 1 423 cases of pertussis surveillance, the positive rate of pertussis was 28.11% (400/1 423), with a median age of 5 years (interquartile range: 2, 8). The positive rate in Yongcheng, Henan Province, and Yiwu, Zhejiang Province were 39.27% (216/550) and 21.08% (184/873), respectively; the positive rate of pertussis was highest in July 2021, and the highest positive rate of pertussis was among those aged 10-14. The positive rate of pertussis in hospitalized cases was higher than in outpatient/emergency cases (26.68%) ( χ2=4.16, P=0.041). Among the 400 laboratory test-positive cases, the highest proportion of atypical symptom cases was in adults aged 20-59 (43.33%, 13/30). The specificity rates of apnea and worsening nocturnal cough in monitored cases under 3 months of age were 100.00% and 73.81%, respectively. Among monitored cases aged 3 months to 9 years, the proportions of symptoms including worsening nighttime cough (63.00%) and night sweats (4.59%) in test-positive cases were significantly higher than those in the test-negative group (47.77% and 0.56%, respectively), with statistically significant differences (both P<0.05). The specificity rates of worsened nighttime coughing and night sweats were 52.23% and 99.44%, respectively. Conclusions:The active surveillance results for pertussis showed that the 10-14 age group exhibited the highest positivity rate. Active surveillance enhanced the detection rate of pertussis. Among laboratory-confirmed cases, the proportion of atypical symptoms was the highest in adults, suggesting that laboratory testing should be combined to diagnose programs of pertussis. For infants under 3 months, worsening nighttime cough and apnea increase the diagnostic specificity, while for individuals aged 3 to 9 years old, worsening nighttime cough and night sweats increase the diagnostic specificity.

Objective Under the guidance of nurses,an intelligent medical waste temporary storage equipment was developed and its application effect was evaluated,aiming to optimize the medical waste recycling process and save human resources.Methods A research and development(R&D)team was established to analyze the issues in the current medical waste temporary storage process.An intelligent medical waste temporary storage device was developed,equipped with functions such as categorized disposal,permission scanning,barcode recognition,intelligent weighing,overflow alarm,and ozone disinfection.From January 19th to February 20th,2023,an intelligent medical waste storage equipment was placed in the medical waste storage room on the 7th to 9th floors of the outpatient clinic of a tertiary hospital in Wuhan city as an experimental group;traditional medical waste storage bins were placed on the 4th and 5th floors of the outpatient department as a control group.The daily disposal indicators and environmental hygiene monitoring indicators of 2 groups of medical waste were compared.Results With the application of the intelligent medical waste temporary storage device,the disinfection rate of medical waste increased from 5.00％to 100％;the overflow rate decreased from 42.52％to 0％;the handover time reduced from 4.98±2.21 minutes to 1.07±0.35 minutes;the standardization rate of handovers rose from 15.83％to 100％.All these differences were statistically significant(P＜0.001).Additionally,the pass rate of bacterial colonies on the inner walls of bins increased from 53.33％to 67.78％,with a statistically significant difference(P=0.012).Conclusion The application of the intelligent medical waste temporary storage equipment significantly improves the efficiency and quality of medical waste management;at the same time,it also plays an active role in improving the storage environment,which can safeguard the environmental hygiene of hospitals and the safety of patients.

Objective:To explore the application effects of application of rehabilitation care decision-making scheme based on case management model in severe burn patients.Methods:The study was a non-randomized historical control study. Thirty patients who met the inclusion criteria and received routine rehabilitation nursing in the First Affiliated Hospital of Army Medical University (the Third Military Medical University, hereinafter referred to as the hospital) from April 2021 to March 2022 were included in routine rehabilitation nursing group (26 males and 4 females, aged 48.50 (31.75, 56.25) years), and 30 patients who met the inclusion criteria and received case management rehabilitation nursing in the hospital from April 2022 to March 2023 were included in case management rehabilitation nursing group (22 males and 8 females, aged 46.00 (36.75, 55.25) years). The length of intensive care unit (ICU) stay, total hospitalization day, and total hospitalization cost of the patients in two groups were recorded. At admission, convalescence, discharge, and 6 months after injury, the patients' life quality was evaluated by the concise burn specific health scale, the sleep quality was evaluated by the Pittsburgh sleep quality index, and the functional independence was evaluated by the functional independence rating scale. At convalescence, discharge, and 6 months after injury, the patients' scar status was evaluated by the Vancouver scar scale. At 6 months after injury, a third-party satisfaction questionnaire was used to investigate the efficacy satisfaction of patients.Results:The length of ICU stay and total hospitalization day of patients in case management rehabilitation nursing group were both significantly shorter than those in routine rehabilitation nursing group (with Z values of -1.97 and -1.99, respectively, P<0.05), and the total hospitalization cost was less than that in routine rehabilitation nursing group ( Z=-1.99, P<0.05). At discharge and 6 months after injury, the life quality scores of patients in case management rehabilitation nursing group were significantly higher than those in routine rehabilitation nursing group (with t values of -3.19 and -4.43, respectively, P<0.05), while the sleep quality scores were significantly lower than those in routine rehabilitation nursing group (with Z values of -2.18 and -3.33, respectively, P<0.05). There were no statistically significant differences in cognitive function scores of functional independence of patients between the 2 groups at admission, convalescence, discharge, and 6 months after injury ( P>0.05). The exercise function scores and total scores of functional independence of patients in case management rehabilitation nursing group at convalescence, discharge, and 6 months after injury were significantly higher than those in routine rehabilitation nursing group (with Z values of -4.37, -2.73, -4.10, -4.37, -2.64, and -4.06, respectively, P<0.05). The scar pigmentation scores of patients in case management rehabilitation nursing group at 6 months after injury were significantly lower than those in routine rehabilitation nursing group ( Z=-2.05, P<0.05), and the scar vascularity scores of patients in case management rehabilitation nursing group at discharge and 6 months after injury in case management rehabilitation nursing group were significantly lower than those in routine rehabilitation nursing group (with Z values of -3.16 and -2.07, respectively, P<0.05). The scar pliability scores (with Z values of -3.16, -2.45, and -4.38, respectively, P<0.05), thickness scores (with Z values of -2.56, -2.35, and -4.70, respectively, P<0.05), and total scores (with Z values of -3.77, -3.04, and -3.13, respectively, P<0.05) of patients in case management rehabilitation nursing group at convalescence, discharge, and 6 months after injury were significantly lower than those in routine rehabilitation nursing group. At 6 months after injury, the efficacy satisfaction scores of patients in case management rehabilitation nursing group were 4.00 (3.00, 4.25), which were significantly higher than 3.00 (2.00, 4.00) in routine rehabilitation nursing group ( Z=-2.72, P<0.05). Conclusions:The implementation of rehabilitation care decision-making scheme based on case management model can optimize the cost efficiency, improve the effectiveness of clinical treatment, and enhance the life quality and satisfaction of the curative effect of severe burn patients.

Objective:To examine the clinical characteristics, treatment, and prognosis of peripherally inserted central catheter (PICC)-related pericardial effusion/cardiac tamponade in neonates.Methods:A retrospective analysis was conducted on the clinical data of two neonates with PICC-related pericardial effusion/cardiac tamponade admitted to Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (School of Medicine, University of Electronic Science and Technology of China) between October 2019 and February 2021. Literature was searched using keywords "peripherally inserted central catheter", "central venous catheter", "deep venous catheter", "pericardial effusion", "cardiac tamponade", and "neonate" in databases including CNKI, Wanfang, Yiigle, VIP Database, PubMed, Web of Science, and Embase databases up to June 2023. Clinical characteristics, treatment, and prognosis of neonates with PICC-related pericardial effusion/cardiac tamponade were summarized. Descriptive statistical analysis was used, and Fisher's exact test was employed to compare the impact of different treatment methods on the prognosis of the infants.Results:(1) Case report: Both infants experienced sudden onset of decreased heart rate and oxygen saturation, respiratory distress, pallor, and cyanosis of the lips. Case 1 did not undergo pericardiocentesis, while Case 2 did. Both infants died. (2) Literature review: A total of 25 articles (six in Chinese and 19 in English) were retrieved, involving 45 infants. Including the two cases from our institution, there were 47 infants in total. Among the 47 infants, 44 (94%) were preterm, and three (6%) were full-term. The gestational age of 46 infants was (29.5±3.9) weeks, with one full-term infant not reporting a specific gestational age. The birth weight of 46 infants was (1 227±600) g, with 43 (91%) being low birth weight infants. Nine cases (19%) did not specify the insertion site; 32 cases (68%) had the catheter inserted from the upper limb and six cases (13%) from the lower limb. After the onset of pericardial effusion/cardiac tamponade symptoms, the catheter tip was located at or near the right atrium in 26 cases (55%), at the junction of the vena cava and right atrium in three cases (6%), within the pericardial cavity or cardiac silhouette in three cases (6%), in the superior vena cava in two cases (4%), in the pulmonary artery in one case (2%), in the left atrium in one case (2.1%), and in the right ventricle in one case (2%). Ten cases (21%) did not specify the exact location. Among the 47 cases, 13 (28%) experienced catheter migration, and 11 (23%) had catheter kinking or angulation. Thirty cases (64%) underwent pericardiocentesis, one case (2%) underwent pericardiotomy, and 16 cases (34%) received conservative treatment. The cure rate in the non-conservative treatment group (pericardiocentesis or pericardiotomy) was 81% (25/31), higher than that in the conservative treatment group (6/16) (Fisher's exact test, P=0.004). Conclusion:Once sudden hemodynamic or respiratory abnormalities occur, cardiac ultrasound should be promptly performed to confirm the diagnosis, and pericardiocentesis should be timely conducted to improve the survival rate of the neonates.

Neonatal hyperbilirubinaemia, clinically presenting as jaundice, is a ubiquitous and commonly a benign metabolic condition in newborn infants.It is a leading cause of hospitalization of neonates in the first week of life.Serum bilirubin has been considered as the most potent superoxide with the peroxyl radical scavenger activity.However, uncontrolled hyperbilirubinaemia or rapidly rising bilirubin can reach a neurotoxic concentration, potentially leading to central nervous system sequelae.Thus, the health status of jaundiced newborn infants is dependent on striking an appropriate balance between the protective effects of serum bilirubin and the risk of bilirubin neurotoxicity.In order to standardize the management of neonatal hyperbilirubinemia (jaundice), many countries have developed clinical practice management guidelines.This review sorted out and briefly interpreted the main contents of clinical management guidelines for neonatal hyperbilirubinemia drafted by the American Academy of Pediatrics and other countries, aiming to provide references of clinical diagnosis and treatment practice to domestic pediatrician.

Anemia and blood transfusion are common clinical problems in newborns, especially premature infants.What are the definition and influencing factors of neonatal anemia? What is the difference between anemia in preterm infants and full-term infants? What are the changes of pathophysiology and their effects on tissues and cells during neonatal anemia? What are the prevention strategies and treatment methods of neonatal anemia? Is there a uniform hemoglobin threshold for neonatal transfusion of red blood cells? What are the risks of blood transfusion? In view of the above problems, this review proposed that the definition of anemia should consider the effects of gestational age, day age, intrauterine or postnatal development status(such as growth retardation), nutrition and so on. "Physiological anemia of infancy" can occur in healthy term infants; "anemia of prematurity" can not be considered as a physiologic and benign event, which is related to the low level of endogenous erythropoietin and iatrogenic blood loss.It is emphasized that neonatal anemia(especially premature infants) is preventable and can be prevented, and prevention is more important than treatment.Neonates lack a uniform hemoglobin threshold and are at risk of blood transfusion during red blood cell transfusion.