Objective To evaluate the application of evidence-based perioperative patient-controlled analgesia(PCA)management in patients with liver cancer receiving transcatheter arterial chemoembolization(TACE)treatment.Methods By using the application model of clinical evidence-based practice,the review indicators were formulated based on the best evidence.The baseline assessment was conducted,the barrier factors were analyzed,the best clinical decision was made,the implementation steps of PCA management,including training,monitoring,education,etc.were refined,and two rounds of clinical review were carried out.The knowledge-belief-practice level and the implementation of review indicators in 50 medical and nursing staff engaged in PCA management,as well as the changes in pain scores,the incidence of adverse reactions due to PCA management,and the patient's satisfaction in 159 patients after the application of evidence were compared with their corresponding values determined before the application of evidence.Results After implementing the evidence-based practice plan and applying the evidence,at multiple time points the pain scores and the incidences of adverse reactions were decreased significantly(P＜0.05),the patient's satisfaction increased remarkably(P＜0.01),the execution rate of medical and nursing staff for the review indicators were strikingly increased(P＜0.01),and the knowledge-belief-practice level concerning PCA management was prominently improved(P＜0.01).Conclusion The implementation of perioperative PCA management in patients with liver cancer receiving TACE treatment can help to reduce the perioperative pain level,improve the patient discomfort,increase the patient's satisfaction degree,and improve the ability of medical staff in performing PCA management and evidence-based practices.

Objective To analyze the current research status of fibrobronchial bronchoalveolar lavage(BAL)in China,explore the development context and research hotspots.Methods This study was conducted from 2003 to 2023 by searching the Chinese literatures on fibrobronchial BAL collected from China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP and SinoMed,and extracting the information of keywords,authors,institutions and publication time of the literatures.Co-Occurrencel4.9,VOSviewer 1.6.19 and Microsoft Excel 2021 were applied to carry out data cleaning,data statistics and graph rendering,and visualized the research hotspots and trends of fibrobronchial BAL.Results A total of 4219 literatures meeting the requirements were included.The largest number of articles will be 438 in 2021.There were 522 core authors with more than 3 published papers.The institutions and journals with the largest number of publications were Hebei Children's Hospital with 26 articles and Journal of Clinical Pulmonary Medicine with 154 articles respectively.The research hotspots mainly include pneumonia,pulmonary infections,clinical efficacy,bronchoalveolar lavage fluid,bronchiectasis,and mechanical ventilation.Conclusion Fibrobronchial BAL is widely used in the diagnosis and treatment of respiratory diseases in China.In the future,it is necessary to strengthen the cooperation among researchers,deepen the theoretical basis,improve the clinical application system,and promote the further development of respiratory department in China.

Objective:To analyze the correlation between psychological resilience and stigma, self-efficacy and self-esteem in patients with constipation after lower limb fracture surgery, and to determine nursing counter measures.Methods:A total of 102 patients who underwent lower limb fracture surgery in Jingdezhen Hospital of Traditional Chinese Medicine from April 2020 to March 2023 were convenience sampling selected as the study objects by a cross-sectional survey. They were divided into constipation group and normal group according to whether postoperative constipation was complicated. Baseline data, Psychological Resilience Scale (CD-RISC), Social Impact Scale (SIS), General Self-efficacy Scale (GSES), and Pearson ′s method was used to analyze the correlation between CD-RISC score and SIS score, GSES score, and RSES score in patients with constipation. Results:Totally 102 survey subjects aged 18-75 (38.87 ± 6.83), including 57 males and 45 females. Postoperative constipation occurred in 37 patients, accounting for 36.27% (37/102). The average age, constipation secret history rate, postoperative analgesic use rate, CD-RIS, SIS, GSES and RSES scores of the constipation group were (50.74 ± 5.52) years, 72.97% (27/37), 62.16% (23/37), (42.11 ± 5.03) points, (59.78 ± 6.40) points, (22.74 ± 3.57) points, (20.15 ± 2.32) points, respectively. The normal group was (37.81 ± 7.45) years old, 40.00% (26/65), 41.54% (27/65), (78.43 ± 5.95) points, (36.10 ± 4.03) points, (28.26 ± 3.53) points, (27.05 ± 5.29) points, respectively. The difference between the two groups was statistically significant ( t values were 7.52-31.29, χ2 values were 10.27 and 4.01, all P<0.05). In the constipation group, CD-RISC score was negatively correlated with SIS score, and positively correlated with GSES score and RSES score ( r values were -0.869, 0.608, 0.582, all P<0.05). Conclusions:The incidence of constipation after lower limb fracture is high, and its psychological resilience is related to stigma, self-efficacy and self-esteem. Clinical nursing intervention is needed to improve the prognosis of patients.

Objective To investigate the effects of intrauterine perfusion with granulocyte colony-stimulating factor(G-CSF)on the endometrial thickness,volume,and blood flow parameters of patients with thin endometrium and their clinical outcomes.Methods We designed a prospective non-randomized synchronous controlled trial and recruited patients with thin endometrium who underwent frozen-thawed embryo transfer(FET)at Mianyang Central Hospital between September 1,2021 and September 1,2023.They were divided into two groups,an experimental group of patients who received the experimental treatment of intrauterine perfusion with G-CSF and a control group of patients who did not receive the experimental treatment.The general data and the clinical outcomes of the two groups were analyzed and compared.The endometrial thickness,volume and blood flow parameters of patients in the experimental group before and after intrauterine perfusion with G-CSF were analyzed.Results The clinical data of 83 patients were included in the study.The experimental group included 51 cases,while the control group included 31 cases.There were no significant differences in the baseline data between the two groups.The clinical pregnancy rate of the experimental group(56.86% )was higher than that of the control group(50.00% )and the rate of spontaneous abortion in the experimental group(27.59% )was lower than that in the control group(37.50% ),but the differences were not statistically significant(P>0.05).In the experimental group,the postperfusion endometrial thickness([0.67±0.1]cm)was greater than the preperfusion endometrial thickness([0.59±0.09]cm),the postperfusion([1.84±0.81]cm3)was greater than the preperfusion endometrial volume([1.54±0.69]cm3),and the postperfusion vascularization flow index(VFI)(1.97±2.82)was greater than the preperfusion VFI(0.99±1.04),with all the differences being statistically significant(P<0.05).Conclusion Intrauterine perfusion with G-CSF can enhance the endometrial thickness,volume,and some blood flow parameters in patients with thin endometrium.

Objective To investigate the relationship between glucokinase regulator protein ( GCKR) gene polymorphism rs780094 and hyperuricemia in Uygur in Xinjiang. Methods A case-control study including 1 026 patients with hyperuricemia and 1 030 normal subjects was conducted. All the subjects were genotyped for GCKR gene rs780094 by Sequenom MassARRAY system. The results of rs780094 genotype and allele frequency between hyperuricemia group and control group were compared. The associations of different genotypes of rs780094 with blood pressure, blood lipid, and blood glucose were analyzed. Logistic regression analysis was used to analyse the relationship between polymorphism of rs780094 and hyperuricemia in Uygur in Xinjiang. Results The distributions of three genotypes(G/G, A/G, A/A) and two allele frequency (G and A) in GCKR rs780094 revealed statistical difference ( P<0. 05 ) between hyperuricemia group and control group. A tendency toward association with hyperuricemia was observed under dominant model(OR=1. 295, 95%CI 1. 078~1. 554,P=0. 006) and recessive model(OR=1. 284, 95% CI 1. 024 ~1. 611,P=0. 030). The levels of systolic blood pressure, diastolic blood pressure, and total cholesterol were lower in hyperuricemia group with GCKR gene rs780094 loci GG genotype than those with AA+AG genotype. After adjusting confounding factors which had significant difference in the single factor analysis, logistic regression analysis showed that rs780094 A/A and A/G might be risk factors of hyperuricemia in Uygur in Xinjiang (OR=1. 355,95% CI 1. 094 ~1. 679,P=0. 005). Conclusion The GCKR rs780094 is associated with hyperuricemia in Uygur in Xinjiang. The A/A and A/G genotype of the GCKR rs780094 may increase the risk of hyperuricemia.

Objective To investigate the risk factors of ICU delirium in critically ill patients. Methods A total of 1 74 critically ill patients in ICU who were older than 18 yrs and stayed in ICU exceeding 24 hs from January 201 5 to June 201 5 were enrolled.Patients were divided into delirium group and non delirium group.Delirium was assessed twice daily with the Confusion Assessment Method for the ICU (CAM-ICU)during the first 7 days.The factors such as history of alcoholism and other 12 factors were analyzed by univariate and multivariate logistic regression analysis to identify those risk factors associated with delirium.Results With 22 cases of delirium in 1 74 patients,the in-cidence of delirium was 12.64% (delirium group).Variables associated with delirium were coronary heart history,operation,tracheal intubation,clinical use of mechanical ventilation,hypoxemia and Benzodiazepine.Multivariate logistic regression analysis showed that coronary heart disease (OR 3.932,95%CI 1.225-12.61 7),surgery(OR 9.691,95%CI 2.103-44.657),hypoxemia(OR 6.595, 95%CI 1.377-31.585),Benzodiazepine use (OR 7.620,95%CI 1.713-33.899)was independent risk factors of delirium in critically ill patients (P < 0.05 or P < 0.01 ).Conclusion Coronary heart disease,surgery,hypoxemia and Benzodiazepine are independent risk factors of ICU delirium in criti-cally ill patients.Early screening and prevention of delirium should be given to reduce the occurrence of delirium for patients in ICU.