Objective:To screen risk factors for ICU-acquired weakness in patients with mechanical ventilation and construct a predictive model, so as to provide a basis for the health management of patients with mechanical ventilation.Methods:Convenience sampling was used to select 312 ICU patients with mechanical ventilation admitted to the Tenth People's Hospital of Tongji University from October 2019 to August 2020 for the study. Patients were divided into training set ( n=220) and test set ( n=92) in a 7∶3 ratio. Based on machine learning algorithms, decision random forest (DRF), extremely-randomized trees (XRT) and generalized linear model (GLM) were used to construct three ICU-acquired weakness risk prediction models for patients with mechanical ventilation, respectively. The performance of the prediction model was evaluated using the area under the receiver operating characteristic curve ( AUC), the area under the precision-recall curve ( AUPRC), and the root mean square error ( RMSE) . Results:There were 7 predictors of risk of ICU-acquired weakness in patients with mechanical ventilation, including age, gender, braking, duration of mechanical ventilation, blood glucose, lactic acid, and parenteral nutrition. Test set and training set validation showed that AUC and AUPRC of GLM prediction model were greater than those of DRF, XRT prediction model. Test set validation indicated that the RMSE, logarithmic loss of GLM prediction model was less than those of DRF, XRT prediction model. Conclusions:Machine learning algorithm based GLM prediction model has good prediction performance. Healthcare professionals can construct evidence-based decisions for interventions in areas such as braking, duration of mechanical ventilation, and blood glucose management.

Objective:To screen risk factors for ICU-acquired weakness in patients with mechanical ventilation and construct a predictive model, so as to provide a basis for the health management of patients with mechanical ventilation.Methods:Convenience sampling was used to select 312 ICU patients with mechanical ventilation admitted to the Tenth People's Hospital of Tongji University from October 2019 to August 2020 for the study. Patients were divided into training set ( n=220) and test set ( n=92) in a 7∶3 ratio. Based on machine learning algorithms, decision random forest (DRF), extremely-randomized trees (XRT) and generalized linear model (GLM) were used to construct three ICU-acquired weakness risk prediction models for patients with mechanical ventilation, respectively. The performance of the prediction model was evaluated using the area under the receiver operating characteristic curve ( AUC), the area under the precision-recall curve ( AUPRC), and the root mean square error ( RMSE) . Results:There were 7 predictors of risk of ICU-acquired weakness in patients with mechanical ventilation, including age, gender, braking, duration of mechanical ventilation, blood glucose, lactic acid, and parenteral nutrition. Test set and training set validation showed that AUC and AUPRC of GLM prediction model were greater than those of DRF, XRT prediction model. Test set validation indicated that the RMSE, logarithmic loss of GLM prediction model was less than those of DRF, XRT prediction model. Conclusions:Machine learning algorithm based GLM prediction model has good prediction performance. Healthcare professionals can construct evidence-based decisions for interventions in areas such as braking, duration of mechanical ventilation, and blood glucose management.

Objective·To analyze infertility couples,dyadic coping level by using latent profile analysis(LPA),and explore the heterogeneity and related factors of different profiles.Methods·From September to November 2023,257 newly diagnosed infertility couples in pre-infertility treatment with assisted reproductive technology(ART)were recruited from Reproductive Medicine Center,Renji Hospital,Shanghai Jiao Tong University School of Medicine.All couples were evaluated by using general information questionnaire,Fertility Problem Inventory(FPI),Dyadic Coping Inventory(DCI),and Fertility Quality of Life(FertiQoL)Tool.LPA was used to explore the dyadic coping profiles of the couples before ART treatment,and general information,FPI scores and FertiQoL scores were compared among the profiles.Multinomial Logistic regression analysis was used to explore the related factors of different profiles.Results·A total of 257 couples with infertility were included,with an average age of(30.15±3.07)years for females,(31.82±3.82)years for males,(3.75±2.16)years for marriage,and(2.90±1.92)years for infertility;there were 118 couples caused by male infertility,109 couples caused by female infertility,and 30 couples caused by both infertility;the average DCI score for males was(128.25±19.15)points,while for females it was(129.91±18.32)points.According to the dyadic coping levels,the infertile couples were divided into four profiles:common positive coping group(153 couples,59.5％),common negative coping group(85 couples,33.1％),male positive coping group(12 couples,4.7％),and male negative coping group(7 couples,2.7％).There were statistically significant differences in the infertile couples'age,FPI score,FertiQoL score,and remarriage rate among the four profiles(P＜0.05).Multinomial Logistic regression analysis results showed that,with the common positive coping group as the reference,the common negative coping group had older men(OR=1.122,95％CI 1.004-1.254,P=0.036),higher FPI scores for both males and females(male:OR=1.019,95％CI 1.003-1.035,P=0.018;female:OR=1.020,95％CI 1.004-1.036,P=0.015),and lower FertiQol scores for males(OR=0.966,95％CI 0.937-0.996,P=0.029).Conclusion·There are four types of dyadic coping profiles in infertile couples before ART treatment.Compared with the common positive coping couples,higher reproductive pressure,elder age,and lower perceived fertility quality of life of males,and higher reproductive pressure of females are all risk factors for common negative coping couples.

Objective To assess the clinical efficacy of butylphthalide sequential therapy(BST)as an adjuvant therapy for delayed onset encephalopathy caused by acute carbon monoxide poisoning(DEACMP).Methods DEACMP patients who visited the department of neurology at Yan'an People's Hospital from January 2018 to June 2023 were selected as the research subjects.Using a random number table method,DEACMP patients were randomly divided into hyperbaric oxygen therapy(HBOT)group,glucocorticoid(GC)group(GC combined with,HBOT),and BST group(HBOT,GC combined with BST),all of which were treated continuously for 30 days.The incidence of adverse reactions and clinical efficacy during the treatment among three groups of DEACMP were observed and compared.Inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living ability before and after treatment among three groups were compared.Results A total of 120 patients were included in the study,with 40 patients in each group.During the treatment period,no serious adverse reactions were observed in any of the three groups of patients,and no patient terminated treatment due to adverse reactions.The total effective rate of BST group was significantly higher than those of GC group and HBOT group,while the total effective rate of GC group was higher than that of HBOT group(P<0.05).Before treatment,there was no statistically significant difference(P>0.05)in the scores of inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living function among the three groups.After treatment,the serum LP-PLA2,SIRI,TNF-α,S100-β,and the NSE levels decreased compared to before treatment(P<0.05),and the indicators of the BST group was lower than those of the HBOT group and GC group,while the indicators of the GC group was lower than those of the HBOT group(P<0.05).After treatment,the MMSE,MoCA,and BI scores of the three groups increased compared to before treatment(P<0.05),but the NIHSS score decreased(P<0.05).In addition,the MMSE,MoCA,and BI scores of the BST group were higher than those of the HBOT and GC groups(P<0.05),while the NIHSS scores were lower than those of the HBOT and GC groups(P<0.05).The MMSE,MoCA,and BI scores in the GC group were higher than those in the HBOT group,while the NIHSS scores were lower than those in the HBOT group(P<0.05).Conclusion Compared with HBOT treatment and HBOT combined with GC treatment,BST adjuvant therapy can improve the clinical efficacy,inflammatory status,cognitive function,and daily living ability of DECAMP patients.

Objective:To evaluate the effect of self-made lithotomy heating mask on intraoperative and postoperative body temperature and short-term postoperative outcome indicators in patients undergoing radical resection of rectal cancer.Methods:Using the method of quasi experimental research design, 100 patients with open rectal cancer in Ningbo Huamei Hospital of the University of Chinese Academy of Sciences from February to July 2021 were selected as the research objects. The patients were divided into experimental group and control group with 50 cases in each group. The control group was kept warm by routine methods, and the experimental group was kept warm by self-made lithotomy heating hood. The changes of core temperature at different time points before, during and after operation were compared between the two groups. The incidence of accidental hypothermia and shivering, the recovery time of anesthesia, and the incidence of various complications within 48 hours after operation were compared between the two groups after operation from the beginning of the operation to 6 hours after returning to the ward.Results:From 30 minutes after anesthesia to 3 hours after entering the ward, the core temperatures of the experimental group at 10 time points were higher than that of the control group, and the differences were statistically significant ( t values were 3.48-37.30, all P<0.01). From the beginning of surgery to 6 h after returning to the ward, the incidence of perioperative accidental hypothermia in the experimental group was 2% (1/50), lower than 24% (12/50) in the control group, and the difference was statistically significant ( χ2=11.06, P<0.05) . The number of cases of shivering in the experimental group was 10, lower than that in the control group of 22, the difference was statistically significant ( χ2=6.62, P<0.05) . The recovery time, extubation time and stay time in anesthesia recovery room of the experimental group were (8.44 ± 2.83), (13.05 ± 4.72), (74.51 ± 11.82) min, which were shorter than those of the control group (15.35 ± 2.09), (17.62 ± 3.28), (89.14 ± 9.19) min, and the difference was statistically significant ( t=-13.89, -5.62, -6.91, all P<0.01). The number of cases of agitation, delirium and nausea and vomiting in the experimental group was 3, 1 and 2 respectively, which was lower than 13, 7 and 8 in the control group, and the difference were statistically significant ( χ2=7.44, 4.89, 4.00, all P<0.05). There was no significant difference in the incidence of adverse cardiac events between the two groups ( P>0.05). Conclusions:The application of self-made lithotomy heating mask in open rectal cancer surgery can effectively improve the risk of hypothermia at different time points during and after surgery, reduce the incidence of shivering, restlessness, postoperative nausea, vomiting and delirium, shorten the time of awakening and extubation, and prevent postoperative complications. It has practical value in clinic.

Heart failure, as a progressive and irreversible clinical syndrome, is an important part of the global prevention and treatment of chronic cardiovascular diseases. The management of its complex symptoms and risk factors cannot completely rely on medical and nursing staff and short-term clinical treatment. Self-care is an effective way to reduce the readmission rate and fatality rate of patients. Symptom perception is a new dimension in the situation-specific theory of self-care in heart failure, and that is a comprehensive process by which patients conduct self-monitoring of symptoms and signs and identify, interpret, and label the meaning of symptoms. Symptom perception of heart failure is crucial to achieve effective self-care, however, there are few studies in China. This article reviews the definition, influencing factors and evaluation tools of symptom perception in patients with heart failure, so as to provide evidence for the intervention and promotion of symptom perception in patients with heart failure.

Objective To investigate the current status and influencing factors of compassion fatigue in clinical nurses,and to provide theoretical references for prevention of nurse burnout and promotion of nurse retention.Methods Totally 992 clinical nurses from ten tertiary hospitals were enrolled through random cluster sampling to complete general information questionnaire,the Professional Quality of Life Scale (Pro-QOL-V),the Resilience Scale for Adults(RSA) and the Jefferson Scale of Empathy·Health Professionals(JSE-HP).Results The prevalence of moderate and high risk of secondary stress and burnout were 71.1％,73.2％,respectively;clinical nurses with work experience of 6 to 10 years presented the highest level of burnout(P＜0.01);lower empathy and resilience,as well as adverse work environment were risk factors of compassion fatigue.Multiple regression analysis showed that the influencing factors of nurse burnout were compassion satisfaction,secondary stress,resilience,workload,recognition,empathy,and payment,which explained 70.5％ of the total variance.Conclusion Secondary stress,burnout and compassion satisfaction in clinical nurses are influenced by nurses' empathy,resilience and work environment,and nursing administrators should pay attention to receiving recognition as positive predictors of burnout,except for workload and payment.

Objective To explore how the emotional experience and stress symptoms associated with compassion fatigue emerges,develops and subsides,as well as their coping strategy for compassion fatigue. Methods By purposive sampling integrating with snowball sampling method,semi-structured reviews with open-ended questions were conducted among 47 registered nurses who are working or have ever being in clinical frontline department to gain their in-depth views about compassion fatigue. Theme analysis was used to analyze the data.Results In emotional experience,two main themes were extracted:positive and negative emotion. Six subthemes including happy,high spirits,interests,sense of self-value,sense of achievement and occupational pride were extracted from positive emotion. While nine subthemes including compassion,grief,depressed mood,irritability,guilty,powerlessness,apathy,fear and anxiety were extracted from the negative emotion. Conclusions Clinical nurses are lack of basic knowledge about compassion fatigue,and their work and life are influenced by compassion fatigue. It should be emphasized and enhanced that domestic hospital administrators should identify and take precaution against compassion fatigue.

Objective To explore the effects of postoperative nursing on patients′ postoperative safety and and rehabilitation process after total knee arthroplasty ( TKA ) that based on concept of fast-tract surgery (FTS).Methods Totally 200 patients who had surgery for total knee arthroplasty from January 2013 to July 2014 were randomly assigned to the routine group (n=100) and the FTS group (n=100). Patients in the routine group were received routine postoperative nursing, while patients in the FTS group received optimized postoperative nursing that based on FTS concept. The time to start eating after surgery, VAS pain score, the removal time of urethral catheter and drainage tube, the first off-bed activity time after operation,the recover speed of knee joint function and incidence of postoperative complications were compared between two groups.Results Compared with the routine group, the time to start eating after surgery in the FTS group was (4.56±0.33) h;the removal time of urethral catheter was (15.12±3.43) h; the removal time of drainage tube was (17.43±3.91) h, and they were all shorten ( t=21.82,31.60,14.99;P<0.01) . The pain score in the FTS group within 3 d after surgery was (1.39±1.12), and was lower than that in the routine group (t=10.993,P<0.01); in the FTS group, the first off-bed activity time after surgery was (16.72±2.01)h;the time of actively straight leg raising was (18.2±6.3)h;the time of actively bending knees for 90 degree was (3.5±1.7) h, and they were all markedly advanced (t=57. 23,8.885,4.545;P<0.01) . There were 6 cases of complications that caused by pain in the routine group, while there were none in the FTS group ( P<0.05) . There was no statistically significant difference in cases with other complications between two groups ( P>0. 05 ) . Conclusions Application of optimization postoperative nursing scheme for total knee arthroplasty based on FTS is safe. It can shorten the time to start eating after surgery, reduce postoperative pain levels, promote the postoperative early ambulation, and has no adverse effect on the incidence of postoperative complications.

Objective To strengthen nursing risk assessment for critical patients and improve their healthcare outcomes.Methods It formed the dynamic closed-loop management mode around the management system, early risk warning system, nurses′ observation ability, emergency procedures, information communication on account of predicting risk factors no timely,disease observation inaccuracy,emergency procedures nonstandard.Results Compared 2009 year with 201 5 year,the numbers of preventing nursing accidents by timely and effective observation increased 37 from 1 0;obviously improvement on reporting illness, communication ability,observing illness satisfied doctors(P <0.01 );the numbers of nursing adverse events was significantly decreased.The abilities of emergency situation judgment,reaction and coping measures in nurses were improve.Conclusions The closed-loop management mode can effectively improve each step′s quality and quality of critically patients care continuously.