ObjectiveTo develop an intervention program based on a shared mental model to enhance the communication and collaboration skills of nurses in multidisciplinary teams in stroke rehabilitation wards. MethodsUsing the shared mental model as the theoretical framework, the intervention program was preliminarily drafted through literature review to establish a theoretical foundation and qualitative research to identify clinical needs. The Delphi method was then used to revise and refine the program. ResultsBased on literature review and qualitative research, intervention elements were extracted across four dimensions: equipment, tasks, team interaction and team members, forming the initial draft of the intervention program. Two rounds of consultations were conducted with 18 experts, achieving a 100% valid response rate in both rounds. The expert authority coefficients were 0.87 and 0.90, respectively. In the second round of consultation, the variation coefficients for the importance scores of each item ranged from 0 to 0.20 (overall Kendall's W = 0.272, P < 0.001), and the variation coefficients for feasibility scores ranged from 0 to 0.21 (overall Kendall's W = 0.275, P < 0.001). The final intervention program included five first-level indicators, eight second-level indicators, and 29 third-level indicators, aligning with the four dimensions of the shared mental model. ConclusionThe intervention program was developed to enhance the communication and collaboration skills of nurses in multidisciplinary teams in stroke rehabilitation wards based on the shared mental model.

Serotonin syndrome (SS), also known as serotonin toxicity, is a rare but life-threatening drug reaction syndrome. This case involves a 17-year-old female patient who developed tremors, fatigue, and tachycardia after taking fluoxetine combined with bupropion and tandospirone for five days. SS was highly suspected, and her symptoms improved following treatment targeted at serotonin syndrome. This case is reported to raise awareness among clinicians about the potential adverse reactions of drug combinations, the importance of early identification of SS symptoms, and precautions when prescribing combined medications to avoid serious consequences.

After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

Serotonin syndrome (SS), also known as serotonin toxicity, is a rare but life-threatening drug reaction syndrome. This case involves a 17-year-old female patient who developed tremors, fatigue, and tachycardia after taking fluoxetine combined with bupropion and tandospirone for five days. SS was highly suspected, and her symptoms improved following treatment targeted at serotonin syndrome. This case is reported to raise awareness among clinicians about the potential adverse reactions of drug combinations, the importance of early identification of SS symptoms, and precautions when prescribing combined medications to avoid serious consequences.

Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

This article reported that clinical pharmacists participated in the anti-infection treatment process of a patient with fever after intracranial aneurysm operation.The initial fever in the patient caused by arachnoid hemorrhage was non-infectious fever.Then followed by intracranial infections,the intravenous regimen of vancomycin and meropenem was optimized according to clinically relevant guidelines and the blood-brain barrier permeability of antimicrobials.Later,Escherichia coli was reported via the cerebrospinal fluid culture,and the patient with intracranial infection was cured by step-down therapy with ceftazidime.During hospitalization,the patient experienced an adverse event of demyelinating myelitis,which was considered to be related to the excessive single dose of intrathecal gentamicin.The intrathecal administration was promptly discontinued,and eventually the patient recovered well in muscle power.Throughout the entire treatment process,clinical pharmacists assisted physicians in providing patient with an individualized treatment plan and provided reference for the safe,effective,and rational use of antibiotics.

Objective:To investigate the incidence of postoperative complications in Chinese patients with gastric or colorectal cancer, and to evaluate the risk factors for postoperative complications.Methods:This was a national, multicenter, prospective, registry-based, cohort study of data obtained from the database of the Prevalence of Abdominal Complications After Gastro- enterological Surgery (PACAGE) study sponsored by the China Gastrointestinal Cancer Surgical Union. The PACAGE database prospectively collected general demographic characteristics, protocols for perioperative treatment, and variables associated with postoperative complications in patients treated for gastric or colorectal cancer in 20 medical centers from December 2018 to December 2020. The patients were grouped according to the presence or absence of postoperative complications. Postoperative complications were categorized and graded in accordance with the expert consensus on postoperative complications in gastrointestinal oncology surgery and Clavien-Dindo grading criteria. The incidence of postoperative complications of different grades are presented as bar charts. Independent risk factors for occurrence of postoperative complications were identified by multifactorial unconditional logistic regression.Results:The study cohort comprised 3926 patients with gastric or colorectal cancer, 657 (16.7%) of whom had a total of 876 postoperative complications. Serious complications (Grade III and above) occurred in 4.0% of patients (156/3926). The rate of Grade V complications was 0.2% (7/3926). The cohort included 2271 patients with gastric cancer with a postoperative complication rate of 18.1% (412/2271) and serious complication rate of 4.7% (106/2271); and 1655 with colorectal cancer, with a postoperative complication rate of 14.8% (245/1655) and serious complication rate of 3.0% (50/1655). The incidences of anastomotic leakage in patients with gastric and colorectal cancer were 3.3% (74/2271) and 3.4% (56/1655), respectively. Abdominal infection was the most frequently occurring complication, accounting for 28.7% (164/572) and 39.5% (120/304) of postoperative complications in patients with gastric and colorectal cancer, respectively. The most frequently occurring grade of postoperative complication was Grade II, accounting for 65.4% (374/572) and 56.6% (172/304) of complications in patients with gastric and colorectal cancers, respectively. Multifactorial analysis identified (1) the following independent risk factors for postoperative complications in patients in the gastric cancer group: preoperative comorbidities (OR=2.54, 95%CI: 1.51-4.28, P<0.001), neoadjuvant therapy (OR=1.42, 95%CI:1.06-1.89, P=0.020), high American Society of Anesthesiologists (ASA) scores (ASA score 2 points:OR=1.60, 95% CI: 1.23-2.07, P<0.001, ASA score ≥3 points:OR=0.43, 95% CI: 0.25-0.73, P=0.002), operative time >180 minutes (OR=1.81, 95% CI: 1.42-2.31, P<0.001), intraoperative bleeding >50 mL (OR=1.29,95%CI: 1.01-1.63, P=0.038), and distal gastrectomy compared with total gastrectomy (OR=0.65,95%CI: 0.51-0.83, P<0.001); and (2) the following independent risk factors for postoperative complications in patients in the colorectal cancer group: female (OR=0.60, 95%CI: 0.44-0.80, P<0.001), preoperative comorbidities (OR=2.73, 95%CI: 1.25-5.99, P=0.030), neoadjuvant therapy (OR=1.83, 95%CI:1.23-2.72, P=0.008), laparoscopic surgery (OR=0.47, 95%CI: 0.30-0.72, P=0.022), and abdominoperineal resection compared with low anterior resection (OR=2.74, 95%CI: 1.71-4.41, P<0.001). Conclusion:Postoperative complications associated with various types of infection were the most frequent complications in patients with gastric or colorectal cancer. Although the risk factors for postoperative complications differed between patients with gastric cancer and those with colorectal cancer, the presence of preoperative comorbidities, administration of neoadjuvant therapy, and extent of surgical resection, were the commonest factors associated with postoperative complications in patients of both categories.

Objective:To investigate the infection and treatment of helicobacter pylori (HP) in flying personnel, as well as their cognition of HP.Methods:By using cluster sampling method, the flying personnel who recuperated at the Second Sanatorium of Air Force Healthcare Center for Special Services Hangzhou were selected for questionnaire survey. They were divided into positive group and negative group according to whether they were infected with HP. The cognition of HP (such as whether they had known HP, how to detect HP, and the symptoms, infection route, as well as the knowledge on treatment and prevention of HP) were compared between 2 groups. The differences on infection situation at different ages, personal lifestyle, diet and living environment were also compared. The treatment of flying personnel in positive group during their stay in the sanatorium was investigated and analyzed among different age groups.Results:A total of 347 flying personnel were included, with 161 in the positive group and 186 in the negative group. The HP infection rate in the rural population before joining the army was higher than that in the urban population, with a significant difference ( χ2=7.19, P=0.007). But there were no significant differences on whether they had long-term smoking history, preferred strong tea or coffee, spicy and fried food and whether their family members were infected ( χ2=0.05-5.92, all P>0.05). The questionnaire showed that the cognition of the negative group was significantly better than the positive group on whether they understood the infection route, symptoms and preventive measures of HP ( χ2=8.28, 12.00, 48.22, P=0.005, 0.001,<0.001), but there was no difference between 2 groups on whether they had known HP, detection methods and treatment after infection ( P>0.05). The treatment rate in positive group was only 29.19% (47/161), and there was no significant difference in the treatment rate among different age groups ( P>0.05). Conclusions:There is a high HP infection rate in flying personnel on base of the survey. The poor awareness of HP would affect the treatment rate and the basic cognition would be beneficial to active prevention. The survey also shows that the environment factors are seemed more sensitive to HP than dietary habit.

Objective:To investigate the correlation between bronchial wall thickness that was determined by high-resolution computed tomography(HRCT)on lung,and pulmonary function and curative efficacy of patients with chronic obstructive pulmonary disease(COPD).Methods:From January 2020 to December 2022,a total of 154 COPD patients were retrospectively selected as the observation group.According to the indicator of the percentage of forced expiratory volume in the first second(FEV1%),the patients were divided into high-risk group(grade Ⅰ,n=51),mild group(grade Ⅱ,n=45),moderate group(grade Ⅲ,n=35)and severe group(grade Ⅳ,n=23)as the 2023 global initiative for chronic obstructive lung disease(GOLD)scale.At the same time,67 healthy subjects were selected as healthy control group.All of them underwent HRCT scan on their chest,and the thickness of the bronchial wall at the opening of the bronchus of bilateral lung apex was measured.The percentage of forced expiratory volume at the first second(FEV1%),forced expiratory volume at the first second(FEV1)and FEV1/forced vital capacity(FEV1/FVC%)(percentage of forced vital capacity)were measured by the pulmonary function apparatus.Pearson correlation analysis software was used to analyze the correlation between bronchial wall thickening and lung function and curative efficacy.Results:The left bronchial wall thickness(1.49±0.21)mm and the right bronchial wall thickness(1.52±0.24)mm in the observation group were higher than those in the healthy control group(t=18.041,15.504,P<0.05),respectively.In the observation group,the higher GOLD grading of the subgroup has higher thickness at the left and right sides of bronchial walls,and there were also significant differences at the thicknesses of bilateral bronchial walls among different grading groups(F=13.888,25.841,P<0.05),respectively.The FEV1(1.82±0.32),FEV1/FVC%(63.09±5.26)and FEV1%(63.36±6.03)in COPD patients of the each subgroup of observation group were lower than those of healthy control group,and the differences were statistically significant(t=6.693,15.392,7.944,P<0.05),respectively.In the observation group,patients with higher GOLD grade has lower decreasing level of the FEV1,FEV1/FVC%and FEV1%,and there were statistically significant differences in pulmonary function levels among the subgroups of the observation group(F=166.541,141.751,57.120,P<0.05),respectively.The results of Pearson correlation analysis showed that the left and right sides of bronchial wall thickening of HRCT scan on COPD patients were positively correlated with FEV1,FEV1/FVC%and FEV1%levels of pulmonary function in COPD patients(r=0.451,0.503,0.498,0.531,0.488.0.515,P<0.05),respectively.Conclusion:The thickness of bronchial wall of HRCT scan images on lung appears high expression in COPD patients,and its expression level can reflect the severity of patients'disease,and has a strong correlation with pulmonary function.